Dental Implant

A dental implant (also known as an internal implant or fixation) is a surgical component that interferes with the jawbone or skull to support a dental prosthesis such as a crown, bridge, denture, or facial prosthesis or to act as an anchor for orthodontics. The basis of modern dental implants is a biological process called osseointegration, in which materials such as titanium form an intimate bond to bone. The implant is first placed so that the bone is likely to integrate, then a dental prosthesis is added. Orthopedic fusion requires a variable amount of healing time before either an artificial tooth (tooth, bridge, or denture) is attached to the implant or an abutment containing a prosthesis / crown is placed.

The success or failure of implants depends on the health of the person receiving treatment, the drugs that affect the chances of bone fusion, and the health of the tissues in the mouth. The amount of pressure that will be placed on the implant and fixation is also evaluated during normal function. Planning the position and number of implants is fundamental to the long-term health of the prosthesis since the biomechanical forces that arise during chewing can be important. The position of the implants is determined by the position and angle of adjacent teeth, by laboratory simulation or by using a computed tomography with CAD / CAM simulations and surgical guides called abutments. The prerequisites for the long-term success of dental implants are healthy bones and gums. Since both can atrophy after a tooth extraction, pre-prosthetic procedures such as a sinus lift or gum patch are sometimes required to recreate the perfect bone and gums.

The final prosthesis can either be fixed, as a person cannot remove the dentures or teeth from their mouth, or remove it, as they can remove the prosthesis. In each case an abutment is attached to the implant. When the prosthesis is installed, a crown, bridge or denture is attached to the abutment with either anchor bolts or dental cement. When the prosthesis is removable, a matching adapter is placed in the prosthesis so that the two pieces can be held together.

Risks and complications related to implant treatment are divided into those that occur during surgery (such as excessive bleeding or nerve injury), those that occur in the first six months (such as infection and bone fusion failure), and those that occur in the long term (such as implantation peripheral inflammation and mechanical failure). With healthy tissue, a well combined implant with appropriate biomechanical loads can have 5 years plus survival rates of 93 to 98 percent and 10 to 15 years for artificial teeth. Long-term studies show 16 to 20 years - general success (the transplant is alive without complications or revisions) is between 52% and 76%, with complications occurring 48% of the time.

Timing of dental implants after tooth extraction

There are different methods of placing dental implants after tooth extraction. The methods are:

1. Immediate implantation after dislocation.
2. The delay in placing the implant immediately after the extraction (from two weeks to three months after the extraction).
3. Delayed implantation (three months or more after tooth extraction).

An increasingly common strategy to preserve bone and reduce treatment times involves placing a dental implant at the site of a fresh extraction. On the one hand, it shortens the treatment time and can improve aesthetics because the soft tissue envelope is preserved. On the other hand, implants may have a slightly higher initial failure rate. It is difficult to draw conclusions on this topic, since few studies have compared immediate and late implants in a rigorous scientific manner.

Healing time

There are several options regarding when to place dental implants, categorized into:

1. Perform immediate download.
2. Early loading (one to twelve weeks).
3. Late Loading (more than three months)

For the implant to become permanently stable, the body must grow bone on the surface of the implant (osteopathic fusion). Based on this biological process, it was thought that loading an implant during the period of osseointegration would induce movement that inhibited osteogenic fusion, thus increasing rates of implant failure. As a result, three to six months of fusion time (depending on various factors) was allowed before the teeth were placed on the implants (restoration). However, later research indicates that the initial stability of the implant in the bone is a more important determinant of the success of the implant integration, rather than a specific period of healing time. As a result, the time allowed for healing usually depends on the density of the bone in which the implant is placed and the number of implants splinted together, rather than the amount of regular time. When implants can withstand a high torque (35 N cm) and are cut to other implants, there are no meaningful differences in long-term implant survival or bone loss between implants that are loaded immediately, at three months, or at six months. . The corollary is that single implants, even in solid bones, require a period of no-load to reduce the risk of initial failure.