Implant

The aim of modern dentistry is to restore the function, comfort and oral health of the patient's mouth.

Whether the dentist replaces a missing tooth or treats a decayed tooth, her principle is always to try to make an ideal restoration by eliminating wear, disease and damage to the jaw bone.

The most popular treatment method for missing teeth today is implants. The reason for this is that the need for treatments is increasing day by day. The reason for this increase is;

• Longer life expectancy of the elderly population
• Age-related tooth loss
• Patients no longer want fixed dentures, meaning they do not want to have the teeth to the right and left of the missing tooth cut down.
• Removable dentures can deform over time and even deform or decay adjacent teeth.
• Psychological consequences of tooth loss on the individual
• Patient satisfaction with implant-based prostheses
• Advantages of implant-supported dentures
• Problems encountered in completely edentulous patients
• The loss of support bone width and height over time
• Deformation of the gums over time
• The tongue grows over time and does not fit in the mouth.
• Exposure of the vascular and nerve networks and pain and sensitivity in these areas

Psychological Aspects of Tooth Loss

The psychological effects of complete edentulism are generally complex. These effects can vary psychologically. While patients reject the aesthetic loss that complete edentulism creates on their faces, they are also bothered by the discomfort that occurs when wearing dentures.

In contrast, 80% of patients treated with implant-supported prostheses reported that their psychological health had improved and that they felt their implant-supported prostheses were a part of their bodies, compared to the traditional removable prostheses they had used before.

Some obsessive patients and patients with nausea reflexes are quite comfortable using this prosthesis, as long as the palate is emptied.

 Results of Removable Dentures 

Removable dentures are generally not wanted by patients. Because this type of denture is not wanted by patients due to the discomfort it creates both while eating and in the tissue it supports. They sometimes cause pain in the gums by causing a dent. In addition to these, removable dentures used in completely edentulous patients are not very comfortable by patients because they move in the mouth while eating and talking. Especially the part close to the tongue in the lower jaw constantly moves and moves.

Advantages of Implant-Supported Dentures

• The primary purpose of placing implants in the jawbone is also to protect the jawbone.
• The implant, thanks to its grooved structure, creates a small massage effect with the jawbone while chewing, and this massage effect helps the blood supply and nutrition of the jawbone. The implant protects the jawbone, especially in people with osteoporosis.
• Instead of a lower denture that constantly moves with the pressure of the tongue and cheek, it can be turned into a denture that does not move like a fixed denture by placing only two implants and making a bar denture on it.
• In order to restore chewing, implants allow us to make a prosthesis that will help the facial support tissue of our patient, especially since the fused lower jaw also prevents the movement of the prosthesis.
• It allows our patients to perceive chewing because, with its fixed and jaw-adhering structure, our patients perceive the jawbone during chewing.
• They prevent the adjacent teeth from being cut.
• Getting used to and adapting to implant-supported dentures is much faster than other removable dentures.
• There is no possibility of damaging the soft tissue like removable dentures.

Implants placed as soon as the teeth are extracted maintain the existing size of the jawbone.

How Much Does an Implant Cost?

Dental implants are an investment. Especially for individuals who are missing a single tooth, implant treatment is a long-term investment in terms of your dental health since it is a treatment that is used for a long time. Despite this, dental implants can be an expensive method, especially compared to other dental construction methods. However, the two alternatives, dentures and bridges, typically need to be repaired or replaced every 5 to 10 years. The cost of this regular maintenance can quickly outweigh the cost of simply switching to implants, which can last a lifetime (as long as you take proper care of them). Also, those who think that implants protect the jawbone — dentures and bridges cannot.

When your jaw deteriorates, your face shape will change. You will start to look older. What’s more, your existing teeth will start to loosen. The jawbone provides the structure that holds the roots of your teeth in place. Once it’s gone, you will lose your other teeth. Keeping the rest of your teeth in your mouth actually protects you from treatments that will cost you money each.

Therefore, we recommend that you think of dental implants as an investment, not an expense.

Another factor that determines the cost of implants is the implant brand.

Implant Brands

Dental implants are screws made of titanium that act as tooth roots for patients who have lost teeth for various reasons.

