Dental Implants

A lot of people lose their teeth, even if this loss is caused by cavities, traumatisms or afflictions of the tissue that sustains the teeth (periodontal tissue).

No matter the cause, fallen teeth need to be replaced both for functional and aesthetic considerations. The most common methods of treatment for replacing missing teeth are fixed dental prosthesis (dental bridges), removable partial or total dental prosthesis, and the most efficient and patient friendly methods – dental implants.

What are the dental implants?

Dental implants represent the artificial replacement of the root of the natural teeth. They are shaped like “screws” that will be placed in the alveolar bone at the site of the missing teeth, and will sustain artificial crowns, dental bridges, or offer support for removable dental prosthesis.

Dental implants are made out of well tolerated materials, that are efficiently integrated in the bone tissue.

While placing a dental implant, the main purpose is to obtain an intimate contact between the outer surface of the implant and the surrounding bone tissue so that the two of them may “bind together” (osteointegration), creating a stable support for the future artificial crown that will be placed on the implant.

What are the advantages of dental implants?

Reduced bone loss. Normally the bone tissue that surrounds the root of the tooth is maintained in good health by natural processes.  However, if the tooth is lost the bone begins to regress gradually, getting smaller in both height  and thickness.

The placement of a dental implant in time stops this bone regression. However, in some patients, the bone loss is so significant that they require a bone graft before placing the implant, so that there will be enough bone to sustain the implant.

Fixed or removable dental prosthesis can not stop bone regression, and after some time (in which the bone gets thinner) they will have to be reshaped or even replaced with new prosthesis that are adapted to the new shape of the bone.

Better functionality. Once the dental implant is completely integrated in the bone, it works just as well as a natural tooth, and the patient can eat and smile without restrictions.

For patients who own a removable dental prosthesis eating certain foods, like an apple for example, can prove to be challenging because this foods can cause the detachment  of the prosthesis or even pain of the gums because of the high masticatory forces that arise. Dental implants can be used to help stabilize the prosthesis, significantly improving its functionality.

They do not require the involvement of other teeth. When missing teeth are replaced with dental bridges, the teeth that border the empty gap, have to be included in the bridge to sustain it. So these teeth will be cut down in size and covered with artificial crowns, even if they are healthy.

If the missing teeth are replaced by dental implants, no additional support will be required from other teeth.

Improved aesthetics. Dental Implants covered by well made artificial crowns are hard to distinguish from natural teeth.

How many teeth can a dental implant sustain?

In general, a dental implant sustains a single artificial crown. However, if more than one tooth is missing, it isn’t always necessary to place a dental implant for everyone of them. A dental implant implant can sustain more than one tooth by using dental bridges. 

  The number of implants necessary depends on the volume and density of the remaining bone tissue and on the masticatory importance of the teeth being replaced. Only the implantologist can correctly estimate the number of implants needed for each patient.

Who can receive dental implants?

Dental  implants can be used for people of all ages as long as they have a minimally required level of bone tissue and the periodontal tissue is not severely affected. Most healthy persons who keep good oral hygiene are suitable candidates for this method of treatment.

The conditions that decrease the rate of success of dental implants or that even prohibit the placement of implants include:

• excessive smoking – it slows down and disturb the healing process
• excessive alcohol use – it disturbs the healing of the gums
• periodontal illnesses – any periodontal or gum disease needs to be treated before the placement of the implant to assure a durable success. Periodontal diseases contribute to the recession of the bone.
• patients with reduced immunity – for ex. people who suffer from autoimmune diseases or who receive chemotherapy
• bruxism

How do we find out if we have enough bone tissue to support a dental implant?

Using a complete dental X-ray and in some cases a CT-scan, we can evaluate the bone density and volume, as well as identify the anatomical structures that must be avoided during the implantation (ex. nerves).

What can we do if there isn’t enough bone tissue?

