The aim of modern dentistry is to restore both the function, comfort and oral health of the patient’s oral area.
Whether the dentist is replacing a missing tooth or treating a decayed tooth, the principle is always to try to make an ideal restoration by eliminating wear, disease and damage to the jawbone.
Today, implants are the most popular treatment method for tooth loss. The reason for this is that the need for treatments increases day by day. The reason for this increase is;
- The elderly population living longer
- Age-related tooth loss
- Patients no longer want fixed prosthesis, that is, they do not want to cut the tooth on the right and left of the missing tooth.
- Deformation of removable prostheses over time and even deformation and decay of the teeth on the side.
- Psychological consequences of tooth loss
- Patient satisfaction with implant prostheses
- Advantages of implant-supported prostheses
- Problems encountered in completely edentulous patients
- The width and height of the support bone fade 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 tenderness in these areas
Psychological Aspects of Tooth Loss
The psychological effects of complete edentulism are often complex. These effects can vary psychologically. Patients reject the aesthetic loss caused by complete edentulism and are uncomfortable with the discomfort of wearing dentures.
In contrast, 80% of patients treated with implant-supported prostheses reported improved psychological health compared to their previous traditional removable prostheses and felt that their implant-supported prostheses were part of their body.
Some obsessive patients and patients with nausea reflexes are very comfortable with the use of this prosthesis with the emptying of the palate.
Results of Removable Prostheses
Removable prostheses are generally not desired by patients. Because this type of prosthesis is not desired by patients due to the discomfort it causes both while eating and in the tissue it supports. From time to time, they cause pain in the gums by knocking. In addition to these, removable prostheses used in completely edentulous patients are not very comfortable by patients as a result of moving in the mouth while eating and talking. Especially the part close to the tongue in the lower jaw is constantly moving and moving.
Advantages of Implant Supported Prostheses
- The primary purpose of placing implants in the jawbone is also to protect the jawbone.
- Thanks to its grooved structure, the implant creates a small massage effect when chewing with the jawbone and this massage effect helps the jawbone to be blooded and nourished. Especially in people with bone resorption, the implant protects the jawbone.
- Instead of the lower prosthesis that constantly moves with the pressure of the tongue and cheek, it can be made into a prosthesis that does not move like a fixed prosthesis by installing only two implants and making a bar prosthesis on it.
- In order to restore chewing, especially since the fused lower jaw also prevents the movement of the prosthesis, implants allow us to make a prosthesis that will help the facial support tissue in our patient again.
- It ensures that chewing is perceived by our patients. Because our patients perceive the jawbone during chewing with its fixed and adhering structure to the jaw.
- They prevent the teeth on the side from being cut.
- Acclimatisation and adaptation to implant-supported prostheses are quite fast compared to other removable prostheses.
- It is not likely to hit the soft tissue like removable prostheses.
- Implants placed as soon as the teeth are extracted preserve the existing size of the jawbone.
How Much is the Implant Price?
Dental implants are an investment. Especially in individuals with a single tooth deficiency, implant treatment is a long-term investment in terms of your dental health, as it is a long-lasting treatment. However, dental implants can be an expensive method, especially compared to other tooth 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 exceed the costs of simply switching to implants, which can last a lifetime (as long as you care for them properly). Also those who think that implants protect the jawbone – dentures and bridges cannot do this.
When your jaw deteriorates, your face shape will also change. You will start to look older. Moreover, your existing teeth will start to loosen. The jawbone provides the structure that holds the roots of your teeth in place. Once it is gone, you will lose the rest of your 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 consider dental implants as an investment, not an expense.
One factor that determines the cost of implants is the implant brand.
Implant Brands
Dental implants are screws made of titanium that serve as tooth roots in patients who have lost teeth for different reasons.
In patients with appropriate bone quality and thickness, implants are placed at the determined points on the jawbone under local anaesthesia without any discomfort. The choice of implant brand is made by the patient and the physician.
Implant brands produce implants according to the type of prosthesis to be made according to the type of jaw bone. The surface design of the implant is the way the brand expresses itself, so the choice of implant brand varies according to the prosthesis to be made to the patient’s bone.
Implants placed on the jawbone provide a complete and aesthetic smile while eliminating the patient’s tooth deficiency and preventing bone and tissue destruction. The brand is also important here. It may not be possible to design an aesthetic smile with every implant brand.
Patients who come to our clinic should undergo a physician control after being imaged with panoramic x-ray and 3-dimensional computer-aided tomography. At this stage, planning is made with the oral examination of our patient and the evaluation of 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 and research the implant brand?
