Implant

What Is an Implant?

A dental implant is an artificial tooth root made of titanium in the shape of a screw, placed into the jawbone to replace a missing tooth. Implants mimic natural tooth roots, and by fixing artificial teeth such as crowns, bridges, or removable dentures onto them, both the function and aesthetics of missing teeth are restored.

Dental Implants Are Used In:

• Single tooth loss,

• Multiple tooth loss,

• Complete edentulism (total tooth loss).

What Are the Advantages of Implants?

Dental implants offer many functional and aesthetic advantages, including:

• Closest alternative to natural teeth: They closely resemble natural teeth in appearance and chewing sensation.

• Do not damage adjacent teeth: Unlike bridge treatments, neighboring teeth do not need to be trimmed.

• Prevent bone loss: Bone resorption that occurs after tooth extraction is largely prevented with implants.

• Provide better chewing and speech function.

• Long-lasting: With proper care and regular check-ups, implants can be used for many years or even a lifetime.

• Provide an aesthetic smile: When tooth and gum harmony is well achieved, implant-supported prostheses are indistinguishable from natural teeth.

How Is an Implant Applied?

Examination and Planning

Before starting treatment:

• The jawbone is examined using panoramic X-rays or 3D tomography.

• Bone thickness, height, and density are evaluated.

• If suitable, a personalized treatment plan is prepared.

Surgical Phase (Placement of the Implant)

• The procedure is usually performed under local anesthesia.

• A small socket is prepared in the jawbone and the implant screw is placed.

• The gum is closed, and osseointegration (fusion of the implant with the bone) is awaited. This period usually takes 2–3 months.

Healing Process and Placement of the Prosthetic Crown

• After the implant has fully healed, an abutment (prosthetic connector) is attached.

• Impressions are taken, a custom-made crown is prepared, and it is fixed onto the implant.

Who Can Receive Dental Implants?

Dental implant treatment can be applied to anyone whose general health condition is suitable and whose jawbone is adequate for implant placement. However, certain criteria must be met for a successful implant treatment.

People Suitable for Implant Treatment:

• Individuals over the age of 18: Bone development must be completed.

• Those with sufficient jawbone: Bone volume must be adequate. If not, new bone can be created using appropriate techniques depending on the needs of the implant area (bone grafts, soft tissue grafts, bone augmentation, sinus lifting, block grafts).

• People with good general health: Patients with diabetes, osteoporosis, or those undergoing radiotherapy/chemotherapy should be carefully evaluated. The use of certain medications affecting bone metabolism (e.g., bisphosphonates) may also influence surgical decisions.

• Those with good oral hygiene: Success rates are higher in individuals without gum disease who maintain proper oral care.

• Non-smokers: Avoiding smoking is important for surgical success.

Situations Where Implants Are Risky or Not Suitable:

• Individuals with uncontrolled diabetes

• Patients with severe bone loss

• Those undergoing radiotherapy or chemotherapy

• Individuals who do not maintain proper oral hygiene
  (Implant surgery may be considered after periodontal diseases are treated.)

Is Implant Surgery Painful?

No. Since local anesthesia is applied during the procedure, the patient does not feel pain. Mild pain and swelling may occur after the procedure, which can be controlled with medication.

Can Implants Be Used for a Lifetime?

Yes. With proper application and regular care, implants can remain in the mouth without problems for a lifetime.

Is One Implant Required for Every Missing Tooth?

No. In some cases, multiple teeth can be placed on a single implant, or alternatives such as bridges or dentures may be considered.

Is There a Risk of the Body Rejecting the Implant?

The risk of failure in the integration of titanium implants with bone is very low.
The success of the treatment may vary depending on the patient’s general health, bone quality, the implant placement area, and the experience of the dentist.

Can Implants Be Placed at Any Age?

Yes, if suitable conditions are met, implant treatment can be performed at almost any age.

The lower age limit is 18 years, because jawbone development is completed at this age. Since implants are structures fixed within the bone, if the jaw continues to grow, the implant may not remain in the correct position.

Is There an Upper Age Limit?

• No, there is no upper age limit.

