DENTAL IMPLANT

Dental implants are divided into three different categories according to their placement:

Endosteal implants (In-bone implants):

This type of implant is placed directly into the jawbone. They are available in screw, cylinder or blade-shaped designs. They are produced from titanium or titanium alloys. The biggest advantage is the superior stability and long-term success rate. However, it requires sufficient bone volume and density for its application. In case of bone insufficiency, bone graft application can be performed first.

Subperiosteal implants (implants under the periosteum):

This type of implant, developed for patients with bone insufficiency, is placed on the bone surface under the gingival tissue. It is in the form of a metal frame specially produced for the patient's jaw structure. The most important advantage is that it can be applied without the need for bone grafting and provides function in a short time. However, it requires a more complex procedure in terms of surgical technique.

Zygomatic (cheekbone) implants:

This method is preferred for patients with insufficient upper jawbone volume. The implant is placed in the cheekbone instead of the jaw, and there is no need for bone graft.

Dental implant treatments are applied with different techniques according to the patient's oral structure and needs. Factors affecting the choice of treatment are:

• The patient's existing bone structure and density
• The number and position of missing teeth
• The patient's general health status
• Oral hygiene habits
• The patient's expectations and budget

Dental implants, according to the treatment technique, are:

Single-stage implant treatment:

In this method, no sutures are applied after the implant is placed, and the connection piece called the abutment is left exposed. Patient comfort is high because it requires a single surgical procedure. Tissue trauma is minimal and the healing process is relatively fast.

Two-stage implant treatment:

In this technique, known as the classical implant method, the implant is placed completely under the gum. After a healing period of approximately 3 months, the abutment is attached with a second small operation. The process of bone integration is more controlled and offers a high success rate.

Same-day implant:

This method, which is applied immediately after tooth extraction, significantly shortens the treatment process. However, sufficient bone support and good oral hygiene are essential for its application. It is especially preferred in cases where there are aesthetic concerns in the anterior tooth areas.

All-on-4/All-on-6 technique:

In this method applied in cases of complete edentulism, 4 or 6 implants are placed in the jaw and supported by fixed prostheses. The need for bone grafts is minimized by using special angled implants. Patients regain their chewing function in a short time.

Those who have any one or more of the following conditions are suitable candidates for dental implant treatment.

• Those who have lost at least one tooth,
• Those with sufficient jawbone volume and density,
• Those with good general health,
• Those who pay attention to oral hygiene,
• Those who have completed bone development,

Dental implants are a comfortable, long-lasting, and natural-looking treatment option for many people who have lost their tooth (or teeth). However, in some cases, this treatment is not recommended or not applied for patients.

• Patients under 18 years of age are not recommended because they have not completed bone development.
• In patients with insufficient bone volume and density, implant treatment may not be applied if the bone graft cannot provide support.
• Dental implant treatment may not be applied to patients with uncontrolled diabetes, immune diseases, high infection, blood clotting problems until their conditions are under control.
• Surgical interventions are not recommended for women during pregnancy and breastfeeding unless there is a very urgent situation.

Preliminary examination and planning phase:

Dental implant treatment begins with a comprehensive pre-assessment. At your first appointment, your dentist will take a detailed health history from you. Your existing teeth and jaw structure will be evaluated by clinical examination. Panoramic X-rays and, if necessary, 3D tomography images are taken for diagnostic purposes. Thanks to these imaging methods, your bone density, nerve pathways, and anatomical structure are analyzed in detail. In light of all the data obtained, a special treatment plan is created for you.

Surgical procedure:

On the day of the procedure, local anesthesia is applied, and the treatment area is completely numbed. In the operation performed under sterile conditions, a slot of the appropriate size is prepared in the bone using special dental burs. The titanium implant screw is placed precisely into this slot. Although the duration of the procedure usually varies between 30-60 minutes, this time may be longer depending on the number of implants applied.

