What are dental implants?
Sooner or later in life, many people come to a point where they have lost one or more teeth. In most cases, the best way to solve this problem is by placing a dental implant. A dental implant is a replacement for the root or roots of a tooth. Like tooth roots, dental implants are secured in the jawbone and are not visible once surgically placed. They are used to secure crowns, bridgework or dentures by a variety of means. They are made of titanium, which is a lightweight, strong and biocompatible material.
What are the advantages of dental implants?
- Improved appearance.
- Improved speech.
- Improved comfort.
- Improved self-esteem.
- Improved oral health.
Am I a candidate for dental implants?
Generally speaking, if you have lost teeth, you are a candidate for dental implants. It is important that you are in good health, however, as there are some conditions and diseases that can affect whether dental implants are right for you. Therefore it is important to let your dental surgeon know all about your medical status (past and present) together with all medications you are taking, whether prescribed, alternative (herbal) or over-the-counter.
Types of dental implants
There are two main types of dental implants: immediate and late implantation. It is important to discuss with your implantologist which method best suits your particular case.
How painful are dental implants?
Usually, local anaesthesia is used during the procedure, and most patients report that implants involve less pain than a tooth extraction.
After the dental implant, you will be prescribed painkillers that will combat any pain, and mild headaches as a result of a muscle strain can be treated with over-the-counter pain medications.
How do I care for dental implants?
In the early post-operative phase it is critical to follow the oral hygienic advice given by your dentist so the healing is rapid and infection is avoided.
Once healing is complete, the implant requires thorough and regular care. The success of the procedure depends very much on the personal responsibility of the patient. Regular dental check-ups are required.
Immediate basal implants
These are a revolutionary and completely new method for dental implantation, where there is no need for bone augmentation even in the worst cases. The implants are made of biocompatible titanium alloy. Basal implants are one single unit (the implant and its supporting structure are connected).
Basal implants differ from classical implants in the manner of placing, and the manner of force distribution, but primarily by the planning and execution of the prosthetic construction and post-operative regime.
The crowns placed over basal implants are the conventionally used crowns: Full porcelain crowns, Porcelain fused to metal crowns, Zirconia crowns and CAD/CAM crowns.
Characteristics of basal implants:
- Basal implants can be placed even in cases of severe bone atrophy – patients with advanced periodontal conditions can be treated with basal implants in one visit.
- Basal implants are suitable for almost all patients, even those without any teeth.
- Basal implants can be placed in smokers and patients with diabetes.
- Basal implants have a 98% success rate that is a higher rate than one of the classic implants. Often this success is due to the avoiding of bone grafting and sinus lift.
- Patients can get their teeth fixed in 3-4 days. Basal implants can be placed immediately after extraction of teeth in one visit. Therefore this method is less traumatic than the classical implants method.
- Potential complications of implantation are minimised because the placement is associated with less invasive surgery, and implants are placed in the deep layers of sterile bone. This reduces the risk of infection several times compared to the classic implants.
- The requirements for oral hygiene of the patient are less demanding because of the resistance of basal implants. The postoperative care for the implants includes excellent oral hygiene (brushing teeth, using dental floss, mouthwash) and regular check-ups. Otherwise, it is very likely to that the implant will be compromised and could be lost.
- Placement of basal implants has a lower price than the classical procedure because of the reduced treatment stages.
- Basal implants are the first choice for moderate or severe atrophy of the jaw, and in cases where patients want immediate restoration of masticatory function.
- Can be used as an anchor for bridges and dentures and allow the patient to immediately restore masticatory function.
- Single crowns can also be placed over basal implants. They are loaded immediately only in certain situations.
Delayed classical implants
Late implantation is a two stage process.
Two stage late implantation:
This is the most common technique is implantation, consisting of:
- Removing the damaged tooth.
- Preparing the jawbone for surgery, a process that may involve bone grafting and/or a sinus lift.
- Placing the dental implant metal post into the mouth
- A healing period that may last several months. During this process, the jawbone grows into and unites with the surface of the dental implant.
- Placing the abutment (structural element) — an extension of the implanted metal post.
- Placing the new artificial tooth (crown).
The most important advantage of this type of implant is that it provides a longer period of osseointegrated implant in the bone – meaning the bone and implant connect together better.
The limitations of the two-stage implants are the extended length of time of the procedure and the inevitable loss of tissue that occurs during the second stage of the procedure.
Your guide to immediate basal implantation
Single jaw procedure:
This can be the day of your arrival in Sofia.
- First you will have a digital panoramic X-Ray of your teeth. The digital X-Ray provides a more clear and accurate image, as well as less radiation.
- After that you will meet the medical team to have a consultation, discuss and confirm the plan of treatment. The paperwork will be completed as well.
- Your premedication will begin. A consultation with a cardiologist and allergologist will be performed.
- After the premedication is completed, a decision as to whether to proceed in the same or the next day will be taken.
This process will be completed within approximately 60 minutes.
This is the day of the surgery.
- You will be offered a choice of musical background to suit your taste.
- Under a local anaesthesia (general anaesthesia is used very rarely, due to the higher risk involved) the teeth extraction (if necessary), implant placement, and plastic correction of the soft and hard tissues are performed.
- After surgery, your blood pressure is taken, and you will have a consultation with a cardiologist.
- The impression of the implants is taken, and a preliminary colour of the crowns is determined.
- Upon discharge from the surgery, you will be prescribed antibiotics and pain killers. Detailed advice on your post-operative regimen will be presented to you.
- In the end, you will have a check up panoramic digital X-Ray.
The operation usually takes between three and four hours. In more complicated cases it can take five to six hours.
In the evening at about 6 or 7pm, you will visit the dental practice.
- A metal example of the construction will be tried on, to judge if it fits well and if you like the shape.
- A final definition of the colour of the crowns will be done.
- Threads are checked up, and general state is examined. You will be asked if you have pain or any other problem.
This process will be completed within approximately five to 25 minutes.
In the evening at about 6 or 7pm, you will visit the dental practice.
- A ceramic example of the construction will be tried on.
- If there are no major corrections to be made, the cementing takes place after the threads are removed.
- If large corrections are necessary, the structure is returned to the dental laboratory. Hence the cementing will take place the next day.
- If there is swelling, the cementing is postponed.
This process will be completed within approximately thirty to sixty minutes.
Double jaw procedure:
The procedure is the same as in a single jaw, repeated sequentially with a few days of rest in-between. It is recommended to plan a stay of approximately ten days.
Please be aware that in the case of immediate basal implantation, sometimes the process of the natural remodelling of the gums can cause substantial shrinkage that can lead to the appearance of some space between the gums and the crowns. In this case, a conservative treatment consisting of prosthetics can give a cosmetic correction. This can happen about twelve months after the implant treatment.