Implants are one of the most important and innovative treatment methods in modern dentistry. This treatment method has become an important part of modern dentistry, due to versatility and convenience for the patient. Dental implants provide the same efficacy during chewing and have high aesthetic appearance as natural teeth. Taking care for an implant is not different from taking care for natural teeth. These factors are important in ensuring the implant would last a long time in the oral cavity.

The implants can be conical or cylindrical and resemble a screw. They are an artificial root of a tooth and are made of special biocompatible titanium alloys. Thus, the implants are retained in the bone due to their carving. Bone grows therein and is fastened to the surface of the implant.

This process is called osseointegration, and is a key for retaining the implant in the bone. It is a very complicated process and it is believed that the bone cells attach to roughness on the surface of the implant. Therefore, the titanium implant surface is treated in a special way in order to create bumps with a well-defined structure and size, so osseointegration can occur.

In classic conical implants, after completion of the osseointegration process and ensuring that the implant is positioned firmly in the bone, a connecting element (abutment) is placed. It is screwed with a special implant screw and in contrast to the implant, which is deep in the bone, this element is visible above the gum. On top of it, a crown is placed using the same method as with standard crowns (read more…). The crown can be two types – cemented on the structure or screw-retained. The advantage of a screw-retained crowns and bridges is that they can to be removed and cleaned over a period of time.

The procedure for the placement of implants is not complicated, but planning of their location is key for ensuring strength and durability. It is necessary to carry out some specific tests before placement in order to confirm that implants are suitable. Contraindications for implants are diabetes, heavy smoking, alcoholism, and mental disorders. The most important study, however, is an X-ray examination of the available bone. A panoramic X-ray picture is required during the first dental visit in order to evaluate the availability of sufficient amount of jawbone for implant placement. Then computer tomography or 3D imaging of the jaw bones is done, which show with extremely high precision, the condition and availability of the bone. Thus, the available tomography is used to determine the number, position, direction of insertion and the size of the implants. It also helps with locating of important structures in the jaw area, such as the upper maxillary sinus and the canal, through which the mandibular nerve runs.

Only after all tests are conducted and the implant treatment is fully planned, the procedure of the implant commences. It lasts about 30-40 minutes for a single implant and up to 2 hours for more. It is carried out as a microsurgical operation.

A local anesthetic similar to that used in tooth extraction is used. The procedure is painless and only discomfort can be felt a few days after implantation. Placing of the implant begins with a small incision of the mucosa and lifting it as a flap, in order to detect the bone. Then with special cutters of different sizes, a hole is drilled into the bone, corresponding to the size of the implant (thickness and length). This is followed by screwing it using a ratchet.
Thus the implants are covered with mucous lining which is sutured. This is called a closed implantation, where the implant is left 6 months, so that osseointegration can occur without straining. During this time a temporary glass fiber construction is made or a temporary denture.

After the 6 months the temporary appliances are removed, and through a very small surgical procedure, the implants are detected, which are already firmly osseointegrated. Now that the implants are opened, the superstructures (connecting elements, abutments) are placed and impressions are taken in order to make the permanent constructions.

There is another method in which the implants are placed immediately after tooth extraction in the space of the root of a missing tooth. This type of placement is called immediate implant placement and it is necessary to use a bone void filler to seal the alveolar bone around the implant. In some cases the implant crowns can be placed immediately after insertion of the implant without waiting for osseointegration. This is called immediate implant loading. Its positive features are that instantly restores missing tooth or teeth, but there is a greater risk of failure at implantation.

The success rate of implant treatment is about 95-96 %, and in some cases up to 98%. It depends much on the care of the patient for the implants – regular cleaning and dental checkups every 3 months, eliminating bad habits, such as smoking and alcoholism. Thus, the implants can last many years. There are cases of implants that have lasted for 15-20 years in the bone.

Implants can be used for restoration of a missing tooth, for making dental bridges, and even for complete dental arches in the upper and lower jaw. Another application of implants is for retention purposes of dentures, especially in the lower jaw.

So placing 4 implants in the lower jaw can ensure retention of the whole plate denture, even when there is completely melted alveolar bone and thus, comfort while eating.

Implant treatment is the most modern and efficient method to treat lack of teeth, due to many advantages such as convenience, aesthetics, preservation of adjacent teeth, prevention of bone resorption and ensuring quality of life and healthy diet. The only drawback is the high cost of this type of treatment, which is determined by the quality of the implants and the need for highly qualified dentist who is able to perform the treatment.

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