Implant treatment
What is a dental implant?
Dental implant is a system in which titanium screws placed in the jawbone serve as artificial tooth roots to replace teeth lost due to various reasons.
What material is a dental implant made of?
Dental implants are made of titanium, a biocompatible material.
Is implant treatment a comfortable and safe procedure?
Implant treatment is a very comfortable and safe treatment application when performed by a competent team under fully sterile conditions. However, it should be known that implant treatment is a two-stage treatment. For a fully successful implant treatment, a compatible and aesthetic prosthesis must be made on a surgically well-placed implant.
Who can receive dental implants?
Patients who are over 18 years old and have completed bone development can undergo implant treatment, but as in every treatment, some factors are important in implant treatment. The most important factor sought in implant treatment is the condition of the jawbone and whether the amount of bone is sufficient. If you think that if I do not have enough bone density, can I have implant treatment, the answer is yes, because we can obtain sufficient bone density with our graft applications, also known as bone powder, in areas where there is not enough bone density. In this way, we can successfully perform our treatment. However, we perform dental implant operations on patients with diabetes, blood pressure, blood clotting problems and advanced heart disease, provided that they get permission from their doctors.
Is there any pain or soreness during the implant operation?
In dental implant operations, the patient does not feel any pain or soreness thanks to the local anesthesia applied into the mouth. After the operation, the pain or soreness felt can be easily relieved with a painkiller that we use in our daily life.
Can implant operations be performed under general anesthesia?
The answer is yes. Together with our specialist doctor and anesthesia team, we can perform the implant operation under fully sterile hospital conditions.
How long does it take to place the implants in the mouth?
Although it varies in each operation, on average, the placement of an implant takes 15 to 20 minutes.
Can implants be placed immediately after tooth extraction?
The answer to this depends on the patient. If there is no defect or inflammatory finding in the extraction area, we can apply implants to that area immediately. In another case, we perform graft application to perform bone rehabilitation in the relevant area. We wait for 2 months after our graft application and perform our implant application after the healing of the relevant area.
How long do you wait for prostheses after the implants?
After the implant application, we wait between 2 and 4 months for the implant to adapt to the jawbone, after which we can place our prostheses.
Do I need an implant for each missing tooth?
An implant is not required for each missing tooth. In case of multiple missing teeth in a region, we can make 2 and 3 prosthetic teeth with 1 implant.
What are the advantages of implant treatment?
The prostheses made after implant treatment form the closest structure to the natural tooth. It has a more aesthetic and natural appearance than other prostheses. Thanks to implant treatment, we can easily eliminate tooth deficiencies without damaging the real teeth and maintain the existing bone level. In addition, even if we do not have sufficient bone level in the lower jaw total prostheses with very poor retention, we can increase the retention to much higher levels with 2 implants we will place.
How long does a dental implant last?
Dental implants can be used for a lifetime without any problems. However, as after every dental treatment, it is very important to pay attention to oral hygiene and to show the necessary care and attention. In this way, we can use the implants for a lifetime without any problems.
How should implants be maintained and cleaned?
Just like our own teeth, we need to brush our implant prostheses 2 times a day as recommended by our doctor. We also need to clean the plaque and food residues accumulated in the interface of our implants with an interface brush or dental floss. You can also maximize your oral hygiene and implant health with mouthwashes and mouthwashes.
Is there a risk of allergy or cancer with implants?
Since the materials used in implants are biocompatible and do not react with the body, there is no risk of causing allergies or cancer.
Are implant applications an expensive treatment?
Although implant treatments may seem like an expensive treatment at first, it is actually not an expensive treatment considering the aesthetic, comfort and other advantages it provides.
If there are medications used continuously before the implant operation, should they be discontinued?
You may need to stop some medications under the control of your doctor before the implant application. For this reason, it is very important that your dentist and your doctor are in constant communication.
Is it necessary to remove an implant-supported prosthesis at night?
Implant-supported prostheses are divided into 2 types: fixed and removable. While it is enough to use your fixed dentures just like your own teeth and take care of them in the mouth in a good way, it is much better for your oral hygiene to remove and maintain them at night in total dentures or dentures, also known as palates in the society.
