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What is a dental implant?

An implant is an artificial root, created to replace teeth that are missing or lost for any reason. By means of treatment carried out by a professional, they integrate perfectly into the mouth to the point of coexisting healthily and naturally with the rest of the tissues.

They are mostly made of chemically pure titanium in order to ensure the highest possible biocompatibility. Once integrated, they serve as support for the artificial teeth.

When is it advisable to get an implant?

In addition to the aesthetic effect and what missing teeth can mean in this respect (psychological changes such as loss of confidence and self-esteem, inhibition when talking or smiling, etc.), there are physical risks.

Missing teeth alter the normal functioning of the mouth when chewing food, which can lead to occlusal problems (how the mouth closes), digestive problems, abnormal distribution of the load on the rest of the teeth, etc. The lack of a tooth, in short, affects all other teeth that are still in the mouth.

Finally, a missing tooth can cause changes in the bone structures inside the mouth and can cause a change the shape of the bone, changes in the tissues and other disorders that later have to be addressed by a specialist using very specific techniques.

What is the treatment like when it comes to getting an implant?

The treatment has several stages, which depend on the case and the health factors of the patients themselves. The broad outline consists of the following:

  • Initial study and planning stage
  • Surgical stage
  • Restoration stage
  • Maintenance stag

What is the study and planning stage?

In this stage, a case study is carried out with the aim of deciding on the ideal time and manner in which to carry out the treatment. This is also when the patient is informed of his/her case and all the necessary details given. The patient’s oral health and general condition are assessed.

Similarly, a treatment plan is created that includes information about the case, the treatment and the expected outcomes.

What is the surgical stage and what does it consist of?

The placement of a dental implant requires prior preparation, in which the implant bed is created. Depending on the case, it can be done in one or two operations.

If it is done in one session, both the implant and the attachments (components required for the placement of the artificial tooth) are put in place. The decision of whether or not to place the prosthesis after the surgery depends on the professional and the state of the patient’s health.

In the case of a two-stage procedure, the first stage is used to insert the implant. The second session, which is usually carried out several weeks later, is used to place the prosthesis, which joins the artificial tooth to the implant.

The standard 1-stage process usually takes 2-4 months, while the 2-stage process takes 3-6 months and may take longer in some cases.

What is the restoration stage?

This stage involves the crown (the artificial tooth) being placed and attached to the implant in such a way that it forms a single stable and long-lasting structure.

This stage is carried out only when the integration process has been proven to be good, is progressing as planned and there are no anomalies that could affect the outcome. This stage may take several sessions as it requires the involvement of specialists other than the implantologist in the process. The new tooth must have a perfect fit and an aesthetic finish similar to the rest of the teeth.

What is the maintenance stage?

Implant treatment does not end once the tooth is in place, and requires regular check-ups to ensure that the result is satisfactory. These check-ups verify that there are no anomalies, can detect and prevent any possible future complications and, in the event of finding any kind of problem, it can be dealt with. In the most likely event that no problems arise, diagnostic and preventive routines are carried out to ensure the long-term health of the treatment.

Is implant treatment unpleasant?

The surgical treatments associated with the placement of implants follow very specific protocols and generally do not involve discomfort or any discomfort is minimal.

The vast majority of treatments are performed under local anaesthesia and only the noise of the instruments used by the professional can be heard and the normal pressure at the time they are used can be felt.

After treatment and once the effect of the anaesthesia has worn off, it is normal to feel some slight discomfort. In some very special cases there may be inflammation or bruising in the operated area. This is no cause for alarm, as it is a natural body reaction and indicates normal tissue regeneration in the human body.

I have been told that I need bone regeneration. What is this?

The area of the bone into which the implant is to be inserted must have a minimum volume to ensure the success of the treatment. That is why it is sometimes necessary to apply bone regeneration techniques, which consist of stimulating the body to create bone either to correct bone defects or to create a base in areas where without this procedure it would be impossible to place an implant.

These techniques require time to heal, so they lengthen the duration of the treatment.

How is the implant attached to the bone?

Bonding occurs through a natural process called osseointegration, in which the bone regenerates and bonds directly to the surface of the implant. When this bonding has taken place, the implant is firmly attached to the bone structure of the mouth, forming part of it.

The bond is very durable over time and that is why implant treatment produces satisfactory long-term results.

How much does an implant treatment cost?

Implantology treatment requires several professionals from different fields. In addition, the procedures and means used in the procedure are of a high technical standard. Treatment cost will depend on the equipment involved, the materials needed and the treatment times.

This entails a higher cost compared to other alternatives, but generally provides long-term benefits that are not otherwise attainable.

Is it necessary to have an implant for every missing tooth?

No. If there are several teeth missing and they are in the same section (a row of missing teeth), a bridge is made, which is supported by the minimum number of implants possible, as long as the success of the treatment is ensured. This avoids unnecessary surgery and facilitates post-treatment.

How long does the treatment last?

As with other dental treatments, the life span of the implant depends largely on the health of the patient, oral hygiene and the physiology of each individual. No estimate can be given that is applicable to most patients. It is the professional who, after a study of the case, will know how long the implant will remain in the patient’s mouth.

There is no known expiration date for dental implants and there are patients who have had them for more than 30 years.

What does it feel like to have dental implants?

Objectively, there is no difference in feeling between a natural tooth and an implant once the implant has been osseointegrated and the prosthesis has been properly placed. The difference is so small that it is not noticeable. If the treatment has been carried out properly, it allows for chewing, biting, etc. with more confidence and the same or greater stability than with a natural tooth.

