Dental implantology is a part of contemporary clinical dentistry (stomatology) that deals with the implantation of osseointegrating implants into the bone of the upper and lower jaw in order to replace one or more lost teeth.
What is an osseointegrating implant?
An implant is a “screw” made of a bio-tolerant and bio-inert material. Currently, titanium is most often used. The word osseointegrating comes from the Latin «os», which means «bone». Due to the special treatment of the surface, the implant itself makes a functional unit with the bone, which can be loaded with a physiologically limited force. In other words, an artificial tooth, which will replace the natural tooth by its function and appearance, may be incorporated on such an implant.
Who is a candidate for dental implants?
One or more implants can be placed in all cases when one or more lost teeth should be replaced.
When can't we use implants?
Nowadays, there are almost no absolute contraindications for the incorporation of implants. One of the contraindications we should mention is a severe form of osteoporosis that affects osseous mass of the upper and lower jaw. As far as relative contraindications are concerned, one can mention unfavourable anatomic proximity, insufficient bone mass for the implant, proximity of the maxillary sinus, proximity of nerves in the lower jaw and unfavourable relations between the upper and the lower jaw. However, very efficient surgical methods for the augmentation of osseous mass, sinus lift, etc., are available for rendering the unfavourable anatomy favourable for such interventions.
There are also contraindications arising from systemic chronic diseases, e.g. cardiovascular diseases, metabolic diseases (diabetes mellitus) and other diseases that can present relative contraindications. However, dental implants can be incorporated even in those patients after adequate preparations and possible pre-medication.
Why do patients choose dental implants?
Some of the most common reasons are:
* If only one tooth is missing, the patients most often choose to have an implant and thus avoid polishing of the adjacent teeth, which would be necessary in replacement of the missing teeth by a conventional prosthetic procedure, i.e. a bridge.
* In partial or complete toothlessness, where a conventional complete or partial removable denture would be indicated, the patients opt for implants and thus obtain a fixed bridge that to a large extent complies with their functional and esthetic requirements.
Why do patients prefer traditional prosthetic procedures?
* The fact that this is a surgical procedure – fear of cutting, drilling and anesthesia
* Duration of therapy – several months
* Price – several times higher than in traditional prosthetics
How are implants placed?
The procedure can be divided into several phases:
* Conversation with the patient, planning and preparation – the patient should obtain all the information related to the procedure and the status after the procedure; a therapist, together with a technician, after performing detailed clinical and radiological (ortopan tomogram, CT, densitometry) examinations, plan every single phase in detail and in arrangement with the patient make a picture of the final prosthetic work. The patient gets acquainted with all the phases and price.
* Surgical phase – the placement of the implant into the bone. The intervention is performed under local anesthesia and it is completely painless. Depending on the number of implants, it lasts from half an hour to an hour.
* Osseous integration – this is the phase in which the implant is fixed. It lasts from 3 to 6 months, depending on the qualitative characteristics of the bones – density and compactness. Today, however, this phase can be skipped as the implants may be loaded immediately after the integration.
* Prosthetic phase – the suprastructure is inserted on osseointegrating implants. The suprastructure depends on the patient’s choice: crown, fixed bridge (cemented), removable bridge, removable dentures anchored on implants depending on indications and the selected concept.