Can implant-supported dentures be renewed?
It is possible to renew implant-supported prostheses that have completed their current lifespan or as a result of changing aesthetic expectations. The existing implants can be preserved in the jaw and the existing superstructure can be changed and renewed in the desired aesthetic dimensions. You can also extend the life of your dentures with good oral care.
Are dental implants recommended for smokers?
In individuals who smoke and drink alcohol, the healing time of the implant is adversely affected and we can see the results we do not want because it adversely affects bone health in the future. However, we ask our patients to stay away from smoking and alcohol at least during the recovery period after the operation.
Do you remain toothless during the healing and waiting period after the implant operation?
Our patients do not have to spend this period without teeth. Thanks to the temporary prostheses made, our patients can continue their lives with their temporary teeth.
How long after the operation can you return to daily life?
You can return to your daily life immediately after the implant operation and you can go to work after 1 or 2 days.
INSTANT IMPLANT AND DISC
In daily life, our teeth are of great importance in our lives both aesthetically and functionally. For this reason, our aim should always be to keep our own teeth in our mouth. However, if we have teeth that must be extracted, implant application will be a solution for us in this sense.
In classical implant applications, we have to wait for a while after tooth extraction, but in modern implant applications and thanks to the developing technology, it is possible to make implants and teeth instantly. Immediately after our implant application, our patients can have teeth immediately with the immediate, that is, temporary prosthesis we make.
As supported by the literature studies, it is also scientifically possible to make implants and teeth immediately after a good implant application.
In daily life, we can use this procedure in the following cases
For the upper jaw:
After the extraction of all teeth in the upper jaw or after the extraction of all teeth in the upper jaw, we can make fixed teeth by applying an average of 6 implants after evaluating the situation.
Depending on the curvature of the jaw and the current bone condition, 4 implants may be sufficient for complete upper jaw prostheses, while in some cases we may have to increase to 8 implants.
For the lower jaw:
If there is complete edentulism, we can immediately make a fixed prosthesis with an average of 4 implants.
Depending on the curvature of the jaw and the existing bone condition, 4 implants may be sufficient for complete prosthesis of the upper jaw, but we may also have to use 6 implants.
If we have a patient with a chewing area in both jaws, 3 implants may be sufficient for us. In case of missing teeth in the ten regions, teeth can be inserted immediately, but we must avoid the mutual contact of these teeth.
What is fast & fixed?
Developed by Bredent Sky implants, it is a system based on immediate implant placement in the edentulous jaw and realizes the patients’ dream of having a fixed tooth in one day.
This concept is mostly developed for patients who are faced with total edentulism. At the same time, it is possible to make implants on the day the teeth are extracted or to make fixed prosthesis on the day of implants in edentulous patients. Patient satisfaction is extremely high in this system, which allows tooth extraction, implantation and temporary fixed prosthesis on the same day.
In which cases is it applied?
-In completely edentulous mouths
– In cases where all of the patient’s teeth are to be extracted
-In cases of bone deficiency in the posterior regions.
Can you explain the conditions with bone deficiency?
Anatomical formations such as maxillary sinus in the upper jaw and mandibular nerve in the lower jaw limit the possibility of implantation. In areas where the maxillary sinus is drooping, there is not enough bone. In such cases, with the advanced surgical technique called “sinus lifting”, we gain the bone required for the implant and place the implant. Again, in the lower jaw, if there is not enough bone in the molar region above the lower jaw nerve where there is very large bone resorption, it is possible to gain bone with augmentation techniques.
However, these methods may not be preferable for patients because they are expensive, require larger surgical interventions and require long periods of time for the construction of the permanent prosthesis. In such cases, longer implants can be placed at an angle and a fixed prosthesis can be made with fewer implants.
Under which conditions can fast and fixed methods be applied?
If there is enough bone in the area in front of the molars in completely edentulous jaws;
If tooth extraction is to be performed, if there is a good cleaning opportunity in the extraction sockets, such as laser;
If oral hygiene has been brought to a good level before extraction;
There is no active persistent perodontitis;
If the dentist has sufficient knowledge and experience in this subject;
If there is a laboratory facility where a temporary fixed prosthesis can be made immediately.
