Dental implants: structure, types and treatment
If a tooth and its root are missing, a dental implant with matching dentures is a viable solution to replace the tooth. The placement of dental implants is considered a proven routine procedure in dentistry to close gaps in the teeth permanently and painlessly. While the benefits of dental implants are undisputed, there is a catch: the sometimes high costs discourage many patients from implant treatment.
What is a dental implant?
As a dental implant, an artificial tooth root is referred to, which is introduced by the dental specialist operatively in the jawbone. The implant serves as a carrier for the dental prosthesis (implant body) – so z. B. for a crown, bridge or removable dentures. Dental implants can replace not just a single tooth, but – if necessary – even several lost teeth. Dental implants are considered a stable, aesthetic and functional solution to replace lost teeth accurately. In the best case, the dentures can not be distinguished from the natural teeth.
Implants with the associated dentures not only mean a gain in quality of life but are also very useful from a medical point of view. The reason: By forwarding the masticatory forces directly to the jawbone, dental implants can prevent bone loss. Therefore, it is very important not to wait too long to insert an implant, because in the worst case, the bone has already regressed to the extent that consequential damage can be expected.
What are the elements of dental implants?
Implants are usually made up of three components. These include the implant body, the implant abutment, and the implant crown.
The implant body forms the basis for an implant. As an “artificial tooth root”, the implant body is surgically implemented in the jawbone. This usually cylindrical shaped implant body is usually firmly anchored via a thread in the jawbone. After a healing phase, the implant abutment and the implant crown can then be inserted.
The implant-abutment – known in technical terminology as an abutment – is precisely fitting titanium or ceramic connection, which serves as an intermediate link between the implant body and the implant crown. Abutments have a connector on both sides. So it can be screwed on one side with the implant body and on the other side with the implant crown.
The denture attached to the implant is called the implant crown. Implant crowns are usually made by specialized dental technicians. Fixation with the implant takes place via screw connections and sockets (implant posts) and often with the help of medical cement. Implant crowns are mostly made of gold or titanium or ceramic. There are also implant crowns, which consist of both materials. In particular, the high-priced ceramic crowns are considered to be particularly compatible with the body and can perfectly reproduce the natural tooth.
Dental implants – Classification of implants by types
The placement of an implant is a routine intervention in today’s world. The different implant types allow, depending on the clinical picture, individual solutions for the patients. For the individual implants, there are differences in the surface texture, shape and anchoring mechanism. Have enforced helical implants. In an edentulous jaw section, implants can also be anchored directly into the jawbone (endosseous implants) or into the mucous membrane.
Implants can be divided into their shape, structure, material and surface finish:
- Subdivision of the implants according to the form: conical, step-shaped, leaf-shaped, needle-shaped, cylindrical
- Subdivision of the implants according to the structure: joints, grooves, perforations
- Subdivision of the implants according to the material: titanium, zirconium, ceramic and mixed forms
- Subdivision of the implants according to the surface condition: etched, titanium irradiated or sandblasted
Dental implants – Classification according to implant shapes
Implant connections are available in various forms. Most implants have a screw shape. These differ in width, length and thread profile. With the help of a rotating instrument, the helical implant can be gently inserted into the jawbone. In addition to the classic screw connection, there are the following forms of connection:
As the name implies, the abutment fits snugly into the implant. This connector is fixed with a screw. Due to the design, the connector always has a tiny joint gap – only in this way can the abutment be plugged together with the implant.
In the conical connection, the abutment is pushed onto the dental implant like a conical lid. This connection leaves virtually no gap open and thus prevents foreign materials – such. B. Leftovers – can settle in the gap. As with the connector, the cone connection is fixed with a screw.
Dental implants- Classification according to implant systems
Within the implant forms, it is also possible to differentiate between a one-piece implant and a two-part implant. As “one-piece” implants are referred to, which consist of one piece.
