Faq
What Are Dental Implants ?
Implants are artificial roots used to replace the roots of missing teeth. When titanium implants are implanted into bone, bone grows in direct contact with the implant surface. This process is known as osseointegration and lets implants become a whole with the bone, as natural roots are.
When was implant surgery born?
The “pioneer age”in implant surgery ended in the ‘80s in the United States and around 1985-1986 in Italy, thus leading to the modern phase of implantology. Implantology was accepted as official branch of odontostomatology only when the prestigious Swedish school of Prof. P.I.Branemark presented to the international scientific community the clinical trials which showed beyond any doubt that implants can be considered as a treatment option with very high success rate, above 95%at 10-years-follow-ups. Our clinical experience, which dates back since 1986, confirms these data. Implantology is nowadays tought in all the most prestigious universities
What are dental implants?
Dental implants are artificial roots made of titanium which are placed in the upper or lower jaws to substitute missing teeth.
Do dental implants need to be certified as medical devices?
Yes, they do, because since June 13, 1998-according to Italian Law, it is forbidden to sell medical devices, including dental implants.
What are the advantages of an implant-supported prosthesis?
When just one or a few teeth need to be replaced, the main advantages,if compared to a traditional bridge, are:
-integrity of the adjacent teeth, withouth
-mainteinaance of the alveolar bone
What kind of patients are eligible for dental implants?
Young patients who have completed their growth phase (average 16years for girls and 18 years for boys), who are congenitally missing one or more teeth. Patients who, due to a traumatic injury, have lost one or more teeth. Patients who have already undergone in the past extensive prosthetic rehabilitations, when the supporting teeth of the old bridges which need remakink are not reliable any longer.patients wearing partial or total dentures, who for function, aesthetic or psychological reasons need a fixed prosthesis. There are virtually no upper age limits, even if every single case needs accurate evaluation of the psycho-physical conditions.
Is it always possible to receive dental implants?
Every single patient needs accurate examination and evaluation, in order to evaluate the conditions which make implant surgery possible. The main pre-requisite is the presence of a sufficient bone quantity to place the implant; for this particular evaluation, beyond the traditional radiographic exams (intraoral x-rays, panorex),the clinician may want to evaluate a CT scan, which provides an accurate 3-D image of the bone to be examined. Another important factor is that the patient is not suffering from an active periodontal disease. An accurate diagnosis and an adequate therapy can make also these patients eligible for implant surgery. Smoke is another important factor to be considered. Recent research shows how smoke can negatively affect both periodontal health and implant surgery outcomes. Patients smoking more than 10 cigarettes/day should be carefully evaluated. Another important factor is the systemic condition of the patient. Moreover only patients who can maintain a high level of at-home dental hygiene and be followed up can be eligible for dental implant treatment. Our practice will provide you with up-to-date dental hygiene instructions.
In case the amount of residual bone is not sufficient, is it impossible to receive dental implants?
Normslly it is possible anyway. Bone can be regenerated by using membranes and autogenous bone grafts or allografts. For example in the upper arch the presence of the maxillary sinus can somketimes be an obstacle to implant placement. In such cases it is possible to partially fill the cavity with a bone graft , and in some selected cases implants can be placed at the same time.
Is it necessary to be hospitalized to undergo implant surgery?
No. In most cases implant surgery is performed under local anesthesia. Patients may receive a sedation to redeuce anxiety levels and increase comfort levels. The operatory setting is adequately prepared for oral surgery.Special devices are used to check the comfort levels of the patient throughout the surgery. For more complicated cases an hospitalization may be advisable; normally the patient is dismissed the day after surgery, or the very day of the surgery.
Is the treatment painful?
No. If the surgery takes place in a dental setting, anesthetics specifically developed for oral surgery are used. These anesthetics are very powerful and induce a deep anesthesia. Patients don’t feel any pain. Once the surgical phase is over, Patients receive a prescription for analgesic-antinflammatory drugs which can effectively control post-op pain.
What is the step-by-step procedure?
It can take from two to three steps from surgery to prosthetic load of implants:
Step 1 titanium implants are surgically placed into bone; a healing time from 2 to 9 months follows, to let the implant undergo the osseointegration process.
