Implants are a preferred option for replacing one or more missing teeth.

An implant is a root-shaped titanium fixture (it may look like a screw) that is placed in your jawbone with great precision. The purpose of an implant is to provide support for a crown (artificial tooth) or a fixed or removable denture or bridge.

• A crown replaces a single missing tooth in a fixed manner and connects to the implant by a fixation screw

• A bridge replaces multiple missing teeth (or even all missing teeth in an arch) in a fixed manner and connects to the implants by way of multiple fixation screws
• An overdenture is a removable device that replaces all teeth in one arch. It clips into place by attachments and is removable by you. It shares some of the characteristics of a regular denture (some degree of movement) and benefits from the implants by clipping onto them (added retention and stability and improved chewing function).

What is the general flow of implant-based cares ?

1. Examination phase

• Medical and dental history
• Clinical assessment
• 3D radiographs (CT scans or CBCT)
• Impressions to obtain casts and analysis
• Taking photographs

2. Surgical Phase

• Implant site development (Tooth extraction, bone augmentation, sinus lift…)
• Implant surgery
• Post-op and follow-up visits

3. Prosthetic phase

• Confirmation of the integration of the implants (1 to 6 months post-op)
• Impression
• Try-in and delivery of the final restoration

4. Maintenance phase

• Long-term follow-up and professional maintenance (essential)
• Periodic radiographs

What are the advantages of implant treatment?

• For patients with missing teeth, dental implants avoid preparation of natural teeth and connecting them together to support a conventional bridge.
• Dental implants avoid the use of removable dentures.
• Implants are very successful dental treatments (90-95 % success rate for the implant body after 10 years). They are in fact more successful than most dental treatments provided.
• Titanium is known by several attractive characteristics, such as biocompatibility and long-term mechanical resistance and stability and can thus be considered the materials of choice. It is widely used in Dentistry and orthopedics.
• After healing, the implant surface and your bone fuse (osseointegration) and the implant is then ready to support a crown, a bridge or a denture.

Also learn about : Needs for bone and soft-tissue augmentations

A key to implant success is the quantity and quality of the bone and gum where the implant is to be placed.

Extraction and ridge preservation

To avoid the natural shrinkage of the ridge after an extraction (30 % to 70 % of the bone can be lost after an extraction), grafting the extraction socket with bone or PRF (platelet-rich fibrin) have demonstrated to significantly reduce that physiologic resorption.

Bone augmentation (bone regeneration)

Ridge deficiencies as a result of past infections and/or tooth extractions can leave you with an inadequate amount of bone in which to place dental implants.

• To correct the problem, the void is filled with bone or bone substitute to build-up the ridge. Bone augmentation can be carried out prior to or at the time of implant placement.
• The bone defect is filled with bone or bone substitute to reconstitute a volume of bone compatible with implant placement.

Sinus augmentation (sinus lift)

The upper back jaw has traditionally been one of the most challenging areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the maxillary sinus. This procedure is performed under local anaesthetic, using either the lateral flap technique or a trans-crestal technique. Sinus Lift Procedure overcomes this problem by raising the sinus floor lining (the membrane) and developing bone for the placement of dental implants.

Soft tissue augmentation

Healthy teeth are surrounded by two types of tissue: gingiva and mucosa. Mucosa is like cheek tissue, it is weak and loose and does not adhere to the roots of the teeth or the underlying jawbone very well. In comparison, gingiva is a strong keratinized tissue that is firmly attached to the teeth/bone. Having an adequate amount of keratinized tissue is important around implants: evidence suggests that the peri‐implant soft tissues are key to maintaining long-term peri‐implant health and aesthetics. When needed, soft-tissue augmentation can be carried out prior to or at the time of implant placement or within the implant-healing phase.

Necessary follow-up and self-care

Just like natural teeth, dental implants and appliances must be maintained daily in a clean, hygienic manner (brushing and interproximal cleaning). Regular professional cleaning visits are necessary to prevent peri-implant disease from occuring.

Also learn about : Extraction of wisdom teeth