DENTAL IMPLANTS

What are dental implants?

Dental implants are a solution to replace missing teeth. An implant is a titanium screw that is inserted into the jawbone, on which crowns or prostheses will be placed to replace the lost tooth in appearance and functionality.

95% percent of implants are made of titanium because it is a biocompatible material that allows osseointegration, that is, fusion with the bone. Although there are no known reports of patients who have suffered an allergy or reaction to titanium, some people with allergies to other metals are reluctant to use titanium in their implants. As an alternative, there are zirconium implants that are not as versatile as titanium implants because they are made in one piece instead of two pieces like titanium implants.

Advances in titanium implants: nano-structured surfaces

Advances in implantology have led to the development of titanium implants with nanostructured surfaces, an innovation that improves the integration of the titanium implant with the bone, increasing its efficiency and durability.

This technique consists in modifying the titanium surface at the nanometer level by means of processes such as acid etching, anodization, bioactive coatings or laser nanotexturing.

Benefits of titanium implants with nanostructured surfaces

• Improved osseointegration: nanotexturing increases the contact surface with the bone, favoring faster and more efficient integration.
• Reduced healing time: thanks to increased cell adhesion, the patient’s recovery process is faster compared to traditional implants.
• Greater primary stability: the initial fixation of the implant is improved, reducing the risk of micro-movements that could compromise the success of the treatment.
• Reduced risk of infections: the antibacterial treatment of some nanostructured surfaces helps prevent peri-implantitis.
• Increased success rate: better long-term results have been observed in patients who have opted for this type of implant.

This advance in titanium implants is especially useful in patients with low bone density, such as those with osteoporosis or severe bone resorption. It is also used in immediate loading treatments, allowing rapid placement of the prosthesis, optimizing the esthetic and functional results of the treatment.

What types of dental implants exist at Adeslas Dental?

To substitute the functionality and aspect of the tooth, prostheses are used in the case of various absences of adjacent teeth and crowns if the absence affects one tooth, which is placed over the dental implant.

Types of dental prostheses over dental implants.

• Removable prostheses over dental implants (mucosa-supported prostheses). They are also placed over dental implants, with the difference that the patient can remove them to clean them and sterilise them. They are normally placed on patients that have no teeth at all.

• Fixed prostheses over dental implants. They are placed directly over the dental implants and are usually made of porcelain, which gives them an aspect exactly the same as a natural tooth. They do not need to be removed to be cleaned, nor do they move on chewing or eating.

Types of dental crowns on implants.

There are two types of crowns for dental implants, depending on the material with which they are made:

Metal-porcelain crown

They are made of metal inside and they are covered with porcelain to be able to imitate natural teeth, but they are not very translucent due to their nucleus. If the gum retracts, a small metallic arch can be seen on the edge. These crowns are recommended for teeth situated in the back part of the mouth and they are more economical.

Zirconium crown

They are 100% made of zirconium and 100% biocompatible, offering a more aesthetic result, since they are translucent, looking a lot like natural teeth. They are the most common type for implants in front positions of the mouth and they are more expensive.

Short implants: a solution for patients with little bone

Short implants represent an effective alternative in cases where the amount of available bone is limited, avoiding in many cases the need for bone grafting. These implants, shorter in length than conventional implants, have demonstrated similar success rates, thanks to advances in design and surface treatment.

Advantages of short implants:

• Less invasive, as they avoid the need for additional procedures such as bone grafting.
• Shorter treatment time and faster recovery.
• They have demonstrated a success rate comparable to conventional implants in patients with moderate bone atrophy.

They are an excellent option for patients with bone loss in the upper or lower jaw, in whom traditional implants may require more complex techniques for placement.

Guided bone regeneration: restoring lost bone volume

In some cases, implant placement may be limited by a lack of sufficient bone to ensure stability. Guided bone regeneration (GBR) is a technique used to increase the amount of bone available in the implant, allowing its placement in patients with bone deficiencies.

This procedure is based on the use of biocompatible membranes and bone grafting materials that stimulate natural bone regeneration. Over time, the body replaces the graft material with its own bone tissue, providing a solid base for the implant.

Benefits of guided bone regeneration:

• Allows implant placement in patients with severe bone loss.
• Improves implant stability and durability in the long term.
• Contributes to better implant integration, achieving more satisfactory esthetic and functional results.

Advantages of dental implants

People that decide to have dental implants fitted to replace missing teeth have multiple benefits, both practical and aesthetic. On once again having all their teeth, they begin to make movements and gestures normally when eating, drinking and smiling, which improves their aesthetics and their physical and mental health.