However, in the case of having to replace a whole set of teeth, a “semi-fixed” prosthesis is used. This has a small degree of movement, but still provides high levels of stability and firmness.

What is the difference between the implant and the prosthesis?

The implant and the prosthesis usually form an assembly in which the implant simulates the root of the tooth (it is the “screw” that is integrated into the bone of the mouth) and the prosthesis is the visible part that includes both the base structure and the crown (the artificial tooth). Therefore, the only visible part is the prosthesis, covered by the crown, which goes on top of the implant.

What types of prostheses are there?

In general, we can distinguish between four types of prosthesis:

  • Single-tooth implant: replaces a single missing tooth without altering the neighbouring teeth.
  • Partial restoration: when several adjacent teeth fail. In this case there is no need for one implant per missing tooth, but rather a structure is created that is fixed to the minimum number of implants possible.
  • Complete fixed restoration: in the case of a completely toothless patient, a structure can be created which is supported by 4 to 8 implants (depending on the case) in each arch.
  • Overdentures or removable prostheses: these are full denture prostheses that are retained by means of anchors attached to the implants. The patient can remove this prosthesis for daily hygiene.

What does an implant look like in the mouth?

It is difficult to tell the difference between an implant with a fitted prosthesis and a natural tooth. Even in dental appointments, an X-ray is often necessary to detect implants. However, certain anatomical conditions may affect the final result. The specialist will be able to tell you what effect to expect and how to achieve the best aesthetic look in each case.

Can they be fitted if I have gum disease?

Implants can be affected by periodontal diseases just like natural teeth. Before starting a treatment with implants, it is highly recommended to treat the disease, thus avoiding complications in the treatment. By doing so, treatment times can be reduced and problems such as peri-implantitis can be avoided. In the event that you have suffered from a periodontal disease, you must notify the specialist before undergoing treatment with implants. Even if it has already been treated, any such disease is chronic and may recur in the future, making treatment difficult.

Can the body reject an implant?

Implants are made of chemically pure titanium, which is biocompatible and does not produce any allergic reaction or rejection once placed in the human body.

However, in some cases it is necessary to remove the implant after it has been placed. These cases do not depend on the implant, but on a lack of osseointegration, poor oral hygiene, an infection of the area or other factors of the patient’s health that affect the normal development of the treatment.

What do you do if you lose an implant?

Although it is an unlikely event, specialists know how to act in cases such as this.

If the implant is lost before inserting the prosthesis, the causes are studied and corrected to prevent it from happening again. In the event that the implant is lost after the placement of the prosthesis, it is removed and the process is the same as in the previous case.

On some occasions it is not necessary to remove the implant and it can be used to place another prosthesis once all the issues that could cause complications have been resolved.

What problems can result from dental implant treatment?

The success of an implant treatment depends on several factors, including the implant or treatment as well as the patient’s own factors. This means that the stages of treatment and their correct execution as well as the general and oral health of the patient are involved.

In the initial stages, sometimes the implant may not be fully osseointegrated, so the treatment can be extended to ensure that the implant is stable within the mouth. Once osseointegration has taken place, problems can arise if the prosthesis fractures or is badly placed. Furthermore, throughout the treatment, the oral hygiene and care carried out by the patient play a key role in the success of the treatment.

If the case has been carefully studied and the treatment carried out by a professional, and the oral hygiene and maintenance visits are completed by the patient, a successful and healthy implant is almost fully assured.

Are implants removable and replaceable?

Once the implant has been osseointegrated it is so stable that it can only be removed by the specialist using “rescue” techniques. Normally, removing an implant is not necessary, except in special cases.

The part that can be removed and replaced is the prosthesis, which is fixed to the implant but not integrated into the bone.

Is there a maximum age for getting a dental implant?

There is no age limit for treatment, but it depends on the state of health of the person. The specialist will always carry out the necessary tests before starting to treat a person in order to ensure that the case will not be problematic and will result in the best possible outcome.

However, there is a minimum age, which depends on each person’s growth. It is not recommended to get an implant until the body has finished growing and fully developing all the bone structures.

What factors can influence an implant treatment?

Implant treatments follow specific protocols and there are ways to treat almost any case. Even so, to ensure the success of the procedure, it is necessary to inform the specialist of any factor or condition that may influence the normal course of the operation. These factors include pregnancy, diabetes, osteoporosis, alterations in blood clotting processes or other factors that alter the structure and behaviour of body tissues and fluids.

How does smoking affect the implant treatment?

Smoking has a very negative effect on any treatment, not only in the case of implants.

The effects of smoking include reduced blood supply, altered tissue, reduced ability to regenerate tissue and increased risk of infection.All this affects the outcome of the treatment.

It is now known that the risk of failure of an implant treatment is much higher in smokers than in non-smokers.

Can they be fitted if I have gum disease?

Implants can be affected by periodontal diseases just like natural teeth. Before starting a treatment with implants, it is highly recommended to treat the disease, thus avoiding complications in the treatment. By doing so, treatment times can be reduced and problems such as peri-implantitis can be avoided.

In the event that you have suffered from a periodontal disease, you must notify the specialist before undergoing treatment with implants. Even if it has already been treated, any such disease is chronic and may recur in the future, making treatment difficult.

How can I identify a periodontal disease?

It is up to the specialist to make the diagnosis after a study of the person’s oral health. Even so, some symptoms of periodontal diseases are:

  • Bleeding gums (not seen in smokers)
  • Halitosis (bad breath)
  • Red and/or swollen gums
  • Presence of tartar or excessive plaque
  • Receding gums
  • Movement and/or separation of the teeth
  • Loss of teeth