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Frequently Asked Questions
What are dental Implants?
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What is Osseointegration?
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Do dental Implants have contraindications?
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Are all dental Implants the same?
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How complex is the surgery?
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Is the post-surgical recovery hard?
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How long does the whole process take, since the
placing of the implants until
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the placement of the final bridgework?
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Can implants be used in patients of all ages?
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What kind of prosthetic pieces can be mounted on
implants?
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How good do the results look aesthetically?
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Is there any kind of warranty on a treatment with
implants?
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What are the essential conditions for a treatment to
be succesful?
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Are there any risks for the patient?
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What is the approximate price of a treatment with
implants?
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What happens when the patient does not have sufficient
bone mass in the area where an implant must to be
placed?
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What solution do implants offer to patients with
parodontal disease (pyorrhea)?
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Are implants a long lasting solution?
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What are the latest advances in Implantology?
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Can patients from other countries be treated in our
practices?
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BIBLIOGRAPHICAL REFERENCES OF INTEREST
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
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 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?I
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
successful?
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The
right planning of each individual case
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The
craftsmanship and expertise of the surgeon (the size
of the implant and its correct placement)
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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 has 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 periodontal 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) 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
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Bibliographical references of interest.
Osseous Reconstruction of the Maxilla and Mandible.
Philip Boyne. Quintessence.
Tissue Engineering Applications in Maxillofacial
Surgery and Periodontics. Samuel Lynch, Robert
Genco, Robert Marx. Quintessence.
Histología Funcional. Texto y atlas en color.
Weather, Burkitt y Daniels. Editorial Jims.
Implant Therapy. Clinical approaches and evidences
of success.
Myron Nevins, James Mellonig.
Quintessence.
The Sinus Bone Graft. Ole T.Jensen
Quintessence.
Osseointegrated Implants. Kenji W.
Higuchi.Quintessence.
Guided bone regeneration in implant dentistry.
Daniel Buser, Christer Dahlin, Robert Schenk.
Quintessence.
Oclusión y diagnóstico en rehabilitación oral.
Alonso, Albertini,Bechelli. Editorial Panamericana.
Fundamentals of Esthetics.
Claude Rufenacht.
Quintessence.
Science and Practice of Occlusion. Charles
McNeill.Quintessence.
Precision fixed Prosthodontics:Clinical and
Laboratory Aspects.M.Martignoni, A. Schönenberger.
Quintessence.
The Bone- Biomaterial Interface.
J.E.Davies. Em2 inc. www.boneengineering.com
(en inglés)
Bone Engineering. J.E.Davies.
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