“EVERY MISSING TOOTH REDUCES YOUR QUALITY OF LIFE”
Our main goal is to keep your natural teeth. However, even when a single tooth is extracted, the natural balance is disrupted and the loss of teeth accelerates. In such cases, implants are a very special solution that provides the closest balance of force to your own teeth, allowing you to laugh beautifully and to eat with pleasure.
Dental implants are artificial tooth roots usually made of titanium or titanium compounds to replace the missing teeth.
Titanium is preferred as the material of choice for dental implants because of its resistance to forces and its capacity of not interacting with body tissues. Implants can be placed in cavities created by previously loss teeth or in the tooth socket immediately after extraction if there is no serious infection.
‘‘PLACING IMPLANTS IS NOT OUR ONLY PURPOSE;
MAKING FUNCTIONAL, AESTHETIC TEETH COMFORTABLE FOR CHEWING AND SPEAKING. “
If the bone is sufficient and suitable to make fixed or removable prostheses, implants are placed in the jawbone with a simple operation. However, if the bone amount and density is not at the desired level, it may be necessary to perform bone formation procedures before placing the implants.
IMMEDIATE IMPLANT | INSTANT TEETH
Nowadays, our teeth play an extremely important role both from an aesthetic and functional point of view. For this reason, our priority should always be to keep our own teeth in our mouth. However, if our teeth need to be extracted, placing implants will be the best option.
In classical implant applications, a long time is needed to let the bone close the gap left by the extraction.
On the other hand, modern implantology allows us to place implants just after the extraction and, to a large extent, to attach a fixed tooth immediately.
he reason for waiting before implant placement after extraction is the possibility of contamination by inflammatory tissues on the implant surface and insufficient bone formation. However, studies have shown us that if the correct techniques are applied, immediate implant application produces correct results. Numerous literature studies on this subject support this view. When implant insertion is done in extracted or previously extracted healed sites with a certain scientific osseointegration torque value, fixed teeth (Immediate Loading) can be loaded on these implants immediately. There are also many scientific studies on this subject. In short, with the right planning and adequate application, people whose teeth are extracted will not experience edentulousness not even for a day.
In our daily life, we can use this solution in the following situations:
1) If all the teeth are extracted in the upper jaw or if there is complete edentulousness due to previous extractions, fixed teeth can be made immediately by planning an average of 6 implants according to the situation. A minimum of 4 implants are required for a fixed prosthesis in the upper jaw. The number of implants can be increased up to 8, depending on the width of the jaw curve, the application technique of the selected permanent tooth and the bone quality.
2) If all teeth are extracted in the lower jaw or if there is complete edentulousness due to previous extractions, fixed teeth can be made immediately by planning an average of 4 implants and fixed teeth can be made immediately. The number of implants can be increased up to 6, depending on the width of the jaw curve, the application technique of the selected permanent tooth and the bone quality.
3) If there is a reciprocal chewing area to be done in both jaws, fixed teeth can be placed immediately by applying at least 3 implants.
4) Fixed teeth can be inserted immediately in cases of tooth loss in the anterior region (the aesthetic area). In this case, the contact of the fixed teeth with the opposite ones should be avoided.
ALL ON FOUR | SIX
One of the main reasons why many people experiencing tooth loss (either because they have no teeth left or because of teeth extractions) cannot find a solution to this situation is the lack of time. All on four / six techniques offer an excellent solution to this problem.
In the All on Four / Six method, the extraction sockets are cleaned with laser as soon as the teeth are extracted, and the implant is placed immediately with fixed teeth placed on it. If there is no tooth, implants can be placed and prosthetic teeth can be fixed immediately.
In jaws that have been neglected for a long time for various reasons, bone loss caused by gingivitis, anatomical bone deficiencies (sagging sinuses in the upper jaw, superficial nerve bundles in the lower jaw, etc.), it is difficult to produce solutions using classical methods.
Anatomical structures in the lower and upper jaws are different in people who do not have any teeth, so the technique applied and the number of implants to be applied may also vary.
– The surface area covered by the teeth is larger than the lower jaw.
– The jawbone is of lower density than the lower jaw, so the integration of implants with the bone becomes weaker and takes longer.
– Especially the upper jaw anterior region is aesthetically important.
– If the sinus is sagging in the posterior region, the support bone will be less, in this case either angled implants must be applied or short implants are used.
When all these factors are gathered together, the result of the static calculation performed by the physician is mostly over 6 implants (All on Six) in the upper jaw.
– The tooth arch is smaller than the upper jaw.
– The jawbone density is higher and the implants can be fixed to the bone more firmly.
Prostheses made on 4 implants (All on Four) fixed to the posterior region implants and the two front implants, which are placed at an angle on the lower jaw nerve bundle, form the perfect abutment for a fixed over-implant prosthesis.
We can apply this method with Staumann Proarch technique to all people whose general health condition allows implant application and who want immediate solutions after serial tooth extractions or in case of complete edentulism.