In patients with appropriate bone quality and thickness, implants are placed at designated points on the jawbone under local anesthesia without any discomfort. Here, the implant brand is chosen by the patient and the physician.

Implant brands manufacture implants according to the type of prosthesis to be made according to the type of jaw bone. The surface design and attachment structure of the implant to the bone is the brand's way of expressing itself, so the implant brand preference varies according to the prosthesis to be made on the patient's bone.

Implants placed on the jawbone eliminate the patient's tooth loss and prevent bone and tissue damage, while providing a complete and aesthetic smile. The brand is also important here. It may not be possible to create an aesthetic smile design with every implant brand.

After our patients come to our clinic, they are examined by a physician after being imaged with panoramic X-ray and 3D computer-aided tomography. At this stage, planning is done by examining the patient's mouth and evaluating the bone. The most suitable implant is selected for patients whose bone structure and implant quality are suitable for treatment.

Choosing the best dental implant brand 

Why does it matter which implant system is installed in your mouth? Why do our patients care so much about the implant brand and do their research?

The type of implant used can significantly impact the longevity, durability, and many other factors of your restoration. Since not all dental implants are the same, it is important to know the key differences between some of the systems.

When considering the right dental implant brand for you, one factor that cannot be ignored is what your dentist uses. Before your surgery date, discuss with your dentist which implants will be placed in your jawbone and why they prefer the one they offer in-office over others on the market. What is the best implant brand for you? This can help you feel more comfortable with the results you can expect as well as the surgery.

There are hundreds of implant companies in the dental implant market. In this sense, implant brands that want to surpass their competitors in a highly competitive market, of course, claim that they are the best.

In this sense, the choice is determined as a result of the examinations of both the physician and the patient.

Examinations to be Performed Before Implant Treatment

Radiographic Evaluation;

The size of the jaw bone is calculated using both three-dimensional tomography and peri-apical and panoramic films taken from the bone region.

During this time, the tissue around the implant is also examined, that is, whether the adjacent teeth have any inflammation, and whether there is gum recession in the entire jawbone are evaluated.

The bone and nerve tissue adjacent to the area where the implant will be placed are examined in detail. The bone gaps in the jawbone and the bone thickness of the area where the implant will be placed are examined in all dimensions.

With advanced tomography techniques, it is also possible to measure bone quality. That is, it is possible to measure where the bone is harder and to prepare special surgical stents to place implants in these hard parts.

Surgical Stent Preparation;

After the hardest and longest area of ​​the jawbone is determined as a result of examination, special surgical stents can be prepared that provide maximum use of this area during implant surgery.

In today's digital world, this stent preparation also allows the temporary prosthesis to be made on top of the implant as soon as it is placed, by superimposing the image taken with three-dimensional scanners with the tomography image.

One of the areas where digital dental identification is used most is implants. In implant applications, the evaluation of tomography results and at the same time the overlapping of the jawbone with three-dimensional scanners provides the doctor with a safe application.

Examination of Soft Tissue;

One of the biggest reasons for failure after implant treatments is the lack of sufficient gum tissue. The absence of a harder gum tissue structure, which we call keratinized gums, in the area where the implant is placed increases the risk of gum problems in the future. In addition, the absence of keratinized tissue around the tooth may affect the continuity of the health of the area around the implant in the long term. With the additions to the gums to be made during the implant surgery, the implant can be saved from these risks.

Examination of the Structure of Neighboring Teeth;

In general, the shape and root structure of the teeth, as well as the structure of the neck parts called cervix, are important in terms of the proximity to the implant. In the implant that will be placed next to a tooth structure with a thin neck, i.e. a thin cervix area, our patient may experience constant food leakage problems. In this sense, especially in applications where we perform single-tooth implants, the structure of the adjacent teeth and the restorations on them are very important. For the long-term success of the implant treatment, the structures of the adjacent teeth should also be examined.

Evaluation of Our Patients Regarding Chewing and Related Forces

In general, the shape and root structure of the teeth, as well as the structure of the neck parts we call the collar, are important in terms of the proximity to the implant. In the implant that will be placed next to the tooth structure with a thin neck, that is, a thin collar area, our patient may experience constant food leakage problems. In this sense, especially in applications where we perform single-tooth implants, the structure of the adjacent teeth and the restorations on them are very important. For the long-term success of the implant treatment, the structures of the adjacent teeth should also be examined.

