Implant Treatment

background to the treatment
what is a dental implant?
the treatment step by step
fixture installation
care following fixture installation
some common questions (fixture)
abutment installation
care following the abutment installation
some common question (abutment)
the prosthetic treatment
care of your teeth
some common (prosthetic treatment)

The instructions provide you with information about the planned treatment. The various stages of the treatment are described, advice and directions are given about what you should pay particular attention to. Remember that these directions are general ones. Your dentist will give you detailed instructions about how you should care for your new teeth.

The satisfactory, long-term outcome of treatment depends largely on the part you play in following the instructions.

For many people today who are without all or some of their teeth, the usual solution (removable dentures) entails considerable problems in their everyday life. Simple things like eating and talking to others are associated with considerable difficulty and feelings of uncertainty.

Extensive research and clinical experience have established that dental implants are a reliable and well-accepted method of treatment, solving many of the problems associated with the use of dentures.

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A dental implant consists of two main parts - a "fixture", which is a titanium screw inserted surgically into the jaw, and an abutment, which is made of titanium and forms a link between the fixture and the overlying bridge.

The two parts of the implant are inserted surgically into the jaw in two stages. In the first stage of the operation the fixture is inserted in the jaw. Following a period of healing the abutment is attached. The implant system then heals, becoming "integrated" with the bone tissue. One way of describing this process of integration is to say that the implants "become part of the jawbone". The new teeth are then attached to the implants. In this way the implants provide a secure anchorge between the jawbone and the new teeth. The result is that the new teeth feel and look like your natural teeth.

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Preliminary Examination
You will be examined beforehand by a specialist who will decide whether implant treatment is a good solution in your case.

Examination
A more detailed examination will then be carried out. You will be told definitively whether implants can be inserted and the subsequent treatment will be scheduled. If you have any teeth of your own, they will be examined and, if necessary, give treatment. It is essential for any other dental problem which exists to be cleared up before treatment can begin.

Operation I Fixture installation
During installation of the fixtures the titanium screws are inserted surgically into the jawbone. The operation is usually carried out under a local anesthetic and lasts for approximately one hour.

Healing Period I
In the course of healing the titanium screws take firm root in the jawbone. Healing takes about three months in the lower jaw and six months in the upper jaw. The difference in the times of healing in the upper and lower jawbones lies in the differing nature of the bone and the healing process in each jawbone.

Operation II Abutment installation
The abutment refers to the titanium link between the fixture and the prosthetic superstructure or denture. The operation is smaller than the previous one and lasts about half-an-hour.

Healing Period II
After a short period of healing, lasting about a week, the surgical treatment is complete

Prosthetic Treatment
Once they are in place, the fixtures and abutments together provide a supporting post. Everything is now ready for the next stage, the task of constructing your new teeth - the prosthetic treatment.

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In this first stage the titanium screws are inserted surgically into the jawbone. The surgeon drills with extreme precision the holes in which the screws are to sit. Following this the titanium screws are screwed into place.

In a jaw in which there are no teeth 4-6 screws are inserted and the operation lasts about an hour. In the case of a jaw where teeth are present the surgeon decides on the appropriate number of screws

The operation is usually carried out under a local anesthetic and you can go home the same day.

In the upper jaw any existing denture is usually put back in place directly after the operation, while for the lower jaw there is normally a delay of about a week. (This only applies to those who have no teeth at all and have previously had dentures.)

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After the operation comes the extremely important healing period during which time the implants have to take firm root in the jawbone. It is important that this should take place without the implants being subjected to any strain. You should, therefore, be extremely careful in the first few weeks after the operation and keep to a suitable diet.

If the dentures chafe at any point or if there are other symptoms in the form of pain, swelling or tenderness, it is important that you should get in touch with your dentist without delay.

A small amount of pain and swelling is normal in the first week after the operation . After about a week the stitches will be removed and the gum will be back to normal within a day or two.

- Examine you gum daily for signs of redness and swelling.
- By all means clean your gums with the aid of soft tootbrush.
- Follow the instructions of your dentist in regard to rinsing your mouth and other oral-hygiene measures.
- You should clean your dentures daily with a soft toothbrush and a non-abrasive toothpaste. It is not advisable to brush the surface of the dentures facing the gum, since this surface has been given a new, soft coating following the operation.

