Indent - Implantology; Dr. Med. Dent. Fagaras Octavian phd/dds

Implantology

Oral implantology is today the base of lost dental heritage reconstruction, similar with natural, without the need of sophisticated and uncomfortable mobile prosthesis or bridges attached on the healthy teeth proximal to the lost ones.

The reproduction of natural function and aesthetic appearance of the lost teeth can be very difficult to be realised. In the past, the lost teeth could have been substituted with dentures or bridges, but with limited results. However, dental implants are natural-looking replacements that also provide the same function as the natural tooth root. Implants are also used to anchor other type of dental restorations.

Dental implantation is a usual surgical procedure?

Yes, but only if it is performed by very experienced doctors with a wide casuistry. This procedure has been implemented several decades ago, to millions of patients.

Dental implantology is not a young specialty, but in the last years it has experienced an exponential growth since it offers the possibility of masticator system reconstruction without mobile prosthetics and returns the quality of life. In the same time we also speak about a sensitive area of dentistry and oral surgery, because surgery is done in delicate areas, often surgeons being confronted with not very favourable anatomical situations. So wide experience is needed to handle all these situations.

In our clinic, implantology is executed by Dr. Octavian Fagaras, with practice in implantology of over 23 years, member in various international implantology associations, lecturer in international congresses and instructor in many postgraduate implantology courses.

What is a dental implant?

A dental implant is an artificial tooth root  used in prosthetic dentistry  to support restorations similar to one tooth or a group of teeth.

Technically speaking, the dental implant is a screw (with a dental root form, equipped with coils) made out of pure medical titanium (having a perfect biocompatibility the oral cavity tissues) , which behaves identically with a natural tooth root, actually forming an artificial root. To fulfil the function of a dental root, the dental implant is inserted into the jaw bone through a short surgical action, under local anaesthesia, intervention which does not require hospitalisation. The implant is integrated in the bone without any pain and forms a solid base for long term stability and stable fixation of the prosthetic crown.

Aesthetics from first moment: According with the actual situation, it is possible  to load the implant and to attach the prosthetic crown.  However, as long as long-term success should be the priority for any treatment with dental implants, the decision of immediate dental implant loading can be taken only after the dentist carefully analysed medical wise the existing situation. If the prosthetic crown can not be immediately attached, the patient will receive a temporary restoration that will be worn until the definitive prosthetic restoration will be attached.

What happens when a tooth is lost?

Tooth loss is a problem that never comes alone; it also triggers maxillary bone atrophy and dental migration, by this raising the unwanted facial appearance problem.

The natural teeth are anchored in the maxillary bone through the roots. The occlusion (bite) and mastication (forces during bite) are producing physical stimulation of each root structure which, in turn, is stimulating the bone around it. Simply, the healthy tooth root is transferring the mastication forces towards the bone and is maintaining its strength and position.

When a tooth is lost, there are no more forces to strain the bone, by this the bone starts to deteriorate, as also the muscles which are losing mass and strength. The bone loss continues and finally leads to a change of smile. The teeth from both sides are starting to move, by this causing additional spaces and unpleasant appearance.

And the dental implant acts like a natural root!

The traditional option to replace a missing tooth is the cemented bridge. While the bridge is successfully replacing the missing tooth crown, it does not replace the root of this tooth. The consequence of not replacing the root is the occurrence of bone loss which produces an unpleasant black space on the gum.

The dental implant is the single option for replacing the missing tooth by replacing of both dental crown and root. The implant is behaving like a natural dental root, ensuring the forces’ transfer, thus preserving bone integrity.

Artificial bone addition

For dental implant procedure to function, it’s a must of sufficient bone mass in the maxillary, and the bone must be strong enough to support the implant. If these conditions are not met, it is necessary that bone mass to be added through a bone addition procedure (bone augmentation).

Simply, bone addition procedure represents a surgical intervention on the bone to increase it’s mass volume by adding bone substitutive materials (bio-materials).

Why is it done?

Bone addition is indicated/needed in the following situations:

  • to increase the bone offer in case of dental implant insert
  • to correct bone defects cause by either injuries (accidents) or following cystectomy
  • after open field curettage of the periodontal pockets in order to stabilise the affected tooth mobility

So, which are the advantages of dental implants?

Whether you are missing one tooth or all, implants are the best way to a natural appearance. Implants can help the quality of life improvement in many aspects:

  • prevent bone loss
  • allow naturally biting and chewing
  • allow you to enjoy your favourite food again
  • help eating habits improvement
  • help other teeth to be kept in natural position
  • support normal speech
  • improve facial and general appearance
  • represent a permanent solution for the missing teeth
  • simply help you enjoy life to the fullest

Implants offer many benefits comparing with conventional bridges. In addition of maintaining bone mass by replacing the tooth root, dental implants offer treatment options for conserving the healthy teeth.

Also, referring to the individual dental crown, by inserting a dental implant, adjacent teeth grinding is not necessary anymore for prosthetic restoration, as the implant will be the support for the future dental crown.

Mini implants – the ideal solution for stabilising the mobile dental prosthetic restoration

Numerous scientific tests show that more than 70% of total or partial dentures for senior patients are becoming inappropriate in time (do not adjust properly/accordingly) and significantly reduce the quality of life. Most times, this can not be attributed to the denture quality but rather to bone resorption and, in a growing number of cases to the soft tissue associated changes (gums).

For individuals age 70 and over, due to long time edentation, the bone dental ridge becomes very narrow and does not allow the standard implant insertion which requires a complex surgical procedure. In addition, these patients general condition does not allow major surgical treatment. So, small diameter implants (mini-implants)  that allow a minimal invasive insertion, perfect fit these conditions. Generally, for fixing the denture it is indicated the insertion of minimum 4 mini-implants in the maxillary. Unlike standard implants, the minis’ allow, most times, immediate prosthetic loading.

How does a mini look like?

A mini-implant is shaped like a thin titanium rod, with a support device that can be incorporated in a prosthesis. The implant upper side looks like a ball, and the support device is made out of rubber, looks like a ring and behaves like a socket. This ring is fixing the denture without breaking the upper side of the implant.

Minis’ have a toothpick size.

The minis’ advantages

  • provides denture stability so the patient can speak and eat more easily
  • no more than two dentist appointments
  • old dentures can be modified and adapted to fit these implants
  • to allow cleaning, dentures can be easily removed

Thus, at the end of the treatment, the patient will be happy to eat, talk and enjoy life  without living the inhibitions of an instable denture!

With an optimal home care and periodical professional checks, your mini implants and your stabilised denture can offer you a natural smile.

Prosthetic rehabilitation on implants – crucial for the implantology final success!

Prosthetic rehabilitation on implants is realised on well defined biomechanical and functional principles, using a face bow and individual articulator, by this allowing a more accurate semblance with the patient’s situation for the technician to obtain high quality prosthesis.

To maintain the implants health and oral hygiene, correct brushing and the use of dental floss are a must.