Implants

What are dental implants

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For loss of one or more teeth, tissue-friendly replacement roots are increasingly being implanted nowadays. Dental implants are artificial tooth roots. They usually have a screw-like or cylindrical design. They are implanted in the jaw bone to replace the lost teeth. A dental implant performs the same function as a person’s own tooth roots because it fuses directly with the surrounding bone.

Today nearly all implants are made of high-purity titanium because it is very well tolerated by human tissues and forms a secure bond with bone. This material has proven valuable in medicine for decades. Titanium is not known to cause any allergies or intolerance reactions. The size and shape of an implant is determined by the individual conditions in the jaw of the patient receiving treatment.

There is no general age restriction to dental implantation. A minimum bone height in the jaw is required for dental implantation. As a result of medical developments, it has now become possible to rebuild an adequate bony foundation in most cases where this bone supply is not already available. This is done by grafting the patient’s own bone or by the use of bone augmentation materials.

If there are problems augmenting the bone, it is possible to switch to short and ultra-short implants which have also proved very successful..

What are the advantages of dental implants?

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In most cases, the neighboring teeth do not have to be ground back. The use of implants prevents advancing bone resorption in the jaw. You will be spared the stress caused by wearing a mucosa-borne mobile prosthesis. In most cases a removable denture becomes unnecessary.

What conditions have to be met?

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An implant can be inserted at any age once bone growth is completed. Normal wound healing capacity and good general health are important for successful implant insertion. Good bone quality and sufficient bone volume also need to be available. Good oral hygiene is essential.

What happens if there is a lack of bone?

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Augmentative techniques are measures used to build up the existing bone. The ultimate aim of these techniques is to make up for the inadequate bone supply so that implants can later be inserted. Small defects of limited dimensions can be repaired by means of guided bone regeneration (GBR). Larger bony defects can only be replaced by grafts or by specific measures such as raising the floor of the maxillary sinus (sinus lift).

How is the augmentative method chosen?

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Precise prosthetic planning is essential before any augmentative measures. This involves adequate preoperative diagnostics, including clinical examination and radiographic investigations as well as model analysis. Computed tomography provides accurate information about important anatomical structures, such as the positional relationship of the floor of the maxillary sinus to the alveolar process or the mandibular canal. During preoperative planning, the nature and scope of the augmentative measures is selected and the timing is decided.

How is implantation done?

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The oral / maxillofacial surgeon performing the treatment inserts the replacement roots into the jaw, usually under local anesthesia. Once inserted, the implants perform the function of a substitute root for the tooth. This creates the basis for a stable replacement tooth, which is placed onto these new roots. After an incorporation phase of 3 to 5 months, the required firm support for the new teeth is thereby guaranteed. Good hygiene and regular aftercare appointments following implant treatment greatly help to prevent complications. More than 96% of implants now hold for more than ten years.

Special forms of implantation

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Immediate implant
If a tooth that is not worth preserving has to be extracted, it is advisable to fill the resulting hole in the bone immediately with an implant, provided the conditions are irritation-free. Then the dentist can decide whether the preferred course of action is submerged healing of the implant by means of primary wound closure or immediate restoration with a crown. Other possibilities involve immediate restoration or immediate loading of the implant.

Immediate restoration
In selected cases, given a favorable bone situation and highly cooperative patients, the freshly inserted implant can be fitted with a crown, especially in the esthetically important anterior area. However, this crown should be shaped so that it does not make contact with other teeth when the patient bites together and so that the patient does not put any load on the crown. Otherwise, this would be known as immediate loading.

Immediate loading
When 4 or 6 implants are being used and provided bone availability in the maxilla and mandible is adequate, the freshly inserted implants can be fitted immediately with an implant-supported bridge construction. This bridge can be immediately loaded with care. The computer-generated Camlog Guide System is used and the implants are inserted with the aid of a template so that the bridge can be placed immediately after the operation.

Lateral bypass
If there is minimal bone volume over the mandibular nerve, which is responsible for sensation in the lower lip, the implant can be inserted past the nerve on the tongue side with the aid of the Camlog Guide System.

Short and ultra-short implants
If augmentative procedures are not wanted or not feasible for medical reasons, short and ultra-short implants (up to 5 mm length) can be inserted. These short implants produce equally good results to “long implants” over a very long period of time.

3D navigation in implantation

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Direct 3D navigation of implants is a new type of surgical system that makes it possible for the first time to transfer the treatment plan precisely and simply to the intraoperative situation. Planning graphics displayed on the computer screen with superimposed X-rays, CT or MRI views can be visualized for the surgeon during the surgical procedure using the technique of “augmented reality”. Spatial coordination of radiological images and patient allows computer-aided stereotaxis (image-guided localization) to be achieved for the first time. As a result, no additional instruments are required for referencing during the operation.

More info can be found at:

Template-guided implant navigation - Camlog Guide