Implantation means inserting an implant into the body.
In dentistry we differentiate between an single-session implantation and an implantation performed over two sessions.
One session means that the insertion of the implanted body and the provision of the prosthesis (that is to say the attachment of the tooth) take place at one sitting.
Since the tooth and with it the implant would need to be able to bear a load immediately, that is to say chewing pressure will be placed on them, we say, in dental jargon, this is immediate loading. If the tooth is however removed from the chewing surface and not loaded we talk of immediate care.
With a two session procedure the implant body is inserted first and only after the healing of the bone does the prosthetic reconstruction take place. This procedure is indicated in the case of insufficient primary stability of the implant (which depends on the bone). With a two session procedure one can opt for open healing or for closed healing.
Open means that a healing cap is placed immediately after the setting of the implant which promotes correct formation of the gums as they heal. Here you can see it done in the lower jaw. Four implants have been inserted, the wounds sutured and the healing caps project out into the mouth. In this way the patient is spared what we call an exposing operation.
The counterpart to this is called closed healing, whereby the wounds, as can be seen in this video have been sutured firmly closed after the implantation – nothing projects into the mouth.
The disadvantage with closed healing is that after the implants have healed successfully the gums which now lie over them have to be opened up again in order to expose (hence exposure operation) the implants. So first the healing caps are mounted for about 1 week before the tooth’s final replacement comes. Nowadays with the improvement in materials the one session procedure is more commonly employed. If it’s two sessions then one usually opts for open healing as a rule, thereby saving the patient a further operation.
The alternatives to implantation depend on the remaining dentition and the wishes of the patient. Bridges, part-prostheses or total prostheses are hardly a real alternative for replacement teeth on implants but they are possible treatment alternatives.
With an experienced practitioner the risks associated with implantation are so small they are negligible. Nevertheless complications occasionally occur which may make possible further measures necessary. With every necessary further measure there is a further possibility of complications which could even progress to become life-threatening. Here only the particular complications of implantation are mentioned and these are:
- Loss of the implant, for example due to infection, to premature loading and/or incorrect technique
- Inflammation of the bone (osteomyelitis)
- Injury to nearby structures such as the tongue, cheeks, nerves, blood vessels and neighbouring teeth and roots with the related consequences
- Infection of the wound
- Fracture of the jaw
- Opening of the maxillary sinus which may eventually lead to inflammation of the maxillary sinus as a result
- Meteoropathy (illness caused by certain weather conditions)
Fortunately due to the positive developments in medicine in the last decades such complications have become very rare.
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