Notable advantages include:

• You recover full functionality of your mouth on regaining all your teeth.
• You can talk and pronounce without difficulties, since your tongue can move naturally.
• You can chew correctly, without having to think about that tooth that is missing.
• Your digestion improves, on being able to correctly chew food again.
• You recover your smile, without fear of exposing missing teeth, which also improves your self-esteem.

Advantages over other treatments, such as removable prostheses.

• They are more comfortable. On being fixed, implants do not need to be attached with cement nor do they have to be removed to be cleaned at night as with removable prostheses.
  
• Greater durability. With good care, dental implants last many years.
• More tasty food. Dental implants do not cover the palate, as is the case with removable prostheses, so the sense of taste is improved.
• Improved fixation. On merging with the bone, dental implants do not run the risk of moving, being displaced or falling out during their use, hence the patient can eat all foods without fear of them falling out.

Dental implant treatment phases

Dental implant treatment is carried out in various phases:

1. Implantological study. A personalised assessment is made of the case, in which aspects such as bite and the shape of the mouth are studied. X-rays are necessary, which may include 3D scans or computerised axial tomography (CAT) scans. This study helps to correctly position the dental implant in the bone.

2. Placement of dental implants. The surgical procedure begins with the application of anaesthetic in the indicated area. With the anaesthetised area, the bone is prepared in which the implant will be housed through a sequence of burrs introduced from the smallest to the largest. Once drilled, the implant will be placed and, if necessary, the injury will be sealed with stitches.

3. Integration of the dental implant into the bone and tissue. Following the surgical procedure, the fusion of the titanium dental implant with the bone takes from two to sixth months. Once merged, the definitive prostheses can be fitted.

4. Placement of the dental prostheses. Once the dental implant has been perfectly integrated, imprints will be taken to manufacture the new teeth. Tests are performed to ensure the aesthetics and functionality of the new teeth and they are cemented or screwed onto the implant.

5. Recommendation of stress-breaker mouth guard. To protect wear and tear, both of your dental implants and the porcelain prostheses, the use of a stress-breaker mouth guard is recommended. Dental implants do not have periodontal ligatures so they do not cushion the chewing forces and the prostheses can suffer overloads. Furthermore, porcelain is more fragile than dental enamel, so you must protect it even more.

6. Maintenance and hygiene. Once the process has been completed, it is important to maintain daily oral hygiene, including brushing and the use of dental floss. Lastly, it will be necessary to regularly visit the odontologist and hygienist, to ensure that the operation has been successful and that the implant is stable and that the crowns or prostheses have been correctly placed over it.

New technologies in dental implantology: Guided surgery and immediate loading

Thanks to advances in implant dentistry, it is now possible to perform more precise, comfortable and predictable treatments for patients. Technologies such as computer-guided surgery, immediate loading, short implants and guided bone regeneration have transformed the planning and placement of dental implants, improving treatment accuracy and outcomes.

Guided surgery and immediate loading

With these technologies, three-dimensional images of the mouth are obtained, allowing professionals to virtually study, diagnose and plan implant treatment in detail and with greater precision.

By means of a CAT scan and a specialized computer program, 3D images are obtained, which allow the best treatment possibility to be studied in order to then apply the best technique, improving the efficiency of the position of the implants, reducing the intervention time, minimizing inflammation after the operation and, on occasions, allowing the teeth to be placed on the spot.

What is the process of computer-guided surgery?

The first step is to obtain a CT scan of the patient and then plan the treatment on the three-dimensional computer image. Models of the patient’s mouth are also taken, a splint or guide is made to locate the holes through which the drills and implants must pass and, finally, the minimally invasive surgery is performed.

What are the advantages of this technique?

Technically, it allows the dental implants to be placed in the most suitable position with regard to the quality and amount of the bone, thereby supporting the future prostheses. Furthermore, it is not necessary to open the gum, so the post-operatory period is easier to bear for the patient, reducing pain and inflammation to a minimum.

What does the immediate loading of the implants involve?

Since a preliminary planning has been conducted of the exact location in which the dental implants will be placed, provisional teeth can be prepared, which will be anchored to the recently placed implants, achieving an aesthetic and functional situation that is easier to bear for the patient until the placement of their definitive prosthesis.

In addition to these new technologies, a further step has also been taken in the prosthetic part of the treatment with the use of dental scanners, allowing the manufacture of the prostheses without the need to take imprints and, on occasions, without the need to carry out verification and adjustment tests, thereby ensuring less inconvenience and fewer appointments for the patient.

There has also been progress in the prosthetic laboratory phase, allowing prostheses to be designed digitally and manufactured by computer-guided planing machines.