A dental implant is an artificial tooth root replacement that is placed into your jaw to hold a replacement tooth or a bridge.

The most widely accepted and successful implant today is the Osseo integrated implant, based on the discovery that the titanium Implants can be successfully fused into the bone forming a structural and functional connection between the living bone and the implant.

The Osseo integrated implant to the bone later receives an abutment and a crown for it to be in full function.

Dental implants have been reported to have long-term success in the rehabilitation of completely, or partially edentulous patients. Various factors need to be evaluated during preoperative planning and the timing of implant placement post-extraction is considered an important factor which influences the esthetic outcome.

There are different timing to place dental implants after tooth extraction. The approaches are:

-Immediate implant placement
Immediate implants are placed in dental sockets just after tooth extraction. Advantages of immediate implants are that treatment time can be shortened and that bone volumes might be partially maintained, also fewer surgical interventions and a decrease in surgical trauma to the soft tissues at the implant site.

The potential disadvantages are an increased risk of infection and failures. Unpredictable gingival recession and crestal bone resorption have been associated with immediate implant placement in the esthetic zone.

-Immediate – delayed implant placement
‘Immediate-delayed’ implants are those implants inserted after weeks up to about a couple of months to allow for soft tissue healing. The main objectives of this protocol are: to ensure the lack of pathology when placing the implant, to optimize the availability of soft tissues for primary healing.

-Delayed implant placement
implant placement protocol characterized by a 12 to 16 week delay of the treatment after tooth extraction; this provides substantial bone fill of the socket that facilitates implant placement and mature soft tissues that facilitate flap management.

Dental implant treatment involves several components: implant itself, prosthetic abutment (connecting implant with the work) and dental crown.

-Cement retained dental implants
Dental implant defines not only the root area (replacement). One of the means through which a crown is attached to the dental implant is by cementing it on an intermediary piece (prosthetic abutment). The prosthetic abutment is screwed to the implant and the crown is fixed on it using an adhesive (dental cement). It represents the perfect way to place the crown for a single dental implant and requires great caution because, during the moment of sticking, cement remains/excess can infiltrate under the gum, damaging the implant in time. Sometimes the crown can be cleaned with difficulty and can lose cement or can be lost / broken.

-Screw retained dental implants
The second method for attaching a crown/dental work to the implant is by screwing it. Therefore, crown is directly screwed to the implant and the fixing screw access hole is covered with obturation material (filling) matching the tooth color. The advantage lies in its easy removal anytime when needed (professional hygiene, small fixes, etc.). The disadvantage lies in the fact that this tiny screw can weaken under high pressure, requiring periodic tightening with special keys, wrenches (with a precisely calibrated force couple).

If your jawbone is not able to support dental implants, several techniques can be used to rebuild bone, restore your natural jawline and provide a sturdy foundation for implant-supported teeth. These include:

• Bone augmentation. This involves restoring or regenerating bone in your jaw when it is not able to support implants otherwise. Research shows that using bone additives and growth factors to fortify the bone generally achieves the best results.
• Sinus lift. Also called sinus augmentation or sinus elevation, this involves adding bone below the sinus in cases where natural bone has deteriorated due to missing upper back teeth.
• Ridge expansion. If your jaw isn’t wide enough to support dental implants, bone graft material can be added to a small ridge, or space, created along the top of your jaw.

Unlike a regular denture, which rests on your gums, implant supported dentures are anchored in your mouth by dental implants. Most often, this form of denture is placed in the lower jaw because dentures tend to be less stable in the lower jaw. However, implant supported dentures can be placed in in the upper jaw as well. In this type of denture, your implant supported denture snaps into place on the implants surgically placed in your jaw. This prevents the denture from slipping or coming loose in the mouth. It also removes the need for denture paste or adhesives. The implant supported denture can be removed at night for cleaning or, if you have a fixed implant supported denture placed, your dentures will act as permanent teeth.

There are two types of implant supported dentures, bar-retained dentures and ball-retained dentures. Both types of dentures require two or more dental implants to be placed and both will provide you with a beautiful, natural smile.

Represented by extremely long implants used in special situations.

Zygomatic implants are placed in the back of the maxillary bone (superior), where maxillary sinuses reside and bone has the lowest density. The tips of these implants are anchored into the zygomatic bones (cheekbones), which maintain volume and density throughout time, even if the maxillary bone is resorbed. These implants are recommended for severe maxillary atrophies, when there is practically no bone left (in the superior maxillary) or remaining bone is in an extremely low quantity, being filled with air by exaggerated sinus volume enlargement. In this case it represents a good alternative to invasive surgery, when patient is unable or unwilling to undertake complex bone additions for lost bone volume enlargement in this region. Zygomatic implants rapidly and efficiently ensure an excellent stability in the posterior area for immediate dental works (allows immediate anchoring to fixed works) .In certain techniques, conventional implants can be successfully combined – in the frontal region we insert conventional implants and in the posterior areas we insert zygomatic implants

For severe maxillary atrophy conditions in all areas (including anterior) a number of two or three zygomatic implants are inserted individually yet simultaneously, in the same session, on each side of the superior maxillary (four or six in total)

The success of implant treatment in the long term, crucially depends on the manner in which they are maintained and cleaned, at home as well as professionally, in the dentist office, every 6 months, as well as special technology (special devices that do not injure gum around the implant, heads that will not scratch titanium and won’t cause irreversible trauma through uncontrolled vibrations on the implant).

1. Eat any food but with a little care
After osseointegration, dental implants become extremely solid, offering an optimal support for dental works, similar with the natural roots.
Nevertheless, as in their case, there is no risk as long as extreme and reckless actions are not resorted to, such as opening packages, chewing nails, bones or other hard objects

2. Oral hygiene maintainance
The daily care of dental implants is very similar to the care of natural teeth. Restored dental implants should be kept clean and plaque free twice a day using a brush and floss. Cleaning is especially important after meals. This is accomplished by gently brushing, giving special attention to all sides of the implant.

3. Maintenance of removable dentures
Removable dentures and overdentures require continuous maintenance. The female adapters that are housed in the denture need to be changed or refreshed every one to two years because they wear off. The operation is extremely simple and quick

4. Stop or at least reduce smoking
It is well known that smoking can cause several dental disorders, at the same time, it has been proved that smoking can lead to dental implant loss. It has been scientifically proven that nicotine severely reduces blood flow, including from the mouth (maxilla, gums, etc.). Tissues from the oral cavity, like all tissues from the body, are nourished by blood. Damage of all tissues from the mouth (bone, gums, tongue and cheek mucosa) will indirectly damage the dental implant (implant is sustained within bone and if bone is lost, implant will also be lost). Not to mention that smoking can cause forms of cancer on the oral soft tissue level (tongue, lips, and cheeks).

5. Professional hygiene
Implants and their crowns require special cleaning instruments that won’t traumatize gums or scratch titanium areas from the crown’s vicinity. Titanium can be easily scratched creating adherent surfaces for bacterial plaque, and therefore, after an improperly executed hygiene