Dental Implants

After completing a dental implant procedure, required warnings are made by dentist and drugs to be used by patient for a while are given. After the anaesthesia losses its effect, the patient can start eating and return to his/her normal life.

In some cases, dental implants are performed along with general anaesthesia. In such cases, the patient is recommended to wait for 4-5 hours and then sent to his/her home in a safely manner.

After dental implants are placed into the jawbone, they begin to recover soon. It is expected that dental implants are united into the jawbone (osteointegration) within 3-5 months in a healthy person. In addition, this period may be reduced to 1 month with some implants with special surfaces.

Dental implants are applied in the event of single tooth loss, more than one teeth losses and total edentulism.

!! In single tooth loss; for aesthetic and functional use by being placed into the empty space without damaging adjacent teeth.

!! In upper and lower jawbones without any tooth; A remission and volume decrease occur in the jaw bone as a result of teeth losses and traumas or physiological bone thinning. Patient could not use his/her prosthesis in the event of excessive bone thinning. In this manner, at least 2 implants on the lower jaw bone and minimum 4 implants on the upper jawbone are placed. Later on, the prosthesis is placed on implants and then fixed. There is an increase in chewing and speech functions.

!! In the event of losing permanent molars; Instead of a removable denture to be placed in back areas, a fixed bridge can be made with one or more implants. If there is not any tooth at the back area, instead of a partial prosthesis, which is removable, simple and difficult to use, a fixed and appropriate bridge can be made with several implants to be placed.

!!In the event of long toothless spaces; In the event that a fixed bridge is made in long toothless spaces, its long body causes problem. However, in a treatment to be performed with implants, one or more implants to be placed into the toothless space increase the support and strength of the bridge and provides solutions close to a natural tooth.

!!In the event of losing all teeth especially in lower jaw; Implant treatment to be performed in such cases provides successful solutions that will improve patients’ life quality. The complete denture, known as palate by public and made traditionally in the lower jaw, causes many problems due to the structure of that area. These prostheses, which are highly useless, are now replaced by fixed prostheses made with implants. With at least 2, preferably 4 or more implants to be placed in the front area of the lower jaw, aesthetic results with excellent function and closest to natural teeth are obtained.

In the patients below 18 age;

Bone development continues in these patients. Generally, these patients are expected to complete the age of 18 and space maintainers are used during this period so that related area is not closed.

In the patients undergoing chemotherapy and radiotherapy;

The body resistance is low in the patients undergoing chemotherapy and radiotherapy, and structural changes are observed in jawbones in the event of undergoing radiotherapy for head-neck area. This poses a risk for implant surgery. In such cases, patients are waited for 6-12 months for self-recovery and to complete their chemotherapy and radiotherapy treatments. Later on, dental implants may be placed upon doctor approval.

Drinking Alcohol and Smoking;

!! Smoking increases the risk of infection by causing bacterial plaque in the mouth.

!! Smoking affects implant’s union with bone negatively due to carbon monoxide and toxic effects of smoking.

!! Delays wound healing.

!! It is recommended to quit smoking 15 days before and 1 month after operation since it causes cases such as decreasing blood build up.

The patients using bisphosphonate;

Such drugs, known by public as drugs preventing bone thinning, stops osteonecrosis (osteoclastic activity). It is suggested that the patients to undergo dental implant procedure should not use such drugs upon the recommendation of patient’s doctor. What is more, dental implant surgery can only be performed after 6 months after drug use cease.

Diabetes Disease;

Diabetic patients who are not under control are among the risky groups of implant operation. These patients recover slower and they have a susceptibility to infection. The dental operation can only be performed in these patients after negotiating an endocrine doctor and taking his/her diabetes under control. The dental operation can be performed successfully in the patients whose blood sugar is under control. In addition, diabetic patients should pay utmost attention to their oral health care and consider the risk of infection.