Evaluation of Our Patients Regarding Chewing and Related Forces;

Our patients continue to have the habits of their old teeth while chewing and biting. Therefore, chewing dynamics must be evaluated. Especially if there are canine teeth, are there any abrasions on their tips, are there any signs of teeth grinding in our patients' mouths? All these should be evaluated and the tooth should be placed accordingly.

Selection of the Structure, Shape, Length and Thickness of the Implant According to the Bone Structure of Our Patient and the Prosthesis to be Made on It

One of the most frequently asked questions by our patients is which brand of implant is used. There are various types of implants in each brand. One of the most important criteria that determines the physician's choice here is that the long-term success of the implant has been academically proven. The use of implants that have not been academically examined and whose long-term success has not been monitored in the patient's mouth also poses a risk for the physician.

For this reason, it is essential that the quality of the implant chosen is at world standards in terms of the implant structure, implant surface, structure and compatibility with the bone.

The shape and length of the implant are determined according to the area where it will be placed. For example, the neck and root structure of the implant to be used in an area close to the sinus may be different from the structure and shape of the implant to be used in the lower jaw to make a bar. For example, a short and wide implant is preferred in the upper jaw, which is approximately 4-5 mm away from the sinus; in other words, the length and width of the implant are planned in advance according to all x-ray images and the prosthesis to be placed on it.

 Planning the Prosthesis to be Made 

The upper and lower parts of the implant treatment must be compatible with the prosthesis we will make for our patients. Implants are in two parts; one is the part inside the jaw bone, the other is the part outside the jaw bone.

The selection of the part that remains outside of the root is as important as the selection of the part that remains outside. In other words, the superstructure options are planned in advance according to the type of prosthesis to be made.

Prosthetic Options in Implant Dentistry 

When choosing implant-supported prostheses, where cost is of course important, the prosthesis to be made must have an economic structure that is predictable for patients.

When evaluating the advantages and disadvantages of metal-supported or metal-free porcelain teeth, aesthetics is of course an important criterion.

While fixed prostheses provide sufficient advantages for our patients who previously had a traditional removable prosthesis and now have a fixed prosthesis, when aesthetic superiority is desired, metal-free porcelains can be used in implant-supported coatings and prostheses.

If our patients have a high smile line, that is, if the gums have receded, the bones have melted and the lips cannot cover the toothlessness, then it is necessary to give the appearance of the gums in the fixed prosthesis on the implants. In this sense, the prosthesis to be made is called hybrid prosthesis.

The Impact of Stress and General Health on Treatment Planning

The general health status of our patient, especially diabetes and smoking are very important in implant planning. For example, multiple implants, bone additions and similar things are risky in terms of wound healing in a patient who smokes. Similarly, advanced surgeries should be avoided in uncontrolled diabetes. In order to be able to perform all these treatments, reducing smoking, regulating sugar, and also reviewing the intestinal flora with a holistic medical approach if the patient has gum problems will increase implant success.

It should also be noted that wound healing will be impaired in a person with a stressed structure. Considering that a very stressed person will grind their teeth in the future, the implant and implant-top coatings should have a hard structure, and the factor that our patient may break these prostheses should be considered, and the material and implant selection should be made accordingly.

Due to the stress factor, implant loss may occur, the spacer of the implant may loosen, and the tooth opposite the implant may also break. One of the biggest reasons for spacer loosening is teeth grinding.

What are the Stages of Implant Treatment? 

Implant treatment is one of the most popular treatments today. What makes implant treatment popular is the satisfaction of patients with the treatment and the permanence of the treatment. However, there is a misconception about implant treatments.

This false belief that implant treatment takes months actually stems from not knowing the exact stages of implant treatment. In cases where the jawbone is sufficient, implant treatment consists of two stages.