– No need for advanced bone surgery
– We do not touch the original structures of the surrounding anatomy. (Like the sinuses)
– It is possible for us to continue our life without having any teeth. This prevents the person from being unhappy and unsatisfied, without compromising one’s social life.
– Since fixed teeth are attached immediately, it is possible for us to eat just after the procedure.
– There is no difficulty in speaking as the teeth are attached immediately.
– If laser implant is applied, swelling and pain will be minimal after the procedure.
The All on Four system has been used for 27 years and its success has been proven in the literature.
In our clinic, the all on four/six technique of Straumann Implants has been applied for 14 years and its success has been confirmed by more than a thousand patients.
Implant applications performed without cutting gums and stitching are called “Seamless Implants”.
It can be done in three ways:
1- Three-dimensional image is processed in a computer program and with a guide plate (Static Navigation)
2- With new generation robot arms working with three-dimensional view (Dynamic Navigation)
3- By processing the three-dimensional image with the experience of the dentist performing the implant application and with the soft tissue acquisition thanks to laser gingival orientation.
In cases where the bone structure and anatomy are known in 3 dimensions and the bone thickness is suitable, the implant can be placed without cutting the gum. Only the implant insertion site is opened with laser and the implant is placed. Since the gingiva is not cut widely, there is no need for stitching and the blood circulation of the bone around the implant is not impaired because the gingiva does not separate from the bone. For this reason, since the bone and the gingiva are not traumatised, the patient experiences a comfortable and fast recovery without any additional pain and swelling.
“It is an implant application that can be placed in the bone as designed on the computer.”
In guided implantology, the 3-dimensional volumetric tomography image and intraoral measurements of the person to be implanted are taken, and the implants are placed in the appropriate bone points according to the guide program. Thus, it is possible to place the implants in the best prosthetic way, shaping their angles and positions with the 3D guide plates prepared before the procedure. Since the end prosthesis is pre-designed on the same planning too, the number of sessions required for the prosthesis after the healing process is minimized without any margin of error.
IMPLANT TREATMENT IN BONE INSUFFICIENCY
In order to make healthy implant-supported teeth, implants should be held by at least 1 mm of tissues all around them. Therefore, sufficient width and length of bone support is needed to make long-lasting implants.
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 during clinical controls and even during the operation
If it is determined that there is not enough bone to make a healthy prosthesis in the jaw, new bone formation can be made by applying different techniques in the jaws. Alternatively a healthy chewing can be achieved with correct prosthetic solutions by applying angled implants with the Straumann Proarch technique.
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): It is the technique in which the implant is placed by opening the bone like a sandwich in insufficient bone thickness.
3) Block bone formation technique: It is applied by taking the 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.
IMPLANT SUPPORTED PROSTHESES
Teeth play an essential role in people’s quality of life. The main purpose of implants is enabling people to have high quality, functional and aesthetic teeth to be used when original teeth are lost.
For this purpose, prostheses applied with different techniques and materials and made with support from implants are called “Implant Supported Prostheses”.
1) Fixed Implant Prosthesis:
These are prosthesis that cannot be removed by the user in any way and are mostly preferred by the patients.
This type of prosthesis is almost always preferred in case of single or a small number of teeth missing.
They are mostly preferred in cases of complete edentulism, but in order to achieve successful fixed prostheses, the right conditions must be created and planning, material and technique must be selected correctly.
Fixed Implant Prostheses are Divided into Two:
a) Cemented (Adhered) Fixed Prostheses:
These prostheses are adhered on abutments which are screwed on implants. The basic logic of this feature is like crowns-bridges on the teeth. It cannot be removed by the patient, and when necessary, physicians cannot easily remove it.
To remove it, it is necessary to apply a blow or cut out the prosthesis. In case of complete edentulism, a minimum of 6 implants must be made.
Choice of material:
Metal supported porcelain crowns, zirconium supported porcelain crowns, monolithic zirconium and composite are used.
b) Hybrid (Screwed) Fixed Prostheses:
These prostheses are fixed to the abutments screwed to the implants. They are more preferred by physicians and patients every day. They cannot be removed by users, but can be easily removed and worn when desired by the physician. Thus, it can be removed when desired, the implant periphery maintenance can be done easily and fractures etc. problems can be easily repaired. In case of complete edentulism, a minimum of 4 implants are required.
Material of choice:
Metal-based zirconium porcelain materials can be used, but soft materials such as composite and enhanced acrylic are more preferred.
2) Removable Implant Supported Prostheses:
These prostheses are prostheses that are supported by both implants and palate, and that the wearer can remove and wear whenever they want. It is especially preferred in cases where the bone tissue is weak and implants can provide little support and when people may have difficulty reaching the implant periphery due to bone loss and cleaning the prostheses.
There are different attachment systems that support the prosthesis. According to this system, they are named as locator attachment holder, ball attachment holder, telescope attachment holder.
In the first examination of the selection of these prostheses, it is necessary to make a decision by examining and analyzing according to the bone structure, wishes, expectations and supporting tissues of the patient. Patients who have no teeth but have sufficient bone level can also use implant supported prostheses.