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Implants

Dental implants are titan screws that are applied to the jaw bones. Due to their usability of carriers of the dentures the dental implants adopt the function of artificial tooth roots. In so doing they are generally screwed (thanks to their screw thread) into the jaw bone (enossal implants) or they are simply plugged in. They connect within 3 to 6 months with the surrounding bones to a tight, utterly stable carrier unit.

What is an implant?

The implantation is the dental prosthesis that is a surgically screwed artificial tooth root in the alveolar bone, which has been a practised and successful procedure for years. The implant mostly consists out of titan that is marked of a extraordinarily high acceptance of tissue and thus enables the bony adhesion between the implant and the bone possible. The implant causes, as has been proved, no malignant changes in the organism whatsoever.

Who comes into question for this?

Everyone who can maintain a good mouth hygiene and when no further contraindications occur that disapprove the intervention. The bony integration of the implant takes place with no problems at 95%-97% of the patients, beyond that there are several factors that are decisive for the success of an implantation; furthermore diabetes, severe cardiovascular diseases increase the risk in case of implantations; at patients under 18 years or pregnant women the implantation is not recommendable;

Preconditions:

  • good mouth hygiene
  • high willingness to co-operation
  • sufficient and corresponding amount of bones as well as consistence (good anatomic preconditions)

Preinvestigation:

  • oral examination
  • radiograph (panoramic x-ray, 3D x-ray), in severe cases a topography
  • study model

What is the meaning of implants in dentistry?

There can be a natural substitutes for each missing tooth, along with the root:

  • single teeth can be replaced, without grinding the neighbouring teeth
  • in case of multi-chain tooth gaps or missing of the last teeth in a quadrant, a fixed bridge can be produced and you can do without removable prostheses
  • in case of toothless jaws a fixed denture with several implants can be ensured, or the stability and thus the feeling of comfort when wearing the prostheses can be increased

Indicators:


- Single denture (as an alternative to bridges so that the neighbouring teeth do not have to be ground off)


- Posts of bridges (often an advantage if no fixed provision would be possible anymore)


- Holding anchor for prostheses (in order to increase the stability of prostheses)

Who is qualified for implants?

Patients must have a good general health status. Moreover the patient must display a healthy gingival structure as well as sufficient horizontal and vertical bones of adequate quality. Unfortunately it often occurs that there is not enough bone available. This is often the case when the tooth loss has taken place long before the implantation and thus the body has degraded the alveolar bones. If this is the case, in many cases a bone construction can be made in order to recreate the missing bone.

Kinds of implantations?

Instant implant
The implant is inserted in the alveole immediately after the extraction. (for this purpose the alveole has to be infection-free, this can only assess the treating implantologist after an examination, does not occur this often)

Late implant
At this you need to wait at least 3-6 months after the extraction until there is he possibility of implanting, as the bone needs to be healed totally, in order to enable an adequate Osseo integration. This is the far more frequent and successful method that which is applied in practise.

Procedure:

Implantation:

Under local anaesthesia the implantation spot is exposed by a cut through the gingiva. After that the implant is inserted into the bone after preboring and the gingiva is again closed above the implant through a suture. The suture has to be removed again after app. 7 days.
(Often the healing screw can be put onto the implant right at that appointment, then there is no second opening necessary.)

Healing period:
3-6 months

Opening and gingival formation:
The head of the implant is exposed through a small cut and a healing screw is screwed onto the implant. This screw needs to heal in at least for 7-14 days because in this time the mucosa has to form around the neck of the implant similar to a natural tooth so that an optimal aesthetic result can be ensured.

Formation:
The healing screw is exchanged by an implant post and the dental technical impression is made. The dental technician then produces the particular denture corresponding to this impression.

Integration:

The finished denture is fixed to the implant post.

Extent of time:
You have to calculate on app. 3-6 months from the moment of the implantation to the ready tooth. If there is still a tooth available at the spot of the implantation and if this one still has to be extracted, you can calculate on another 3-6 months. The exact procedure is decided by the treating doctor.

