Dental implant
A dental implant that is termed an endosteal or abutment is said to be the sole prosthesis to come into contact with the jaw and other structures of the skull to support a dental prosthesis like a crown, bridge, denture, or facial prosthesis and serve as an orthodontic anchor. The foundation of today’s dental implants can be described by a process known as osseointegration, where the materials used for such implants; titanium and zirconia materials, can undergo an intimate bonding process with the bones.
The implant is first placed in a position that it will likely osseointegrate, then a dental prosthesis is placed. Osseointegration demands variable healing time before the dental prosthesis a tooth, bridge, or denture is fitted to the implant or an abutment is placed to support a denture or crown.
Success or failure of the implants is mainly based on the thickness and health of the gum and bone tissue around the implant, but also on the individual’s health and the drugs that influence them.
The likelihood of osseointegration is also assessed. The level of stress that will be exerted on the implant and the fixation during normal use is also assessed. Placement planning and the quantity of implants are important to the long-term health of the prosthesis since forces exerted by chewing, at times, can be considerable. Where the implants are located is either decided by the location and angulation of neighboring teeth, laboratory simulations CT scans with CAD or CAM simulation, or surgical guides referred to as stents.
The most popular two types of dental implants. They basically differ from one another based on how they get attached to your jaw.
Endosteal Implants
This is the most popular type of dental implant. It is in the form of a small cylinder or blade screw. The endosteal implant is implanted into your jawbone to support one or more. If you have your own teeth or bridges, your physician can recommend that you get an endosteal implant.
Subperiosteal Implants
This is an implant that sits on or over your jawbone. This is a metal rod that is inserted under your gum and passes through to support it. You can have a subperiosteal implant if you cannot wear conventional dentures, do not have sufficient natural jawbone to place an endosteal implant, or do not wish to undergo bone augmentation to restore the bone.
Other procedures
Your physician will take into account the state of your jaw and the extent of missing teeth to make a choice between endosteal or subperiosteal implants. He can also employ other treatments, which could be suggested alongside your dental implants.
Medical uses of dental implants
The most prevalent use of dental implants is to hold dentures in place. Dental implants used now work through a biological process by which bone grows into the surface of certain materials, including titanium and some ceramics. The bonding between implant and bone can last for decades under mechanical loading without failure.
Another of the rapidly expanding uses includes the placement of implants in securing obturators. These may utilize connections to implants placed in the facial bones. Based on the particular situation, the implant could be utilized to support a fixed or a removable prosthesis intended to replace part of the face.
Single-implant restorations
Restorations on single teeth are self-contained units and not bridged to the other teeth or implants. A single missing tooth is replaced. In order to restore a single tooth, a support screw joins an abutment to an implant first. Subsequently, a crown is cemented with dental cement or a small screw to the abutment, or in a single piece of fusing together with the abutment upon fabrication. Dental implants can be employed to sustain a multi-tooth denture. They can be supplied either as a fixed bridge or removable denture.
Mini Orthodontic Implants
Dental Implants are applied to orthodontic patients for replacement of missing teeth or as a temporary anchorage device in order to permit orthodontic movement from the placement of an additional anchor point. For movement of teeth, there needs to be a force in the direction of the desired tooth movement. The force induces periodontal ligament cells to cause bone remodeling, which resorbs bone along the path of tooth movement and fills in the resulting gap.
In order to generate a force on a tooth, there must be a point of anchor that does not shift. Implants lack a periodontal ligament and bone remodeling will not be caused by the application of tension and hence they are the best points of anchor in orthodontics. Orthodontic movement implants are typically small and not osseointegrated. These may be removed simply after treatment completion.
Dental Implant Surgery
A cut at the bone crest separates the thicker attached gingiva into approximately two so that the ultimate implant will have a thick tissue band surrounding it. Each of the two ends of the tissue, and each referred to as a flap, is retracted back to reveal the bone. Another procedure is flapless surgery, whereby an area of tissue is taken out for insertion of the implant instead of for elevating the flap.
Following reflection of the soft tissue and application of a surgical guide or stent as necessary, pilot holes are inserted with precision drills at a very controlled speed so as not to burn or cause pressure necrosis of the bone.
The pilot hole is progressively enlarged with wider drills, normally three to seven consecutive drilling passes, depending on the length and width of the implant. Care is exercised to prevent the destruction of the osteoblasts or bone cells due to heat. A cooling salt or a water spray prevents heating.
The implant screw can be inserted in position; it can also be self-tapping. Alternatively, it comes into contact with the prepared area and a similar implant; in this manner, it gets screwed using a controlled torque wrench so that it does not overload the bone at large.
Gingiva is positioned circumferentially around the entire implant to provide a wide strip of healthy tissue over the healing abutment. Conversely, an implant may be submerged where the surface of the implant is covered with a cap screw, and the tissue is closed to cover it completely. A second procedure will therefore be required later to expose the implant.
Recovery Time
In order for an implant to be stable in the long term, the body needs to develop bone over the surface of the implant. With this biological activity in mind, it was assumed that loading an implant during osseointegration would cause movement that would hinder osseointegration and thereby increase the implant failure rate. Thus, three to six months of integration time, depending on a number of factors, was provided before the teeth were put on the implants.
However, more recent research has shown that the time needed for healing in order to get stability in the implant within the bone is more important for successful implant integration than the actual healing time. Consequently, healing time is based on the density of the bone that the implant is placed into and the number of implants that are combined together, not a general time. If the implants are stable against high torque and in close proximity to other implants, then there were no differences between long-term survival of the implants and bone loss in the immediately loaded implants, three months, or six months.