How is fast & fixed application performed?
If any, the teeth that are judged to be shaking or periodontally very troublesome are extracted.
6 angled or 6 straight implants are placed in the upper jaw and 4 angled or 6 straight implants are placed in the lower jaw by escaping from the sinus prolapse or nerve canal.
Angled fast and fixed abutments that will make all implants parallel to each other are screwed onto the implants.
The impression analogues are placed on the abutments and impressions are taken with the open impression technique.
The impression analogues are removed and gingival shapers are placed on the abutments and the session is ended.
According to this impression, a temporary prosthesis is prepared in the laboratory and fixed in the patient’s mouth within 24 hours after the operation.
The patient has temporary but fixed teeth after one day.
What are the disadvantages?
It is a costly system due to many intermediate parts and details.
No matter how durable a temporary prosthesis is made, this prosthesis may have problems such as untimely breakage and cracking.
When the prosthesis breaks, the integrity of the system is broken. Immediate intervention and elimination of the problem is required.
If the problem is not intervened immediately, some implants are overloaded and this may lead to loss of implants.
Can patients eat anything with temporary prostheses?
In this system, as soon as the implants are made, hard foods should be avoided for the first 1.5-2 months and completely soft foods should be preferred. If this is not done, too much force comes to the implants and may result in implant loss.
What is the reason for angled placement?
In cases where there is bone deficiency in the posterior regions, with the Fast & Fixed technique, the implants are placed at an angle to the jaw bones, not vertically, without the need for further surgery. This geometry allows the implants to withstand loads more easily.
Is it a painful procedure?
There is no pain during the operation.
How can we summarize the points to be considered?
Anatomical conditions in the mouth should be evaluated very well and points that should be avoided such as sinus cavities and nerve canals should be avoided.
Measurements should be made on the tomographic image and planned well. Otherwise, unwanted complications may occur.
Implants should be placed in the bone in a sufficiently stable manner. In this respect, the physician who will perform the surgical procedure should be experienced and master the system.
Temporary fixed prosthesis should be durable enough. Otherwise, the prosthesis will break and serious problems will occur.
The patient should take very good oral care. Especially in the first 3-4 months, the mouth should be cleaned under the prosthesis with a mouth shower. Otherwise, infection may develop.
As soon as the implants are made in this system, hard foods should be avoided for the first 40-60 days and completely soft foods should be preferred. If this is not done, too much force is applied to the implants and may result in implant loss.
What are the advantages?
The biggest advantage is that it offers instant fixed teeth. The patient gets rid of the palate prosthesis in one day. Even temporary fixed prosthesis offers a serious comfort compared to the old prosthesis.
There is no need for a second surgical procedure in this system. The permanent prosthesis stage can be started directly by taking impressions. Since the patient can use temporary fixed prosthesis until the permanent prosthesis is made, the same comfort continues.
It offers fixed prosthesis to patients who cannot be treated due to anatomical formations such as maxillary sinus and mandibular nerve.
Since the system allows much longer implant placement, fixed teeth are made with fewer implants (4 in the lower jaw, 6 in the upper jaw).
Since the permanent prosthesis can be made in hybrid form, pink gum aesthetics can be achieved.
All On Four – Six
All four/six techniques offer an excellent solution for patients who have lost or have to lose all their full jaw teeth.
In the upper jaw;
The surface area covered by the teeth is larger than the teeth in the lower jaw.
The jawbone has a lower density than the lower jaw, so the integration of the implants with the bone is weaker and takes longer.
Especially the anterior region of the upper jaw is aesthetically important.
If the sinus is sagging in the posterior region, the support bone is less, in this case, either angled implants should be applied or short implants are used.
When all these factors are gathered together, as a result of the static calculation made by the physician, mostly over 6 implants (All on Six) are preferred in the upper jaw.
In the lower jaw;
The tooth curve is smaller than the upper jaw.
The density of the jawbone is higher and the implants can be fixed more firmly to the bone.
Prostheses made on 4 implants (All on Four) fixed to the posterior region implants placed at an angle on the lower jaw nerve bundle and two implants in front are preferred for a fixed implant prosthesis.