The Patients with Cardiac Disease and Using Pacemaker;

The implant operation should not be performed for the patients with cardiac disease without consulting their doctors.

There is not any problem in performing an implant operation in the patients using a cardiac pacemaker. However, in these cases, appropriate antibiotic use should be started in order to decrease infection risk before implantology. Moreover, dentist should take information about his/her patients about whether the patient has a special medical condition. Following these controls, the implant operation can be started if there is not any problematic situation.

The Patients with Hypertension;

The patients with hypertension may show overreaction in the event of any pain, stress. Blood pressure may rise acutely during dental treatment if an overreaction is given to any stimuli, and complications of congestive cardiac failure or rarely stroke, bleeding may appear. For this reason, before starting the treatment of the patients with hypertension, their blood pressures should be measured and doctor consultation should be performed in suspected cases.

Blood Coagulation Disorders;

The patients with blood coagulation disorder are not applied implant operation.

As you can guess, there is a high competition in the production of implants which are used increasingly. Today, there approximately 600 implant brands. There are nearly 100 different designs used in the production of these implant brands. Countries such as Switzerland, Germany, Italy, America and Sweden are leading in dental implant production and R&D services. An increase in domestic implant production is seen in our country in recent years in accordance with government assistance and market requirement.

The implant success is affected by implant type, how long it is used and the support it gives to R&D studies. Some private implant brands may produce implants providing conveniences for patients and dentists thanks to high budgets they allocate for R&D services. While such implants are advantageous for patients due to rapid recovery times, they provide convenience for dentists with their more developed connection types used for adding superstructures.

Dental implants are successfully placed instead of previously lost teeth. Placing implants instead of the teeth pulled out due to infection seem changes between 1-3 months in line with the severity of infection. If the bone defect due to infection is serious, bone grafting is administrated on that area and thus, made ready for implant operation.

Before implant operation;

The films of the patient, who is planned to be implanted, are taken and the quality of bone and condition of that area are examined. It is then decided on the length and diameter of implant. Meanwhile, patient is given an effective oral hygiene instruction.

Dental implants are performed by surgical operations. Placement of a single implant may seem changes between 10-30 minutes according to the quality of bone and the area where implant will be applied. Implant operation is completed in 2 stages in the edentulous patients.

The patient is applied local anaesthesia before an implant operation, which is a surgical procedure. Therefore, patient does not feel any pain during surgical procedure. Patients, undergoing an implant operation, may experience mild pain after aesthetic effect loses its effect on the same day. This period may get longer for the patients with low pain threshold.

Dental implants are applied in the event of single tooth loss, more than one teeth losses and total edentulism.

Health conditions preventing implant treatment;

• In the patients smoking much;

Smoking has negative effects such as increasing the risk of infection by causing bacterial plaque, appearing in tissues in the mouth, affecting implant’s union with bone negatively due to its carbon monoxide and toxic effects, delaying wound healing and decreasing blood build up. In such cases, implant procedure may be performed upon the approval of a dentist by decreasing smoking use before and after implant operation.

Note: The patients undergoing implant operation are recommended to quit smoking 15 days before and 1 month after operation.

• Diabetic patients;

Diabetic patients who are not under control are among the risky groups of implant operation. The tissues of diabetic patients recover slowly and they have increasing infection risk. The dental operation can be performed in the patients whose blood sugar is under control. In diabetic patients, surgical operation is performed in a small area as much as possible. It is of utmost importance for diabetic patients to pay attention to their oral health care. Diabetic patients should follow their periodical dentists examinations.

• The Patients with cardiac disease;

The implant operation can be performed for the patients with cardiac disease after consulting and taking the approval of their doctors.

• The Patients with hypertension;

The patients with hypertension may show overreaction in the event of any pain, stress. Blood pressure may rise acutely during dental treatment if an overreaction is given to any stimuli and complications of congestive cardiac failure or rarely stroke, bleeding may appear. For this reason, before starting the treatment of the patients with hypertension, their blood pressures should be measured and doctor consultation should be performed in suspected cases.

