Implant Treatment and Prosthesis Types for Single Tooth Missing

Today, with the development of treatment options, the frequency of tooth loss is decreasing. We know that the more healthy tooth tissue remains, the longer the life of the tooth. That is why instead of coatings (crown restorations) porcelain fillings (inlay, onlay, overlay, endocrown), if possible, capping treatments instead of root canal treatment, renewal of root canal treatment instead of extraction, orthodontic treatments instead of coating the teeth for aesthetic purposes, we use the person's own teeth in aesthetic treatment.

Despite all this, in cases such as unresolvable infections and irreparable fractures, we may need to extract teeth as the only solution, even if we don't want to. In the past, we could only fill the missing teeth with bridge treatment by cutting the teeth next to the gap. With the introduction of implant treatment, implant treatment has become the gold standard for single tooth deficiencies.

Why should I choose implant treatment?

Another reason is that the root structure of each tooth is formed to carry its own load. For example, let's say we cut the 2 teeth next to a missing tooth and make a bridge. Since there is no root to carry the load of the missing tooth, the load on it is shared with the adjacent teeth. This causes the adjacent teeth to carry more load than they should, and if careful adjustment is not made, the root health is put at risk.

In addition to all this, the jaw bones are specialized to support teeth. When a tooth is extracted, the body begins to dissolve the bone there because there is no root there to participate in chewing. Because just like an arm in a cast weakens, “an unused organ atrophies.”

Why is implant-supported prosthesis construction important?

At the end of the day, the purpose of having an implant is not the implant itself but the prosthetic tooth that will go on it. For this reason, just as the surgeon selection that will perform the implant surgery is important, it is also important that the person who will perform the tooth on it has high knowledge about implant-supported prosthetics and is an expert and experienced physician in prosthetics. Because the structure of the bone and soft tissues around the tooth and the tissues formed around the implant are completely different from each other. In an improperly made prosthetic tooth (crown, coating), it can only fall out, breaking, there is no problem of odor or food leakage. The main problem is the bone loss around the implant as a result of an inappropriate prosthesis. Did you know that improperly made implant-supported prostheses can cause bone loss around the implant and even implant loss?

What are the implant-supported prosthesis options?

Although there are many developments in the field of implants today, we basically have 2 options: cemented and screw-retained implant-supported prosthesis. Both options are long-term treatments if applied correctly.

As a result of the studies, we dentists know very well that the biggest reason for an inflammatory condition occurring around the implant is that the adhesive residues we call cement are not cleaned well and start inflammation in the surrounding tissue. In the light of this information, implant dentistry has started to switch to screw systems as much as possible, even though cement-supported implant prostheses have advantages.

Since the production of screw-retained implant-supported prostheses requires great technical precision, strong physician knowledge, and extra production costs, cement-retained prostheses are widely used. However, when screw-retained restorations are applied correctly, they prevent the constant falling of the crowns, especially in patients with short teeth, the risk of infection around the implant decreases since there is no cement residue, and it allows the crown to be easily removed and cleaned underneath during regular check-ups and when necessary.

As we come to the end of our article, we would like to state that the most important thing about implants, despite the different techniques and methods, is the correct diagnosis, a well-thought-out treatment plan and regular check-ups after treatment. If you have a missing tooth, our advice to those who are considering having an implant is:

– Make sure that both the surgeon who will perform the surgery and the doctor who will make the prosthesis are experienced and have experience in this field,

– To provide care for the relevant area as instructed by the physician after the implant and the prosthesis are placed on it,

– It is essential to have a check-up by a doctor every 6 months and have your chewing activity checked. Because it should not be forgotten that our own teeth are somewhat mobile in the bone but the implant is fixed, our own teeth may wear out but our implant-top coating does not. For this reason, we must be sensitive about the location of the implant and the care of the implant in our active chewing system.

Dr. İrem Sena Divanlıoğlu