If the quantity of bone is not sufficient to support the future dental implant, we can use bone grafts as well as special procedures for bone regeneration like:

•  “sinus lifting” (internal or external) – if we must replace teeth from the posterior side of the upper maxillary, this procedure increases the height of the available bone for implantation, by raising the sinusal floor of the maxillary sinus
• bone grafting – this procedure consists of taking bone from another part of the body (ex. the jaw) and placing it in the area where the bone tissue is scarce; in time the graft will adhere to the already existing bone

From where can the bone graft be obtained?

The best source for bone grafts is the bone tissue from our own body, like the mandible, tibia and the hip bone.
Bone tissue taken from our own body offers the best chance for graft integration and a reduced time of healing in comparison to other sources of bone (ex. bank bone, animal none, synthetic bone).

How are the dental implants placed? 

Before deciding to use dental implants the overall state of oral health must be evaluated. If there are signs of dental or periodontal disease they must be treated before the implants can be placed.
For this purpose, in our clinic no implants are placed before the medic is certain that the health of the oral tissues is adequate. This involves treating any pathological process present. This is usually done by cleaning the mouth of dental plaque and tartar, removing inflammation and infection sites, and helping the gums and periodontal tissue regenerate by the use of GINGIVAL PROTECT technique.

The GINGIVAL PROTECT technique is a new and unique method of treatment for periodontal disease, that helps the soft tissue around the teeth and bone regain its health, and thus increasing the chances of success for dental implants.

Before placing the implants we must also “heal the byte”. Excessive byte forces are transmitted from the teeth to the gums and periodontal tissue causing gum recession and periodontal inflammation.

In order to “heal the byte” we must identify the pathological contacts between the upper and lower teeth and eliminate them. In our clinic, this is done by using a state of the art technology – the T Scan System for digital occlusion. This system uses an electronic probe that transmits the forces of the byte to a computer which translates the information received into images. The medic reads these images and locates the excessive dental contacts which he can then eliminate by polishing.

After treating the periodontal health and byte problems a series of X-rays will be taken in order to evaluate the state of the bone present. The bone must have minimum necessary height and width.

The classical method for placing dental implants

The procedure will be done under local anesthesia and if needed using an IV drip (ex. if the patient is very anxious).

The gum which covers the bone in the area where the implant will be placed is partially cut and removed from the surface of the bone. With the help of specially designed burs the medic drills a channel in the bone in which the dental implant is tightly inserted. Then the gum is replaced over the bond and implant and sutured.

If the bone tissue is not enough the medic can chose to place a bone graft or work with smaller implants if this is possible.

After the operation a period of up to 6 months is necessary for healing and implant integration in the bone before the artificial crown or dental bridge can be placed.

During this “healing period” the patient can wear a removable dental prosthesis to improve his aesthetic.

The ROBODENT TECHNIQUE for placing dental implants

In our clinic we use a state of the art system for placing dental implant – the Robodent System, which brings many advantages for the medic, but especially for the patient.
Before the procedure, the patient will get a CT-Scan done in our clinic, which is absolutely necessary using this method of treatment.

Unlike the Classical Technique, throw this new method the placing of the implants is done by GPS guiding of the bur. The medic can watch in real time the advance of the drilling bur inside the bone, so he knows the exact depth and angulation of the bur. This aspect significantly increases the chances of success of the operation and the implants lifespan.

One advantage of this technique is that the gum is not cut and removed from the bone so there will be no need for suture wires which have to be removed 1-2 weeks after the operation.
But perhaps the most important advantage to the patient is that a temporary fixed prosthetic can be placed on the implants immediately after the surgery.

After the permanent artificial crowns or dental bridge are placed, the bite will be controlled and made adequate by using the T-Scan System. So we can be sure that no excessive forces will act on the implants causing them to detach in time.

In both techniques – Classical and Robodent, the procedure takes only a few hours and the patient can go home immediately after and to work the next day if he so wishes.