Importance of Controls After Implant Treatment

What is the question our patients ask us after implant treatment? ” What is the lifespan of my implant? What is the condition of my implant? Are there any biological or technical complications?” And they usually want to hear positive things in response to these questions.

The success of the implant is 97 per cent. Implants are 97% successful, then what do our patients wonder; “What if I get into 3%”.

What is the danger of implant loss and periimplantitis? Moreover, if the reason for the loss of our patients’ teeth is gingival problems, gingival recession and even bone loss, the success of the implant in implant treatments is the success of the implant, but our patients are individuals. The person eats, speaks, makes biting movements with his/her implant, in other words, he/she is a kind of implant user. For this reason, it is very important that the implant user, i.e. our patients, take care of the implant while using the implant, take care of it and go to the controls.

In 2012, 2765 people with implants were personally researched in Switzerland, where Dr JAN DERKS personally saw 900 patients and examined them. In the research conducted here, male patients were more satisfied with aesthetics and usage than women. Elderly patients expressed their satisfaction with the ratio of young people.

These patients were asked whether they had complications with their implants during 6 years of use, and ⅓ of them mentioned minor complications.

In the study conducted by Dr Jan Derks, the subjects were representative of the whole country.

When a day is spent in implant losses, implant losses are evaluated in 2 categories.

1. Early period
2. Late period losses

While investigating the causes of implant losses, they realise that there are some factors in the cause of loss in general terms;

1. Smoking
2. Diabetes (diabetes)
3. Systemic status, general health of our patients
4. Medicines they use
5. General characteristics of the implant

• Length
• Surface structure
• Brand Name

EARLY IMPLANT LOSS

Loss of the implant immediately after the implant is inserted, in a study conducted in 2015, if our patients have gingivitis when they come to us, these patients have 3 times more implant loss, again the length, brand and surface structure of the implant are factors in this situation.

Implant application errors, not working without water, lack of blood supply in the patient, not paying attention to the use of medication after implant surgery, not following the rules to be considered after surgery such as incorrect ice application are always the cause of early period losses.

All these reasons are observational data. Early loss of a short implant does not mean that it will bring good results when a longer implant is used. We cannot know the reason why a clinician prefers a thinner implant. Therefore, early implant loss is based on observation and experience.

The most common cause of late implant loss is periimplantitis. In other words, periimplantitis is the reason for the loss of an implant fused with bone over time.

HOW TO RECOGNISE PERIIMPLANTITIS?

After implant treatments, we should check our patients every 6 months. What do we look for in these checks? Is there bleeding in the gingiva, this is an important finding. Radiographically, we should see the continuity of the bone around the implant. We must check whether there is any bone resorption, we need documentation for this. This documentation should be taken at each check-up and controls should be performed over the years. If there is a bleeding problem in our patients, it should be checked whether there is periimplantitis and a diagnosed periimplantitis should be treated.

WHAT IS THE CAUSE OF PERIIMPLANTITIS?

The plaque structures of our patients cause this. If we look at the periimplantitis cases, there is definitely periodontitis (gingival problem) in their past.

If there is plaque accumulation in our patients and there is no bone loss yet, gingival bleeding completely normalises in 3 weeks when the plaque is cleaned before periimplantitis occurs.

In individuals who do not take care of their teeth, the occurrence of periimplantitis will be 3,4 times higher.

Implant losses develop in individuals with bruxism. Even cracks and fractures occur in implants. But the most common cause of late loss is periimplantitis.

The risk of periimplantitis is higher in people with poor general health. It has been observed that the probability of periimplantitis in the lower jaw is 20% more than the upper jaw.

In the development of periimplantitis, the choice of ABUTMENT, ie the superstructure, is also very important experts say that it is very important. For this reason, they conducted research in 2 groups of patients.

A 5-year follow-up of 80 mucocyte patients was made. There are 39 patients in one group of patients and 41 patients in the other. The patient group of 39 patients have regular care and controls and only 7 people in this group have periimplantitis. The group of 41 patients does not have regular check-ups and 8 develop periodontitis.

CAN PRECAUTIONS BE TAKEN TO PREVENT PERIIMPLANTITIS DURING IMPLANT APPLICATION?

The thickness of the area to be implanted, that is, the thickness of the mucosa, is very important, that is, our patient should have a thick gingiva from the beginning, if there is not enough thickness in the gingiva from the beginning, this thickness should be created. It has been proven that thick gingival tissue prevents periimplantitis.

THE RATE OF FORMATION OF THE PROBLEM IS IMPORTANT IN PERIIMPLANTITIS TREATMENT

In periimplantitis, it is necessary to go to the root cause of the problem. How did the problem occur and what is the cause?

It is also important to intervene as soon as the problem occurs, because when the problem occurs, that is, when symptoms such as bleeding in the gum occur, in 80% of cases, there is a melting of 0.1, 0.2 mm. This loss of bone is very important for early diagnosis and treatment. Sometimes in such a case, it helps to simply eliminate plaque formation because a bone loss of 0.1 mm is not that important. Therefore, the time it takes for the problem to arise and for it to be resolved is important.

After the detection of the problem, depending on the amount of the problem, the treatment should be performed either by opening the area or without opening it. For this reason, routine controls are very important after implant treatments. Performing these checks by the dentist once a month prolongs the life of implant treatments and prevents possible “LATE TERM LOSSES”.