Osseointegration period:

After the implant is placed, the process of integration with the bone begins. This biological process is called osseointegration. During this period, which lasts an average of 2-3 months, a solid bond is formed between the titanium implant surface and the jawbone. The healing process may vary depending on your age, bone quality, and general health status. In this process, you can use temporary prostheses recommended by your physician.

Prosthesis Phase:

After the bone-implant fusion is completed, the prosthesis construction phase is started. Firstly, a fastener called an abutment is placed on the implant. Then, special porcelain or zirconium crowns are prepared for you in the laboratory by taking measurements. Finally, these crowns are fixed on the abutment, and the treatment process is completed.

Care and follow-up after dental implant:

The success of implant treatment is directly related to regular care and check-ups. Your dentist will recommend a special oral care routine for you. Thanks to 6-month periodic checks, the life of your implants will be prolonged, and possible complications can be detected at an early stage. With the right care, you can use your implants for decades without any problems.

The duration of dental implant treatment may vary depending entirely on the preferred treatment method and the tissue healing time in the patient. However, an average implant treatment can generally be completed between 2 and 4 months. However, treatment can be extended up to 6 months if necessary.

• Initial examination and tests: 1 day
• Implant placement: 1 day
• Fusion and healing time: 2-3 months
• Supporting with abutment and tooth placement: 1 week

Recovery after dental implant treatment requires careful monitoring and care, as it is a surgical procedure. The process may vary depending on factors such as the person's general state of health, the quality of the jawbone, the type of implant (e.g., single tooth or multiple implants), the surgical technique applied (e.g., one-stage or two-stage), and the patient's lifestyle. The healing process after a dental implant is as follows:

First days after surgery (0-7 days):

This period is immediately after the surgical intervention and is usually the phase with the most intense symptoms.

Pain and swelling:

• Mild to moderate pain, swelling, bruising, or tenderness is normal after surgery. These symptoms usually subside within 2-3 days and largely disappear within 5-7 days.
• Your dentist may prescribe painkillers and anti-inflammatory medications for pain management. In rare cases, stronger painkillers may be recommended.
• It is recommended to apply cold compresses to the cheek area at 10-15 minute intervals for the first 24-48 hours to reduce swelling. The cold compress reduces swelling and bruising by constricting the blood vessels.
• After 48 hours, if the swelling persists, a warm compress can be applied, because at this stage it promotes healing by increasing blood circulation.

Bleeding:

• Light bleeding or oozing is normal after surgery and usually subsides within the first 24-48 hours. Your dentist may place sterile gauze on the area to control bleeding. Gently biting the gauze for 30-60 minutes will help stop the bleeding.
• If the bleeding is intense or prolonged (for example, if it continues after 48 hours), the dentist should be consulted immediately.

Nutrition:

• During the first 48 hours, liquid and soft foods should be preferred (e.g., soups, smoothies, yogurt, and pureed foods).
• Hot, spicy, acidic (e.g., orange juice), or hard foods (e.g., nuts, crisps) should be avoided, as these can irritate the implant site or damage the sutures.
• Chewing should usually be done on the other side to avoid food contact with the implant site.
• Drinking plenty of water keeps the inside of the mouth moist and promotes healing. However, the use of straws is not recommended, as the sucking action may impair clotting.

Oral hygiene:

• Brushing teeth and rinsing the mouth should be avoided for the first 24 hours, as this can disrupt clotting and delay healing.
• After 24 hours, gentle tooth brushing and mouth rinsing can be done as recommended by your dentist. An antiseptic mouthwash is usually recommended, but instructions for use should be followed.
• Direct pressure on the implant area should be avoided, and a soft-bristled toothbrush should be preferred.

Activity and lifestyle:

• Heavy physical activity (e.g., sports, weight lifting) and work requiring excessive exertion should be avoided for the first few days, as these activities may increase blood pressure and cause bleeding.
• Smoking and alcohol are not recommended. Smoking slows healing by reducing blood flow and increases the risk of infection. Alcohol can increase bleeding and interact with medications.

