Implants are replacements of dental elements with bio-compatible material of the roots of lost teeth.
What is an implant?
An implant is a titanium screw (as used in orthopaedic prostheses in the hip, shoulder, knee or as rigid structure brace in the case of serious fractures) which may have diverse forms and dimensions, chosen by the dentist on the basis of the patients’ characteristics and the result desired.
What are implants for?
Replacing teeth which can no longer be maintained in the mouth with osteo-integrated implants permits rehabilitation of mastication with fixed prostheses even in patients who would otherwise be forced to use mobile, total or partial, prostheses (false teeth).
In the case of patients with no teeth but sufficient bone tissue in the maxilla and mandible, two or more implants may be planned which transform the total mobile prosthesis (better known as “dentures”) into a mobile prosthesis with mounts which significantly improve comfort and functionality when chewing.
Which examinations and tests are needed for an implant?
Before planning intervention which is to all intents and purposes a surgical operation, certain instrumental examinations are required as support to the surgeon. An ortho-panorama and endo-oral x-rays of the operation zone are highly useful, easy and fast to execute.
However, many cases require other, more specific examinations with a TC DentaScan (that is Computer Tomography specifically for the mouth) and three dimensional reconstructions of the operation zone.
The ortho-panorama and endo-oral x-raysoften do not deliver accurate information about the position of multiple noble anatomic structures, such as the mandibular canal which hoists the vascular-nervous bundle of the same name, the maxillary sinus, the chin fori and other structures. Further, classical radiology does not permit us to display in three dimensions, nor, thus, the depth of the structures on which we shall be working. Tomography is therefore required. Obviously this is not a routine radiological examination, and it is thus prescribed only when necessary.
Osteal regeneration
Guided osteal regeneration has enabled us to extend the possible positioning of implants, permitting there use also in situations which are unfavourable from the anatomical viewpoint. The application of particular membranes which separate the bone from the surrounding tissue enable regeneration of osteal cells with good clinical results and recovery from small osteal defects.
What does immediate post-extraction loading mean?
Immediate implant loading indicates the positioning of the implant and crowns (capsule) during the same session, permitting the patient to use implants immediately to chew (immediate load means chewing load here).
Immediate implant loading in this case indicates the positioning of the implant and crowns immediately after extraction of the tooth.
Which phases does the patient go through?
If we consider traditional techniques, there will be a first session in which the teeth are extracted as planned beforehand. After approximately one month, we plan implant placement; obviously if we find conditions in which the dental elements are missing or have been extracted earlier and thus we have space for the implants, there is no need to wait for the bone to re-form where the teeth had previously been. At this point, the implants remain submerged for at least ninety days (three months). During this period, varying from three to five months, the patient behaves as they did before the implants, maintaining meticulous oral hygiene, especially in the implant zone.
Can implants be placed where there is insufficient bone?
Osteal regeneration techniques, ranging from bone grafts, to osteal distraction and expansion, also permit the insertion of implants in patients who, a short time ago, were destined for traditional prostheses. Filling in the maxillary sinus with the patients’ and/or grafted bone, and bone expansion are now consolidated techniques. Osteal distraction and osetogeneis via PRP or staminal cells are highly successful techniques although recently acquired, and with which excellent results are obtained only in expert hands. To date, regeneration techniques are safe and predictable, although evaluation of the is the role of the dentist which assess the case by analysis of many aspects.
How do I behave after the insertion of one or more implants?
This surgical operation, in most cases, requires one or two stitches (sutures). These remain in place for 1-2 weeks and are then removed. During this period the patient must be particularly careful with hygiene in the operated area, applying a chlorhexidine based gel and rinsing with a specific mouthwash with antibacterial action. For the early days, the teeth should cleaned taking great care in the area stitched.
After removal of the sutures, the patient must take great care with the implant through to placement, some three months later of the capsules on the implants. Plaque accumulation is the primary cause of failure in implant duration. |
