Dental services

Dental implants

Why is it important to replace teeth?

Aesthetics is only one of the many reasons. Gaps in the denture - or even one missing tooth - may negatively affect your bite so if the replacement does not take place, the tooth opposite the gap will gradually grow out of line and the neighbouring teeth will lean in the empty space. If several teeth are missing, the remaining ones get overburdened. As a result, you may lose more teeth in the near future. After some time the bone around the missing teeth becomes sparser and starts to deteriorate, which later makes tooth implantation more difficult. Food remnants may deposit in the hole that remains after the extracted tooth, which may lead to further tooth decay and gum diseases.

About implantation in general

Losing teeth tells on all of us. We cannot chew or articulate properly, we cannot smile freely and may feel uncomfortably in a company.

Implantáció

However, missing teeth have to be replaced as soon as possible, since tooth gaps not only result in discomfort but, with the passing of time, they also lead to stomach problems, digestive difficulties and mandible-joint related problems. As a result of the loss of teeth and bone mass, teeth may migrate and lean according to the direction of the bite force, which may even result in changing our facial features.

Still, a lot of people find it hard to accept the idea of partial or complete, fixed or removable dentures. Dental implantations may be the solution for them.

Replacing teeth with implantations is undoubtedly expensive and bears some risks. However, as a result of the positive experiences of our patients, the feeling of comfort due to avoiding removable dentures, the significant improvement of life quality and the favourable professional experiences, this procedure gradually becomes a routine solution applied by dentists and dental surgeries.

What is an implant?

The implant is an artificial tooth root, surgically implanted in the place of the lost tooth. The denture built on the implant will be just as strong and usable as if it was built on the original tooh. It is more natural than any other prosthetic device; it makes you feel as though you have got your real, strong, healthy teeth back.

What are implants made from?

The material is usually pure, unalloyed titanium, which is completely accepted by the human body. Due to its special biological, chemical and physical characteristics, after some time it grows together with the bone. As a result, it will hold the artificial tooth or teeth fixed on it perfectly securely. It does not corrode, is resistant to acids and other substances, cannot be magnetised and it is extremely strong compared to its weight. It is tissue-friendly and causes no harm whatsoever.

Who can we recommend implants?

A patient is suitable of implantation if he has a good general health status, good oral hygiene, has the sufficient amount of bone tissue and there is no excluding factor. Last but not least: he is prepared to observe the rules of oral hygiene, prescribed by the doctor.

Who is it not recommended to?

Regarding successfulness, major risk factors are heavy alcohol consumption, heavy smoking, drug addiction and serious cardiovascular diseases. No implantation can be performed before the growth of the mandibles finishes (14-18 years of age).

Risks

90-95% of tooth implantations can be regarded successful. In very rare cases the implant may not attach to the bone and when it is exposed, it turns out that it has remained loose. In this case the loose implant has to be removed and another one inserted.
Long-term success is impossible without strictly observing the rules of oral hygiene. Implants may attach to the bone stronger than natural teeth, but their connection to the gums is much weaker. As a result, improper tooth and oral care can cause more harm around the implant than otherwise. However, if the patient keeps the rules, the implant may last lifelong.

Can the implant be rejected later?

Improper oral hygiene and, as a result, the accumulating bacteria living in the plaque and scale deposited on the implant may lead to diseases of the paradentium and loosening of the artificial root, just like in the case of natural teeth. This is why it is extremely important to apply the proper tooth-brushing technique, use dental floss, and, in some cases, use other special devices of oral hygiene. It is also essential to control the implants annually.

Advantages and opportunities of tooth replacement with implants

Implants make it possible to replace individual teeth without having to file the neighbouring healthy teeth.
Using implants, tooth replacements or bridges are possible in cases where the traditional solutions would only facilitate removable dentures. The implanted tooth is more comfortable, more natural and easier to manage.
In case of complete tooth loss, it is possible to provide the patient with a fixed denture, a bridge on the implants or a combined denture with only 4-8 implants. Dentures on implants ensure more stability and better biting ability, while providing excellent aesthetic experience. Further advantages of the implant is that it can prevent the loss of bone tissue, which is unavoidable after losing teeth.
The combination of all these effects serves the improved life quality of the patients.

Before implantation

Before surgery, the operating oral surgeon concludes a survey of state, i.e. he maps the anatomic features of the patient, orders X-ray and laboratory examinations (mainly concentrating on blood coagulation and blood sugar level data), obtains information on the eating, drinking and smoking habits of the patient. Afterwards, the doctor decides which teeth need to be replaced and whether the available bone tissue is sufficient to insert the implants or it is necessary to apply bone replacement.

