IMPLANTS

Before an implant treatment can be carried out, some preliminary examinations and often preliminary treatments by the dentist are necessary. This is usually the case when several teeth or even a toothless jaw needs to be restored. Under certain conditions, dental implants can also be treated directly without the need for extensive preliminary examinations. 

The course of treatment for dental implants includes the following points: 

Preliminary examination of the fixed teeth, bone structure and the jawbone:

• Detailed examination of the patient's medical history and analysis of the missing teeth
• General examination of the jaw
• Take x-rays of the jaw and skull
• Advice on individual treatment options and dental implant systems

A healthy oral cavity and healthy gums are the conditions for high quality implantation and long-term success. Therefore, individual pre-treatment may be necessary in some cases.

Pretreatment of the damaged areas:

• Treatment of tooth decay 
• Removal of tooth roots and teeth that are not worth preserving
• Care of the gums in case of periodontal disease 
• Manufacture of a temporary denture 
• Bone build-up in the case of bone loss for sufficient bone supply
• Planning the treatment of dental implants by implantology 

The implantation of the new teeth: 

• Local anesthesia
• Opening of the oral mucosa and insertion of the implant screw into the jaw
• Assemble a sealing cap for closed healing 
• Impression taking for the fabrication of the temporary tooth crown
• Insertion of the temporary dentures 

The best prerequisite for a successful implantation and a flawless treatment process is a healthy oral cavity. For this, in implantology, the dentist must have successfully treated the diseased teeth or inflammation of the tooth holding apparatus (periodontitis) before placing the implant. In order for the implant to heal without complications, the patient must ensure good oral hygiene.

Healing can also be impaired by too early or unexpected stress. This can be the case, for example, with unconscious teeth grinding or clenching (bruxism).

Other risk factors that can interfere with the healing of implants are general diseases such as poorly controlled diabetes. If there are general illnesses, you should therefore consult your family doctor closely. 

Regular check-ups at the dentist are important after the implantation. In this way, the dentist can check whether the artificial tooth root is healing well. After about three months, the implant should be so firmly attached to the bone that it can be loaded. The dentist then uses various methods to take an impression of the jaw relationships. The impression or scan serves as a template for the dental technician to select a suitable shape for the implant post and then to manufacture the desired denture individually for the patient. The manufacture of implant-borne crowns, bridges and prostheses (superstructures) also requires special knowledge and skills as well as well-thought-out planning from the master dental laboratory.

It is important that the dentist and dental technician continue to coordinate closely even after the dentures have been incorporated. In particular, the fit of the removable dentures must be checked by the dentist. If the jawbone regresses and the prosthesis loses its original hold, the dentist takes a so-called relining impression, for example. The dental technician then adjusts the base of the prosthesis to the oral situation and restores the hold of the prosthesis. Further information can also be found on the website of the Swiss Implant Foundation.

Usually over 90 percent of artificial tooth roots heal successfully. However, smoking makes healing much more difficult. On average, the risk of losing a dental implant is twice as high for smokers than for non-smokers. The risk increases with increasing nicotine consumption. In heavy smokers, up to a third of the implants can be lost. This is due to the poorer wound healing caused by smoking. The risk of faster and more severe breakdown of the jawbone in the vicinity of implants is also significantly higher in smokers. The implant can be lost prematurely. Smokers should therefore renounce the blue haze even before an implant has to be placed.

Depending on the individual risk of disease, regular, professional tooth cleaning is of central importance for the success of an implantation. The dentist or a specially trained employee in our practice in the heart of Zurich shows the patient how to properly clean and care for implants as part of oral hygiene training. In particular, the transition between the implant and the gum must remain free of bacterial deposits. Otherwise there is a risk of peri-implantitis, an inflammation around the artificial tooth root. In the worst case, the dentist has to remove the implant again.

It is therefore important to clean the spaces between the teeth and the area around dental implants particularly intensively. Dental floss and special interdental brushes should be used daily.

"If the artificial dentures are not properly cared for, bacteria can adhere to the implant post, migrate down along it and cause inflammation of the gums," explains Prof. Dr. Hans-Christoph Lauer, Director of the Polyclinic for Dental Prosthetics at the University of Frankfurt am Main. “If the inflammation progresses, it can spread to the bones. Peri-implantitis develops. It is often worse and spreads faster than periodontitis on natural teeth. "

This is due to the structure of the implant. The connecting piece protruding from the gums is smooth and easy to clean for daily oral hygiene. However, the part anchored in the bone has threads and a rough surface. Once bacteria have penetrated this far, it is much more difficult to remove than from a natural tooth. Peri-implantitis should always be treated as early as possible. Without treatment, the implant can be lost. You can find more information on the website of the Society for Oral Implantology Switzerland.