• implant placement
• Making the implant coating,

This is possible in cases where the jawbone is sufficient. The treatment phase of implant treatment in insufficient bone or in an aesthetic region is different from others. In cases where there is insufficient bone, it is necessary to create bone first, that is, to increase the amount of bone in that region. Then, bone formation is added to the stages of implant treatment. In implant treatment that requires an aesthetic application, it is also necessary to create gums in addition to bone formation, then our patient definitely needs a stage with gum addition treatment before or after the implant is placed. To summarize, in implant treatments where the bone is not sufficient, the treatment phase is three-stage: first creating bone, then installing the implant, then applying the implant coating. In cases where there is no bone in an aesthetic region, a fourth step, namely, gingival arrangement around the implant, is required. There is an intermediate stage after the implant is placed in the jawbone. This stage is the healing cap stage according to the method preferred by the physician. The healing cap is a temporary cap that shapes the gums that are attached for the shaping of the neck of the implant. This cap is then replaced with the superstructure called ebatment, where the tooth will be made. Although the stages of implant treatment vary depending on the implant brands and the health of the area where the implant will be placed, they generally include the stages mentioned above.

How to Take Dental Impressions? 

When a part of dental treatment, namely a restoration such as a coating or a laminate, inlay-onlay, is to be made on the tooth structure, it is necessary to take measurements of the teeth and the jawbone where the teeth are located. Impression trays are used to take dental measurements, and the dimensions of the impression trays are according to the size of the person's mouth, according to the lower and upper jaw. There are usually three sizes of impression trays, numbered 1, 2 and 3. It is possible to take measurements from the mouth with impression trays produced separately for the lower jaw and the upper jaw.

When a dental impression is to be taken, the impression material is also selected according to the treatment to be performed on the tooth. In cases where detailed impressions are required, two-system impression materials are used. In two-system impression materials, first an impression material that takes the general measurement of the mouth is taken. In this dual system called silicone impression material, after the first impression is taken, the second impression, that is, the impression material that is more liquid and can take more detailed measurements, is placed inside the first impression. In approximately 5-10 minutes, the measurement of almost the entire jaw and the area where the restoration is made is clearly taken. This is one of the most frequently used methods of taking impressions. Another method is the digital impression technique with the developing technology today. In the digital impression technique, the general measurement of the mouth is taken with three-dimensional scanners. There is no impression material here. The three-dimensional scanner takes the measurement of all the details of the mouth and delivers it to the laboratory via an e-mail.

In the other method, namely the measurement taken with silicone or single-stage alginate, the model is obtained by pouring plaster into the impression material. In the digital measurement, the model is obtained by pouring and digging the plastic material with special devices that serve as printers. In both methods, the measurement does not involve any pain or discomfort.

Frequently Asked Questions About Implant Treatment 

What is the Cost of Dental Implants?

When our patients call our offices, the first question we are often asked is, “how much do dental implants cost?”

Questions about cost are more common than questions about post-operative pain or even procedure success rates!

Of course, it is possible to accept the variability of the economy and economic situations.

We get it. Our patients also have families to cover their expenses, and we know how difficult it can be to meet all your needs. However, dental implants can be more affordable than you think. Before we get into the numbers, we want to encourage you to look at the cost of dental implants as an investment rather than an expense.

For this reason, we are aware that the best implant is actually our original teeth, and we try to protect the health of our teeth first and keep them in the mouth as long as possible by performing treatments without extracting the teeth.

In this sense, we definitely explain to our patients preventive medical practices, that is, ways to keep teeth in the mouth for a lifetime.

We should not forget that the best implant is our healthy teeth.

How Long Does Implant Treatment Last? 

The lifespan of the treatments performed is almost the same as the original teeth when compared to the original teeth. In other words, an implant with healthy bone and healthy gum tissue after being placed in the mouth has the same lifespan as the patient's original teeth. When well cared for, implants can be used for a lifetime. Implant-top coatings may need to be replaced from time to time.

Is Implant Application a Painful Treatment? 

During implant-supported treatments and implant treatments, local anesthesia is used so that our patients do not experience a painful process. In other words, when these treatments are performed, anesthesia is used to numb the area when needed. This ensures that the treatments are painless.

What Should Be Considered During Implant Treatments? 

During the application of implant treatments, you should use the painkillers and antibiotics that your doctor has told you. You should also follow the care recommendations without neglecting them. Brushing your teeth, oral care, smoking, reviewing your general health status and improving all of these will increase the success of implant treatments.

