Faced with the need to put on a implant it is logical that fears and doubts arise regarding a surgical procedure, but, placing an implant is an act minimally invasive and careful, which is more similar (in terms of sensations and discomfort) to a filling than to an extraction.
It is true that there are complex cases where, due to lack of bone, we have to resort to complex regeneration techniques, but these are the minority. Currently, short, narrow implants are preferred to regenerative surgery based on recent scientific research.
As for the size of an implant, the standard diameter is 4 mm and the length is 10 mm, i.e. smaller than a bean.
The treatment is completely painless, performed under local anaesthesia. There is only a slight vibration and a salty taste due to the use of saline which cleans and keeps the temperature of the instruments stable.
Subsequently, many patients do not even require analgesic treatment, as they do not usually hurt or become inflamed.
There are different techniques for implant placement:
1. STANDARD IMPLANT:
This is the form most common to place the implants and we carry it out when there is no longer a tooth and we have sufficient bone both in width and height and masticatory or keratinised gum.
It consists of a minimally invasive surgery through an eyelet in the gum or by making a small incision access to be able to locate the bone. Subsequently, after passing several drills to prepare the space, we place an implant.
At this point there are two alternatives during the healing period:
- Traditional technique or when there is little stability of the implant once it has been placed, which could cause movement during healing, and therefore, its non-integration with the bone. This technique consists of leaving the implant buried under the gum so that no external agents intervene and facilitate the union of the bone with the implant.
- One-stage technique, where a healing abutment is connected to the implant, which remains exposed in the mouth, flush with the gum. This technique avoids a second surgical intervention, as once the healing time is over we would only have to disconnect the abutment to be able to access the implant and make the prosthesis to measure.
As long as the implant is stable and there are no negative factors such as smoking or prosthesis support, there is no difference in success between one technique and the other.
2. IMMEDIATE POST-EXTRACTION IMPLANT
We often encounter patients who, for aesthetic reasons, for reasons of time or apprehension, we are obliged to place implants. at the same time that we extract a non-repairable tooth.
This is possible if we have enough bone to be able to stabilise an implant, regardless of whether the tooth to be extracted is infected, as long as an adequate treatment of the implant is carried out. reduction of infection before and during treatment.
In these cases we must use regeneration techniques to fill the space that may remain, due to the different dimensions between the implant and the root that we have extracted.
What is always clear to us is that patients do not like to see themselves without teeth and therefore, if it is an aesthetic sector, we can make an immediate provisionalisation attached to the implant itself or by gluing a provisional tooth to the adjacent teeth.
3. IMPLANT WITH IMMEDIATE LOADING OR IMMEDIATE PROVISIONALISATION:
This point is the one that most controversies we ask ourselves in the dental clinic. Advertising about implants on television, social networks or the internet can create false hopes for patients.
When we place an implant, we need it to stay in place for a long period of time. physically retained due to the design of the implant. This is why threaded tapered implants are currently the implant of choice.
The mechanical stability achieved by the implant is progressively lost as the days go by from the fifth day onwards.
But the human body is very intelligent, and sends out bone-forming cells, or osteoblasts, which attach to the rough surface of the implant and generate new bone for a new physical-biological bond called osseointegration to take place.
The most critical moment The time of lowest retention of the implant in the bone is between 2 and 6 weeks, where an error in the healing process due to micromovement may occur, leading to failure or loss of the implant, which is commonly known as "rejection".
You already know how bone bonding occurs and the main reason for implant failure, which, according to studies, does not exceed 2%. Now you will have a better understanding of what provisionalisation and immediate loading.
We can place a temporary crown in an implant that we have just placed, if it is sufficiently stable in the bone, although it will depend on how many teeth we are going to replace.
In the case of replacing one or more teeth, a temporary crown can be placed, but it is not advisable for the temporary crown to collide with the opposing teeth, as they would be subjected to certain movements and would cause the implant to fail. On the other hand, when we replace all the teeth in the shape of a horseshoe, they can come into contact, since the union between all the implants would diminish those micro-movements that cause failures.
In the dental clinic Velez & Lozano We have a team headed by Dr. Fernando García Vélez, a specialist in dental implantology, with hundreds of cases successfully treated. You can call us on 968 28 46 28 or make an appointment at https://velezylozano.com/cita-online/
And if you have any doubts or questions, you can send them by mail; pacientes@velezylozano.com