How does tooth root implantation take place?

The implants are inserted using local anaesthesia, as an outpatient treatment. During the procedure, the oral surgeon prepares the concerned section of the mandible (makes a cut on the gum), drills a hole in the mandible and then places the implant in this hole. After inserting the implant, he stitches up the gum. The patient gets antibiotics and analgesics. The stitches are removed after 1-2 weeks; afterwards, the implant heals and grows together with the bone under the recovered mucous membrane of the mouth.

The process of recovery

After inserting the implant, several months must pass until the implant ossifies, which means that the bone cells practically grow into the microscopic pores on the surface of the implant. This ensures the stable position of the implants so that they can later endure everyday bite pressure without getting damaged. This process of osseo-integration takes around 6 months in case of both the upper and the lower mandible. In the meantime the implant heals covered under the gum.
After complete recovery, tooth replacement (bridge, crown or a complete denture) can be prepared and secured.

Preparation of the denture

When the recovery time has passed, the implants are revealed from under the gum. This does not require another operation as only the screw in the implant has to be freed by making a tiny cut on the mucous membrane. The neck-head parts, or abutments are then screwed into the implants and they will later bear the crowns. From this point on, the procedure is more or less the same as in case of traditional dentures built on natural teeth.

How long does the treatment take?

The length of the treatment may depend on the number of implants and the necessity of bone replacement.

The days following surgery

It is practical to place cold compress on the operated area in order to reduce swelling. The patient may not eat until the effect of the anaesthetics wears away. Coffee, tea, alcohol, smoking and hot, spicy food are to be avoided for at least one day. Oral hygiene, as well as disinfecting gargling will be especially important on these days. One should not forget about the prescribed medicine and the analgesics, if necessary.

Lack of teeth after implanting the artificial tooth roots?

If the implants are placed in the front section of the mouth, the dentist has a temporary denture or bridge made so that the patient will have teeth in the meantime. In case the patient has a complete denture, he can wear this during the whole recovery period.

Successfulness of the implantation

The implantation can be regarded successful if there is no sensation of pain or foreign body; there is no inflammation around the implant, which is not loose and the X-ray images do not show that the bone tissue becomes sparser around the implant. The term 'successful implant' thus largely refers to long-term successfulness, which is true of 90-95% of all tooth implantations. Nowadays the number of failed implantations has been minimised, partly due to the fact that if an implant is rejected - for whatever reason - it can be followed by another, successful implantation. As a result, we can say that unsuccessful implantations are very rare today.

Later on

Cooperation between the patient and the doctor does not stop after the successful implantation. One of the main conditions of the long-term success of implantation tooth replacement is perfect oral hygiene and regular dental check-ups. After the implantation, the patient generally has to appear at a check-up at least annually. On these occasions the dentist checks the adhesion of the bone and the gum around the implant, as well as the general state of the tooth implant, and performs the necessary corrections, if any.
It is extremely important for patients with implants to see their doctor immediately if they observe any changes.

How to look after the implants?

Implants are to be treated just like your natural teeth. It is important to wash teeth and use floss daily, as well as regular dental check-ups.
The relationship between the dentist and the patient should not finish after performing the implantation as the long lifetime of the implant, which may be decades or even lifelong, necessitates its continuous control.

How long do implants last?

Depending on its position and the patient's oral hygiene, the implant generally last for 10-20 years but in many cases for a lifetime.
If you have had an implantation treatment, smoking is strictly forbidden as it can increase the risk of the implant being rejected.

What is meant by overburden on the implants?

If the implants are overburdened, it may even lead to their loss. Overburdening may be a result of too few implants bearing the pressure on the whole denture. This is why it is so important to plan the number of implants individually and accurately. Thus the number of implants to be inserted in a certain case will be decided during the planning stage. The implantation of too few implants is medically unacceptable even if it may result in financial savings for the patient at that moment as later the overburden will endanger the existence of the other implants.

Can allergy or tumorous degeneration occur in relation to implantation?

The material of the implants is generally pure, unalloyed titanium. Thanks to its special biological, chemical and physical features, the implants will grow together with the bone after some time.
The medical literature has never described any allergic or tumorous degenerations related to implantation as the surface of the implant is constituted by a stable compound, titanium-oxide.
This material is not soluble by the bodily fluids so it cannot react to the immune system, either. Using the proper implantation technique and properly prepared crowns or dentures, the implants may serve the patients for a lifetime.