To whom can All on Four/Six be applied?
We can apply this method with the Bredent / Fast&Fixed technique to all people whose general health status allows implant application and who want an immediate solution after serial tooth extractions or in case of complete edentulism.
What are the advantages of All on Four / Six?
No need for advanced bone surgery
We do not touch the original structures of the surrounding anatomical structures (such as sinuses).
It is possible to continue life without ever being toothless. This prevents the person from being psychologically unhappy, there is no need to compromise social life
As the fixed teeth are fixed immediately, it is possible to eat immediately.
There are no speech difficulties because the teeth are fixed immediately.
If implant application is performed with laser, swelling and pain after the procedure is minimized.
The All on Four system has been used for 27 years and its success has been proven in the literature.
“Bredent Fast&Fixed” technique has been applied in our clinic for 11 years and its success has been confirmed by more than a thousand patients. Applying this system with Er:YAG laser also reduces post-procedure pain and swelling and increases the success rate as infected tissues can be cleaned with high success.
LASER USE IN DENTISTRY
The use of lasers in dentistry is developing and progressing day by day by increasing its benefits and usage areas. Although soft tissue lasers, diode lasers and Nd:YAG lasers are widely used, Er:YAG (hard tissue) lasers offer very important advantages and treatment successes, especially in implant surgery and hard tissue (bone and tooth) operations.
1) In Seamless / Guided Implant Applications:
It provides an advantage in terms of tissue gain by opening and guiding the gum tissue. In this way, the implant is applied without cutting, without bleeding, without disruption in tissue blood supply and with minimum pain. It also reduces the risk of new infections by providing disinfection in all tissues it comes into contact with.
2) Immediate Implant Applications by Cleaning the Infection After Extraction of Teeth:
Even in teeth that normally require waiting due to infection, implants can be made immediately after extraction by cleaning with a laser. In cases where there is no infection, it significantly reduces the risk of post-procedure complications.
3) Use of laser in Implant Applications on which Immediately Fixed Teeth will be Made
Increases the success rate of implant integration into the bone (fusion).
4) In the preparation of tissue before bone replacement in cases of bone deficiencies:
By providing safe cleaning of infected tissues and disinfection of the remaining bone tissue, it activates new bone formation and increases success.
5) In Peri-implant Infection (periimplantitis) Treatment Procedures:
Laser is the best known implant and bone surface cleaning and disinfecting tool in the treatment of infection and subsequent bone resorption on previously made implant surfaces. Thanks to the laser, the implant surface almost regains its original surface structure and it is possible to treat it.
Seamless Implant Applications – Flapless Implant Applications
Implant applications performed without cutting the gums and without stitches are called flapless implant applications.
It can be done in 3 ways:
With a guide plate by processing the three-dimensional image in a computer programme (Static Navigation)
With new generation robot arms working with three-dimensional image (Dynamic Navigation)
By processing the three-dimensional image with the experience of the physician performing the implant application and with soft tissue gain thanks to the gingival orientation with laser.
In cases where the bone structure and anatomy are known in 3D and the bone thickness is appropriate, the implant can be placed without cutting the gum. Only the place where the implant can enter is opened with a laser and the implant is placed. Since the gum is not cut extensively, there is no need for suturing, and since the gum is not separated from the bone, the blood circulation of the bone around the implant is not disturbed. For this reason, since the bone and gum are not traumatized, the patient experiences a comfortable and rapid healing process without extra pain and swelling.
Guided – Guided Implant Applications
In guided implantology, a 3D tomographic image and intraoral measurements of the person to be implanted are taken, planned in the guide programme and the implants are placed at the appropriate points in the bone. In this way, it is possible to place the implants in the most prosthetically appropriate position with the guide plates whose angles and positions are prepared in 3D before the procedure. Since the final prosthesis is also pre-designed on the same planning, the number of sessions required for prosthesis after the healing process is minimized without any margin for error.
