In 1952, a Swedish orthopaedic surgeon named Branemark, who was enthusiastic about bone recovery and reconstruction, observed bone growth around titanium in a rabbit’s leg. Branemark continued his studies on both human and rabbit, and after several experiments, he could finally prove this useful characteristic of titanium.
Branemark decided to continue his studies and concentrate more on the mouth because he felt an increasing need here. In 1965, Branemark placed the first dental implant inside a patient’s mouth.
What is an implant?
An implant is a screw made of titanium or zirconia which is placed and fixed inside the mouth during surgery. A prosthesis is placed on top of it and it would seem as if the patient has a natural and healthy tooth.
Steps need to be taken until the patient can use the prosthetic tooth as a natural tooth. An implant looks just like a normal and natural tooth and gives the same feeling while chewing as a normal one. An implant is useful when the patient has lost functionality in some teeth and can be used for one tooth or all teeth, removable or fixed.
An implant’s biggest advantage is keeping the remaining bone and preventing bone loss. Another advantage is that there is no need to shave down adjacent teeth. An implant can also make the denture much more stable.
Implant’s advantages towards bridges
Not using the two healthy adjacent teeth while implanting is one of the advantages because in the bridge method, when you use the adjacent teeth as a base, they end up being damaged and your natural teeth eventually decay. The bone loss that had been started by tooth extraction will continue. But placing an implant prevents any damage to adjacent teeth and the fixture in the jaw decreases jaw bone loss significantly.
After any tooth extraction, the gum level would recess a little. Immediate dental implant placement is a method to minimalize this tissue loss.
In most cases, we can pull out the tooth and place an implant in the extraction socket during the same appointment. The immediate dental implant procedure is suggested for single-rooted teeth only.
Usually, it is possible to place a temporary crown on this implant immediately after the extraction and implanting. Sometimes when a patient visits the doctor with a severely damaged tooth, the tooth will be extracted and the implant would immediately be placed and crowned. Finally, the patient will leave with a new tooth. However, not all patients can use this method and the dentist has to check if it’s indicated or not.
When some teeth are lost, the bone adjacent to the teeth may start shrinking. Gum disease can also cause bone loss.
Different types of prosthesis for implants
Single tooth implant
In this method, we place a crown on one implant.
This is possible in 2 ways:
For anterior teeth, a foundation is placed on the implant and then the crown is cemented on it to get a better look.
For posterior teeth, for the ease of next steps, the crown is screwed straight onto the implant.
In this method, there are more crowns attached than implants. For example, for 3 extracted teeth there are only 2 implants.
When the patient has lost large amounts of gum and bone, we may need to rebuild the gum appearance using pink materials.
The most common problem that patients have with dentures, is a loose lower denture. This problem is fixed after placing implants.
In an implant-supported overdenture, the denture is placed on implant structures like buttons so the loose lower jaw becomes fixed.
This can be done for both the upper and lower jaw, however this need is felt more in the lower jaw.
Remaining bone and the amount of bone loss determines the number of implants. The least number of implants for a lower overdenture is two and for an upper overdenture is 4.
All on 4
This technique was invented by the Portuguese dentist, Paulo Malo in 1977.
The term All-On-4 refers to the technique in which all fixed artificial teeth are supported by four implants.
In this system, we put 4 implants in the front part of each jaw to support a fixed bridge.
One of the most important advantages of this system, especially in patients with severe bone loss, is that we can place our posterior implants obliquely to avoid the maxillary sinus and mental nerve.
Accessory surgeries for implant
Maxillary sinuses, or upper jaw, are respiratory spaces above the molars and premolars. Sometimes these teeth’s roots are placed inside the sinus.
A common surgery on this space is called sinus lift.
As long as the molars and premolars exist, the sinuses are located in their natural place. But when you lose some tooth, the sinuses grow and destroy the bone in the upper jaw.
On the other hand, losing teeth can automatically cause bone loss; the rate of bone loss is different person to person.
Bone loss means that there may not be enough bones or space for implants, thus the amount of leftover bone will be measured using radiography or a CT scan.
Therefore, if it has been a while since you extracted your teeth, a sinus lift surgery may be performed to solve this issue.
There are two methods for this:
In this method, we will use the same hole we made in the bone for the implant to place some grafting materials inside. The implant would be placed at the same time and the surgery would end easily.
This method is usually for patients who have lost lots of bone.
In this method, after raising a flap above the implant area, the bone powder and materials would be placed inside the sinus. After covering with a membrane, we will suture the place.
Depending on the amount of bone loss, we’ll place the implant in the same session or 6 to 9 months later.
A successful implanting procedure requires strong, high-quality bone. If your jaw bone has shrunk, we can rebuild it using a bone graft for a successful treatment.
The materials used for bone grafting can have various sources. Nowadays, xenografts are most common, which are usually harvested from cows.
After tooth extraction, the gum surface will recess a little. Immediate dental implant is a method to minimalize this recess, but in some cases when the space between the tooth and gum is visible in the patient’s smile, placing an immediate implant is usually not enough.
For these patients, it is recommended that they undergo a gum grafting along with the implant.
In this surgery, a small piece of the soft tissue covering the palate is taken and is placed on and around the implants. This is also recommended when the gum around the implants is not very healthy.
Exclusively from BioHorizons, Laser-Lok is the only implant surface texture shown to attract a true tight gum attachment. Laser-Lok is a series of cell-sized channels laser-machined onto the implant surface and abutments