Dental Implants
What is an implant?
An implant is a titanium screw that works as an artificial tooth root. It is indicated in areas where there is a lack of teeth or where teeth need to be extracted. After being fixed to the bone, biological integration occurs between the bone cells and the titanium, providing sufficient strength to support a prosthesis, restoring the patient's aesthetics and chewing function.
Can implants be rejected?
Yes, but it is rare. Implants are biocompatible, meaning that the body accepts them as part of itself. What happens are failures related to the non-integration of the bone of the implants, which in most cases can be reversed by installing another implant. Currently, the success rate is above 90%.
What are the steps involved in installing an implant?
There are several techniques for installing implants and prostheses, but we will briefly discuss the conventional installation of an implant. It has 2 steps:
1- Surgical. In this step, the implant is installed in the bone. It will rest below the gum during the healing or osseointegration process. After the healing period, which varies from 3 to 6 months depending on the anatomical region operated on, we install a device called a healing device, which aims to give the gum a more appropriate contour before installing the prosthesis.
2- Prosthetic. When the gum is adequately healed, we begin making the prosthesis. The healing abutment is removed and a support pillar for the prosthesis is installed. The prosthesis, or the crown of the tooth, will be placed on top of this pillar..
Immediate Loading
A treatment modality that installs the prosthesis immediately or within a few days after the implant is installed. For immediate loading to be viable, it is necessary to use special implants, the patient must have good bone quality and the implant must have excellent initial locking during the surgical procedure.
Can I replace as many teeth as I want?
Yes. It is possible to replace a single missing tooth, several missing teeth or replace a denture.
Is it necessary to use an implant for each tooth?
No. It is possible to make prostheses that use two implants and rehabilitate an area with three missing teeth. Implants can be single or multiple, and the teeth of the prostheses can also be individualized or joined together. The greater the number of implants installed, the greater the stability of the prosthesis.
Do implants hurt?
Contrary to what most people think, implant installation surgery is delicate and painless. A good surgeon installs an implant very quickly and delicately. Bone tissue is poorly innervated and implant surgery is much less painless than tooth extraction.
For those who wear dentures, is it possible to have my fixed teeth back?
Yes, it is possible. In the mandible, or lower arch, the anterior region called the chin, we have excellent bone density and by installing 4 to 6 implants we can rehabilitate the entire arch. This surgery is also called the Branemark protocol. In the upper arch, there are anatomical regions (maxillary sinuses and nasal fossa) that, depending on the bone reabsorption, make it difficult to install conventional implants and often lead to the need for bone grafts or zygomatic implants, which usually occurs in people who have worn dentures for many years. However, we have techniques to resolve all types of clinical situations. The surgeon specializing in oral and maxillofacial surgery is the best-prepared professional to perform bone grafts and zygomatic implants.
lower complete denture - Branemark protocol
upper complete denture without palate
unitary substitution
Bone grafts
When is a graft indicated?
Patients who experience early loss of teeth, whether partial or total, suffer severe bone loss, both in height and in bone volume in the jaws. When a rehabilitation treatment using implants is proposed, for the procedure to be successful, there must be enough bone to stabilize the implants, in which case a bone graft is necessary to prepare the region that will receive the implants.
What are the graft options?
This can be done in several ways: removing bone from the patient himself and repositioning it where there is bone insufficiency/loss, also known as autogenous grafts, which present the best results; grafts of processed bones from animals of other species, such as freeze-dried bovine bone (xenografts); biomaterials, such as hydroxyapatite (alloplast grafts); or even through bone from a human tissue bank (allogeneic bone).
What are the possible donor areas for grafts?
There are several areas where grafts can be obtained, such as the crest of the iliac bone (hip bone), tibia, skullcap, ribs and the oral cavity itself, especially the jawbone. The oral cavity has advantages, such as proximity of the donor bed to the recipient bed, cellular compatibility, no need for general anesthesia and hospital admission, reducing costs.
Donor regions
buccal donor sites for autogenous grafts
Biomaterials
compatible biological or synthetic materials for bone grafting
Block graft
used in regions with bone insufficiency after late or traumatic tooth extraction.
Guided bone regeneration
Particulate grafts with membranes for correction of small bone defects
Maxillary Sinus Lift
What is a maxillary sinus lift?
It is a bone grafting technique on the floor of the maxillary sinus, in which the mucosa lining the maxillary sinus is lifted through a delicate surgical procedure and the bone graft is inserted underneath it. The use of maxillary sinus floor elevation techniques with the interposition of autogenous graft and biomaterials is one of the most widespread forms of rehabilitation in recent decades because it does not require hospitalization, benefiting both the patient and the professional with advantages such as reduced hospitalization costs, reduced morbidity and operative time. In some cases, it is possible to perform the graft combined with the installation of implants in the same procedure.
How long does it take for the graft to take hold?
After 6 to 8 months of performing the graft, the patient is ready to receive the implants and continue with the treatment.
Is it possible to perform the implant in the same surgery as the maxillary sinus lift?
Yes, this is a great advantage, because at the same time as the incorporation of the bone graft occurs, the implants already undergo the osseointegration process. And after approximately 6 to 8 months it is already possible to install the prosthesis.
Pneumatization of the maxillary sinus
regions with pneumatization of the maxillary sinus with bone insufficiency for implant installation
Biomaterials
Compatible biological or synthetic materials for bone grafting in maxillary sinus lift
grafting with implants
maxillary sinus lift and immediate implant placement
Bone regeneration
After incorporation of the grafts, the teeth are safely installed