implantology

If we talk about what a dental implant is and define it simply, we can say that it is artificial tooth roots that are made and placed in the jawbone to replace missing teeth in areas where tooth loss occurs. Dental implants are screws made of titanium.

After teeth are extracted, the bone surrounding those teeth begins to melt over time, this is called resorption. As a result of this loss of bone, the chewing function cannot be performed properly. Speech problems occur, the profile of the face deteriorates, lip support disappears, wrinkles around the mouth increase, and the tip of the nose and chin come closer together. For these reasons, implant placement should be considered to replace the roots of extracted teeth. The bone forms a tight bond with the implant surfaces (osseointegration), allowing them to function like natural teeth. Biting and chewing functions stimulate the bone and prevent osteoporosis. During the process of replacing missing teeth, healthy teeth are left untouched.

Implant is a treatment method that can be applied at any age. However, bone development needs to be completed in young people. This occurs until the age of 16-17 in girls and 18 in boys. There is no upper age limit for adults. It can be applied to people of all ages with suitable general health conditions. Older people need dental implants more because they lose more teeth and there is melting in their jaw bones.

Implant applications are performed at least 3 months after tooth extraction, so that the bone where the implant will be placed can re-form at the extraction site. In some emergency cases, implants can be placed in the same session as tooth extraction. These types of implants are called immediate implants. Although the prosthesis construction time is shortened in this way, it is not a preferred method in our clinic. Your physician will share with you more detailed information on the subject.

Surgical Operation: In the first operation, your dentist places the implant in the jawbone. The operation can be performed with local anesthesia without any pain or discomfort. Most of the time, it is even a simpler operation than tooth extraction. During the operation, you will only hear slight vibrations caused by the treatment. Operation time varies between 15 minutes and 1 hour depending on the number of implants to be placed.
During the operation;

• An incision is made to see the bone,
• The hole where the implant will be placed is opened,
• The implant is placed,
• The implant is covered (with a temporary healing cap) and the incision is stitched back to its original state.

There may be slight pain in the evening after the implant procedure. Many patients state that this pain is milder than the pain experienced after tooth extraction. This pain can be relieved with mild painkillers. In many cases, this is not even necessary. You will not even feel the presence of the implants after the treatment is completed.

After the operation; You will rest for a while in the clinic. To stop the bleeding, you must bite the gas tampon given by your dentist. Your dentist will write you a prescription in case of pain and inform you about post-operative procedures and follow-up appointments. After the operation, you should eat soft foods such as soup or mashed potatoes. If you are using a prosthesis, your dentist may ask you not to use your prosthesis until the stitches are removed. The day after the operation, you can start rinsing your mouth with salt water or the mouthwash prescribed by your physician, brush your teeth, use dental floss, and continue your normal daily activities. You will usually be able to continue your normal life the day after the procedure and return to work within a few days. You need to visit your dentist after a week to have your stitches removed.

Sinus Lift: There are spaces called sinuses in the right and left parts of the upper jaw bone (maxilla). The main function of these spaces is to reduce the weight of the skull bones. These cavities can expand volumetrically under the influence of air pressure, especially after tooth extraction. This volumetric expansion and decrease in bone volume is more common in areas that have been left untreated and toothless for a long time. This may prevent implant placement in the toothless areas under the sinus.

In such a case, it is necessary to increase this vertical length by adding bone or to lift the sinus floor upwards. Some of the implant systems have produced shorter implant bodies for use in the posterior region of the upper jaw. These implants are sometimes applied directly and sometimes together with a sinus floor correction.

In the direct sinus lift process, after the square-shaped bone wall in the vestibule is thinned from the top and cut to the mucosa on the other three sides, the sinus mucosa is mobilized upwards and the bone wall is turned inward, and the base is filled with a supporting material, such as hydroxylapatite granules. If desired, the implant can be applied in the same session.

After sinus lift operations, your physician will make additional requests such as not blowing your nose violently, not sneezing, and in cases where sneezing is necessary, sneezing with the mouth open so as not to increase the pressure in the sinus, and will prescribe medications to help you in this regard.

After this stage, 2-4 months are waited and the implant provides osseointegration with the bone. In order to help the osseointegration of the implants, it is necessary to avoid excessive pressure on the jawbone (e.g. eating soft foods) and clean the gums and remaining teeth regularly. Careful care and patience are important factors that will increase the success of implant application.

Placement of Abutments: Once osseointegration is complete and the implants are fully fused to the jawbone, another minor surgical operation is performed. During this operation, abutments (small titanium connectors) that will connect the implants to the prosthesis are placed. These may be permanent abutments or temporary healing caps that will stay in the mouth until your dentist makes permanent abutments. It usually takes a few weeks for your gums to heal. Taking care to maintain good oral hygiene will also accelerate the healing process. After your gums heal, your prosthesis will be made.

Implant applications are divided into three types according to the number of missing teeth: single tooth missing, multiple tooth missing and total tooth missing.

Single Tooth Missing: If a single tooth is missing, that gap can be closed with a single implant. In traditional bridge construction, two adjacent teeth are cut and the bridge is adjusted. With this type of restoration, very good aesthetics and function can be achieved for a while, but this type of prosthesis cannot protect the bone around the extracted root, and that bone begins to melt over a period of time. Implant application has many advantages in cases of single missing teeth:

• Its appearance, function and feel are similar to those of natural teeth.
• It is much more aesthetic in the long run.
• There is no possibility of decay.
• There is no need to cut adjacent teeth.
• It is more hygienic and easier to clean than a bridge.

Multiple Tooth Deficiencies: There are three treatment options for multiple tooth deficiencies: Tooth-supported bridges, removable partial dentures and implant-supported bridges. In such a case, the superiority of implant-supported prostheses is obvious. Removable prosthesis accelerates bone resorption. In addition, clasps placed on natural teeth put excessive stress on the teeth and weaken them. Many patients using partial dentures complain that their dentures are uncomfortable and that they cannot wear them regularly. The advantages of using implant-supported prosthesis in these cases can be listed as follows:

• Its appearance, function and feel are similar to those of natural teeth.
• They are more stable and comfortable than partial teeth.
• They can perform the natural biting and chewing function. They stop the resorption in the bone.
• The integrity of facial structures is preserved.
• No damage is caused to adjacent natural teeth.

Total Missing Teeth: The tooth made on patients who have lost all their teeth is called total prosthesis. This type of prosthesis has a number of disadvantages:

• It is often uncomfortable and difficult for the patient to use.
• These types of dentures function worse than natural teeth, especially when eating.
• As the bone resorbs, the prosthesis becomes looser and comes out of the mouth when laughing or sneezing.
• Patients without teeth and with resorbed jawbone appear older.
• The use of prosthesis causes patients to feel insecure.
• Patients who use dentures often have bad breath.

It is possible to solve all these problems with implant-supported total dentures. They are more stable and prevent the change of facial contours by protecting the underlying bone.