The type of implant used can significantly affect the longevity, durability and many other factors of your restoration. Since not all dental implants are the same, it is very important to know the main differences of some systems.
One factor that cannot be ignored when considering the right dental implant brand for you is the one used by your dentist. Before your surgery date, discuss with your dentist which implants will be placed in your jawbone and why they prefer what they offer in-office over others on the market. This can help you feel more comfortable about the surgery as well as the results you can expect.
There are 100s 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, argue 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 jawbone is calculated with both three-dimensional tomographs and peri-apical and panoramic films taken from the bone area.
At the same time, the tissue around the implant is also examined, that is, the adjacent teeth and whether these teeth have any inflammatory conditions, as well as whether gingival recession is present in the entire jawbone.
The bone and nerve tissue adjacent to the area to be implanted is examined in detail. Bone cavities in the jawbone, bone thickness of the area to be implanted, are examined in all dimensions.
With advancing tomography techniques, it is also possible to measure bone quality. In other words, it is possible to measure where the bone is harder and to prepare special surgical stents to place the implant in these hard parts.
Surgical Stent Preparation;
After the hardest and longest region is determined as a result of the examination of the jaw bone, special surgical stents can be prepared to ensure maximum use of this region during implant surgery.
In today’s digital world, this stent preparation allows the image taken with three-dimensional scanners to be overlapped with the Tomography image at the same time, allowing the temporary prosthesis to be made on the implant as soon as the implant is inserted.
One of the most commonly used areas of digital dental identity is implant implant applications, evaluation of tomography results in implant applications and at the same time overlapping the jaw bone with three-dimensional scanners provides a safe application to the physician.
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 keratinised gingiva, in the implanted area increases the risk of gum problems in the future. In addition, the absence of keratised tissue around the tooth may affect the continuity of the health around the implant in the long term. The implant can be saved from these risks with the additions to the gingiva to be made during implant surgery.
Examination of the Structure of Neighbouring Teeth;
In general terms, the shape and root structure of the teeth and the structure of the neck parts, which we call the collar, are important in terms of implant neighbourhood. In the implant that will come next to the tooth structure with a thin neck, that is, the collar region is thin, our patient may experience continuous food escape problem. In this sense, especially in single tooth implant applications, the structure of the teeth on the side and the restorations on them are very important. The structures of the neighbouring teeth should also be examined for the long-term success of implant treatment.
Evaluation of Our Patients Regarding Chewing and Related Forces
In general terms, the shape and root structure of the teeth and the structure of the neck parts, which we call the collar, are important in terms of implant neighbourhood. In the implant that will come next to the tooth structure with a thin neck, that is, the collar region is thin, our patient may experience a continuous food escape problem. In this sense, the structure of the teeth on the side and the restorations on them are very important, especially in single tooth implant applications. The structures of the neighbouring teeth should also be examined for the long-term success of implant treatment.
Evaluation of Our Patients on Chewing and Related Forces;
Our patients continue the habits of their old teeth during chewing and biting. Therefore, chewing dynamics must be evaluated. Especially if there are canine teeth, whether there are abrasions at the ends of them, whether there are 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 built on it
One of the most frequently asked questions of our patients is which brand of implant is used. There are various types of implants in every brand. One of the most important criteria determining the physician’s preference here is that the long-term success of the implant has been academically proven. The use of implants that have not been examined academically and whose long-term success has not been monitored in the patient’s mouth poses a risk for the physician.
For this reason, the quality of the implant preferred in terms of the structure of the implant, the surface of the implant, its structure and its compatibility with the bone must be at world standards.
The shape and length of the implant is determined according to the area to be treated. For example, the neck and root structure of the implant to be used in a region close to the sinus and the structure and shape of the implant for making a bar to be used in the lower jaw may be different from each other. For example, it is preferred to use a short and wide implant in the upper jaw, which has a bone distance of about 4-5 millimetres to the sinus; in other words, the length and width of the implant are planned from the front according to all x-ray images and the prosthesis to be made on it.
Planning the Prosthesis
According to the prosthesis we will make for our patients, the lower part of the implant treatment should be compatible with the upper part. Implants have two parts; one is the part inside the jawbone and the other is the part outside the jawbone.
The choice of the part of these parts remaining outside is as important as the choice of the part remaining in the root. In other words, according to the type of prosthesis to be made, superstructure options are also planned from the front.
Prosthesis Options in Implant Dentistry
When choosing implant prostheses, where cost is of course important, the prosthesis to be made must have a predictable economic structure by the patients.
Aesthetics is of course an important criterion when evaluating the advantages and disadvantages of metal-supported or non-metal-supported porcelain teeth.