Sinus Lift:
Unfortunately after a long adontia it can occur in the upper jaw that the maxillary sinus grows towards the oral cavity. That means that there is not enough vertical bone available for an implantation. In this case the implantologist can lift the sinus by the use of a surgical intervention. This is later converted to own bone by the organism. This intervention can take place simultaneously with the implantation or has to happen 6-8 months before the implantation. For this purpose the extent of the loss of bone is decisive.

What can be done in case of too few bone?

If the existing bone is not sufficient for the implantation, a bone construction or a substitute can be made. For the implantation a thickness of bone of 6mm is necessary and a length of bone (in the direction of the implant) of app. 8-10mm is necessary. If one of these figures is undershot it has to come to the bone construction with sterile and compensatory bone material that is gentle to tissue (e.g. Bioos), further on also own bone can be extracted for this purpose.

It often occurs in the upper jaw in the lateral tooth area that too few bone is available. Due to longer adontia the bone is degraded especially fast, here is also the maxillary sinus located, so if the bone strength between the oral cavity and the maxillary sinus does not suffice, a so called sinus lift has to take place. At this the mucosa of the maxillary sinus is lifted and like this the compensatory bone material is brought in here. This operation procedure is a very good and safe method to increase the amount of bone.
Whether the implantation can simultaneously take place with the bone construction, depends on the anatomic facts and can only be decided by the surgeon. In case of very few bone the bone construction has to take place at first, only then the implant can be applied after 6-8 months.

Compensatory bone = Augmentation

If there is not enough bone available, the missing bone can be completed with compensatory bone material. This intervention can take place simultaneously with the implantation or has to happen 3-6 months before the implantation. The extent of the bone loss is decisive for this.

What types of implants are there?

There are several hundreds of companies on the whole world that deal with the production of implants and the screws and burrs that are necessary for this. We offer two types of implants to our patients – Nobel Biocare, the brand leader among the implant producers, and Pitt Easy , a German product from Oraltronics.
Nobel Biocare is market-leading among the implant producers, their implants are considered as very well compatible, persistent and aesthetic. In 1950 the basis for implantation was made from Prof. Bränemark. Due to his results it came to the foundation of the company Nobel Biocare. This company thus has the longest experiences with implants on the market. Very intense research and development have lead to the production of the implant systems that are used today. The Nobel Biocare products that are used by us permit a precise, aesthetic and stable implant solution. The special form and surface condition even often enable an instant implantation simultaneously with the extraction. Moreover they provide the facility of the application of zirconium abutments, with the aid of which perfectly aesthetic results can be attained. Beyond that this company offers a multitude of abutments that contribute to the solution of a lot of problems.
Pitt Easy is a German product from the company Oraltronics. It offers a cost saving alternative to Nobel Biocare. These implants are used for the production of fixed prosthetic solutions or their stability is also sufficient for the attachment of prostheses.

Aftercare:

After the production of the dentures an optimal mouth hygiene is required. Furthermore check ups are indispensable, here radiographs are made in order to test the condition of the implants and a professional dental hygiene can be accomplished when needed.

Complications:

Although implantations are a quite safe matter nowadays, it happens that implants are repulsed by the body, that means that they do not grow in bony. This happens quite seldom, but there is the possibility. Experience has shown that an optimal mouth hygiene can benefit the integration of implants. On the other hand it is also proven today that smokers, diabetics, persons that are ill with osteoporosis, as well as cancer sufferers have to expect with an increased rate of repulsion.
Moreover it can come to bleeding, swelling, postoperative pain as well as unexpected allergic reactions or infections comparable to every other operation. In order to dam the danger of infection, antiseptic mouth rinse and an antibiotic therapy will be administered to you.
In case of implantations in the lower jaw the very near proceeding mandibular nerve can be hurt, at what it can come to sensory disturbances in the lower jaw and the area around the tongue.
In case of upper jaw implants it can come to the opening of the maxillary sinus.