• Blood Coagulation Disorders;

It should be consulted with the doctors of the patients with blood coagulation disorder.

Recovery strength of patient;

The most important factor affecting success in implantology is patient’s recovery strength. The patients with a good general health condition may recover in a shorter time. Geriatric (Elderly) patients recover in a longer period.

Being over 18 (completion of bone development)

The bone development of individuals, who do not complete their adolescence, is not completed. It is not recommended to perform an implant operation on such a patient. Even though any tooth is lost in these years, space maintainers are used so that related area is not closed until the completion of bone development.

Alcohol and Smoking;

• !! Smoking increases the risk of infection by causing bacterial plaque in the mouth.
• !! Smoking affects implant’s union with bone negatively due to carbon monoxide and toxic effects of smoking.
• !! Delays wound healing.
• !! Decrase blood supply

Note: It is especially recommended that Implant Patiets should give up the smoking 15 days before and 1 month after the tratment.

Diabetes Disease;

Diabetics who are not under control are among the risky groups of implant operation. These patients recover slower and they have a susceptibility to infection. The dental implant can be made for the patients whose blood sugar is under control. The surgical operation area is kept as small as possible for the diabetics. It is very important to provide mouth hygiene for diabetics after the implant treatment is completed. Diabetics should be periodically checked by the dentists.

Implant Brand

As you can guess, there is a high competition in the production of implants which are used increasingly. Today, there approximately 600 implant brands. There are nearly 100 different designs used in the production of these implant brands. Although it is confusing that there are so many brands and different designs in the developing implant sector, they do not differ much from each other since they serve for the same purpose.

Although the operation success of implant brands is around % 10; some private implant brands produce such implants that they provide convenience to the patient and physician thanks to their high budgets for R&D. While such implants are advantageous for patients due to rapid recovery times, they provide convenience for dentists with their more developed connection types used for adding superstructures.

Hypertension and Heart disease;

For the patients with heart disease, the implant should not be applied without consultation with their doctor.

The Patients with Hypertension;

The patients with hypertension may show overreaction in the event of any pain, stress. Blood pressure may rise acutely during dental treatment if an overreaction is given to any stimuli, and complications of congestive cardiac failure or rarely stroke, bleeding may appear. For this reason, before starting the treatment of the patients with hypertension, their blood pressures should be measured and doctor consultation should be performed in suspected cases.

Blood Coagulation Disorders;

The patients with blood coagulation disorder are not applied implant operation.

Maintenance after implant operation;

A general good health condition of the patient is the first requirement for a successful implantology. The patient with good health and bone structure has sufficient healing potential. The correct diagnosis for the patient and carefully selection of the implant are very important for the physician and patient.  It is very important that the implant is properly cleaned and maintained after successful implantology. After the surgical procedure of the implant; the patient should comply with the physician’s advice. The patient faults have a big role in implant losses. It is necessary to comply with the relevant key recommendations such as not eating anything for 2 hours, not smoking for 24 hours, not consuming hot and hard foods for 24 hours, etc.

The main success of the implant emerges in the long term. The reaction of the implant against the load is very important to mention about its success. This shows us how important the artificial tooth (prosthesis) is placed on the implant. Planning of implant prostheses should be meticulously done and the overload applications on the titanium implant in the bone should be avoided and the height of the prosthesis should be adjusted well.

Implant is directly related to quality and quantity of the jaw bone. Therefore, the implant is applied fort he patients who have completed the bone development. The bone development is completed after the age of 15-16 in girls and after the age of 17-18 in boys. While implant treatment has minimum age limit depending on bone development; it has no limit for upper age and it can be even applied for older patients.

The implant treatment can be applied to older patients with generally healthy and having sufficient bone in their jaw bone. However, systemic disorders that may occur at this age or earlier, sometimes make treatment difficult.

