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An implant is an artificial tooth root made of titanium that is placed into the jawbone to replace missing teeth due to various reasons. Implant treatment is now the most commonly used method for solving functional and aesthetic problems caused by missing teeth.
There is a record of a dental implant procedure performed by the Maya civilization in 700 AD. At that time, sea shells containing high amounts of tricalcium phosphate and calcium carbonate were used as implant material.
Today, some dental implant companies still use these materials as surface coatings for implants. After the Maya civilization, there was little progress in dental implant development for a long time. In the 18th century, John Hunter frequently performed tooth transplantation procedures.
In 1806, teeth with platinum supports called mineral teeth were produced to be placed in extraction sockets. In the early 1800s, J. Maggio placed tube-shaped gold implants in freshly extracted tooth sockets. Various forms of gold implants were used for placement in extraction sockets in later years.
Alvin and Moses tested their first implants on dogs. In 1938, they performed the first application of a grooved dental implant made of a chrome-cobalt-molybdenum alloy, which the patient used until they died in 1955.
Branemark, an orthopedic surgeon, conducted research on bone healing in 1952 and was unable to remove titanium tubes he had implanted in a rabbit femur. As a result of this accidental development, he developed test implants made of pure titanium. After years of work, the first dental implant was placed in a patient by Branemark in 1965.
When we lose our teeth for any reason, the bone in that area no longer receives enough chewing force. With insufficient force, the bone begins to erode, and if left untreated, we may face serious resorption (bone loss) in the long term.
Along with functional disabilities, many aesthetic problems also arise with bone loss. When teeth are lost, the speed and severity of aesthetic problems that come with aging increase. Lines around the lips and cheeks deepen. One of the most important reasons for using dental implants is to reduce bone resorption and the problems that come with it.
In cases of complete tooth loss or partial tooth loss, traditional prosthetic treatments can be done. These prostheses can be classified as mobile complete dentures, mobile partial dentures, and fixed dentures. However, these prostheses have many disadvantages compared to implant-supported prostheses.
Patients who use mobile dentures have serious problems with the retention of the prosthesis in the mouth. Patients often have to use adhesives to reduce the movement of the prostheses in the mouth. In addition, the chewing forces of mobile prostheses are much lower than our natural teeth.
Dental implant treatments relieve the patient from the difficulty of using a removable prosthesis. The patient can eat and speak more comfortably.
If there are partially toothless areas in the mouth, fixed prostheses, i.e., bridge treatments, can be applied. In this case, tooth tissue is removed by cutting the healthy teeth. This can cause the teeth to decay and become sensitive in the long term.
Taking all these factors into account, we can achieve the most natural results in terms of both function and aesthetics in the treatment of our lost teeth with implant applications and prostheses made afterwards.
At our Ankara clinic, patients who come for implant treatment first undergo a detailed radiological examination and clinical examination. After panoramic film imaging that shows the entire mouth structure, if necessary, tomography is taken to examine the areas where implant placement is planned in more detail.
After the radiological examination and oral examination, when it is decided to proceed with implant application, it is necessary to decide which method will be used for implant placement. We can mention four main methods:
In the two-stage surgical technique, a incision is made in the gum tissue at the site where the implant is to be placed, and the bone is exposed so that the implant can be placed into the bone. Then, the gum tissue is stitched up and closed, and healing is allowed to occur so that the implant can fuse with the bone. After the first surgical procedure, none of the implant's parts are visible from the outside.
After a waiting period of 2-3 months, the second surgical procedure is performed, in which a small incision is made in the area where the implant is located and the gum tissue is shaped to prepare the area for the placement of the prosthetic device. A healing cap is then placed in the prepared area.
In the single-stage implant technique, a similar process to the two-stage method is followed where an incision is made in the gum tissue to expose the bone and the implant is placed directly into the bone. Then, a healing cap is placed on top of the implant and the gum tissue is sutured closed. The advantage of this technique is that there is no need for a second surgical procedure to place the healing cap.
Immediate placement is a technique where an implant is placed into the extraction socket immediately after a tooth is extracted, without waiting for the socket to heal. This technique is successful if there is no infection and there is sufficient bone volume after the extraction.
If we believe that the width and height of the bone are very good, we can place the implant without making any incision and just by opening a small hole where the implant will be placed. In this case, there is no need for stitches.
The decision on which method to use will be made after a detailed examination by your dentist to determine which method is best for you.