While fixed prostheses provide enough advantages for our patients who previously had a traditional removable prosthesis and now have a fixed prosthesis, metal-supported porcelain can be used in implant crowns and prostheses when aesthetic superiority is desired.
If our patients have a high smile line, that is, if the gums are receded, the bones are melted and the lips cannot cover the toothlessness, then it is necessary to give the appearance of gums in fixed prostheses on implants. Prostheses to be made in this sense are called hybrid prostheses.
The Effect 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. In a patient who smokes, multiple implant construction, bone additions and similar things are risky in terms of wound healing. Likewise, advanced surgeries should be avoided in uncontrolled diabetes. In order to carry out all these treatments, reducing smoking, regulating sugar, and if the patients have gum problems, reviewing the intestinal flora with a holistic medicine approach increases the success of the implant.
In addition, it should not be forgotten that wound healing will be impaired in a person with a stressful structure. Considering that a very stressed person will have teeth grinding in the future, the factor that our patient may break these prostheses should also be considered in terms of the hard structure of the implants and implant overlays to be made, and material selection and implant selection should be made accordingly.
Due to the stress factor, implant loss may occur, the spacer of the implant may loosen, and there may also be fractures in the tooth opposite to the implant. One of the biggest causes of spacer loosening is tooth grinding.
What are the Stages of Implant Treatment?
Implant treatment is one of the most popular treatments today. The issue that makes implant treatment popular is the satisfaction of the patients with the treatment and the permanence of the treatment. But there is a false belief for implant treatments.
This false belief that implant treatment lasts for months is actually due to the fact that the stages of implant treatment are not fully known. In cases where the jaw bone is sufficient, implant treatment consists of two stages.
- placing the implant
- implant overlay,
This is possible when the jaw bone is sufficient. The treatment phase of implant treatment in insufficient bone or in an aesthetic area is different from the 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 area. Then bone formation is added to the stages of implant treatment. In implant treatment that requires an aesthetic application, in addition to bone formation, it is also necessary to form gums, then a stage with gum attachment treatment is definitely required in our patient before implant treatment or after implant placement. To summarise, in implant treatments where bone is not sufficient, the treatment stage is three-stepped as bone formation, then implant placement, then implant overlay. In the absence of bone in an aesthetic area, a fourth step, that is, gum 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 gum-shaping cap that is inserted to shape the neck of the implant. This cap is then replaced with the superstructure called the sizing, that is, the superstructure in which the tooth will be made. Although the stages of implant treatment vary according to the implant brands and the health of the area where the implant will be inserted, it generally includes the stages as mentioned above.
How to Take a Tooth Measure?
When a restoration such as a veneer or a lamina, inlay-onlay is to be made on the tooth structure, it is necessary to take an impression of the teeth and the jawbone where the teeth are located. Measuring spoons are used to take tooth measurements. Measuring spoons have sizes according to the size of the person’s mouth according to the upper and lower jaw. There are usually three sizes of measuring spoons, usually numbers 1.-2 and 3. It is possible to measure from the mouth with measuring spoons produced separately for the lower jaw and for the upper jaw.
When the tooth impression is taken, the impression material is also selected according to the treatment to be performed on the tooth. In case a detailed impression is required, two-system impression materials are used. In two-system impression materials, an impression is taken with an impression material that first takes the general measurement of the mouth. In this dual system called silicone impression material, after the first impression is taken, the second impression, that is, the impression material that has a more viscous consistency and can take more detailed measurements, is placed into the first impression. In approximately 5-10 minutes, the entire jaw and the restoration area are measured clearly. This is one of the most frequently used methods of impression taking. Another method is the digital impression technique with today’s developing technology. In the digital impression technique, the mouth is measured in general with three-dimensional scanners. There is no impression material here. The three-dimensional scanner measures the entire detail of the mouth and delivers it to the laboratory via an e-mail.
In the other method, that is, the impression taken with silicone or alginate, which is a single-stage measurement, the model is obtained by pouring plaster into the impression material. It is obtained by pouring and digging the plastic material with special devices that act as a digital model printer. In both methods, impression taking does not involve any pain or discomfort.
Curiosities About Implant Treatment
What is the Cost of Implant Teeth?
When patients call our offices, the first question we are often asked is, “how much do dental implants cost?”
Questions about cost are more frequent than questions about post-operative pain or even procedure success rates!
Of course, it is possible to accept the variability of economics and economic situations
We understand. There are also families who need to cover the costs for our patients and we know how difficult it is to cover all your needs. However, dental implants may be more affordable than you think. Before we get into the numbers, we would like to advise you to look at the cost of dental implants as an investment rather than an expense.