Swelling after implant operation;

The swelling in the surgical area after the implant operation is normal. The cavity for the implant in the jawbone causes mild trauma in the gingival implant area. Since the dentist expects a little swelling in this area, he wants to make an ice compress to the implant area.

The ice bags in the patient’s hand are kept for 3-5 minutes on the implant area from outside the mouth and it is applied by resting for 8-10 minutes. In case of ice keeping for a long time, you may suffer from ice burn. This application will decrease the swelling.

Be careful not to apply pressure on the implant while eating; until the implant merges with the jawbone.

You should go to the dentist immediately; If the pain continues and an abscession occurs or you feel numbness on the lip.

How should we eat?

You have to pay attention to your nutrition for a few months after implant surgery. In this period as a merging process of titanium implant with the jaw bone, you will not damage the stability of the implant by eating soft foods that are not hot or cold. Despite your dentist’s advices on this issue, we can give the following examples for information;

You can eat soft food such as yoghurt, cheese, soups, fruit juices at room temperature, soft-boiled eggs, soft meat, milk, ice cream, pudding and the inside of bread at room temperature. You can naturally take vitamin C by consuming fresh fruit juices, kiwi, apples, strawberries, grapefruit, oranges, etc, because your nutrition will be less than before.

Not Consuming Hot and Cold Foods;

You should follow the advice of the dentist after an implant treatment. It has a great importance for a successful implantology. After a successful implant operation; the first thing your dentist will advice you: not consuming hot and very cold foods. It is necessary to follow this advice between 3-10 days depending on the number of applied implants, the brand of the implant and the level of the surgical procedure.

Not Consuming Hard Foods;

Gingival opened by surgical operation is sutured and closed after operation. It is very important that the stures does not get hit until the gingival heals. It is necessary to avoid consuming hard foods or any behavior that may put pressure on this stured area,  until stitches are removed by the dentist. In this process, it is necessary to be nourished by consuming soft or liquid foods. If you have an implant only on one side, using the non-implant side is more logical

Implant and Mouth Care;

Mouth care is very important for the first 48-hour after implant operation. It is necessary to avoid the movements that make pressure in the mouth. It is not recommended to rinse your mouth or gargle for 1 day after the implant operation. You should slowly throw out the saliva accumulated in the mouth. The pressure in the negative direction for spittings by sucking is very harmful. And it should be avoided from the movements such as breathing or blowing that will make pressure in the mouth.

Be careful to brush and floss during mouth cleaning in the first days. It should be applied as slowly as possible. And you can clean the implant areas with damp cotton cloth or gauze patch.

Using drug

The pain ain in the first few days after the surgical operation is considered as normal by physicians. After the surgery, you should regularly use analgesics and antibiotics according to dentist’s instructions. Even if you have no pain, you should continue using analgesics as planned. Because analgesics can be used for a while to disappear the swelling except for their effects. If a mouthwash has been given by the physician, it should be used according to dentist’s instructions.  Gargling in the first days can be harmful.

The gingiva is opened by cutting during the implant operation as a surgical procedure and is closed by suturing after the operation. Althouh the wound in this region heals quickly; it should be avoid from blood thinners for the first 2 days. It is not recommended to use aspirin as a blood thinner instead of analgesics given by the dentist. Patients who use aspirin as a blood thinner should not give up aspirin without consulting their physician.

Smoking and Alcohol;

Smoking and alcohol use after the implant operation affect negatively the healing process. It is not recommended to use these harmful substances before operation. Some of the negative effects of these two harmful substances on the implant are listed below.

• !! Smoking increases the risk of infection by causing bacterial plaque in the mouth.
• !! Smoking affects implant’s union with bone negatively due to carbon monoxide and toxic effects of smoking.
• !! Delays wound healing.
• !! Decrase blood supply

Note: It is especially recommended that Implant Patiets should give up the smoking 15 days before and 1 month after the tratment.