Stitches:

• If non-melting stitches are used, they are usually removed within 7-10 days. Dissolvable stitches dissolve spontaneously within 1-2 weeks.
• A slight feeling of discomfort at the suture site is normal, but if the sutures loosen or open, the dentist should be consulted.

Short-term recovery (1-2 weeks)

During this period, acute postoperative symptoms usually subside, and the patient gradually returns to normal life.

Symptom reduction:

• Pain and swelling largely disappear. A slight tenderness may persist, but this is usually tolerable.
• If bruising is present, it disappears within 7-10 days.

Nutrition and diet:

• Soft foods should be continued, but the diet can be gradually expanded. For example, switch to more solid but chewy foods such as boiled vegetables, pasta, or soft meats.
• Hard, sticky, or small-grained foods should be avoided, as these can get stuck in the implant site.

Oral hygiene:

• Regular tooth brushing and flossing should continue. However, the implant area should be treated gently and too much pressure should not be applied to this area.
• The use of antiseptic mouthwash can be continued for the period recommended by the dentist (usually 1-2 weeks).

Check-ups:

The dentist will schedule a follow-up appointment, usually in 7-14 days. At this appointment, sutures can be removed, the healing of the implant site is assessed, and X-rays are taken if necessary.

Osseointegration (fusion with bone, 3-6 months)

This is the most critical phase of dental implant treatment. The integration of the implant with the jawbone (osseointegration) takes place during this period.

Process:

Since the implant is made of a biocompatible material such as titanium or zirconium, it fuses with the bone and forms a stable foundation. This process usually takes 2-4 months in the lower jaw and 4-6 months in the upper jaw, because the bone of the upper jaw is usually less dense.

Temporary prostheses:

• In some cases, a temporary prosthesis (crown, bridge, or denture) may be placed for aesthetic or functional reasons. However, these prostheses are designed not to put too much pressure on the implant.
• Patients using temporary prostheses should avoid hard foods and be careful when chewing.

Placement of a permanent prosthesis (after 3-6 months)

• The dentist places an abutment on the implant. Then, an impression is taken, and a customized prosthesis is prepared in the laboratory.
• After osseointegration is complete, a permanent prosthesis (crown, bridge, or complete denture) is placed over the implant.
• The placement of a permanent prosthesis is usually a painless procedure and may not require local anesthesia.
• After the prosthesis is placed, the patient becomes fully accustomed to the new tooth within a few weeks.
• For the first few weeks, an adaptation period may be required to allow the denture to settle in the mouth and chewing functions to return to normal.
• A slight discomfort or foreign body sensation is normal, but this will soon pass.
• If the denture becomes loose, painful or does not fit properly, you should consult your dentist.

Possible complications:

• If the following symptoms occur during the healing process, the dentist should be consulted immediately:
• Severe or prolonged pain (especially after 7-10 days).
• Intense bleeding or failure to stop bleeding.
• Signs of infection such as fever, swelling, or pus.
• Loosening or movement of the implant.
• Problems with prosthesis fit or persistent discomfort.

The lower age limit for dental implants is 18. However, in some special cases, the dentist may make exceptional decisions. The reason for the lower age limit here is that the jaw development is not yet complete.

There is no upper age limit for dental implants. However, there may be a decrease in the volume and density of the jawbone with bone resorption. If this decrease cannot be supported by treatment, implant treatment cannot be applied. If it is applied, the bone may not be able to hold the screw, or the screw may damage the bone during placement.

Dental implant treatment is generally a safe and long-lasting treatment. As with any surgical intervention, dental implant treatment also has some risks.

• Infection may develop in the intervention area where the implant is inserted.
• In cases where the dental implant is applied to the lower jaw, the mandibular nerve may be damaged.
• Excessive bleeding may occur during or after the surgical procedure. Blood thinners increase this risk.
• If there is extensive erosion in the bone where the implant is placed, the implant and bone may not fuse or may loosen over time.
• If the dental implant is placed in the upper jaw, the sinus cavity may be damaged. Therefore, infection may develop in the sinus.