Before the implantation, these treatments may be necessary:
Sinus elevation, sinus lift, bone building, bone replacement

Sinus lift operations became general practice nearly two decades ago as more and more people choose tooth implantation.
When the examination preceding implantation reveals that the bone is not thick enough for the implants or the oral cavity is too close to the mandible, bone replacement may be necessary. This is a surgical treatment that is applied routinely nowadays. In essence, the appropriate section of the decayed upper mandible is thickened towards the oral cavity (sinus maxillaris) using bone transplant or bone replacement material, thus making it suitable for the implantation.
Bone replacement and implantation may take place at the same time but the doctor may decide that he will first prepare bone building and wait until recovery before inserting the implant. In this case recovery needs 4-6 months before the implant can be inserted.
The material used during bone replacement (sinus lift) may be so-called auto-transplant, taken from the patient's own bone material, or artificially produced (alloplastic) bone replacement material. The treatment is possible both on the lower and the upper mandible.
If only minor bone replacement is needed, the GBR (guided bone regeneration) technology can also be applied. This means that after inserting the bone replacement material a special membrane is placed under the periosteum, covering the location of the bone replacement. This method can be applied at the same time as the implantation or at a different time.

Immediate implantation

This means that the implantation is inserted within 0-48 hours following the tooth extraction. What does this mean?
If you have a tooth or root in the smile zone that cannot be saved using any conservative technology and it needs to be removed, the question always arises how long you will have a tooth gap following extraction.
In the aesthetic zone, the replacement of lost teeth must always be planned with special care.
You have to know that tooth extraction is always followed by the degradation of a significant volume of bone tissue. The gum covering the tooth withdraws and a few months later the dental papillae flatten and become smooth and horizontal. The once nice, rounded gum contour may be gone for good.
If the implant is inserted in place of the removed tooth immediately, the nice, crescent-shaped gum contour is preserved and instead of the degeneration of the bone tissue after the extraction, such bone regeneration induction effects occur that fill up the tiny gaps that possibly remain between the alveoli and the inserted implant. In order to preserve the nice gum contour, it is necessary to implant a gum-shaping screw and, if the primary stability of the inserted implant is appropriate, we can even prepare a temporary abutment and a temporary crown.
However, we do have to wait until complete osseo-integration finishes, which is around 6 months in case of immediate implantation as well. When this time has lapsed, the final abutment and the final crown can be prepared and fixed on the implant. Today it is not only possible to prepare completely metal-free crowns but, if you require perfect aesthetics, the implant abutment that holds the crown can also be carved from metal-free zirconium-oxide, with the use of robots.

The history of tooth implantation

There is evidence of gold, wood and animal teeth used for the purposes of implantation from as early as the Hellenistic culture in the 4th century B.C.

Towards the late 18th century the implantation of human teeth on other persons became overspread and fashionable in the upper circles of the society. Many people offered their teeth for some financial compensation.

In 1952 the then young Swedish professor, Per-Ingvar Branemark realised that the titanium plates then used in animal experiences had a very unique characteristic: they were capable of completely grow together with the living bones. Experimenting on rabbit shin bones, he realised that the two parts reossified easily if a titanium rod was inserted in the middle. Today, fifty years later, this method is widely applied and the method has justified itself: Branemark's first patient still had the titanium-rooted teeth thirty-five years after the operation.

This discovery meant the beginning of a new age in medicine. Titanium has since been used in articular surgery in order to unify fractured bones, replace lost tissues, restore shape and, last but not least, apply dental implantation. Titanium is capable of tying molecules of water, sodium, calcium, chlorine and phosphate, to which the protein structures of the bone tissue can later attach.

In dentistry, in actual fact we can talk about the implantation of artificial roots and not teeth. The procedure already has more than a hundred different types. The so-called screwed implants are the most common, which are not complicated to insert but require accurate preparation, a lot of attention and professional expertise.

Of course, Branemark was only the pioneer and the choice is confusing today - some say there are eight hundred different implants, others claim the number is a thousand and three hundred. The most commonly used types are the Swedish Branemark and the Swiss Bonefit-ITI. Branemark type implants are inserted in two phases. First they implant the rod in the mandible; this will serve as the root of the tooth. Five-six months later the gum is opened up again and the titanium supportive structure of the artificial tooth can be placed on the already embedded artificial root of bio-material. Finally, the crown is fixed on this structure. In case of Bonefit-Iti, however, there is no need for two phases as the head of the tooth root rises above the gum. When the gum has completely healed around the abutment, the crown or the denture is placed on it.