• Implants can also be placed in patients aged 70, 80, or even 90, provided their general health condition is suitable.

What Really Matters:

• Is bone density sufficient?

• Are systemic diseases under control?

• Is the patient suitable for surgery and healing?

Are There Health Risks Associated with Implants?

Risk of Infection:

• An infection may develop in the area where the implant is placed. If proper hygiene is not maintained, this can lead to implant failure.

Implant Failure (Osseointegration Problems):

• If adequate bonding between the implant and the bone does not occur, the implant may fail.
  This situation is more commonly seen in:

• Patients with diabetes (especially uncontrolled diabetes),

• Individuals with low bone density,

• Smokers.

Nerve Damage:

• If implants placed in the lower jaw are positioned too close to the nerve, come into contact with it, or if the nerve is injured during surgery, temporary or permanent numbness may occur.

Sinus Problems (Upper Jaw Implants):

• Implants placed close to the sinus in the upper jaw may damage the sinus cavities. This risk can be prevented with additional surgical procedures such as a sinus lift.

Implant Brands and Material Differences

• Titanium Implants: The most commonly used type, with high compatibility with bone.

• Zirconium Implants: An alternative for patients with metal allergies; more aesthetic but more expensive. Since they are used less frequently, long-term outcomes and possible complications are not yet sufficiently documented.

• Popular Brands: Straumann, Astra Tech, Nobel Biocare, Bego, Nucleoss, Thommen
  (Dentists may recommend different brands based on their own experience and clinical results.)

What If There Is Insufficient Bone in the Area Where the Implant Will Be Placed?

• Bone Grafting: If the jawbone volume is insufficient, new bone formation is achieved using natural or synthetic bone graft materials or bone blocks.

• Sinus Lifting: In implant procedures close to the sinus cavities in the upper jaw, bone volume is increased by placing bone grafts on the sinus floor.

• Mini Implants: Special, narrow-diameter implants designed for patients with very thin bone structure.

• All-on-Four Technique

What Is the All-on-Four Technique?

The All-on-Four technique is a treatment method in which a fixed prosthesis is placed using only four implants in patients who have no teeth (or teeth that need to be extracted) in the upper or lower jaw.

• The two implants in the posterior region are placed at an angle (tilted).

• The two anterior implants are placed vertically.

• Thanks to this positioning, additional procedures such as bone grafting are usually not required.

How Is It Performed?

• Examination and planning: Bone structure is evaluated using 3D dental tomography.

• Tooth extraction (if necessary): Teeth that need to be removed are extracted.

• Implant placement: Four implants are placed into the jaw under local anesthesia.

• Temporary prosthesis: A temporary fixed prosthesis is placed on the same day or within a few days (commonly known as “teeth in one day”).

• Healing process: Bone–implant integration is completed within approximately 3–6 months.

• Permanent prosthesis: The final fixed prosthesis is placed.

Advantages of the All-on-Four Technique

• No need for bone grafting: Angled implant placement helps bypass sinus or nerve limitations in the posterior region.

• Fewer implants, lower cost.

• Fixed teeth on the same day: Patients can often receive their temporary teeth within hours after implant placement.

• Fast recovery and high patient satisfaction.

Disadvantages / Points to Consider

• Not suitable for every patient (cannot be applied if bone volume is severely insufficient).

• Temporary prosthesis must be used very carefully, as excessive load on the implants during the healing period should be avoided.

• Smoking and uncontrolled diabetes may reduce the success rate.

What Is Dental Tomography?

Dental tomography is an advanced radiological imaging method that allows detailed visualization of the teeth and jawbone.

In Which Situations Is It Used?

• Dental implant planning:
  Bone thickness and height are measured.
  It is used to determine the location of the sinus cavity in the upper jaw and the mandibular nerve in the lower jaw.

• Before wisdom tooth extraction:
  The position of the tooth within the bone and its relationship with the mandibular nerve are evaluated.

• Detection of cysts, tumors, or infections

• Jaw fractures and temporomandibular joint (TMJ) disorders

• Pre-orthodontic treatment planning

• During endodontic treatment:
  Evaluation of root canals, root fractures and cracks, and lesions related to the root canal.