• Dental implants are the treatment that gives the closest result to natural teeth in terms of use and appearance.
• Before the operation, high-resolution photographs of you are taken, and the prostheses to be attached with the treatment to be applied with various software are applied to your face. Thus, it may be possible to see the teeth that will be placed in accordance with your mouth and facial structure in advance.
• The crown to be applied on your dental implant will be zirconium or porcelain. Both materials are similar to the natural tooth surface.
• Chewing and speaking functions are as comfortable as with your own teeth.
• The implant fuses with your bone. Therefore, it is very robust and long-lasting.

In dental implant treatment, the implant must integrate with the bone. Therefore, the volume and density of the bone must be sufficient. Bone resorption weakens the bone both in terms of volume and density. The degree of bone resorption is very important here. Necessary tests and imaging should be performed for this. If it is found to be weak, a number of supportive and alternative treatments can be performed depending on the degree. These treatments are as follows:

• If the bone is weak, bone strengthening is performed by applying a bone graft, i.e., bone powder treatment. If the desired result is obtained from this supportive treatment before dental implant treatment, implant treatment can be started.
• With small volume implants, less abrasion can be done on the bone. Short implants can be ideal for this situation.
• Erosion of bone can be controlled with osteoporosis treatment. In such cases, dental implant treatment can also be initiated.

Dental implant treatment is a treatment that requires experience, technical skills, and knowledge. The treatment should be performed in accordance with the patient's mouth, dental structure, and expectations. The realism and good quality of the treatment will increase the lifespan and comfort of the implants. So what kind of features should the clinic and the physician you choose have in order for this treatment to be highly successful?

• The clinic environment must have the required international hygiene conditions.
• There should be trained staff and physicians necessary for the treatment. Technological equipment must be adequate for the age.
• 3D tomography device, digital imaging and measurement systems will leave no room for error in the treatment applied. We strongly recommend that you examine the implant brands that the clinic works with. These brands must have global quality and reliability.
• You should make sure that your dentist who will perform dental implant treatment is an expert and experienced physician in this field.
• Your dentist should listen carefully to you and your expectations and design customized solutions and smile designs. He/she should create a treatment plan according to your situation. Be sure to examine the results of your dentist's previous treatments.
• Before starting dental implant treatment, your dentist should inform you about all the steps, give you detailed information about the process, and answer all your questions in an informative way.

Is an implant necessary for every tooth loss?

No, implant treatment is not necessary for every tooth loss. However, if you value aesthetic appearance, want to find a solution without damaging other teeth, and do not want your jawbone to be damaged, implant treatment may be a suitable solution for you. However, we recommend that you make the healthiest decision in light of your doctor's recommendations.

Will I feel pain during implant treatment?

During implant treatment, the mouth is numbed with local anesthesia. Therefore, you will not feel any pain or ache during the treatment. However, pain, aching, swelling, and tenderness may be felt after the treatment as the effect of anesthesia decreases. However, this can be kept under control with painkillers and gradually disappears after the first week.

Are dental implants durable?

Dental implants are very durable and long-lasting treatment parts. However, this durability depends on the patient's lifestyle and cleanliness. You can use it much longer and healthier when the necessary oral hygiene conditions are met, regular doctor check-ups are attended, and you do not bite hard objects. If necessary, the tooth body of the dental implant can be replaced.

How long do dental implants last?

The lifespan of dental implants depends on many factors. The lifespan of an average implant is 20 years, or a lifetime if well cared for.

Careful and regular dental care extends the life of the implant. If you want to learn how to take care of it, we have explained it in detail for you above.

Regular dentist checks provide early intervention in case something goes wrong with the process.

Brands with high-quality standards offer you the opportunity to use longer-lasting implants.

Harmful and abrasive habits such as the use of harmful substances and biting hard objects will shorten the life of the dental implant.