Implant Treatment in Bone Insufficiency
In order to make implant-supported teeth in a healthy way, the implants must be held by at least 1 mm tissues around the entire circumference of the implants. Therefore, bone support of sufficient width and length must be available for long-lasting implants to be made
There are two basic methods to determine that there is enough bone:
1) Clinical examination by a knowledgeable and experienced physician
2) 3D imaging with dental volumetric tomography, where we can see all the details that cannot be detected in clinical controls and even during the operation
If it is determined that there is not enough bone in the jaw to make a healthy prosthesis, new bone formation can be made by applying different techniques in the lower or upper jaw, or a healthy chewing can be provided with the correct prosthetic solutions by applying angled implants with the Fast & Fixed technique.
New bone formation techniques are as follows:
1) Sinus Lift Technique: If there is no bone in the posterior regions of the upper jaw, new bone formation can be achieved vertically in the sinus area.
2) Split Osteotomy (Sandwich Technique): In case of insufficient bone thickness, it is a technique in which the implant is placed between the bone by opening the bone like a sandwich.
3) Block bone formation technique: It is applied by taking block bone from the back of the jaw or hip and placing it in the missing area.
4) Box Technique: It is applied with artificial bone materials and thermoplastic molding technique.
Sinus Lift – Sinus Lift
Sinuses are air cavities located above the posterior molars in the upper jaw. Sinuses, which are actually a functional organ, can make it difficult to apply implants in this area by melting the bone underneath over time after the teeth underneath are extracted. For this reason, sinus operations require high precision and physician experience.
Sinus lift operations are divided into two as open lift and closed lift. If there is 4-5 mm or more bone, but it is not enough for the implant, the process of providing new bone formation by raising the sinus with the help of appropriate hand tools from inside the mouth without the need to open a side window is called closed sinus lift. In cases where closed lift is applied, the implant procedure can be performed in the same session. Bone powder or PRF (concentrated blood containing growth cells) can be used for bone formation. In open lift application, bone formation is provided by opening a window from the sinus side wall. If sufficient retention is achieved, the implant can be applied in the same session. In cases where it is not provided, it is waited for 6 months.
“The main purpose of sinus surgeries is to increase the reduced bone volume underneath with bone formation materials without damaging the sinus anatomy. Thus, when the bone formed in the area matures, a successful implant application can be made in this area.”
In some cases, if there is bone in the areas adjacent to the sinus cavity, treatment can be applied without the need for sinus operation by placing an angled implant. If there is a little bone under the sinus cavity, the need for sinus operations can be eliminated with short implants.
Implant in Systemic Diseases
Today, our teeth have a very important place in our lives both aesthetically and functionally. We need to protect our existing teeth as much as possible and take good care of our teeth. However, in some cases, unfortunately, we cannot prevent losing our teeth. In such cases, implant treatments come to our aid.
It should never be forgotten that the systemic health of our body is very important, we should take very good care of our body and pay close attention to our general health.
As damaging as unconscious practices that put the health of the person at risk, it is just as damaging to take away the comfort of life by unconsciously avoiding these treatments for people who can have implant-supported prostheses by taking appropriate precautions and controls.
Toothlessness causes unhealthy nutrition in people and psychologically wears out the patients.
In implant applications, as in every medical treatment, there may be situations that should not be done. These conditions that should not be treated are called contraindications. If the contraindications are detected very well, we will not perform damaging treatments, and we will not leave people without contraindications toothless by identifying them and performing the necessary treatments.
Contraindications can be divided into two as local and systemic. The presence of systemic diseases plays an important role in the planning and implementation of implant treatment. There are certain systemic diseases that affect bone metabolism, wound healing in tissues and ultimately the success of implant treatment. In addition, systemic diseases treated with medication or other methods have the potential to affect implants and surrounding tissues.
Cardiovascular (Heart and Vascular Diseases)
”In heart diseases, especially the use of blood thinners should be monitored and consultation with the treating physician should be made when necessary by taking the correct anamnesis.”
It has been observed that certain diseases such as hypertension, atherosclerosis, vascular stenosis, coronary artery disease and congestive heart failure; although they cause suppression of blood flow, decreased oxygen density and malnutrition of tissues, they do not prevent the implant from integrating into the bone and as a result, cardiovascular diseases do not have a negative effect on the clinical success of implants.
