What is Dental Implant?
Dental in other words applied intra orally implants generally consist of titanium based materials and have artificial root form.
In recent years, implants are produced from zirconium material. Zirconium implants are more resistant to fractures. Sometimes, in a long term period, fracture may occur especially on neck part of the titanium. Therefore, zirconium material is used instead of titanium. Thus, fractures may be prevented.
For success of implants, along with material selection implant surface also has major importance. Especially having SLA surface and surface area blasting with laser and increasing
surface volumetrically are also valuable. The success of implant is related with features of the surface. Sterilization of this surface is an important factor.
Sterilization of Implant;
While preparing implants, during packaging the implant and the packet inserted inside is sterilized at the last stage.Elimination of all bacteria is aimed. In this procedure all the bacteria are destroyed with a special procedure. If this is not performed properly, unfortunately the implant can not stay inside the mouth and it can fall.
After sterilization procedure, it is very important to store the packaged product in proper conditions. Additionally, sterilization procedure have an expiration date inside the packet. Expiration date should be considered. Those dates are indicated on packet barcode number. Those dates should be followed. Failure will be inevitable for implants with expired expiration date.
The shape of implant replaced in tooth is a factor that effects success.The first implants were thin and flat but the shape is studied due to long term failures, and evolved to a shape more like root form. This change increases the success rate.
Shape issue is moved to an advanced stage and the importance of shape selection according to implant site rises. A standard root formed implant is replaced to previous extracted bone and the grooves on implant are not aggressive. When tooth extraction and implant operation should be performed at the same session for
the patient, then the grooves of implant should be more aggressive and significant. The first integration is very strong thanks to those aggressive grooves.
It means the importance of implant placement. If the hole in other words cavity prepared for the implant is not correct, unfortunately the primary stabilization of implants can not be successful. The prepared hole may be bigger than the diameter of implant or some areas may be wider than the implant. When the implant is inserted, it should be tightly placed. The implant shouldn’t move from it’s place. The success rate increases when primary stabilization of implant is good.
İmplant manifacturers have major importance. Especially their success rate increases according to their experience in this field. A few company started implant manifacturing in 1960 and they still continue producing implants. Those companies have too much knowledge in their system. Lately implant production is started in our country. It should definitely be supported but still there is no sufficient knowledge unfortunately. It should be careful during company selection because this is an issue related with health. Some companies can be very competitive about the price however only the product quality shouldn’t be considered, companies that can provide support about the product even 20 years later should be selected.
Drill Set Used for Implant Surgery;
The most important part which should be used during implant placement is drills, they are used for preparing a hole inside the bone. The sharpness of those metal cutting rotary parts and their
feature not producing any unnecessary damage can effect success directly. If they are not sharp enough and sufficient water cooling system is not used during cutting procedure then unfortunately bone is heated. When the bone is heated, tissue death which is also called necrosis occurs on this area. There is no attachment between the necrosis area and the implant and implant will fall related development of infection. Therefore, drill care and the number of their usage is crucial.
The most important factor is the experience of the doctor who will place the implant about this field. An experienced doctor will consider all the above mentioned criteria. At the end of this evaluation, eliminates all the factors that may effect the success rate of the implant and make his/her preparations and controls according to this. Later on starts placing implants. He/she prepares the place for implant in a required angle, position and width. During preparation, he/she considers anatomical formations. Especially cares for the nerves and sinus cavities. After a careful preparation, places the implant in correct angle and in a manner that the grooves of implant are not exposed. If the placement is not correct, failure occurs again. The experience and hand ability of the surgeon is very valuable for this procedure.
After Implant Surgery;
After implant procedure, correct suturing and thigh and good primary closure is also important. After the operation, food remnants and bacterial invasion should be prevented from this field. During placement of temporary teeth, adverse forces should not be applied on implant. If there are adverse forces, they may
damage the implant. It should be careful about nutrition. Protein weighted nutrition contributes wound healing.
The effect of smoking on implant, implant and smoking
It is totally a marketing success that smoking has increasing popularity despite not having any benefit. Smoking has incredible damages in every breath. The same damages also occur on implants and teeth. Toxic materials inside the smoke and the heat of the smoke negatively effects the implant.
Poisonous gases of the smoke causes bacterial formation. The smoke reaches bone and implant from surgical margins. On the area it produces harmful micro organisms and mobilizes them. Infection develops and the implant will fall with this effect. At the same time, heat of cigarette smoke inhaled inside the mouth is about 37- 60 C. Inhalation of the smoke lasts approximately 2-3 seconds, and 30-40 mm3 smoke enters in oral cavity. This smoke damages the implant and other dental elements due to the thermal and volumetric effects of smoke.
Can Implant be Applied for Smokers?
For this reason, smoking is absolutely forbidden 1-2 days before the implant operation and the following 48 hours. If it is possible post surgically it should be increased to 1 week. It is necessary to stay away from smoking because it negatively effects tissue healing.
Bridge or Implant ?Why Implant?
The answer is definitely implant. Actually this is a question like, horse carriage or car? Selecting bridge prothesis means standing against science because there is an option to make a tooth similar to the previous one by technological and scientific developments.
Bridge Prothesis; They are porcelain based prothesis which can be done by preparing two adjacent teeth for completion of missing tooth. In this procedure, two healthy and intact teeth having life long remaining potential inside the mouth are prepared. What happens to prepared teeth later on? Those two teeth bear the load of missing tooth. This load produce trauma for teeth in long term period. At the same time, they can damage nerves during preparation of teeth and sensitive feeling continues for 2 months. They can damage gingiva in long term period. As a result, a foreign material is replaced instead of the natural one. This bridge may cause damages in long term period. Therefore frequent follow up is necessary. Closure type of mouth may also change. Therefore articular problems may occur. Color arrangement of the bridge may not be possible. By the time, tooth color may change and but bridge color will stay the same. This is a disadvantage. Additionally, bone resorption occur on the missing tooth area and collapse occurs by the time . After this collapse, food impaction problem occurs and bad smell starts. Bridge prothesis should be changed in 7-10 years.
Implant isa tissue friendly material, there is no need to prepare or touch two adjacent teeth. It is placed instead of only missing tooth.Therefore, it doesn’t damage other tissues. There is no bone resorption on missing tooth area and stays the same. Thus, there is no food impaction. Mouth closure is not change too much, because occlusion is not effected too much due to adjacent tissues are not prepared. Color matching is easier. Intra oral balances of forces stays the same and therefore articular problems are not experienced. The treatment is life long. Once the implant is placed, it stays there in life long period. Actually it is the most cheapest method when compared with the other systems.