Discover the origin of dental implantology, different types of implants, and different prosthesis as not all treatments with implants are the same
Implantology started its development due to a discovery that took place after a number of experimental and surgical studies in biology conducted by the University of Gothenburg (Sweden) in the 60’s and the Institute for Applied Biotechnology in the 70’s also in Gotheburg. Those investigations were aimed to broaden the knowledge of the possibilities of reparation and regeneration of bone and medullar tissues and the ideal design for non-biological components that would meet the tissue requirements to allow bone bonding on a molecular basis.
The discovery of the bone bonding properties of Titanium took place when it was found that the microscopic titanium holders that were implanted on the bone could no longer be removed after healing of the scar as the titanium had bonded completely with the bone.At this point, Osseointegration was defined as a direct, structural and functional connection between the bone and the surface of an implant under functional load.
The idea of applying this discovery to rehabilitation of tooth loss in the 60’s, after numerous testing with animals, leads to what we know today as Dental Implantology.
In 1965 the first toothless patient was treated with this new experimental technique. Since then, constant studies and investigations to improve the size and shape of implants have been conducted, as well as the treatment of titanium with several coatings in order to achieve ideal bone bonding.In the early days implantology was only applied in extreme cases. The little knowledge and the low level of trust in this technique forced the first professionals to be cautious in their surgical practice.
Nevertheless, the favourable clinical results and the improved techniques, along with the research and effort put in by labs, have taken the indications of Implantology to unexpected levels.Today it can be said that we are able to offer our patients a highly safe and widely developed technique that contributes to remarkably improved life quality.
Along with the functional improvements of implants, the aesthetical demands have also increased dramatically. Therefore, nowadays we are able to offer impeccable aesthetical results regarding the front teeth, for example in the case of traumatic loss in very young patients. The result of the replaced pieces will offer an identical look compared to the adjacent natural pieces. Therefore, it is no longer recommendable to carve adjacent pieces to place a bridge.
What is an Implant?
An implant is a metal screw made of pure titanium with a special coating treatment on its surface to guarantee its bonding with the bone. It is a biocompatible medical prosthetic piece prepared to be implanted in the human body, undergoing the most meticulous sanitary controls from fabrication until placed on the patient’s bone.
It is a high precision piece, designed to resist considerable loads, like the motion executed by jaws during chewing. It must meet the perfect mechanical requirements in terms of its head, adjusting with the bridgework that has to be placed on top, not allowing any looseness.
For this reason it is important to always use implants of recognised quality.
A restored tooth piece consists of three parts: the implant, the connector and the crown or cover.
Different types and sizes of implants
There are many types of implants on the market.
In terms of material they can be separated into titanium implants with smooth surface and rough surface, depending on the treatment that has been applied. In the early stages all implants had a smooth surface but more recent studies have proved that the bone bonding shows faster and more efficient results when the surface is rough.
Regarding the mechanism that prevents the implant from un-tapping, the implants are divided into the ones with internal hexagon, external hexagon and friction.
With regards to its design there are both self-tapping and non self-tapping implants. The self-tapping design offers greater precision, easier placement and considerably reduces overheating of the bone during surgery. Statistics show that these implants have a smaller risk of failure.
In terms of size, they can differ in diameter and length. It is important to place wider implants when replacing a molar whenever possible, as these pieces will be subject to heavier loads that the front teeth. The diameter of an implant is not a random parameter, but is set according to the results of scientific research. The wider implant available on the market has a 6mm diameter and is recommended to replace molars. The standard, most common size is 3.75mm and is indicated for replacing front teeth.
Implants are also available in different lengths. It is recommended to always use the longest possible implants, according to what the bone area allows. This ensures the best long-term results
The importance of prosthetics. Different types of prostheses on implants:
In general, patients are quite well informed about what implants are in the surgical aspect, but very few people know about the different options available when it comes to choosing the prosthesis.
In every treatment with implants, prosthetics play a major role, not only because it will be the visible part once the treatment is completed but also because the level of comfort and functionality will depend on them, in other words, the final quality of the treatment.
Therefore, it is important to bear in mind that implant treatments have 2 stages: surgery and prosthetics. And although surgery always creates more impact and worries for the patient, from a professional point of view it is the prosthetics that are equally complex and the one that requires precise technical knowledge, skills and a good sense of aesthetics to be carried out successfully.In terms of the different types of prosthesis that can be placed on implants we can establish a first classification between removable prosthesis and fixed ones.Removable prostheses on implants are the most simple and inexpensive, as they are made of resins. The main advantage being the price, and offering an aesthetically acceptable result, although comfort and functionality could be not very satisfactory. This type of treatment requires a smaller number of implants for its placement and represents a great innovation in terms of comfort compared to the traditional removable dentures.
Fixed prostheses are used for complete rehabilitations (when all pieces of a jaw are replaced at once) as well as for bridges involving several pieces or unitary pieces. The fixed prosthesis is cemented or screwed on the implant’s pillar and therefore it can only be removed by a dentist during control visits. In terms of functionality it is the best substitute for natural teeth as it allows patients to chew and talk as if they were their own teeth.
Fixed prostheses are done in ceramic and offer superior aesthetic results tan resin. Usually ceramic prostheses on implants are elaborated on top of a precise structure of metal alloy that is covered by ceramic material and is custom made for each case. However, the use of new materials such as Zirconium, is the latest trend in Dentistry, which allow for prosthesis to be placed without the use of a metal alloy base, in favor of improved aesthetics and biocompatibility.
It is not an overstatement to say that ceramic quality pieces are unique jewels of craftsmanship absolutely tailor made for each patient bearing in mind their facial structure, anatomy and aesthetic preferences. Two crowns are never the same.