What are dental implants?
If you lose one or more natural teeth, an implant can help. The tooth and tooth root are completely replaced by the implant. Dental implants consist of three parts:
- the implant body, which is anchored in the bone
- the neck part
- the crown (also called “superstructure” in the technical language)
Depending on the type of crown used, the actual tooth replacement, a distinction is made between fixed and removable dental implants.
The neck part of the implant, the passage point through the oral mucosa, is very smooth so that the oral mucosa can adhere tightly. This is important to prevent bacteria from entering the jawbone and causing inflammation.
The dental crown is finally screwed or glued onto the head of the neck section.
Mini implants
The shorter treatment time is also reflected in the lower price of the “minis”.
The disadvantage is that special titanium alloys have to be used for the mini implants because of their smaller diameter. Under certain circumstances, patients can react to these alloys with allergic reactions.
Dentists use mini-implants primarily to replace small teeth, as the larger, conventional dental implants often cannot be used here for space reasons.
The dentist can place implants both in the case of individual missing teeth, but also in the case of complete toothlessness. Tooth loss can have various causes:
- Congenital (primary) causes: Congenital maldevelopment of the teeth, often together with other complex malformations of the facial region (for example, oral and maxillofacial cleft).
When not to use dental implants
Various health conditions may prohibit the use of dental implants. These include:
- severe cardiovascular diseases
- Metabolic diseases (for example, diabetes mellitus)
- Blood coagulation disorders
- regular use of medication (cytostatics, cortisone or bisphosphonates)
- heavy smoking
- too small jaw
- teeth grinding (bruxism)
- nerves or blood vessels too close to the implant
What do you do with dental implants?
Precise treatment planning with appropriate education, diagnostics and follow-up care is important for successful dental implant treatment.
The right dentist
Therefore, look for either the title “Master of Science in Oral Implantology” or the designation “Tätigkeitsschwerpunkt Implantologie”. These are certified by medical associations and require that the dentist in question has already performed a certain number of procedures – including at least 200 dental implants in total or 50 dental implants per year.
First contact
First, the dentist will ask you about any previous illnesses or medications you are taking in an initial detailed consultation. He will then examine your entire oral cavity in detail. Imaging procedures such as X-rays, computer tomography or magnetic resonance imaging (MRI) complete the preliminary examination.
If you have diseased teeth or gum inflammation, the dentist will treat these accordingly as part of the so-called pre-treatment.
Bone augmentation
The bone can be built up with procedures such as jaw spreading, sinus lift, insertion of bone pieces, for example from the pelvic bone, or by the administration of bone substitute materials.
Anesthetic procedures
The operation
First, the dentist opens the mucosa over the jawbone with a small incision. After drilling a small hole, the dental implants are screwed or tapped into the bone and the mucosa is then closed with a suture (closed healing). Alternatively, the implant can also heal without suture closure (open healing).
In total, the surgery takes about an hour and is most comparable to the extraction of a wisdom tooth. The dentist removes the sutures after about one to three weeks. A new anesthetic is not necessary for this.
Once the implant and tissue have healed well, access is created to screw the actual denture into the implant.
What are the risks of dental implants?
Pain, swelling and bruising are a frequent consequence of dental implants. It is therefore helpful to cool the operated area immediately after the operation. If necessary, the dentist will also give you a painkiller. You should inform your doctor if you experience dental implant pain.
Infection
Preventive administration of antibiotics reduces the risk of infection and implant loss. However, antibiotics are not suitable for the treatment of peri-implantitis, as they do not reach the dental implants well and have little effect on the bacteria there. Often the implants have to be removed again.
Injuries caused by the procedure
Injuries to nerves, blood vessels and other structures during the insertion of implants can cause pain and other discomfort:
- Tooth roots: Roots of neighboring teeth can be injured if they protrude into the drilling area.
- Blood vessels: Injuries to blood vessels during the insertion of dental implants are rare, but cannot be ruled out. Anyone taking anticoagulant medications (for example, acetysalicylic acid) must therefore discontinue them before surgery as a precaution.
- Bone: The implantation can injure the jaw bone. In the case of severe jaw atrophy, the jaw may even fracture.
After placing the dental implants, you should ensure thorough oral hygiene. Initially, use a soft toothbrush that is gentle on the gums, dental floss, an interdental brush and an antibacterial mouth rinse.
If possible, you should not smoke, as this can significantly impair the healing success.
If implants hurt or other problems occur, you should inform your dentist.
Dental implantation is a relatively safe and common procedure in dentistry, with about 200,000 surgeries performed annually. Modern dental implants expand treatment options and can also achieve cosmetically convincing results.