Studies have shown that calcium channel blockers such as Nifedipine (Adalat, Nidilat, etc.), which are used in the treatment of these diseases in patients with congestive heart failure and hypertension, can reduce bone resorption by providing direct calcium entry into the cell. Likewise, they have shown that calcium channel blockers reduce bone resorption by up to 50% depending on the dose. This shows the positive mechanism of action of some cardiac drugs.
Diabetes Mellitus
”In many cases, implant application can be performed in diabetic patients by following the scientific values. In our clinic, we have cases with a history of up to 14 years and follow-up.”
If you are diabetic and want to have an implant, if you apply with the examinations you have so far and your physician’s opinions, it will be possible to have your dental treatments if it is found appropriate after a detailed examination and, if necessary, consultation with another physician who follows your follow-up or is competent in this field.
Diabetes has various systemic complications such as eye, kidney, brain vessels, micro and macro vascular disorders and wound healing disorders. In the mouth, it is associated with dryness, extensive caries, fungus and gum disease.
According to the data obtained from articles investigating the implant success of diabetic patients with multiple implant placements; it has been concluded that the rate of implant loss in diabetic patients under control is within normal limits. The results of implant treatment of diabetic patients under control in our clinic also support this view.
According to the data of these studies, it is necessary to maintain good glycaemic control before and after surgery to guarantee osseointegration of the implants and to prevent delay in soft tissue healing. For this purpose, the HbA1c test is performed, which shows the average blood-glucose concentration over the last 6 to 8 weeks. The implant application is evaluated by clinical control and clinical evaluation of the results.
Dental Treatment in People Using Cortisone (Corticosteroids)
”Like every drug, duration and dosing are important in cortisone use. The decision regarding implant application should be made by the physician after the general anamnesis and clinical control of the patient.”
Corticosteroids are drugs with strong anti-inflammatory effects used in the treatment of many systemic diseases.
These drugs reduce inflammation and are effective in reducing swelling and associated pain; however, they also reduce protein synthesis and delay wound healing. In addition, they reduce the leukocyte count and decrease the patient’s resistance to infection. Therefore, appropriate antibiotics should be used for 3-5 days after the initial dose.
Relationship between osteoporosis and teeth
”In the light of the following data, it can be concluded that osteoporosis is not a contraindication for dental implant treatment. However, it is still recommended to provide general control, evaluation and complete oral hygiene before the surgical procedure.”
Osteoporosis is a bone disease that occurs in the skeleton with the dilution of the protein mesh in the bone as a result of the decrease in bone mass with age, causing the bones to break very easily. Osteoporotic (bone resorption) changes in the jaws are similar to those in other bones of the body.
(Osteoporosis is not a contraindication for immediate stabilization of implants as it causes a greater loss of trabecular bone density than cortical bone. Many clinical studies of postmenopausal patients over the age of fifty have shown loss rates close to those of other patients, and hormone replacement therapy (HRT) has no effect on the rate of loss).
In a meta-analysis by Chen et al. (analyzing a large number of literature studies), the relationship between osteoporosis and dental implant loss was not statistically significant.
Bifosfanate Use and Dental Implant Treatments
“Intravenous bisphosphonates pose a high risk for implant surgery. The duration of use and doses of these oral medications should be decided by the physician who will administer the treatment by evaluating other diseases and medications used, general clinical examination and anamnesis, together with serum CTX test if necessary.”
Bisphosphonates are a group of drugs commonly used for many bone diseases and are approved by the US Food and Drug Administration (FDA) for the treatment of osteoporosis, metastatic bone tumors and Paget’s disease. Bisphosphonates act by suppressing osteoclasts or reducing bone resorption.
The relationship between radiotherapy and dental implant treatment
“Head and neck radiotherapy causes oxygen deficiency in tissues, vascular shrinkage and tissue deterioration. Due to the decrease in tissue viability, it cannot be remodeled and the risk of bone destruction is increased.”
In patients who have undergone radiotherapy, the risk of implant non-integration is increased 2-3 times more. It has been reported that the use of hyperbaric oxygen 20 times with a pressure above 1 ATM before and after the procedure increases the success in people in this situation.
