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About Dental Implantation

Dr. Timo Paberit, surgeon at Merimetsa Dental Clinic

Implantation is the safest, most aesthetic and natural way of replacing teeth. This article explains the procedure and its advantages.

What is dental implantation?

Implantation is the safest, most aesthetic and natural way of replacing teeth.  It is no longer a very new method; it has been an alternative to other types of prostheses for nearly 30 years. In Estonia, implantation has been performed for over ten years.

What are dental implants?

In essence, dental implants are titanium screws that are placed into the jawbone during a minor surgery to replace the missing roots. After the screw has bonded into the jawbone, a crown made of metal and ceramic (an artificial tooth) will be made. The implants can also be used to support removable prostheses. The implant replaces your missing roots and helps to preserve the quality of the jawbone. Other types of prostheses do not compensate for the loss of your own root and changes in the jawbone start immediately. As a result, the jawbone collapses in that specific area. This also impedes or even prevents the use of any type of prosthesis later on. In addition, implants help to divide the force of biting evenly between the teeth, preventing the overuse of existing teeth.

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The situation shown above can emerge if the missing tooth is not replaced in time. The jawbone between the two teeth collapses and the surrounding teeth lean towards the void. This, in turn, may cause several problems: additional gaps between teeth; loss of contact between the upper and lower teeth due to the relocations; this, in turn, may impede chewing in that area. If several teeth are missing, the overuse of your existing teeth is inevitable, and this may result in further tooth loss. Inclined teeth may make it hard or impossible to use any other type of prosthesis. To sum up, this sort of a situation can cause a lot of problems and even bigger expenses on dental care.

One of the advantages of implantations is the possibility to save the jawbone. It is impossible in case of all other prosthesis since they only restore the visible part of the tooth (the crown.) When the root is missing, the jawbone inevitably collapses; the jawbone, however, supports the soft parts of the face such as the lips, cheeks, skin etc. After the jawbone has collapsed, it is very hard to compensate for the changes. Therefore, we should save our natural teeth and roots as much as possible. In case that proves to be impossible, the most natural and stabile method of replacement is implantation. The best way is to replace the tooth immediately after extraction; this way the changes in the jawbone can be prevented.

Example:

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The photos illustrate a clinical case where the reconstruction of the tooth proved to be impossible and the tooth, therefore, had to be extracted. In reconstruction, the patient wished for the most natural and aesthetic result possible and was not interested in a removable prostheses. This left us with two choices: to install a short bridge that uses neighbouring teeth as support or to install an implant. The patient decided for an implant and rightly so, as the neighbouring teeth were healthy and in order to place the bridge they should have been significantly reduced in size. The patient was also aware that the bridge would have neither supported the jawbone nor prevented its collapse.

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Implants help preserve the quality of the jawbone and enable a close to perfect restoration of the tooth. As the photos show, a crown that is very similar to natural teeth has been installed on the implant and a small “miracle” has happened.

How are implants installed?

Dental implantation is a minimally invasive and a rather painless procedure performed without general anaesthesia. It is preceded by a consultation, X-rays and the preparation of diagnostic models. These procedures are essential to compiling a treatment plan and take more time than the operation itself.

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In order to place an implant, a small incision is made into the gum to allow access to the jawbone. With the help of special drills, a slot will be made into the bone. After the screw has been installed, stiches are placed on the wound. In certain cases, a temporary crown can also be placed immediately. In most cases, however, it takes 3-6 moths for the implant to bond with the bone and only then can a crown be made.

Here are some pictures that explain the process:

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1) A titanium screw is installed into the jawbone, it will bond with it and replace the missing root.
2) After healing, another surgery is performed during which a connection through the gum is made. After this, impressions for a crown will be taken and a dental technician will make it.
3) The extremely precise crowns are placed on the screws.
4) The result is natural and very durable.

Why prefer implants?

  • They preserve the jawbone. With other types of prostheses it will start collapsing.
  • The surgery is painless and the neighbouring teeth do not need to be damaged. Dental bridges require the neighbouring teeth to be grinded smaller and this may cause sensitivity or even a damage to the nerves.
  • Crowning natural teeth is not recommended if healthy teeth need to be grinded smaller.
  • Implants help to avoid the erosion of the neighbouring teeth and help to even out the force of chewing.
  • They prevent the neighbouring teeth from leaning towards the extracted tooth and, therefore, help avoid joint problems in the lower jaw and bite issues.
  • If installed properly and at the right time, they last a lifetime which cannot be said about crowns and other types of prostheses.
  • If necessary, different prostheses can be used and combined with implants. Therefore, in the long run, it may be a cheaper solution than paying for several crowns and bridges.
  • A low risk of failure: only a few medical conditions prevent implantation and it is impossible for the body the reject the implant.
  • They restore the aesthetic appeal of the face since the bone is preserved.
  • They help create an aesthetic and natural shape of the gums.
  • Implantation is possible immediately after the extraction.
  • In some cases, a temporary crown can be placed immediately.

 

Is implantation expensive?

At first, it may seem a lot costlier than other types of prosthesis, but you should think one step ahead. As mentioned before, implantation can actually save you money since the screws can last a lifetime. In case of other prosthesis, it may be necessary to rework them several times and the problems with teeth may never end. We also try to enable patients to pay by instalments so that the patient could get the best possible treatment.

Conclusion

As a dentist, I try to offer my patients the best state of the art treatment possible. I like to think that the patient should be treated as I would want myself to be treated. This is exactly why I want to compile a treatment plant suitable for your exact needs and, if necessary, consult with other experts. If I should have to choose a method for replacing my own teeth I would definitely choose implantation. It is the most natural and lasting method for replacing teeth.

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Dr Timo Paberit, surgeon at Kreutzwaldi Hambakliinik, is a Core Member of GAO: a full associate and an international lecturer. Dr Paberit participates in the organisation by giving lectures and presenting difficult cases to doctors all over the world.

 

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