Today, with the development of treatment options, the frequency of tooth loss is gradually decreasing. We know that the greater the amount of healthy remaining tooth tissue, the longer the life of the tooth. Therefore, we use porcelain fillings (inlays, onlays, overlays, endochrones) instead of veneers (crown restorations), hairdressing treatments if possible instead of root canal treatment, root canal treatment renewal instead of extraction, orthodontic treatments instead of veneering teeth for aesthetic purposes, and the person’s own teeth in aesthetic treatment.
Despite all these, in cases such as infections that cannot be solved, fractures that cannot be restored, we may need to perform tooth extraction as the only remedy, even if we do not want to. In the past, we could only replace 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 in single tooth deficiencies.
Why should I prefer implant treatment?
No material used is as functional and healthy as healthy tooth tissue. The basic rule for the tooth to remain in the mouth for a lifetime is to preserve as much healthy tooth tissue as possible. When we look at this principle, replacing the missing tooth with a bridge by cutting the side teeth should not be preferred unless it is not necessary. Because removing unnecessary healthy tissue shortens the life of other teeth.
Another reason is that the root structure of each tooth is formed to carry its own load. For example, let’s assume that we make a bridge by cutting 2 teeth next to a missing tooth. Since there is no root to carry the load of the missing tooth, the load on it is shared to the side teeth. This causes the side teeth to carry more load than they should, and root health is put at risk if careful adjustment is not made.
In addition to all these, the jaw bones are specialized to support the teeth. When a tooth is extracted, the body starts to dissolve the bone because there is no root there to participate in chewing. Because, just like a casted arm weakens, “the unused organ atrophies”.
Why is it important to build a prosthesis over the implant?
At the end of the day, the purpose of the implant is not the implant itself, but the prosthetic tooth on top of it. For this reason, just as the choice of the surgeon who will perform the implant surgery is as valuable as the choice of the surgeon who will perform the implant surgery, it is just as important that the person who will make the tooth on it is a physician who has a high knowledge of implant prostheses and even a specialist and experienced physician in prosthesis. Because the structure of the bone and soft tissues around the tooth and the tissues around the implant are completely different from each other. In an improperly made prosthetic tooth (crown, veneer), there is not only the problem of falling, fracture, odor, food leakage. The main problem is the melting of the bone around the implant as a result of improper prosthesis. Did you know that improperly made implant prostheses can cause bone resorption around the implant and even implant loss?
What are the implant prosthesis options?
Although there are many developments in the implant field today, we basically have 2 options: cemented and screw-retained implant prosthesis. Both options are long-term treatments if applied correctly.
As a result of the studies, we dentists know very well that the biggest cause of an inflammatory condition around the implant is that the adhesive residues, which we call cement, cannot be cleaned well and initiate 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 cemented implant prostheses have advantages.
Since the production of screw-retained implant prostheses requires a lot of technical precision, strong physician knowledge and extra production costs, cemented prostheses are widely used. However, when applied correctly, screw-retained restorations prevent the veneers from constantly falling off, especially in patients with short teeth, reduce the risk of infection around the implant since there is no cement residue, and allow the veneer to be easily removed and cleaned underneath at regular controls and when necessary.
As we come to the end of our article, we would like to emphasize that the most important thing about implants is the correct diagnosis, a thoughtful treatment plan and regular post-treatment checks, no matter how different techniques and methods are available. If you have a missing tooth, our advice to people who are considering having an implant,
– Both the surgeon who will perform the surgery and the physician who will make the prosthesis on it should be experienced and work in this field,
– After the implant and its prosthesis is made, to ensure the care of the relevant area as prescribed by the physician,
– 1 in 6 months, you should be examined by a physician and have your chewing efficiency 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 coating does not wear out. For this reason, we should be sensitive about the position of the implant and the maintenance of the implant in our active chewing system.
Dt. İrem Sena Divanlıoğlu