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Is it painful?
The procedure is carried out under a local anesthetic and, since the latter is extremely effective, you will feel no pain during any part of the operation. After the operation, when the anesthetic starts to wear off, you may feel some pain and discomfort. There is usually some swelling and bruises occasionally appear. These symptoms are at their height 2-3 days after the operation. Ordinary painkillers are normally sufficient to relieve any pain that occurs after the operation.

When will I be able to use my dentures again?
As a rule, the upper denture can be replaced immediately after the operation, while the lower denture can be replaced after about a week.

Why are the screws made of titanium?
Titanium has the unique property of fusing with the bone tissue through a process of "integration", becoming like part of the body in the process. This gives the implant its extreme strength of attachment.

What should I eat?
To avoid unnecessary strain on the fixture initially after the operation, you should keep to a diet consisting of pulped food and liquids.

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Once the fixtures have integrated with the bone, the final operation of inserting the abutments takes place. This is a minor procedure in which the surgeon removes the covering screws needed to protect the fixtures during healing

The abutment (the link between the fixture and the overlying bridge) is then screwed into place on the fixture.

The operation is now over and no further surgery is needed. Healing takes about a week after which the next stage can begin, the task of constructing the new teeth - the prosthetic treatment.

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It is now important to keep the area around the abutments clean. This may be somewhat painful in the first few days after the operation. Careful brushing with a soft toothbruch is usually possible 1-2 days after the operation. A mouth rinse may be recommended by your dentist.

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Is it painful?
The installation of an abutment is not as major an operation as the installation of a fixture. It is also carried out with an effective local anesthetic, so that no pain at all is involved. Some swelling and pain may occur after the operation. It is usually sufficient to treat any discomfort you fell with ordinary painkillers.

When can I start to use my dentures again?
In most cases dentures can be used immediately following the abutment operation.

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By now you have reached the stage in your treatment when your fixtures have healed in the jawbone and the abutments have been screwed on to them. It is now time for the final stage - the prosthetic treatment.

During this stage a prosthodontist and a dental technician will work together as a team to construct your new teeth.

The work starts with the prosthodontist taking an impression of your jaws. From the impression an exact copy is then made of you jaws which is used as a model when constructing your new teeth. As the work proceeds, you will beasked at each stage to try out what will eventually be your new teeth.

The prosthodontist will make any adjustments needed until both you and s/he are satisfied with the result. The work normally takes between two and four weeks.

The final stage comes when your new, finished prosthesis are inserted and the work is complete!

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Now that you have you have your new teeth, it is more important than ever to see that you clean them properly. This applies particularly to the area around the abutments.

- Cleaning in the spaces between the abutments is achieved with the aid of bottle-brush, an inter dental brush and floss silk thead which is inserted under the teeth. Those of you who have removable dentures will naturally find hygiene an easier task.

- On the teeth themselves an ordinary soft toothbrush should be use. Do not use an abrasive toothpaste. Ask your dentist if you are not sure what type of brush to use.

A small angled brush (an "interspace" brush) is suitable for reaching the back of the teeth.

Looking after your new teeth also includes visiting your dentist for regular check-ups. The first of these visit takes place after a week, when you and your dentist will discuss how your new teeth are functioning, how they look and whether you have any problems talking. At the same time your dentist and/or dental hygienist will make sure that you are taking the proper hygienic measures.

Subseauent visits are recommendedafter one, three and seven months, and after the first year follow-up visits should take place annually.

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What will the final result be like?
As you can see in the picture, no part of the implant is visible during a "normal" smile.
To enable you to clean your teeth properly, there is a space between the gum and the teeth.

How long will my teeth last?
Today there are patients who have had their implant dentures for 25 years, In the same way as "real" teeth, the teeth themselves may wear or break. The difference is that they can now be removed and and repaired, enbling their original appearance to be reproduced.

By far the most important thing needed for a satisfactory, long-team outcome in regard to your new teeth is careful adherence to dental hygiene and regular visits to your dentist.

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