Implant treatment can be applied to any systemically healthy individual who has reached the average age of 18, has completed growth and bone development. In the presence of any current disease or previous diseases that may pose a risky situation in terms of implant treatment, the patient's doctor is contacted and treatment planning is made within the necessary arrangements.
There is no upper age limit for implant treatments if the patient's systemic condition and bone structure are good.
The success rate of implant treatments is up to 98% if the patient's diagnosis and treatment planning is carried out ideally. What is important in success rates is to take the patient's medical history well; bone measurements, clinical examination should be done very carefully and then the procedure should be performed by a physician specialised in surgery.
Implant treatment is a standard dental treatment performed under local anaesthesia. In other words, the same amount of anaesthesia, i.e. injections, is applied during filling or tooth extraction, and a similar amount of anaesthesia is applied during implant surgery. And the patient feels absolutely no pain during the procedure.
As a general principle, the same process is experienced after implant treatment as we ask the patient to pay attention to after any surgical procedure. Since local anaesthesia is applied, the patient should not eat anything until the effect of anaesthesia wears off.
After the anaesthesia wears off, it is recommended to chew with the opposite jaw for a few days, not on the treated side. If a bilateral operation has been performed, a soft diet will be beneficial for wound healing.
Care should also be taken not to eat hot, acidic, spicy foods and very hard foods. Patients should use the medication prescriptions given to them by their doctors without interruption as recommended. Applying ice intermittently on the first day will also reduce oedema formation. If advanced surgical procedures have not been performed, those who have implants can continue their normal daily lives after the operation.
After the needle is injected and numbness is achieved, it takes an average of 15-20 minutes to place the implant.
If there is not enough bone in the area where the tooth is missing and we plan to implant, this bone level and volume must be provided. Firstly, the area should be evaluated very well anatomically.
In the upper jaw, the sinus cavities and the base of the nose; in the lower jaw, the nerve pathways should be well identified and the height and width of the bone adjacent to these areas should be measured accurately. If the presence of insufficient bone is detected as a result of the measurements, organic bone powders, the patient's own bone or bio-compatible synthetic materials are used to fill the deficiencies.
Depending on the condition of the case, procedures to strengthen the bone can be performed together with implant surgery, or in more advanced cases, bone-oriented operations are performed first and implants are placed after sufficient bone level is obtained (this can sometimes take weeks).
If the area where the implant is applied is not visible and there is not a large number of missing teeth, not using temporary prosthesis will make the healing more comfortable. However, if the operation area is in a visible area and toothlessness has a negative effect on social life, removable or fixed temporary prostheses can be made with a method that your physician deems appropriate.
The main material of the implant is titanium and it is a highly safe material in terms of creating an allergic reaction. There is no data in the literature that the implant is harmful.
The negative effects of smoking on systemic health and wound healing are known. Smoking reduces the implant success rate. Patients who smoke should be informed about these effects; they should be advised to quit or reduce smoking. In patients who cannot quit smoking, treatment can be continued by the physician and the patient, taking the risks into consideration.
It varies for each case. On average, teeth can be made 3 months after upper jaw applications and 2 months after lower jaw applications.
However, when factors such as the age of the patient, the density of the bone in the application area, the situations where it is unacceptable for the area to remain toothless in social life, and the quality of the implant brand are taken into consideration, teeth can be placed on it in much shorter periods, even on the day the implant is applied. On the contrary, in patients with advanced surgical procedures, it may be necessary to wait up to 6 months.
If the tooth extraction is not traumatic, if there are no signs of infection in the area, if there is sufficient bone volume, the implant can be placed in the tooth extraction socket as soon as the tooth is extracted. It is an extremely healthy method with good results.
Immediate implant placement in the tooth extraction socket immediately after tooth extraction is called immediate implant application.
All on four is a technique in which a prosthesis is completed with four implants placed towards the front area instead of performing advanced surgical procedures when the patient has insufficient bone in the posterior regions. This eliminates the need for sinus lift procedures to strengthen insufficient bone in the maxillary sinus area.
Similarly, it allows for applications in areas outside the nerve in the lower jaw. In the principle of the technique, it is recommended that the posterior implants be placed at almost a 45-degree angle.
Dental implant costs may vary depending on the brand of the implant used and the current economic situation. Your treating doctor can provide you with the most accurate information on this subject.
Dental implants can be used for many years as long as proper care rules are followed and oral hygiene rules are adhered to.
In our clinic, with the understanding of "primum non nocere" which is accepted as the first principle in all medical practices and means "first, do no harm" in Latin, increased hygiene measures are applied to ensure that our patients and their families do not get harmed during the ongoing pandemic.
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