For this reason, with the awareness that the best implant is actually our original teeth, we first protect the health of our teeth and try to keep our teeth in the mouth as much as possible by performing treatments without extracting the teeth and keeping the teeth in the mouth.
In this sense, we definitely explain to our patients about preventive medicine practices, that is, ways to keep teeth in the mouth for a lifetime,
It should not be forgotten that the best implant is our healthy teeth.
What is the Lifespan of Implant Treatments?
The lifespan of the treatments is almost the same as the original teeth when compared to the original teeth. In other words, after being placed in the mouth, an implant with a healthy bone and a healthy gum tissue has the same lifespan as the patient’s original teeth. When well cared for, implants are used for a lifetime. Implant overlays may need to be replaced from time to time.
Is Implant Application a Painful Treatment?
Local anaesthetics are used to prevent our patients from experiencing a painful process during the application of implant treatments and implant treatments. In other words, when these treatments are performed, numbing is provided with anaesthesia when needed, which ensures that the treatments are painless.
What are the Things to Consider During the Application of Implant Treatments?
During the application of implant treatments, you should use the painkillers and antibiotics prescribed by your doctor completely. You should also make care recommendations without neglecting them. Tooth brushing, oral care, smoking, reviewing the general health status and improving all these increases the success of implant treatments.
Complexes and Considerations After Implant Treatment
What is implant infection, i.e. 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 in implant treatments to be replaced. Regardless of the reason why the tooth is lost, one of the most important criteria that determines the life of implant treatments after implant placement is the health of the surrounding tissue and neighbouring teeth. It is not possible to talk about implant health in an infected mouth. In general terms, implant infection, i.e. peri implantitis, is a condition in which the tissues around the implant are infected. The tissue around the implant consists of two parts.
- Gingiva
- Jawbone
Bleeding gum odour is one of the most important symptoms when infection starts in the gums around the implant. If there is such bleeding, it is necessary to ensure that proper brushing and care is adequate. In cases where oral care is not adequate, gum infection then progresses to bone infection. As a result of this progression, bone loss around the implant occurs. If bone loss around the implant reaches an advanced level, it is not difficult for the implant to shake and fall off. For this reason, if there is bleeding around the implant, it should be taken seriously and an examination of this area should be requested by seeing the doctor who installed the implant. 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 must be eliminated. The source of the infection is sometimes the overflow of the adhesive into the gum tissue during the bonding of the implant crown. When all these are detected, a treatment plan is also drawn up. Infection of the tissue around the implant, which is still at the initial level, can be easily treated. Therefore, early diagnosis is important in eliminating the problem. In this sense, gingival bleeding occurring in the tissue around the implant should be taken into consideration and the dentist should be checked. When the gingival bleeding disappears, it can be easily observed that the infection also disappears.
Does an implant cause allergies?
No allergic reaction to the implant material has been observed 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 the original tooth and covered with bone.
When can I start eating after the implant tooth is placed?
It is of course the wish of many of our patients to start eating immediately after the teeth are inserted and to eat comfortably. When the teeth are inserted, it may be strange in the mouth for a while, which is quite normal. Although it varies according to the adhesive used when our implant overlay is attached, food can usually be eaten after 2 hours. However, the coordination of the tongue and cheek during comfortable chewing and chewing takes some time. In long-term tooth loss, the tongue is accustomed to entering the cavity area. For this reason, the tongue and cheeks of patients with implant overlays or implant teeth will be unfamiliar at first. The most important reason for this unfamiliarity is that the tongue spreads out in that area and now it is unfamiliar with the incoming tooth. For this reason, the tongue will not touch the implant tooth like a scanner for a while. This is usually the first 48 hours. After 48 hours, acclimatisation begins.
Are there any methods to facilitate eating with an implant tooth?
In order to start eating on the implant tooth, it is useful to first practice in that area and even prepare it by exercising the cheek muscles. Generally, eating with an implant tooth does not cause any pain or discomfort and our patients can easily adapt. During this adaptation, it is quite normal for the opposite tooth to feel as if there is a height for a while or to cause discomfort as if it is making a knocking sound. Because the mechanism of the implant tooth holding the jawbone is different from the normal tooth. Surely, the jawbone will 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 have this height checked from time to time after long-term use.
Do implant treatments cause cancer?
Although this is a very common question, we have not come across any person who has cancer after having implant treatment. There is no information or document about this in the literature.
Implant Teeth and Controls
For this reason, 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 enamel’s ability to wear, but when the implant tooth does not wear, this causes a feeling of height in the mouth during eating in the future. This height, which is the result of the other teeth being worn and the implant tooth not being worn, should definitely be regulated by the physician during the controls by making some abrasion.