Titanium implants has % 97 success rate in the World and have side effects or allergic reactions in the human body. Titanium material with full bone compliance was firstly used in the 1950s in the dpartment of orthopedics in medicine. The first tests were made on monkeys to merge two bones and was highly successful. After this success, it is thought to be applied on the jaw bone and a perfect compliance has been observed. Implants, surface properties of which have improved with today’s technology, became integral parts of the jaw bone.

This century is a golden age for titanium implants. While the implants produced with high engineering are living the most perfect and mature period; scientific studies are ongoing produce natural teeth that can replace the implant for next years.

Dentist in the failure of implant operation;

The failure of implants can be also caused by the wrong application of the dentists. Dentists can sometimes plan more implants than the required because of commercial concerns. It is wrong trying to solve the problem with 4 implants instead of 2 implants. Unnecessary applied more implants cause an extra load on the jawbone and reduce bone resistance. The extra implant will also have side effects. It is expected that the dentist performing the implant operation try to have the best result with minimal implants. If the number of the implants is kept minimum, then this operation will be more economic for the patient; because implant is an expensive application. Considering all these situations; It should not be recommended more than enough implants. A safe planning should be made with a minimum number. More implants than the required because of commercial concerns will make the patient tired and bring many problems.

Another issue about physician errors is the wrong choice of implant. Implants are produced in various sizes and structures. Selection of implants whose forms are different from each other is extremely important. The dentist should choose the right implant by examining the jaw bone and the general condition of the patient.

Effects of Brands on the Failure of Implants;

Another issue is the brand of implants. There is not a big difference between the worldwide known implant brands. However, leading implant brands can make a difference with their shares for R&D expenses and engineering levels. These differences can be seen in the forms of the implants and surface properties. So it provides convenience to the dentist during the surgery, and it merges more quickly with the jaw bone and provides benefits to the patient in terms of waiting time.

Dentists makes mistakes about brand selection because of the commercial concerns. These mistakes are generally made by dentists who want to supply implants cheaper and they are nonbrand materials produced under incorrect and bad conditions. During the implant operation, it should be paid attenntion to the quality of the physician and the brand of implants. Despite of the domestic production, the imported implants are generally used in our country. Implants in various brands and structures are coming to our country from many countries. There are incorrectly produced implants among them. These incorrectly produced implants are sold cheaper in the world market and they can be preferred by some clinics and hospitals. It is tried to sell quickly these cheap implants with advertisements. Yo must be careful and beware which brand of implant is used and you must research the clinic, hospital and physician. Otherwise, you can endanger your health with an application of a cheap implant.

Patient’s role for the failure of the implants;

It is very important that the implant is properly cleaned and maintained after successful implantology. After the surgical procedure of the implant; the patient should comply with the physician’s advice. The patient faults have a big role in implant losses. It is necessary to comply with the relevant key recommendations such as not eating anything for 2 hours, not smoking for 24 hours, not consuming hot and hard foods for 24 hours, etc.

The main success of the implant emerges in the long term. The reaction of the implant against the load is very important to mention about its success. This shows us how important the artificial tooth (prosthesis) is placed on the implant. Planning of implant prostheses should be meticulously done and the overload applications on the titanium implant in the bone should be avoided and the height of the prosthesis should be adjusted well.

The lifetime of the implants is longer than other conservative dental treatments. According to researches, it is observed that the implants made from titanium 30 years ago protect highly their existence. Looking at the properties of titanium may be more descriptive to understand why implants are longlasting.

Properties:

• Titanium does not cause allergies in the human body.
• More durable than steel and 75% lighter than the specific weight of stainless steel
• Titanium has very high mechanical resistance against breakage and bending.
• Titanium is a very strong stainless steel. It is more resistant against corrosion than stainless steel.
• Titanium is resistant against very high temperature. Melting point: 1650 ° c
• Titanium is not affected by many strong chemicals.