The Importance of Check-ups After Implant Treatment

What is the question our patients ask us after implant treatment? "What is the lifespan of my implant? What is the status 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 rate of the implant is 97%. Implants are 97% successful, so what do our patients wonder about? "What if I get into the 3%?"

What is the risk of implant loss and periimplantitis in our patients? Moreover, if the reason for the loss of our patients' teeth is due to gum problems, gum recession or even bone loss, the success of the implant in implant treatments is the success of the implant, but our patients are individuals. A person eats, speaks, makes a biting movement with their implant, in other words, they are a kind of implant user. For this reason, it is very important for implant users, that is, our patients, to be careful, maintain and have their check-ups while using the implant.

In 2012, a study was conducted on 2765 people who had implants. In the study conducted in Switzerland, Dr. JAN DERKS personally examined 900 patients. In the study conducted here, male patients were more satisfied than female patients in terms of aesthetics and usage. Older patients expressed their satisfaction more than younger patients.

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

In the research conducted by Dr. Jan Derks, the subjects were composed of people who represented the entire country.

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

1. Early life
2. Late losses

While investigating the causes of implant loss, they realize that there are some factors that cause the loss, and these factors are generally;

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

• Length
• Surface structure
• Brand

Early Implant Loss

Immediately following implant placement, implant loss is three times more common in patients with gum inflammation when they come to us, according to research conducted in 2015. Again, the length, brand and surface structure of the implant are factors in this situation.

Implant application errors such as not working without water, lack of blood flow to the patient, not paying attention to medication use after implant surgery, and not following the rules to be observed after surgery such as incorrect ice application are always the reasons for early period losses.

All these reasons are observational data. Early loss of a short implant does not mean that a longer implant will yield good results. We cannot know why a clinician prefers a thinner implant. Therefore, early implant loss depends on observation and experience.

The most common cause of LATE TERM IMPLANT LOSS is peri-implantitis. In other words, the cause of the loss of an implant that has fused with the bone over time is peri-implantitis.

How to Understand Peri-Implantitis?

After implant treatments, we should check our patients every 6 months. What do we look for in these checks? Is there bleeding in the gums? This is an important finding. We should also see the continuity of the bone around the implant radiographically. We should definitely check if there is any osteoporosis, we need documentation for this. This documentation should be taken at every check-up and checked over the years. If our patients have a bleeding problem, they should be checked for peri-implantitis and a diagnosed peri-implantitis should definitely be treated.

What Causes Peri-implantitis?

Our patients' plaque structures cause this. If we look at peri-implantitis cases, they definitely have periodontitis (gum problems) in their past.

If our patients have plaque accumulation and no bone loss yet, the gingival bleeding returns to normal within 3 weeks when the plaque is cleaned before peri-implantitis occurs.

Individuals who do not care for their teeth will be 3.4 times more likely to develop peri-implantitis.

Implant losses are seen in individuals with bruxism. Even cracks and fractures occur in implants. However, the most common cause of late-term loss is peri-implantitis.

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

Experts say that the selection of ABUTMENT, that is, the superstructure, is also very important in the development of peri-implantitis. For this reason, they conducted research on patients from 2 groups of patients.

80 patients with mucositis were followed up for 5 years. There were 39 patients in one group and 41 patients in the other. The patient group consisting of 39 patients had regular maintenance and check-ups and only 7 people in this group had peri-implantitis. 8 patients in the group consisting of 41 patients did not have regular check-ups and developed periodontitis.

Can Precautions Be Taken to Prevent Peri-Implantitis When Applying an Implant?

The thickness of the area where the implant will be placed, namely the mucosa, is very important, that is, our patient should have thick enough gums from the beginning, if there is not enough thickness in the gums from the beginning, this thickness should be created. It has been proven that having thick gum tissue prevents peri-implantitis.

The Speed ​​of Problem Formation is Important in Peri-Implantitis Treatment

In peri-implantitis, it is necessary to get to the root cause of the problem. How did the problem occur and what is its cause?

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

After the problem is detected, treatment should be done either by opening the area or without opening it, depending on the extent of the problem. For this reason, routine check-ups after implant treatments are very important. Having these check-ups done once a month by the dentist prolongs the life of implant treatments and prevents possible “LATEST LOSSES”.