Dental implants

FAQ

• What are dental Implants? Implants are pure titanium bindings that are placed on the maxillary bones as a replacement of the original roots of lacking teeth, in order to provide an artificial piece that offers better functionality and the same or better aesthetics.
• What is Osseointegration? Osseointegration is a biophysical phenomenon that produces the bonding of Titanium and bone tissue on a molecular level. This integration is so strong that it would be impossible to separate the Titanium from the bone once they are bonded as the implant would take part of the surrounding bone with it.
• Do dental Implants have contraindications? There are very few absolute contraindications, among which we can consider bone diseases that affect bone metabolism, specific infections, tumors that affect the bone or great doses of radiotherapy. It is important to underline that the human body does not refuse implants; the worst risk is that the bone grafting may fail (this is only 2% on the cases treated). An important factor here is the craftsmanship of the surgeon, although it also has to be said that some cases are more complicated than others. When an implant fails, a new one can (and should) be placed.
• Are all dental Implants the same? Not all implants are the same. There are many brands on the market and not all of them meet the same quality standards, nor have they all been tested using the most advanced scientific studies. The quality of implants is essential; this is why it is important to rely on a brand that offers sufficient warranties. The most important aspects are the treatment that the implant surface has been subject to and the mechanization of its upper half.This is where the main differences are.

  The implants that we use are the only ones authorized by the American Dental Association (ADA) to be loaded two months after surgery. This gives us an idea of the quality criteria of the manufacturer and of the excellence of the product, as for most implants the recommended timeframe is 6 months.

• How complex is the surgery? It is an ambulatory intervention; this means you can go home after surgery and the operation is carried out in the dental practice, as long as it is equipped with the necessary material for surgery. Local anesthetics are applied in most cases. In long operations (complete rehabilitations, maxillary sinus elevation, bone grafting) we can use the assistance of an anesthetist to apply monitored intravenous anesthetics. The patient does not feel any pain at any time.
• Is the post-surgical recovery hard? On the contrary to what might be believed, implant surgery recovery is often much lighter and painless than other minor dental treatments. A well-placed implant should not hurt; it may only cause sore gums in the scarring process. It is important to keep a very strict dental hygiene to keep the area clean at all times and to prevent the surrounding gums from getting infected. Usually, antibiotics are prescribed to be on the safe side. In the case of major surgery like maxillary sinus elevation and bone grafting, the area can get swollen during the first days after the operation, although it does not hurt and daily tasks can be carried out.
• How long does the whole process take, since the placing of the implants until the placement of the final bridgework? Generaly the final bridgework can be placed in two months after surgery. In some cases the procedure can be even faster, but when the patient needs bone grafting procedures it would be necessary to wait longer. In either case, a provisional denture is provided during the treatment and the patient can lead a normal life.
• Can implants be used in patients of all ages? Implants can be used on youngsters once they have finished their growing process, usually around 16 for females and around 18 for males. For adults there is no contraindication regarding age limit.
• What kind of prosthetic pieces can be mounted on implants? Basically there are two types of prosthetic rehabilitation on implants: fixed ceramic prosthetics, which provides the best aesthetics and functionality results, and the removable prosthetics, made of resin, which is a more inexpensive but also less sophisticated treatment.
• How good do the results look aesthetically? As long as the implants are placed correctly, the aesthetic results of most restorations are usually much better than the patient’s original teeth. The patient has to bear in mind that not only will he or she achieve oral health, but also a beautiful smile. The patient should also demand this.
• Is there any kind of warranty on a treatment with implants? A well-placed implant with the right dimensions (size must be proportional to load and the bigger, the safer) lasts a lifetime.
• What are the essential conditions for a treatment to be succesful? The right planning of each individual case. The craftsmanship and expertise of the surgeon (the size of the implant and its correct placement). Manufacturing of bridgework having in mind the load and the right closure, to avoid unusual forces that would add unnecessary stress on the implants.
• Are there any risks for the patient? The greatest risk is the possible loss of sensitivity of the lower lip, in the unlikely event that the kin nerve is touched or broken during surgery. This sensitivity loss can be temporary or permanent. This is why the surgeon has to be very careful and diligent working around this area, as the implant needs to be big enough to hold the load it will be subject to, and small enough not to damage the nerve.

  It is also very important that the implants are placed in the right position from the beginning because once they have bonded with the bone, they are “welded” together and extracting the implant would mean a great loss of bone material in the jaw, which would complicate the rehabilitation and the results would never be the same.

• What is the approximate price of a treatment with implants? The price of a medical treatment depends on many factors, but to give you an idea, the minimum cost of restoration of every single dental piece to guarantee a desirable quality level, including the implant, connector and prosthetics averages 1,500 € in Spain.

  The total cost of the restoration will depend on how many pieces need to be replaced, if bone grafting is necessary, if the bridgework is ceramic or acrylic, etc.

• What happens when the patient does not have sufficient bone mass in the area where an implant must to be placed? Today there are advanced techniques available to apply surgery in the most extreme cases. We can carry out maxillary sinus elevation and bone grafts that can be extracted from elsewhere in the patient’s body (autogenous bone) or from external sources (donor or synthetic bone); the success rate in these cases is surprisingly high. Fortunately, there are very few cases of patients not being eligible for oral restoration. The field of bone grafting is, without a doubt, one of the main advances in Implantology during the latest years.
• What solution do implants offer to patients with parodontal disease (pyorrhea)? For patients with this condition implants are the solution. Traditionally, these patients were doomed to lose their teeth for good. The only treatment we could then recommend was to keep a good hygiene and repeated visits to the dentist. The final perspective was always clear: the complete removable plastic denture.

  Now implants have revolutionized the way to treat those patients. It is very important to know that while we keep the existing pieces of a patient with advanced periodontal disease, bone mass is being lost overtime, until we proceed with implant surgery and stop the process. It is crucial to take the step before it is too late. Sufficient bone mass is essential for a good restoration and an aesthetic result. In very extreme cases it is harder to reach the aesthetic aspect.

• Are implants a long lasting solution? It might be one of the few cases in Medicine, where the artificial solution has a better functionality than the original organ. An implant that works properly in the mouth (because it is placed in the ideal position and holds a load which is proportional to its size) has a much longer life span than a natural tooth.
• What are the latest advances in Implantology? Implantology has recently shown great advances in aesthetics. Nevertheless, from a scientific point of view, the most important recent advances are the techniques in bone grafting and the usage of Platelet Rich Plasma (PRP and PRGF) in the most compromised cases, as they offer us the possibility to efficiently create bone mass in a safe and fast way, which was not available in the past.
• Can patients from other countries be treated in our practices? Many patients come to us from other countries. We offer travel and lodging facilities to all our patients coming from outside Barcelona. We can also take care of your post-operative rehabilitation. For more information please contact: deborah@icab.es