Another issue is radiotherapy after implant application. How long after the implant is applied, this treatment is performed and the dosing has a significant effect on the result. It has been reported that the risk is less in old implants.
The relationship between ectodermal dysplasia and dental implants
”Ectodermal dysplasia is an inherited disorder characterized by defects in tissues such as hair, skin, nails and teeth. The most common oral clinical presentation is one or multiple missing teeth.
Classical dental treatment and prosthesis techniques often fail due to insufficient tissue support. The correct method is implant-supported treatments to be performed after the development is completed.
While implant application is not recommended in single tooth deficiency treatments, it has been found that the anterior region of the lower jaw is the most suitable region for implant applications in severe cases of hypodontia (tooth deficiency). Studies have reported significantly lower maintenance and success rates in the upper jaw compared to the lower jaw.
Implant-supported prostheses can be technically divided into two types:
1) Fixed Implant Prostheses:
These prostheses are types of prostheses that cannot be removed by the wearer in any way and are mostly preferred by patients.
These types of prostheses are almost always preferred in the absence of one or a small number of teeth.
They are also often preferred in cases of complete edentulism, but in order to make successful fixed prostheses, the right conditions, planning, material and technique must be chosen correctly.
Fixed Implant Prostheses are divided into two:
- a) Cemented Fixed Prostheses:
These prostheses are prostheses that are glued on the abutments screwed on the implants and with this feature, their basic logic is like crowns-bridges made on the tooth. They cannot be removed by the patient and physicians cannot easily remove them when necessary. In order to remove it, it is necessary to apply a blow or cut the prosthesis. In case of complete edentulism, a minimum of 6 implants must be made.
Metal supported porcelain crowns, zirconium supported porcelain crowns, monolithic zirconium and BioHPP substructure composite are used as materials.
- b) Hybrid (Screwed) Fixed Prostheses:
These prostheses are fixed to the abutments screwed to the implants. They are increasingly preferred by physicians and patients. They cannot be removed by the user, but can be easily removed and inserted by the physician at any time. Thus, they can be removed when desired, maintenance around the implant can be easily performed and problems such as fractures etc. that may occur for any reason can be easily repaired. Minimum 4 implants are required in case of complete edentulism.
As a material; zirconium porcelain materials with metal substructure can be used, but soft materials such as composite and improved acrylic are more preferred.
2) Removable (Removable) Implant Prostheses:
These prostheses are prostheses that are supported by both implants and palates and can be removed and inserted at any time by the wearer. They are especially preferred in cases where the bone tissue is weak and the implants can provide little support, and in cases where people may have difficulty in reaching around the implants and cleaning the prostheses due to bone loss.
There are different attachment (retainer) systems that support the prostheses. According to this system, they have names such as locator attachment holder, knob attachment holder, telescope attachment holder.
The choice of these prostheses should be made by examining and analyzing the bone structure, wishes, expectations and support tissues of the person in the first examination. People who have no teeth but have sufficient bone level can also use implant-supported prostheses.
Periimplantitis – Implant Inflammation
It is an infection that occurs around the implant due to surgery, prosthesis construction or due to the tissues around the implant, due to lack of attention to oral hygiene and leads to bone loss in the surrounding tissues. With the accumulation of bacteria, the tissues create an infection for self-protection, which leads to bone loss.
It is of course possible to treat inflammation in the peri-implant tissues. The treatment method varies according to the amount of tissue loss that has occurred. In some cases, it may be sufficient for our treatment to clean the gum and bone tissue directly with a laser without opening it at all, while in some cases, the gum tissue can be opened with a small laser intervention and cleaned in such a detailed and successful way that it cannot be cleaned with any other tool and new bone formation can be provided. In this treatment, it would be most appropriate to use ER:YAG hard tissue laser.
“During the treatment of implant inflammation, the most successful method used to make the implant surface as close as possible to its original structure without damaging the implant is, of course, surface cleaning with ER:YAG Laser and SWEEPS technology.”
Can periimplantitis be treated?
ER YAG lasers, known as hard tissue lasers, are the most successful systems in the treatment of periimplantitis. The main purpose of this treatment is to remove the infected bone and tissue and replace it with healthy regenerated bone and tissue.