Step 2 at the end of the osseointegration period a minor surgery is performed under local anesthesia to place onto the head of the implant a healing abutment, which will be visible on the gum.
Step 3 after the healing of the soft tissues around the abutment, the prosthesis is manufactered and fixed to the implant. In selected cases, only one surgery will be performed to both place the implants and the healing abutments; therefore after osseointegration the prosthetic step will follow. After the diagnostic phase the surgeon will inform the patient about the number of steps necessary to finish the case. In a few selected cases it is possible to place the provisional prosthesis the day of the surgery or the final prosthesis a few days after surgery: Thias technique is referred to as “immediate loading”.
How many implants are necessary?
The number of necessary implants is related to the number of missing teeth; excluding total rehabilitations (patients who have no teeth on either the upper or lower arch), the general rule is one implant per missing tooth, sometimes two implants per missing tooth (for example in the case of molars, which have two roots). When two or more adjacent implants are placed, generally prosthetic crowns are attached together in order to better support chewing forces
How can the surgery anxiety be reduced?
Almost all patients feel anxious before surgery and you should’t feel ashamed if you happen to feel like this. To reduce anxiety you may be prescribed sleeping pills the night before, and the day of the surgery you will receive more medications to decrease your discomfort.For particularly anxious patients or for major surgeries , you may receive I.V. sedation administered by a specialist in anesthesiology who will take care of you throughout the surgery. Please do not hesitate to ask for further information about the type of sedation which suits you better.
RISKS AND COMPLICATIONS
Generally speaking, risks and complications can be compared to those of a common oral surgery if the patient is healthy. Risks and complications can be reduced by means of an accurate diagnosis and appropriate radiographic imaging, for example CT scan. However, after surgery a sense of numbness may persist for a few weeks or months. This is a rare event and in very few cases may be permanent: This may occurr more often when surgery is performed in the lower arch. In elderly patients hematomas can occurr quite frequently. You shouldn’t worry about swollowing:this is a normal post-op factor. Anti-inflammatory therapy will reduce this occurrence. For every single kind of surgery, patients will be provided with specific risks and complications informations.
What are long term risks and complications of implant-supported prostheses?
Long term complications for implant-supported prostheses are uncommom. However over years some inflammatory or mechanical problem may occur:
In case of inadequate home hygiene procedure or .professional hygiene visits, implants, just like natural teeth, can have undergo inflammatory problems caused by plaque and calculus. Bacterial infections (peri-implantitis), if left untreated, may lead to the loss of the implant.
Should any discomfort or pain occur,patients should immediately seek for advice. Periimplantitis at early stages is easy to treat!
Permanent prostheses are screwed or cemented to implants. Due to function, fixation screws may become lose or fracture. Over time cement may lose its retentive strength. When such an event occurs, the prosthesis may become lose, and even if no discomfort or pain occurs, the prosthesis should be immediately fixed to avoid damaging the implants or fracturing fixation screws.
Also in these cases it’s mandatory for the patient to seek for immediate advice.
MEDICAL THERAPY
Clinical trials have demonstrated a higher success rate in patients who have been administered an antibiotic pre/post-op therapy and an anti-inflammatory therapy. Use of chlorexideine significantly reduces infective complications.
Is an adverse reaction to titanium possible?
No, because titanium is a totally biocompatible material. On the other hand, an implant failure may occurr.
Immediate failure (no osseointegration before the prosthetic step)is an extremely rare event (according to our experience and to the published data immediate failures can reach 2-3%).
IS THERE ANY DEVICE TO CHECK OSSEOINTEGRATION?
Yes, a non-invasive examination can be carried out in a totally painless way.A transducer is connected to the implant and the level of osseointegration is displayed. This information allows to know when the implant can functionally be loaded.
HOW LONG WILL MY IMPLANTS LAST?
When rigurous technical guidilines are followed, Once an implant is osseointegrated it will last forever, as long as the patients keeps an accurate hygiene and comes back for regular check-up visits.
Is it possible to remake implant-supported prostheses?
Yes:all the implant supported prostheses ar fixed onto implants by screws or special cements which can be removed by the prosthetic dentist in case of need. Patients, on the other hand, cannot remove them: they look and work like natural teeth.