Dental implants are the best substitute for missing teeth available today. Of course, the best is the tooth itself; but when it comes to replacing the lost tooth, the implant has no competitors, since, unlike the classic fixed bridges, it is not necessary to grind down (wear down) the neighboring teeth. In addition, it provides a totally fixed solution, unlike the classic removable partial or total prosthesis.
Sometimes, due to lack of bone or other reasons, we plan cases with fewer dental implants to support removable full or partial dentures (implant-supported overdentures).
How are pre-implant tests planned?
Nowadays, we cannot consider an implant treatment without first having properly planned the case. The first thing would be a health questionnaire plus a personal interview with the patient to study if he/she is a candidate from the medical point of view for dental implants.
The second would be the radiographic study. Undoubtedly, the best radiographic test for this treatment is the computerized axial tomography (CAT), since it provides us with the information to measure the volume of bone available. Finally, there are the tests aimed at designing the future smile, such as dental molds, radiological splints, photographs, etc…
How do you know if the patient can have an implant?
After an initial study of the patient, we classify the patient from a medical point of view to determine the suitability or precautions to be taken into account according to each case in a personalized way. Almost all patients can have implants, and there is no age limit, however, in some cases we must look for other alternatives or postpone the treatment until medical conditions allow it.
How long do they last and do they have to be changed?
Regarding the duration of the implants it is important to specify that there are two parts in the treatment. The first part of the treatment is the implant itself, i.e. a small titanium screw implanted in the bone, just under the gum. After a period of between 6 weeks and 4 months (depending on the manufacturer and the case) the treatment is complemented with a crown, which is the part of the tooth that is visible and which is firmly attached to the implant by means of a series of screwed or cemented attachments, depending on each case.
The survival of dental implants, according to scientific literature, is 95-98% at 10 years according to different studies. This means that out of every 100 implants between 2 and 5 are lost (generally due to bad brushing); that is to say, if the brushing is correct there is a good chance that the implant will be a success. It should be noted that the survival of implants in patients who smoke (85%) is significantly lower. In general, if the surgeon’s technique is correct and the patient is healthy, there is no reason to fear the loss of the implant and there would be no need to change the implants.
As for prosthetic complications, i.e. those related to the crown screwed or cemented to the dental implant. These can vary according to each case and the quality of the patient’s care of the prosthesis. For example, loosening of the screws that hold the prosthesis to the implant, fracture of the prosthetic screw, or even breakage of the ceramic that covers the crown, are almost always complications that can be solved effectively, but which can also be prevented or made easier to solve with periodic check-ups.
What happens if I lose bone while I have the implant?
Indeed, peri-implantitis is a disease that consists in the loss of bone surrounding the implants. Its equivalent around the teeth is called periodontal disease (commonly called pyorrhea), in fact, the latter is a major risk factor for peri-implantitis, as well as poor oral hygiene and smoking, so we must examine our patients well before implant treatment to evidence the presence of periodontitis and treat it properly. Peri-implantitis is a risk that exists nowadays, but that we solve more and more efficiently if the loss is partial, favorable and detected in time, achieving in many cases the resolution of the problem. When this is not possible, we place another implant.
Of course, the best treatment for peri-implantitis is good case planning from the beginning and prevention; of course, with periodic implant revisions and instructing our patients to have a good oral hygiene.