Restoring the loss of a tooth with an implant is a treatment option that has become dominant today because it offers many advantages over classic bridges.
These advantages are the avoidance of grinding natural teeth, the preservation of the ridge tissues, their future utilization, and the quick solution of functional and aesthetic restoration in immediate implantation and loading. The only downside is, perhaps, the cost. The treatment plan is simple when it is to be applied to the posterior areas of the jaws, it becomes demanding and difficult when it is to be applied to the anterior aesthetic area - especially when there is a gummy smile - due to the high aesthetic requirements. A basic criterion of the aesthetics of the anterior teeth is the symmetrical appearance of the dentition, the color, volume and harmony of the soft tissues of the periodontium. The main challenge for the dentist is to restore these natural biological balances when a tooth has been lost.
Implant treatment planning in partial denture restoration is easier because the adjacent teeth make it easy for the surgeon to identify the location and direction of implant placement.
The type of prosthetic restorations are immovable bridges, welded or screwed with preferably pure implant support. The choice of mixed support with implants and natural teeth, if desired, is made on the condition that the natural teeth (supports) are periodontally healthy. The most important advantages in the case of the use of implants in prosthetic restorations of partial missing teeth are the avoidance of grinding of natural teeth and the preservation of the tissues of the crest of the jaw.
The basic design in the restoration of total dentition in the upper and lower jaw with immobile prosthetic work, includes the placement of 6 or more implants as the case may be, which must be placed according to prosthetic criteria, in order to achieve better functional and aesthetic results.
Under conditions, immobile prosthetic restoration is possible in the total dentition, with 5 implants or even with 4 in the lower jaw. In order to achieve an excellent therapeutic result, it is important to make a thorough treatment plan. A careful study of the x-rays, the suspended casts, and the exact position and inclination of the implants must be determined with auxiliary splints. The treatment plan is easier when there is no atrophy in the jawbone, it becomes more complicated in extensive atrophy, because we have to restore in addition to the molars of the teeth and the structures of the mouth from the deficits of the hard and soft tissues of the jaws. Restoration then requires the application of augmentation techniques
Overdentures, based on implants, are a reliable alternative solution, with many advantages, to the retention and stability problems of conventional full dentures.
The advantages they offer, compared to conventional dentures, are psychological, functional and biological, such as improved stability and retention, increased masticatory ability, better aesthetic perception and reduced bone resorption of the alveolar crest. It is an ideal solution for the treatment of completely edentulous patients, with extensive soft and hard tissue deficits, who need to be restored in addition to the molars of the teeth and the structures of the mouth from the tissue losses. To technically realize an implant-supported overdenture, many design models, methods, solutions and numerous materials are proposed. The treatment plan requires 4 implants for the upper jaw and at least 2 for the lower jaw. Support for complete dentures on implants comes mainly from the mucosa, while implants contribute to the retention of the denture and less to its support. There is also the design of more rigid structures, which do not allow mobility or rotation of the retention elements, in which the support requirements of the implants are the same as the support requirements of fixed prosthetic work.
Maintenance of Result
A necessary condition for the long-term success of implants is their care with the application of appropriate daily oral hygiene. Oral hygiene is no different from hygiene applied to natural teeth. It is done with a classic or electric toothbrush and special interdental brushes or similar accessories.
The purpose of daily oral hygiene is to remove food residues and microbial plaque from the surfaces of prosthetic works and implant components. The presence of microbial plaque can lead to inflammation of the gums around the implants, which in the long term can develop into more severe (peri-implantitis) and cause bone loss around the implants.
A basic condition for the long-term success of implants is the implementation of a schedule of visits, which will be determined by the Dentist. In these visits there will be a check on the level of oral hygiene of the patients, a recheck of the restorations, the health of the gums and the oral cavity, to prevent possible inflammations.
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