The goal of modern dentistry is to restore patients’ normal facial structure, chewing functions, aesthetics, comfort, speech abilities, and health by eliminating tooth decay or replacing missing teeth. What makes implant treatment unique in this field is its ability to achieve these goals without being hindered by disruptions, diseases, or injuries to the chewing system. However, as the number of missing teeth increases, achieving this goal becomes more difficult. Thanks to ongoing research, diagnostic tools, treatment planning, implant designs, new materials, and techniques, predictable success in the treatment of many difficult clinical situations is now a reality.
A dental implant (also known as an endosseous implant) is a medical product that is surgically placed in the jawbone to support dental prostheses such as crowns, bridges, or removable dentures, or to be used as a fixed support in orthodontic treatments.
At the core of modern dental implants is a biological process called osseointegration, which refers to the tight integration of materials such as titanium with bone. First, an implant is placed inside the bone, then it integrates with the bone, and finally a dental prosthesis is placed on top of it. An important healing period is required before a dental prosthesis (crown, bridge, or removable denture) can be placed on the implant-supported superstructure.
The success or failure of dental implants is directly related to the general health of the person receiving them, the medications that affect bone integration, and the overall health of the oral tissues. The prerequisite for long-term success of dental implants is healthy bone and gum tissue.
Oral implantology dates back a long time. Throughout history, extracted teeth, pieces of wood, ivory, dried bone, gold, and silver alloys have been used as implant materials. Over time, intensive studies have continued, and implant systems that produce successful results have finally been discovered.
Today’s implants are made of pure titanium, as it is the most compatible material with human tissues. Titanium does not cause any side effects in surrounding tissues or distant organs after it is placed in the body.
Implants are placed inside the bone and osseointegrate with the bone. Osseointegration means structural and functional direct bonding between living bone and the implant surface that carries the load. This means there is no gap between the implant and the bone.
Implant treatment can be applied in the case of a single tooth, multiple teeth, or the loss of all teeth. It can be applied to people of all ages whose bone development is complete. The most important thing is that the bone structure in the jaw is suitable for this. Therefore, implant planning should be done carefully by experts in this field. Ideally, both the maxillofacial surgeon and the prosthodontist should plan the treatment together. In this way, an appropriate system can be determined according to the patient’s needs and the condition of the bone for both the root part of the implant and the prosthesis part.
After implant surgery, the following precautions should be taken:
1- Saliva and mouth rinsing should not be done on the first day. This way, blood clotting will not be disrupted and there will be no bleeding.
2- To reduce swelling after the operation, ice should be applied to the area throughout the day. Ice should not be continuously held and should be applied at 15-minute intervals. Ice application is only recommended on the first day. It is not recommended to be done on other days.
3- Smoking and alcohol should not be consumed.
4- Soft foods should be consumed, and the surgical site should not be touched.
5- Oral hygiene should be taken care of, and medications should be taken on time and as instructed.
If these rules and other rules explained by the doctor are followed, the process after the operation will pass smoothly.
The factors that affect the success of implant treatment are:
1- Correct indication and planning of the implant.
2- The implant used should have sufficient properties.
3- The application method and the competence of the applying team (should be performed by expert physicians).
4- The healing capacity of the gum and bone and the individual’s immune system.
5- Correct planning and application of the temporary and permanent prostheses to be applied (should be performed by expert physicians).
Implant studies are a team effort, and the success of the implant depends on this. In this team, there must be a surgeon and a prosthodontist who will jointly decide where the implant will be placed and how many implants will be placed, and a gum disease specialist must be present to ensure good oral hygiene and perform checks after the superstructure is placed.
After the implant is placed, the healing process begins. Gum healing takes 7-10 days. After this process, the gum returns to its old state, but the healing of the bone, which means the fusion of the implant placed with the bone, is a slightly longer process. This is entirely related to the fact that the bone tissue is a tissue that heals slower than other tissues. The lower jawbone heals faster than the upper jawbone in terms of structure. Therefore, the healing period for implants placed in the lower jaw is shorter than the upper jaw. If no procedure was performed to create bone with the implant, a waiting period of about 1.5-2 months in the lower jaw and 2.5-3 months in the upper jaw is required for the implant-bone fusion. The healing of the implant is evaluated by X-ray and osteal measurement techniques, and if it is decided that the healing is complete, the prosthesis construction begins. If there is insufficient healing, the waiting period may be extended. If any procedure was performed to create bone with the implant, the healing time is about twice as long as that of an implant placed in normal bone. Again, evaluation is performed after this period, and the prosthesis procedure begins according to the result of this evaluation. During the period before the prosthesis is made, the patient continues their normal life. If necessary, temporary teeth that the patient will use during this healing period are made immediately after the operation or within a week. Whether these temporary teeth are removable or fixed is decided by the prosthodontist according to the patient’s condition. The construction period of the actual prostheses to be made after the implant has healed also depends on the number of teeth to be made for the patient.