Implants: A revolutionary discovery

06/04/2020

The goal of dentistry for many years has been to develop a reliable system for restoring lost teeth based on a stable base or root in the jaw bone, i.e. the implant.

The ability to safely place a material on the human bone and have a reasonable time expectancy for successful operation has now become a reality with the use of osteosynthetic implants as discovered by pioneering Professor P.I. Branemark in Sweden about 40 years ago.

The keys to implant treatment are:

  • the use of high purity titanium that is extremely biocompatible with bone,

  • their shape,

  • the specialized installation technique.

This type of implant is inherently very different from the types used in the past with questionable results. Branemark's initial studies were in patients without any teeth and despite that, success rates were quite high. In general, with this type of treatment we expect more than 90% success rate in depth of 15 years.

Many factors can affect the success rate of implants, especially the individual characteristics of each patient. Below is a brief summary of the most important factors.

  1. The amount and quality of bone. The more bone there is around the area where the implant will be placed, the better for its safety. Bone quality, how strong and healthy it is, also plays a very important role in its biological stability.

  2. The number of implants used to restore an area of lost teeth must be sufficient to cope with the corresponding operating loads of chewing. For example, if a large bridge of many teeth is placed on only two implants, it is possible that these implants will not withstand the weight of chewing and will break or loosen from the bone and be lost.

  3. The patient's general health plays a very important role, especially smoking and metabolic diseases. In detail, smoking is very harmful because firstly it prevents the smooth healing of the implants after their surgical placement and secondly it constantly burdens the health of the gums in general (and therefore the gums around the implants) because it reduces their defense against pathogens. Smoking is considered to be the No. 1 risk for losing implants. From a nutritional point of view, well-regulated cholesterol and vitamin D levels have been shown in more and more studies to play a key role in the functional and aesthetic longevity of implants. Our bones need to be in good condition all the time if we want to keep our teeth and implants strong. Situations that concern the general health of the body such as osteoporosis, diabetes and other metabolic and hematological diseases, must be monitored and regulated for life. In addition, let's not forget that exercise is essential for all of us.

  4. The condition of the remaining teeth as well as the level of oral hygiene affects the implants. The presence of damaged teeth, which are sources of germs or that do not work well in chewing, will burden the implants due to microbial infection and / or overload - both of which are important causes of implant loss. Daily oral hygiene is essential to be meticulous. Implants do not forgive negligence in daily care, the presence of plaque and tartar, and the development of pathogenic microbes in their environment. Detailed brushing of teeth with a clean toothbrush and fluoride toothpaste, as well as the use of interdental cleaning agents (floss, interdental brushes), are necessary actions that must be repeated daily, day and night.

  5. Of great importance, especially nowadays in the particularly stressful way of life, is the control of the dysfunctional forces that develop in the jaws with the clenching or grinding of the teeth, which is called bruxism. It is estimated that 90% of the world's population has minor or major bruxism. During bruxism, tensions between the teeth develop, stronger than normal ones, which are able to cause extensive structural damage to the teeth, implants and prosthetic work. It is important to diagnose a malfunctioning tendency in the mouth early and to take appropriate preventive and protective measures immediately with the use of a suitable splint, and the patient should be prepared to deal with premature damage and failure to treat it.

  6. Regular visits to the doctor's office with a frequency indicated by your dentist according to your needs, which are determined by the extent of dental / implant therapy and the biological risk of the mouth - periodontal condition, tendency to caries, bruxism. Patients with periodontitis or whose teeth decay quickly should visit the dentist three to four times a year. For those who do not have such high risk factors, a simple tooth cleaning twice a year (every six months) is enough. Complete clinical and radiographic examination of the implants and careful adjustment of the convergence at specific intervals are very important for proper monitoring and good maintenance so that they remain in the mouth for many years.

It is recommended that each patient take some time and be informed as much as possible about the treatment options available for their own case.

Michalis Kalaitzakis, Surgeon - Dentist