IMPLANTOLOGY

No. Studies indicate that:

98.7% OF IMPLANT PLACEMENT PROCEDURES ARE SUCCESSFUL.

Implant placement is a very subtle and precise procedure performed under local anaesthesia. It consists in placing the implant in the correct location in the bone. Then the healing (osteointegration) period begins, during which a permanent connection between the surface of the titanium implant and bone is created. This process usually lasts for 3-6 months or less, if oral conditionsfor implant-bone integrationare favourable. After this time, the next, prosthetic stage of treatment can begin (see -> implant-based prosthetics).

IMPLANTOLOGY AND BONE REGENERATION ARE BASIC PROCEDURES THAT IMPROVE FACIAL APPEARANCE.

Implant placement not only restores missing teeth, but also maintains the bone in the subsequent years. Tooth extraction always leads to bone atrophy, which affects the aesthetics of the entire face, causing, for instance, sinking facial profile. The implant placement procedure should be carried out soon after extracting the teeth, before bone atrophy progresses and the teeth adjacent to the gap begin to displace.

The ASTRA TECH Implant System™ used at Villa Nova clinic was developed with biological and biomechanical principles in mind. It is one of a few dental implant systems based on thorough pre-clinical and clinical research studies. The ASTRA TECH Implant System™ offers shorter healing time, less time spent by the patient at the dentist’s surgery and the confidence of predictable, durable and aesthetic results that can only be guaranteed by many years of clinical trials.

Even a single missing tooth, particularly one in the front part of the dental arch, is a serious problem in terms of:

• aesthetics,
• functioning (impaired chewing ability),
• psychology (constant incertitude, lack of self-confidence), and even
• social status (a full, beautiful smile is an advantage both in private and professional life).

For more than 30 years, dental implants have been a perfect solution for all these problems. Dental implants:

• restore a beautiful, confident smile to the patient;
• enable permanent restoration of the missing teeth;
• provide the patient with complete physical and mental comfort;
• guarantee excellent aesthetic results with natural looking teeth;
• make it possible to avoid problems associated with traditional prosthetic restorations (removing the dentures, stripping the teeth).

Dental implants are a perfect solution for most people with one or more missing teeth.

Replacing a single tooth:

• Long-term functionality and aesthetics guaranteed by implants is highly desirable in case of a missing tooth.
• Dental implants require no stripping of healthy, adjacent teeth to use them as abutments for a bridge.

Replacing several teeth. The patient can choose between:

• Separate crowns supported on several dental implants.
• A bridge fixed on two or more dental implants.

Both options eliminate the need for stripping healthy, adjacent teeth to use them as abutments for a bridge.

Replacing all teeth. The patient can choose between:

• A full, permanent bridge, fixed on several dental implants.
• A removable overdenture, which stays securely in place, mounted on two or more dental implants.

All these solutions guarantee that artificial teeth (which look just like natural teeth!)stay securely in place, providing confidence while eating and speaking.

All patients, even those with extremely small amount of bone tissue, can benefit from implant-based dental reconstruction, through the use of advanced bone regeneration surgery techniques. These include:

• sinus lift
• bone regeneration with the use of biomaterials,
• osteodistraction.

ADVANTAGES OF IMPLANT SOLUTIONS:

• They reduce the chances of damaging healthy, adjacent teeth, e.g. while stripping them before fitting a bridge.
• They can protect gum and bone tissues, contributing to the preservation of aesthetic face appearance.
• They are an alternative to removable and permanent dentures.
• They look, feel and function just like natural teeth – they are stable.
• They do not require the use of adhesives.
• They boost self-confidence.
• They help avoid awkward situations related to loosened dentures.

TREATMENT PROCEDURE

PRELIMINARY CONSULTATION

The patient’s expectations regarding the treatment’s prosthetic and cosmetic effects are a significant factor in the entire implant treatment.Achieving optimal implant treatment results often requires additional procedures, such as bone or soft tissue reconstruction, or even orthodontic treatment. An initial conversation with the patient allows to dispel any doubts and answer any questions the patient might have about the treatment procedure. An approximate treatment duration and cost are also discussed. During the consultation, the doctor also informs the patient about any potential risk, warranties and the responsibilities of both the doctor and the patient.

The entire treatment follows well-established procedures.

MEDICAL HISTORY

It allows to gather information on the patient’s needs and expectations, as well as general health condition (with particular attention to diseases of the heart, lungs, liver and thyroid, possible diabetes, osteoporosis or coagulation disorders). Also important is the information on the patient’s oral hygiene practices, as perfect oral hygiene significantly contributes to the success of the treatment.

CLINICAL EXAMINATION

During this essential part of the diagnostic process, which involves in particular a thorough examination of the site of the planned implant, the doctor evaluates:

• soft tissues – status of the mucous membrane (thickness, colour, mobility);
• dentition – caries, mobility;
• periodontium – bleeding, gum pockets;
• state of occlusion;
• toothless areas – width and height of alveolar processes;
• oral hygiene – dental plaque, tartar and sediment;

RADIOLOGY

From among all available imaging techniques that are helpful in implantology, we constantly rely on panoramic X-rays, which allow us to assess the conditions for the planned implant placement procedure:

• the amount and condition of the bone which will serve as the base for the implant –a point of departure for planning the treatment;
• the state of the teeth adjacent to the gap;
• the size and location of anatomical structures that may hinder the procedure (bottom of the maxillary sinus, nasal cavity, nerve canals).

Computer tomography (CT) is used mostly in case of extensive procedures or if the amount of bone is very small and the highest precision is necessary.

