Implantology

Having healthy teeth is important for proper chewing and speech

Having beautiful teeth with a harmonious smile, as well as healthy, is a priority for people who work in contact with the public and for whom aesthetics is a non-negligible factor.

The lack of teeth can prove to be a very negative aspect, capable of:

  • making chewing difficult by conditioning the power supply;
  • affecting the patient’s daily routine and social life
  • changing the facial profile by making the individual appear older over the time because of a progressive resorption at the alveolar bone level.

Some time ago the loss of teeth forced people to face the problem with only one solution, that was the removable partial or total prosthesis, which was uncomfortable and often highly risky.

The dental implant is today the best method to replace missing teeth. Dental implantology consists essentially of inserting prostheses into the maxillary or mandibular bone, replacing the root of the tooth or missing teeth. Once integrated into the bone itself, coronal prostheses are mounted on these radicular prostheses, that is one or more artificial teeth made of metal, ceramic or similar. The implant consists in fixing a titanium screw with a cylindrical or conical shape in the bone to better adapt to the anatomy of the bone.

The composition of the dental implant 

The implants are built in various lengths and diameters to increase the capacity of osseointegration and bone regeneration, e.g. the direct connection between bone and implant, without interposition of soft tissue. The material with which the implants are made is titanium.

The dental implant does not cause any type of negative change in the body and is essentially composed of two main parts:

  • the screw that is surgically inserted into the patient’s jawbone;
  • the pillar (or stump) which has the role of creating a connection between the screw and the prosthetic structure.

 

What to do before the operation 

As a first step, the doctor must be informed of all the patient’s health problems. In the event that the patient is not certain, it is always better to run all the tests so as to ensure that there are no contraindications to the use of the implants. If you are taking medications or if you have allergies, it is essential to tell the doctor about it.

In order to plan the operation, the dentist needs a panoramic X-ray (or a CT scan) to check the quantity and quality of the bone and establish the length, thickness and direction of insertion of the dental implant. The specialist must act in a condition of total cleanliness in order to avoid infections, so dental hygiene is highly recommended to the patient before moving on to the operation. Regardless of the technique used to insert the implants, the treatment is not painful as anesthesia is always administered.

 

The advantages of dental implants

There are several advantages to dental implantology, including:

  • dental implants prevent from bone resorption;
  • the teeth adjacent to the implant are not touched;
  • dental implants do not move, ensuring safety and naturalness;
  • gum pain will disappear due to mobile prostheses;
  • dental implants, if properly treated, are a long-lasting solution;
  • dental implants are certified as the patient is given a certification of originality of his implants and of his prosthetic components, so that in case of need he can receive assistance anywhere in the world. The “Implant Passport” is issued to each patient after the operation and contains the description of the components used in order to allow their unique identification.
  • The patient, in case of need, can exhibit the “Implant Passport” at any dentist in the world who, by identifying the components used, can intervene in the most appropriate way;
  • the rejection almost never take place if the plants used are of certified quality. It happens, unfortunately, when the correct osseointegration of the implant is missing, which originates in insufficient sterility of the operating field or in the case of technical errors (for example in the case of overheating of the bone or insufficient stability before implantation).

Maxillary sinus lift

In implantology the anatomical limits and the quantity of residual bone often prevent the right balance between endosseous development and prosthetic emergency.

In cases where they have been lost for a long time, for the upper teeth of the posterior and lateral sectors (premolars and molars), it is necessary to resort to bone regeneration maneuvers, also called maxillary sinus lift, before being able to position an implant.

The maxillary sinus is a cavity in our facial massif, on the same level as the posterior superior teeth, which helps the patient breath as well as to lighten the skull.

Following the loss of the dental elements, this cavity expands at the expense of the alveolar bone up to situations in which there is no bone availability that allows the positioning of an implant. In such situations it is possible to re-establish a sufficient quantity of bone with mini-invasive (mini-raise) or more extensive maneuvers in cases of severe atrophy (large rise).

In many cases it is possible to insert the implants along with a maxillary sinus lift operation; in cases where the bone is deeply resorbed it is necessary to wait for a healing period of 9-12 months before proceeding with the insertion of the implants.

Implantology with immediate loading 

Immediate-loading dental implantology allows the insertion of titanium dental implants and by loading them during the same session or in any case within 24 hours after surgery, restoring the patient’s chewing function in a short time. The main advantage of this technique is that it allows you to get a beautiful and lasting smile in a short time.

Immediate-loading dental implants combine all the features for optimal replacement of natural teeth. Generally it is the ideal solution in cases of total or partial edentulism (loss of teeth) and allows the complete functional rehabilitation of the teeth, guaranteeing stability and safety.

In order to use the immediate loading technique, the dental implant must have an excellent endurance in the bone and only the surgeon, during the implant insertion procedure, will be able to decide for immediate loading or for deferred loading (on average to insert the dental implants in the upper arch it is necessary that four or five months have elapsed after the operation itself, three or four months for the implants inserted in the lower arch).

 

Requierments for implantology with immediate loading 

Immediate loading implantology is almost always possible if the patient has the following characteristics, as stated in international protocols:

  • the presence of a certain amount of bone;
  • the primary stability of the implants once inserted (35 Newtons);
  • good periodontal support (gingival);
  • the absence of bruxism (dental grinding) or severe malocclusion;
  • the presence of a good occlusal balance (correct masticatory occlusal plane).

In the cases of monoedentulia of the aesthetic sector it is possible, in exceptional cases, to place an implant and at the same time the prosthetic crown which, however, will be released from the masticatory loads, performing only the aesthetic and phonatory function: we can refer to it as immediate prosthesis. A fundamental requirement for realizing an immediate load / function is that the implants have absolute primary stability during the intervention phase.

The shortening of treatment times is an advantage both for the patient, who can quickly regain both functionality and aesthetics, as well as for the clinician. Another positive aspect of this technique is represented by the smaller number of necessary surgical sessions, whose direct consequence is a greater respect for the hard and soft tissues of the oral cavity. It is important to remember that the dental implant replaces missing teeth but not sick teeth.