Teeth implantation – frequently asked questions

There are many methods of reconstructing the chewing function after the loss of teeth. These can be:

  • removable dentures (acryl dentures, nylon dentures, acetal dentures, clasp dentures and others)
  • fixed dentures (tooth crowns and bridge-like prostheses).
  • teeth implantation.

What is a dental implant?

A dental implant is a «titanium screw» that replaces the tooth root. It is placed at the first stage of implantation (surgical stage).

The second stage is installation of a healing screw and manufacturing of the tooth crown. In dentistry, it is called a two-stage implantation technique.

There is a method when implantation is used just after tooth extraction — a one-stage technique.

There is a method when an implant is placed and a tooth crown is fixed on — a one-stage loaded technique.

All these techniques have indications and contraindications.

Will an implant survive?

It is a frequently asked question. From our clinical experience, in 95%-97% cases a tooth implant is successful.

Not to be one of the 3-5% of implant non-survival cases, it is necessary to observe a number of conditions (to place a tooth implant is only the beginning of the way):

  • providing the doctor with full information on illnesses, use of medical preparations, previous surgeries and postoperative complications (even if you think that this information is by no means related to teeth, we should keep in mind that our body is integral) observance of all implantologist’s recommendations after tooth implantation.

There are several myths about teeth implants:

  • I cannot be anesthetized. Reality — implantation allows local anaesthesia (an injection is shot in the implantation site).
  • I have very feeble bones. Reality — there are implant systems especially for feeble bones.
  • I have a metal allergy. Reality — implants are made of titanium, which is bioinert.
  • It is expensive. Reality — it is relatively expensive. There are lots of implant systems with different prices. And the most important thing is that a bridge-like prosthesis can be more expensive than a tooth implant.
  • The implantation site hurts after surgery. Reality — it can hurt for several hours, after which there is no pain at all (it hurts less than with tooth extraction).
  • It heals long, it takes long time to be without teeth. Reality — permanent crowns can be placed on the lower jaw in 1,5-3 months, on the upper jaw — in 3-6 (depending on the system). But it is possible to make temporary crowns in one day or make removable dentures for the healing term.

If it falls out, I will be left without the tooth. Reality — if an implant did not survive, the manufacturer replaces it with a new one. And we will place it once again. You will not pay for the second implant.

Contraindications to tooth implant placement

Contraindications can be divided into groups:

Implants cannot be placed when a patient has:

  • blood diseases, blood-clotting disorders;
  • mental diseases (inappropriate perception of information);
  • malignant neoplasms;
  • systemic diseases of conjunctive tissues (systemic lupus erythematosus).

Implants can be placed, but under certain conditions (after full recovery and rehabilitation after acute states (stroke), after discontinuation of drugs, after oral cavity sanation):

  • poor oral cavity hygiene
  • recent surgeries
  • taking certain drugs
  • acute diseases of bodies and systems
  • rehabilitation period after previous treatments
  • taking blood thinning drugs
  • body emaciation (cachexia)
  • age under 16
  • drug and alcohol addiction.

How is an implant placed?

After the doctor, together with the patient, has planned the type of implantation and the system of implants, local anaesthesia is used. It is possible to make implantation under sedation (anaesthesia). Then a small gingiva incision is made, with the following bone bed drilling and implant placing.

Then there is installed a plug (and sutured, of course) or a healing cap, which forms a place for the future crown, or there is installed an abutment and a temporary crown.

All these variants are individual and decisions are taken in the course of treatment. Implant placement takes 15-20 minutes in average.

Which implants are better?

It is not easy to mark certain implants, but it is possible to divide them in two groups:

  • leaders are implants present in the market for over 20 years: Straumann (Switzerland), Nobel Biocare (Switzerland), Astra Tech (Sweden), BioHorizons (USA)
  • other implants.

It should be noted that implants are made of:

  • titanium GRADE 4 — most of the implants
  • titanium GRADE 5 — small diameter implants (titanium is even stronger).
  • zirconium oxide (such implants are used in the rare cases of titanium allergy).