One-piece implant systems
The one-piece system has been widely used especially in the past. Especially in small gaps, the one-piece implant system – due to the small diameter – is often used. However, since the implant head protrudes from the mucous membrane after insertion, there are sometimes problems during the healing phase.
Two-piece implant systems
When the two-piece implant system is an implant – ie a z. B. made of titanium artificial tooth root – planted in the jawbone. Then the implant neck and the implant crown (eg a full ceramic crown) are screwed on.
In implant systems today, the two- or multi-part implant system has largely prevailed over the one-piece. The screwed-together implant parts largely prevent – in contrast to the one-piece implant system – that it comes during the healing period to a painful load on the tooth tissue.
Implants – classification according to implant types
The helical implants include the standard-sized “standard implants” made of titanium or ceramic and usually one-piece “mini-implants” that have a smaller diameter. On the other hand, there are so-called Zygoma implants, which are characterized by their great length.
Especially in older patients with a weaker bone structure to mini implants offer. These form a very cost-effective implant solution for the lower and upper jaw. Mini Implants have – with about 3mm – a significantly narrower diameter than normal-sized implants and are particularly gentle on the jawbone.
A zygoma implant is a dental implant, which is characterized by its great length (about 3-5 cm). It is anchored not only in the jawbone but screwed at an oblique angle in the very stable cheekbone. The Zygoma implant ensures a particularly stable hold. Often, zygomatic implants can be loaded immediately after insertion so that implantation of implants with dentures can proceed in a single session.
Advantages and disadvantages of dental implants
Advantages of dental implants
Dental implants not only offer a deceptively real look, but also good protection against the degradation of the jawbone. In addition, implants allow the closing of gaps in the teeth without abrading the adjacent, natural teeth. Implants can also fill larger tooth spaces that can not be bridged with conventional bridges. Even with a completely edentulous jaw, great results can be achieved with implants. Last but not least, implants are characterized by their outstanding longevity.
Disadvantages of dental implants
In the case of poor oral hygiene, peri-implantitis is at risk. This is an inflammatory disease around the implant. If only the gingival margin is affected, the periodontium and the jawbones are also affected by peri-implantitis later on. If the peri-implantitis is not treated appropriately, the loss of the implant threatens.
The implant treatment
dental implants (artificial tooth root) has set the dentist or implantologist quickly. Screwing the artificial tooth root sometimes takes less than half an hour. On the artificial tooth root then a provisional is screwed on. Thereafter, the implant requires about 1 to 4 months rest to grow in well. In the next session, the dentist then unscrews an abutment on the dental implant and attach a crown. The attachment point can also be used for another high-quality denture. The treatment is usually less painful than expected. After 7-10 days, a follow-up appointment is usually arranged with the patient.
Painless implant treatment
Many patients are afraid of implant treatment because they are afraid of painful surgery. But the treatment can be carried out painlessly and stress-free by modern anesthetic procedures. Anyone who has a particular fear of dental treatment can receive a particularly relaxed implant treatment with additional measures such as sedation or general anesthesia. The procedures of a painless implant treatment at a glance:
Local anesthesia – also known as “local anesthesia” – is anesthetized by an injection of the respective surgical site, so that neither pain nor touch during implant surgery is felt.
So-called sedatives act on the brain during oral sedation and have a calming effect. The oral sedation makes you sleepy and has the effect that you often can not even remember the treatment. Because of dizziness, the patient should be followed and treated for some time after treatment.
Sedation with nitrous oxide
The laughing gas inhaled through a mask has an anxiolytic and relaxing effect. After the treatment, you will soon be fit again. In the US, sedation with nitrous oxide is already very common – in Germany, more and more dental practices now offer this method.
In the case of anxiety patients, implant treatment is possible on request under general anesthesia. However, general anesthesia always requires ventilation. Therefore, this method is relatively expensive.
The overview shows – there are many ways to get a painless implant treatment. Depending on anxiety and pain, the patient has the choice between local anesthesia or even general anesthesia.