Complexes That Will Occur After Implant Treatment and Things to Consider

What is implant infection or peri-implantitis? 

The health of the gums is always an important criterion that determines the life of the tooth. When teeth are lost due to gum problems; gum health is very important for the implant treatments to be performed instead. Regardless of the reason for which the tooth is lost, one of the most important criteria that determines the life of implant treatments after the implant is placed is the health of the surrounding tissue and neighboring teeth. It is not possible to talk about implant health in a mouth that contains infection. In general, implant infection, or peri-implantitis, is the condition in which the tissues around the implant are infected. The tissue around the implant consists of two parts.

• Gum
• Jawbone

When an infection starts in the gums around the implant, bleeding gums and bad breath are one of the most important symptoms. If such bleeding occurs, it is necessary to make sure that proper brushing and care are done adequately. In cases where oral care is not done adequately, the gum infection then progresses to bone infection. As a result of this progression, bone loss occurs around the implant. If the bone loss around the implant reaches an advanced level, it is not difficult to shake and fall out the implant. For this reason, if there is bleeding around the implant, it should be taken seriously and the doctor who installed the implant should definitely be seen and an examination of this area should be requested. Your dentist can determine whether there is bone loss by taking an x-ray from this area. If an infection is detected in the implant area, the source of this infection should definitely be eliminated. The source of the infection is sometimes the adhesive spilling over into the gum tissue during the bonding of the implant overlay. A treatment plan is also created by detecting all these. Infection of the tissue around the implant, which is still at an early stage, can be easily treated. Therefore, early diagnosis is important in eliminating the problem. Gum bleeding occurring in the tissue around the implant should be taken into consideration in this sense and a dentist check-up should be performed. It can be easily observed that when the gum bleeding disappears, the infection also disappears.

Do implants cause allergies?

No allergic reaction was observed to the implant material after implant treatment. The material used in implant treatment is titanium, a tissue-friendly material. For this reason, it is accepted by the bone as if it were an original tooth and is covered with bone.

When can I start eating after dental implants are installed? 

After the teeth are installed, it is certainly the wish of many of our patients to start eating immediately and eat comfortably. When the teeth are installed, it may feel strange in the mouth for a while, this is quite normal. Although it varies depending on the adhesive used when our implant-top coating is installed, eating can usually be renewed after 2 hours. However, it takes some time to chew comfortably and for the tongue and cheek to coordinate while chewing. Namely, in long-term tooth losses, the tongue has gotten used to entering the gap area. Therefore, at first, the tongues and cheeks of patients with implant-top coatings or implant teeth will feel strange. The biggest reason for this feeling is that the tongue spreads out in that area and feels strange for the new tooth. For this reason, the tongue probes the implant tooth like a scanner for a while. This is usually the first 48 hours. At the end of 48 hours, adaptation begins.

Are there any methods to make eating easier with dental implants?

In order to start eating on an implant tooth, it is useful to first practice in that area and even prepare it by exercising the cheek muscles. Eating with an implant tooth usually does not cause any pain or discomfort, our patients can easily adapt. During this adaptation, it is quite normal for the opposite tooth to feel like it is high for a while or to feel uncomfortable as if it is making a knocking sound. Because the mechanism of the implant tooth holding the jawbone is different from the normal tooth. The jawbone will definitely adapt to this situation in a short time and the comfort of eating will be provided in a short time. In the meantime, it is necessary to be patient and if there is any height in the tooth, it should be corrected by going to the dentist. In addition, it is necessary to check whether this height is present from time to time after long-term use.

Do implant treatments cause cancer? 

Although this is a very common question, no one has ever had cancer after having implant treatment. There is no information or documentation about this in the literature.

Implant Teeth and Controls

This is why it is important to check the height every six months. Unlike normal teeth, implant teeth do not wear out. Normal teeth show some wear over time. This is due to the wearability of the enamel, but when the implant tooth does not wear out, it causes a height to be felt in the mouth during eating in the future. This height, which is the result of other teeth wearing out but not the implant tooth, should definitely be adjusted by the doctor by doing some abrasion during check-ups.