IMPLANTOLOGY
A dental implant is a screw-shaped artificial tooth root, usually made of titanium, that is placed into the jawbone to replace teeth lost due to gum disease, tooth decay, trauma, or other causes. Implants can be used to replace a single tooth or multiple missing teeth, helping restore chewing function and aesthetics that would otherwise be provided by bridges or removable dentures.
How are dental implants placed?
Implant treatment is carried out after the patient has been evaluated by the relevant departments, which may include radiology, prosthodontics, periodontology, and oral and maxillofacial surgery.
The area where the implant will be placed is numbed with local anesthesia. In the conventional two-stage surgical approach, the gum tissue is lifted, a space is prepared in the bone, and the implant is carefully inserted.
Depending on the condition of the bone, an average healing period of approximately three months is generally allowed for the implant to integrate with the surrounding bone. After this osseointegration period, a second minor surgical procedure may be performed to expose the implant and place a healing abutment. Once the gum tissue has healed, the implant-supported prosthetic treatment can begin.
Can everyone receive dental implants?
Dental implants generally provide long-term success in individuals who are in good general health, are able to maintain adequate oral hygiene, and have sufficient bone tissue to support the implant.
When the available bone volume is insufficient, advanced surgical procedures and bone augmentation techniques may be used to create adequate bone for implant placement.
However, factors such as smoking, uncontrolled diabetes, diseases affecting bone metabolism, and certain medications may negatively affect implant treatment outcomes.
What is an implant-supported prosthesis?
Implant-supported prostheses can generally be divided into three main groups: fixed implant-supported prostheses, removable implant-supported prostheses, and hybrid prostheses.
Fixed implant-supported prostheses are restorations that are attached to implants in a manner similar to conventional crowns and bridges. They are generally used when there is sufficient bone and soft-tissue support.
Removable implant-supported prostheses are prostheses that obtain support from both the implants and the surrounding oral tissues through various attachment systems selected according to the patient’s functional needs. They are particularly useful when the available hard and soft tissues are insufficient for rehabilitation with a fixed prosthesis.
Hybrid prostheses combine certain characteristics of fixed and removable implant-supported restorations. They cannot be removed by the patient and therefore provide the feeling of using a fixed prosthesis. However, they can be removed periodically by the dentist for examination, maintenance, and professional cleaning. These prostheses may receive support from both the implants and the surrounding tissues.
What is a sinus lift and why is it necessary?
The air-filled spaces located on the right and left sides of the upper jaw and connected with the nasal cavity are called the maxillary sinuses.
These spaces are located close to the roots of the upper back teeth. Over time, enlargement of the sinus cavity, together with bone loss that occurs after tooth extraction, may reduce the amount of available bone in the posterior upper jaw.
When there is not enough bone to safely place an implant in this region, the floor of the sinus can be surgically elevated. This procedure is known as a sinus lift or sinus elevation.
In simple terms, the procedure is performed under local anesthesia. The gum tissue is lifted, and an opening is created through the lateral wall of the sinus. The membrane lining the sinus is carefully elevated, and bone graft material is placed between the sinus membrane and the existing bone. The surgical area is then closed with sutures.
Depending on the clinical situation, the implant may be placed at the same time as the sinus lift procedure or may be placed approximately 4–6 months later, after the grafted area has healed.
What diseases can affect the tissues around dental implants, and why do they occur?
After implant placement and successful healing, inadequate oral hygiene may allow bacteria to accumulate on the implant surface. This can cause inflammation of the soft tissues surrounding the implant, a condition known as peri-implant mucositis.
If left untreated, the inflammation may progress and lead to loss of the bone surrounding the implant. This condition is called peri-implantitis.
As bone support is progressively lost, the implant may eventually lose its connection with the surrounding bone and become mobile.
Regular dental examinations and proper oral hygiene are therefore essential for maintaining the health of the tissues surrounding implants and improving their long-term survival.
What are the signs of diseases affecting the tissues around implants?
A dentist should be consulted without delay if any of the following symptoms are observed around an implant:
- Bleeding of the soft tissues surrounding the implant
- Swelling or inflammation
- Unpleasant odor or taste
- Loosening or movement of the implant-supported prosthesis