PLANNING THE TREATMENT

After gathering and analysing the necessary details, the implant surgeon provides the patient with the information about treatment solutions available in the given case. It is also the right time to dispel any doubts, acquaint oneself with the treatment plan and make a decision regarding the treatment.

CONSENT FOR THE PROCEDURE

Before starting the procedure, the patient receives a consent form for signing. It constitutes an agreement between the doctor and the patient that not only enables the procedure, but also confirms that the patient is fully aware of the procedure, as well as his or her responsibilities.

IMPLANT PLACEMENT PROCEDURE

After performing all the necessary examinations and discussing the details of the procedure, the implantation procedure, i.e. placing the implant begins.

The procedure consists in drilling holes in precisely specified points in the bone, where dental implants are subsequently screwed in and then covered with the gum tissue in order to speed up healing. Depending on the number of implants, the procedure takes from half an hour to two hours. Screwing one or several dental implants into a well-formed bone is a painless procedure, as it is performed under standard local anaesthesia, and patients can continue their daily activities.

Depending on the clinical circumstances, two options of implant treatment procedure are available. In case of a one-stage procedure, the dental implants are placed in their location and fitted with temporary abutments. In case of a two-stage procedure, the implants are placed in their location, covered with gum tissue and then left to heal. Abutments are fixed after a certain amount of time. In both cases, a temporary denture is provided, and the healing process begins. It lasts up to three months in case of the mandible and up to six months in case of the jaw.

UNCOVERING THE IMPLANT

After the healing period ends, the doctor uncovers the upper part of the implant in order to insert a cover screw, which extends the implant up to the gum edge.It is the most awaited moment, as the mucous tissue is then healed and natural gum contouring achieved. Subsequent visits will result in the desired effect of a beautiful smile.

FITTING THE PROSTHETIC RESTORATION

After the cover screw gives shape to the gum around it, which lasts around 3-4 weeks, the prosthetic reconstruction of teeth on the implants can begin. The prosthetist will take a dental impression, and the prosthetic technician will prepare a tooth crown, a bridge or a denture with fasteners. After the prosthetic restoration is ready, it is fastened to the dental implants (read more ->implant-based prosthetics). During the obligatory follow-up visits, the dentist will evaluate the functional and aesthetic result of the treatment.

There is virtually no discernible difference between your natural and new teeth.

The dentist will sometimes decide to insert the implant immediately after extraction, which shortens treatment duration and has a beneficial effect on bone tissue and gums around the implant. This is particularly important in the externally visible part of the oral cavity.The dentist makes the decision on a case by case basis.

1. Who may be given implants?

In general implants may be implanted in all adults of good general health and who have a sufficient amount and quality of bone in the site of the planned implant:

• adults – a prerequisite for such treatment is the completion of the development and complete formation of jaw bones;
• generally healthy individuals – the general health condition is of significant importance, since past or current systematic diseases, such as unstable diabetes, tumours, blood disorders, osteoporosis, etc. negatively affect the osteointegration (implant fixation) process and wound healing;
• individuals with a sufficient amount and quality of bone – regular healthy bone tissue provides the base for the implant; thus, the success of the treatment depends on this to a significant extent. Atrophy of the alveolar process and insufficient space for the implant are significant problems, but not impossible to resolve; the most recent methods of pre-implantation surgery are helpful in such cases.

2.Is the implant placement painful?

The implant placement is performed under local anaesthesia; thus, it is painless. On the other hand, due to the delicacy and precision of the surgical technique, the discomfort of this procedure is similar to that associated with tooth extraction.

3. Can implants replace the natural teeth completely?

Implant-based restoration provides excellent aesthetic effects and efficiently restores the masticatory function. Note that implant-based restoration is definitely the optimal solution, as only it may ensure a permanent effect of the treatment and comfort of use, and only it is able to replace the natural dentition completely.

4. What complications may occur after the procedure?

Usually, under favourable condition of both general health and oral cavity, the appropriately performed procedure poses no risk to the patient. Commonly after the implantation procedure a slight transient pain and swelling of the soft tissues may occur. Patients take an antibiotic for a few days after the procedure to prevent more serious complications.

5. What is the durability of the implant?

The implant itself is indestructible; however, as it is implanted in the living body, foreign body reaction depends to some extent on the condition of the body. If after the implantation, some general factors, such as diseases or addictions occur, they may affect the result of the treatment. On the other hand, the prosthetic portion, which is usually covered by the guarantee, may wear, which requires periodical replacement of certain elements (e.g. the porcelain parts).

6. Is oral hygiene important?

Oral hygiene is of greatest importance for the success of the implantation treatment. The patient’s duty is to maintain exemplary oral hygiene, to allow the implants to perform their role for a long time. Such a task requires self-discipline and strict co-operation with the dentist, which begins just after the procedure – the patient is not allowed to eat anything for two hours and is recommended to avoid hot meals for the whole day. Smoking should be avoided for at least for 48 hours after the procedure and it is important that meals promoting the build-up of dental plaque should also be avoided. As any debris accumulating around the implant may lead to infection and, in extreme cases, to rejection of the implant, the patient should start gentle tooth brushing as soon as possible. Using a disinfecting mouthwash 2-3 times a day would improve oral care. This is just the beginning; it is of great importance that such regular oral hygiene be maintained for the whole period of the implant-based restoration. The regular application of professional tooth cleaning, usually during the check-up, is also recommended.

7. How may smoking affect implant treatment?

Smoking compromises the tissues’ regeneration capabilities, and thus significantly reduces the chance for acceptance and long-term maintenance of the implant; in fact, it may cause a four-fold increase in the risk of implant rejection. Smoking also contributes to the build-up of deposits on teeth and prosthetic restoration, which are more difficult to remove.