There are differences in surface treatment. But the variants are few:

  • acid etching of surface,
  • sand-blasting of surface to create roughness,
  • both at the same time.

Is it possible to place an implant when a tooth was extracted long time ago?

If a tooth was extracted long time ago, you have several variants:

• to do nothing, and then an antagonist tooth will advance and a tooth standing beside will lean towards the defect

• to place a removable denture (butterfly) which will annoy you with unpleasant sensations and will simply fall out at the most inappropriate moment;

• a bridge-like prosthesis, for which it is necessary to devitalize (kill tooth nerves) and to face two adjacent teeth;

to place in implant — a good modern decision to return chewing efficiency.

Is it possible to place implants just after tooth extraction?

It is. This is called a one-stage technique. But for this, a patient must have no inflammatory processes in the bone and have a sufficient bone volume. In our clinic, we often use a one-stage technique. A decision on the implantation technique is taken together with the patient at the planning stage, when examining the computed tomography scan and oral cavity.

What is the correct diet after implantation?

There are practically no special dietary restrictions after implantation. More exactly, it is necessary to consider the number of implants. With 1 or 2 implants, there are practically no limitations. With implantation of edentulous jaws, you should limit yourself in spicy, salty and hard food, not to irritate the wound bed. You should not drink alcohol when taking antibiotics.

How many implants can be placed at a time?

In a single setting, it is possible to place all the teeth — 28 implants. But, as a rule, nowadays, edentulous jaws need just 6 implants in the upper jaw and 6 implants in the lower jaw to fully restore the chewing efficiency.

What is better for a badly damaged tooth: an implant or a crown?

If a tooth is badly damaged but its walls are thick, it is better to cover it with a tooth crown and thus save it. But if a tooth is badly destroyed (and needs extracting), it is possibly better to place an implant (in order not to face the adjacent teeth for installing a bridge-like prosthesis) and a crown over it.

How much time does an implant heal?

Implant healing takes 2-6 months. It depends on the system of implants and many other factors.

After dental implant placement, we get a primary stability of 25 Newton and higher. After 3-5 weeks, this stability drops by about 50-60%. In this period, one must nourish and cherish the implants, trying not to load them. And only when an implant is 3-6 months (depending on the jaw), it osteointegrates in full.

Is implantation possible with periodontitis?

Implantation is possible when there is a bone. If, with periodontitis, the X-ray shot shows that the bone is sufficient, implantation is possible. An obligatory condition in this type of implantation is strict observance by the patient of oral hygiene requirements.

What does the phrase «guaranteed implants» mean?

Practically, all implants have manufacturer guarantee. Implantation itself has no guarantee and cannot have it, as it is a foreign object insertion into the human body. And everybody is individual. In our clinic, we insert a new implant. If an implant does not survive, it is replaced under the guarantee — the patient additionally pays for the AntiAIDS package only. Thus, we give our own guarantee and save patient’s money.

How long is dental implant lifetime?

In average, an implant should be fit for use for 10 years at least. It depends on many factors:

  • the way the patient follows the oral hygiene;
  • patient’s unhealthy habits;
  • absence of injuries and any somatic diseases that can cause bone lysis (destruction).

What are the differences between Korean and Swiss implants? There are many Korean implant systems as well as Swiss ones. The main difference is the manufacturing country.

Swiss implants are leaders, as they appeared in the 1960s. Their manufacturers have been longer working on the technology of implant surface treatment, implant shape, etc.

Korean systems are practically not inferior to the predecessors, though they appeared much later. Their main advantage is relatively low cost.

As for survival, both Korean and Swiss implants give 95-97%.

What do we have all in all?

Implantation success depends not only on the doctor or implant quality. An important factor remains observance of all doctor’s recommendations, timely oral hygiene and preventive measures. Dentistry is developing fast. With digital technologies, teeth implantation became safer and complications decreased considerably.

For more information on teeth implantation in MM Dental, go to «Teeth Implantation» page.

Makarenko Maksym

Максим Макаренко Speciality: surgery, implantology, periodontology and prosthetics