Implants

Healthy neighboring teeth and the jawbone can be damaged by traditional tooth replacements involving bridges and prosthesis. In fact the bone substance only remains preserved if it is naturally loaded. This occurs via the root through which the tooth is anchored in the bone. Tooth roots can be imagined as deep lying roots of a tree or as foundation pillar for a bridge. If a tooth root goes missing the jawbone is no longer naturally loaded and resorbes slowly.

Many of us know the consequences of this from bitter experience: neighboring teeth or dentures become overloaded in the long run and loosen so that other teeth can also disappear. Partial and full prosthesis remain as foreign bodies, cause pressure points and drastically reduce taste as well as tactile and temperature perception. This means that the prosthesis have to be continually readapted, entailing also insecurity when speaking, smiling and eating.

Such problems do not arise at all with implants. Therefore, it is not surprising that several million implants are now placed worldwide every year, ranging from single tooth to restorations for entire jaws. The demand for this form of modern dentistry, which has now been available for more than 30 years, is increasing continuously. Although they are initially more costly, implants in the long run certainly represent the more economical solution over conventional crown or bridge treatments.

Dental implant is one of the most popular solutions for missing teeth. A titanium screw replaces the old root and a naturally looking crown is attached to perfectly replicate the missing tooth. Unlike bridgework, implants do not affect the surrounding teeth. Integrated into the jaw, they avoid the gum problems and bone loss that can accompany a bridge or dentures.

Replacing a Single Tooth

If you are missing a single tooth, one implant and a crown can replace it. A dental implant replaces both the lost natural tooth and its root.

Replacing Several Teeth

If you are missing several teeth, implant-supported bridges can replace them. Dental implants will replace both your lost natural teeth and some of the roots.

Replacing All of Your Teeth

If you are missing all of your teeth, an implant-supported full bridge or full denture can replace them. Dental implants will replace both your lost natural teeth and some of the roots.

What are the advantages of implants?

A dental implant provides several advantages over other tooth replacement options. In addition to looking and functioning like a natural tooth, a dental implant replaces teeth without sacrificing the health of neighbouring teeth. The other common treatment for the loss of teeth is a tooth-supported fixed bridge that requires adjacent teeth be ground down to support the cemented bridge.

With complete loss of teeth, implant-supported full bridges and dentures are more comfortable and stable than conventional dentures, allowing you to retain a more natural biting and chewing capacity. Also, because implant-supported bridges and dentures will replace some of your tooth roots, your bone is better preserved. The loss of bone that accompanies conventional dentures leads to recession of the jawbone and a collapsed, unattractive smile.

Because dental implants will replace your tooth root, the bone is better preserved. With a bridge, some of the bone that previously surrounded the tooth begins to resorb (deteriorate). Dental implants integrate with your jawbone, helping to keep the bone healthy and intact.

How will the implants be placed?

You will generally need to have 1 or 2 trips to Hungary to complete the full treatment. Remember Hungary is only a little over 2-3 hours away from the UK and Ireland and can be combined as a short break away from work – some appointments can be organised to take in a long weekend.

The first step is to place the implant/s, which looks like screws or cylinders, into your jaw. This is done under local anaesthetic (sedation and general anaesthesia is available for more nervous patients). Over the next two to six months, the implants and the bone must be allowed to bond together. During this time, a temporary replacement solution will be made, so that you will immediately be coming home with that new smile. This initial stage generally requires a 1 or 2 night stay.

The second step, will be to place the crowns and bridges. After a short time, you will experience restored confidence in your smile and your ability to chew and speak. To create the crowns from impression generally takes about a week. You can stay in Hungary for the week and enjoy the delights of Budapest or we can arrange for you to have a holiday in another part of Hungary (Lake Balaton for instance). You would have the impressions made at the beginning of the week and crowns fitted at the end. Alternatively, you can make two separate short visits of 1 or 2 nights.

Bone Grafting or Sinus Augmentation

A key to implant success is the quantity and quality of the bone where the implant is to be placed.

The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. If you have lost bone in that area due to reasons such as periodontal disease or tooth loss, you may be left without enough bone to place implants.

Bone grafting or sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants. A simple common technique for this is to fill some of the sinus cavities with biocompatible bone grafting material. This then gives more bone density and strengthens the area to allow implants. This will also help with regenerating the loss of bone tissue.

Procedure

A typical implant consists of a titanium screw, with a roughened surface. This surface is treated either by plasma spraying, etching or sandblasting to increase the integration potential of the implant. At edentulous (without teeth) jaw sites, a pilot hole is bored into the recipient bone, taking care to avoid vital structures (in particular the inferior alveolar nerve within the mandible).

Computer simulation software based on CAT scan data allows virtual implant surgical placement based on a barium impregnated prototype of the final prosthesis. This predicts vital anatomy, bone quality, implant characteristics, the need for bone grafting, and maximizing the implant bone surface area for the treatment case creating a high level of predictability. Computer CAD/CAM milled or stereo lithography based drill guides can be developed for the implant surgeon to facilitate proper implant placement based on the final prosthesis occlusion and aesthetics.

Contraindications

There are no absolute contraindications to implant dentistry, however, there are some systemic, behavioural and anatomic considerations that should be considered.

Uncontrolled type II diabetes is a significant relative contraindication as healing following any type of surgical procedure is delayed due to poor peripheral blood circulation. Anatomic considerations include the volume and height of bone available. Often an ancillary procedure known as a block graft or sinus augmentation are needed to provide enough bone for successful implant placement.

There is new information about bisphosphonates (taken for osteoporosis and certain forms of breast cancer) which put patients at a higher risk of developing a delayed healing syndrome called osteonecrosis. Implants may be contraindicated in patients who take this class of drug.

Bruxism (tooth clenching or grinding) is another contraindication. The forces generated during bruxism are particularly detrimental to implants while bone is healing; micromovements in the implant positioning are associated with increased rates of implant failure. Bruxism continues to pose a threat to implants throughout the life of the recipient. Natural teeth contain a periodontal ligament allowing each tooth to move and absorb shock in response to vertical and horizontal forces. Once replaced by dental implants, this ligament is lost and teeth are immovably anchored directly into the jaw bone. This problem can be minimized by wearing a custom made mouthguard (such an NTI appliance) at night.

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