Dental Implant Treatment

What Is a Dental Implant?

A dental implant is an artificial root placed in the jawbone to support the prosthesis that replaces a missing tooth. For a single gap, a crown is made on one implant; where several teeth are missing, a bridge or another prosthesis can be supported by an appropriate number of implants.

The Three Components

• The implant body: the part inside the bone, most often made of titanium.
• The abutment: the connecting piece between the implant and the prosthesis.
• The prosthetic tooth: the crown or bridge you see in the mouth; its material and design follow the treatment plan.

Osseointegration

After placement, the implant forms a bond with the surrounding bone over a period of months. How long this takes varies with the site, the bone and any additional procedures, and it is followed up rather than assumed. Having an implant integrate is the beginning of maintenance, not the end of treatment.

Who Is Assessed as a Candidate?

Completed jaw growth, oral health, the state of the bone and gums and general health are assessed together. Age alone does not decide it. The examination first establishes whether the existing teeth can be kept, and why the tooth was lost.

Gum disease, diabetic control, smoking and drugs affecting bone metabolism can change the plan. Tell us about every medication you take, including blood thinners; do not stop a medicine or change its dose on your own. Any necessary decisions are made together with the doctors treating you.

Uncontrolled diabetes, active cancer treatment and previous radiotherapy to the jaws call for specific assessment. These do not automatically rule out treatment, but they change what precautions are needed and who else has to be involved.

Implant, Bridge or Removable Prosthesis?

An implant can, in some patients, fill a gap without cutting down the neighbouring teeth. In exchange it involves surgery, healing and long-term maintenance. With a bridge, the condition of the adjacent teeth is what matters; with a removable prosthesis, the support, retention and how you expect to use it.

No one method is better for everyone. The health of the existing teeth, fitness for surgery, your ability to maintain the result, the time involved and the budget are all discussed together.

Immediate Placement and Early Loading Are Two Different Decisions

Immediate placement means putting the implant in at the same appointment as the extraction. Early temporary loading refers to when a prosthesis is attached to an implant already placed. These are separate decisions; being able to do one does not mean the other is possible.

Initial stability, the state of the extraction site, the bone and soft tissues and the bite are all assessed. If needed, either the placement or the prosthetic stage is postponed. The natural changes in tissue after an extraction are not entirely stopped by placing an implant.

Single, Multiple and Full-Arch Options

For one missing tooth, an implant and a crown; for adjacent gaps, an implant-supported bridge may be considered. A separate implant is not needed for every missing tooth. In full edentulism there are All-on-Four, fixed prostheses on a different number of implants, and implant-supported removable options. The number and placement follow the conditions in the mouth.

Can Implants Be Placed Where Bone Is Insufficient?

Often yes, but not always, and not by a single method. Guided bone regeneration, block grafting and sinus lifting address different patterns of loss, and each adds its own healing period and its own risks. In advanced upper-jaw loss, zygomatic implants require specialist assessment.

Which applies to you is decided from imaging and examination. An additional procedure is a decision with its own trade-offs, not a formality that makes any case treatable.

Risks and How Long an Implant Lasts

Infection, bleeding, damage to nerves or neighbouring structures, failure to integrate, and loosening or fracture of prosthetic components can occur. Progressive bone loss around an implant can also develop, and it can be painless in its early stages. Your individual risks are explained before the procedure.

No lifetime guarantee can be given for an implant or a prosthesis. What research reports is what happened in studied groups:

Read the figures below together: implants tend to stay in place, while the crown on top is the part that more often needs repair. Neither figure predicts an individual outcome.

• Moraschini and colleagues (2015) pooled 23 studies covering 7,711 implants with a mean follow-up of 13.4 years, reporting cumulative survival of 94.6% and mean marginal bone resorption of 1.3 mm. The authors note the disparate outcome measures used across the studies — survival and success are not the same measurement.
• Buser and colleagues (2012) re-examined 511 implants in 303 partially edentulous patients after 10 years: survival 98.8%, success 97.0%, six implants (1.2%) lost, and peri-implantitis in 1.8% over the decade. This was a cohort described by the authors as orally healthy, which is part of why the figures are high.
• Pjetursson and colleagues (2018) looked at what sits on top: estimated 5-year survival of 98.3% for metal-ceramic and 97.6% for zirconia implant-supported single crowns — but only 86.7% and 83.8% respectively were free of any biological or technical complication over the observation period. Chipping of the veneering ceramic occurred in about 2.9% and 2.8%; significantly more zirconia crowns failed through material fracture (2.1% versus 0.2%).

Maintenance and When to Come In

Regular brushing and interdental cleaning appropriate to the design of your prosthesis are needed. The cleaning aids and the review interval are set according to your own risk. Mouthwash and antibiotics do not replace mechanical cleaning, and long-term use is not something to decide on your own.

Come in to be checked if you notice bleeding, swelling, a bad taste, increasing pain, or movement in the implant or prosthesis. Treating disease around an implant is not limited to antibiotics; professional care, surgery where necessary, and continued follow-up may all be required.

Frequently Asked Questions

Is the procedure painful, and when can I go back to work?

Pain during the procedure is controlled with anaesthesia. Pain and swelling can follow. Return to work depends on the extent of what was done and on how physical your job is; the same number of days is not given to everyone.

Will I be without teeth during treatment?

Temporary options are discussed at the examination. Whether a temporary prosthesis is fixed or removable, and when it can be used, depends on how healing goes. It may not allow the same use or the same diet as the definitive prosthesis.

Does smoking affect the outcome?

It is one of the risk factors most consistently reported for problems around implants, alongside poor oral hygiene and a history of periodontitis. This is worth discussing before treatment rather than afterwards.

Can I have an MRI scan?

Yes. Titanium implants do not prevent MRI. Tell the radiographer what you have; an artefact may appear near the implant in the image.

What does the fee cover?

The implant body, the abutment, the prosthesis, imaging and any additional surgery can be separate items. The number of implants and the prosthetic material affect the total. Ask for a personal plan that states which stages are included. Insurance and institutional cover are confirmed per policy and per procedure.

Which implant systems are used?

At Dentopol Ümraniye the implant systems in use are Implance, Osstem, BEGO and Straumann. Which one is used depends on the bone, the prosthetic plan and the case; you can ask your surgeon for the manufacturer and model of the implant to be used, and it is worth keeping that information for any future maintenance by another clinician. The brand on its own does not determine the outcome — survival and complications depend on patient factors and maintenance as well as on the system.

Scientific References

• Moraschini V, Poubel LA, Ferreira VF, Barboza ESP. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. *International Journal of Oral and Maxillofacial Surgery*. 2015;44(3):377-388. PMID 25467739. DOI
• Buser D, Janner SFM, Wittneben JG, Brägger U, Ramseier CA, Salvi GE. 10-year survival and success rates of 511 titanium implants with a sandblasted and acid-etched surface: a retrospective study in 303 partially edentulous patients. *Clinical Implant Dentistry and Related Research*. 2012;14(6):839-851. PMID 22897683. DOI
• Pjetursson BE, Valente NA, Strasding M, Zwahlen M, Liu S, Sailer I. A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic single crowns. *Clinical Oral Implants Research*. 2018;29(Suppl 16):199-214. PMID 30328190. DOI
• Brånemark PI, Hansson BO, Adell R, et al. Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period. *Scandinavian Journal of Plastic and Reconstructive Surgery, Supplement*. 1977;16:1-132. PMID 356184.