Implants
Dr. Marco Hahn
 

 



Implants

People in need of artificial teeth, for instance a bridge or even removable artificial dentures, hear more and more about implants. What exactly are implants, for whom is it applicable, and what does it cost? Two experts explain.

It’s an enticing prospect: Artificial dentures that can’t slip or fall out – even when biting in a hard apple! That’s exactly what implants offer.

But, many don’t know enough about implants in order to weigh the pro and cons.

Here you’ll find the most important information and tips by dentists and implant-specialists Dr. Marco Hahn (Clinica Dental Cap Negret/ Altea):


 

Artificial roots are firmly embodied in the bone.

Implants are artificial roots made from titanium, which are embodied in the jaw, and serve as anchors for replacements of missing teeth, or removable artificial dentures (for instance a removable bridge). After a healing phase the new dentures are firmly secured to the implants.

Cross section of gums and jawbone: on the left a tooth, on the right an implant with an implant crown.


Implants

In comparison to conventional artificial dentures, implants have many advantages:

For instance, grinding healthy adjacent teeth in order to fit a bridge isn’t necessary if an implant is used to fill the gap. The implant is firmly attached and feels like one’s own teeth. And: “The jaw bone remains stable, while under bridges or when using prostheses, the bone regresses over time which leaves gaps and badly fitting prostheses with unsatisfactory grip”, Dr. Hahn and Dr. Kaiser point out.

The reason: The toothless jaw bone, only covered by the gums is missing the pressure that normal, healthy teeth exert on it. Under bridges and/or under the superficial pressure of prostheses the bone continues to diminish over time. This can take several years. Sooner or later however annoying gaps appear under bridges which looks unnatural and in which food leftovers are trapped.

With prostheses the problems are even more serious: when the bone has regressed prostheses easily slip, lose their grip and painful ulcerations develop. Implants, in contrast, are embedded in the jaw bone. Because of this the pressure exerted on the jaw while chewing is led deeply into the inside of the bone. The bone needs that pressure to stay strong and to keep the bone metabolism active.


How the implantation procedure functions.

Under local anaesthesia first the gums are opened and the implant bed in the jaw bone is prepared. Then the implant is brought into the bone and the gums are closed with small stitches. After ca. 10 days the stitches are removed. In the following months the implant embeds itself in the bone: New bone tissue grows around the rough surface of the implant, firmly attaching it to the jaw. After this healing cycle the gums are opened point-wise, the implant impression is made and the dentures are screwed on and/or cemented in the end. In particularly favourable cases implants can be fitted with dentures the same day.

Are implants impossible in patients with insufficient jaw bone mass?

In the contrary! Already lost bone (for instance caused by existing gaps or lost teeth), is replaced by guided bone regeneration; a procedure that is usually done in the same session as the implant. During this procedure bone material is transplanted (for instance from the lower- into the upper jaw) and/or bone grafting material is used. In many cases however bone loss has progressed so much that bone recovery takes several months before the implantation procedure can be started.

Implants with insufficient bone mass without additional bone augmentation

A new method to enable implants in patients with insufficient jaw bone (for instance in a toothless lower jaw) without additional bone augmentation is called NobelGuide TM and uses the latest computer technology. First the jaw bone is measured precisely by means of a CT-scan. With the high-precision template that is obtained the dentist can set the implants in the remaining bone using every available millimeter to the fullest. The patient leaves the practice with a securely fitting interim solution. Another advantage: The dentist doesn’t have to cut the gums open, he only needs to punch out several tiny spots. For this reason he also doesn’t have to stitch afterwards. The duration of the operation is cut in half and the patient doesn’t suffer from any complications worth mentioning.


  Implants       Implants  
             
             

What is important in the first weeks after the procedure.

During this period it’s very important to take care of the following:

No cigarettes! Toxic components in the smoke damage the wound tissue, increasing the risk of complications.

  • No milk products! Lactic acid bacteria disturb the healing process.
  • No beverages containing caffeine, like cola drinks, coffee and black tea! These beverages speed up the circulation and promote postoperative haemorrhages.
  • No alcohol! Alcohol dilates the blood vessels thereby increasing the risk of postoperative haemorrhages.

For whom are implants suitable – and which is to be considered.

 In theory one can replace all teeth with implants - single, several or whole dentures. Age restrictions basically don’t exist. Allergies against the implant material titanium practically don’t occur.

 But:

  • The doctor first has to thoroughly examine your health, x-ray the jaws and examine the oral cavity. In some cases extended examinations are necessary, for instance using CT-scans.
  • The gums must be healthy. Inflammations must be treated and heal before any procedure is started.
  • Sufficient bone must be available in order to securely anchor the transplant(s) and/or must be created through bone augmentation.
  • Diabetics suffer from slow wound healing because of poor blood circulation. Treatment only in accordance with family doctor!
  • Coagulate-restraining medicines (Aspirin, Marcumar, Plavix) increase the risk of haemorrhaging. Because of this their use must be stopped before the operation, in consultation with the family doctor and the dentist.
  • Before and after transplant procedures, antibiotics must be administered to heart patients in order to prevent bacterial infections.
  • Smokers should refrain from smoking the first 2 weeks.

Very important

  • Only let experienced specialists that had the appropriate training place implants because this is a surgical procedure! Not only the surgical but also the prosthetic experience of the treating dentist is of crucial importance for a successful implant. Ask your dentist for his qualification – if he had specialist training he will be proud to show you his certificates – or ask your dental organization for addresses.
  • Implants have, when they are set correctly and maintained properly, an excellent prognosis. Required is a perfect oral hygiene – brush twice a day, clean the inter-dental spaces daily and get professional cleaning done 2-4 times annually.
  • Not all implants are the same! Make sure that your dentist only uses quality brand implants (for instance by Nobel Biocare) to ensure quality and long-term parts supply.
  • Also with crowns, bridges and dentures that are attached to the implants ( supraconstruction ), for instance full ceramic crowns, there are big differences in quality.

Sadly, implants are not cheap – quality has its price. Depending upon the type and expenditure one should take at least € 1600,- per implant with crown into account. Bone augmentations add an extra amount to the total. To create a removable implant attached bridge for a fully toothless jaw costs from ca. € 7500,- and up. To compare: A full denture costs under € 1.000. Many private insurance companies do cover the predominant part of the costs of an implant procedure.


 
Dr. Marco Hahn
Dr. Marco Hahn