In this blog post, we explore the potential and limitations of dental implant procedures as a safe treatment option for replacing damaged teeth.
As we enter an aging society, interest in bone health is growing. In particular, dental health is directly linked to essential dietary habits, making it a major concern not only for the elderly but also for young and middle-aged adults. Consequently, technologies that restore the function of old or damaged teeth have become increasingly important, and one such technology is dental implants, often referred to as “third teeth.”
Getting an implant is similar to constructing a building. Just as in architecture, where the building’s framework is erected and then filled with concrete, the implant process involves embedding a fixture—made of a material that bonds well with bone—into the jawbone and covering it with gum tissue. Once the fixture is secured to the jawbone, it becomes firmly anchored. After the approximately one-hour procedure is complete, the crown—an artificial prosthesis—can be used as a new tooth. Unlike the bridge technology used prior to implants, which required treating the teeth on either side of the affected area, implant surgery offers the significant advantage of precisely treating only the damaged section.
Just as blueprints are essential when building a house, it is crucial to thoroughly assess the patient’s dental condition before implant surgery. Not everyone with damaged teeth is eligible for the procedure, as the condition of the jawbone, alveolar bone, and gums determines the treatment plan. If there is insufficient alveolar bone, a bone graft must be performed before surgery, and if the existing teeth are in poor condition, extraction may be necessary. X-rays are taken to assess these factors, and if the patient has an underlying medical condition, it may complicate the implant procedure. In particular, if symptoms are severe, the procedure itself may not be possible.
Before implant surgery, a process is required to increase the volume of the jawbone to accommodate the implant. Failure to undergo this process may cause complications when placing the fixture. Therefore, the procedure begins after increasing the volume of the jawbone through drilling prior to surgery. Materials used for fixtures include metal, ceramic, polymer, and composite materials, all of which bond well with the jawbone. Titanium is commonly used because it does not cause inflammation in the gums.
There are two main methods for implant surgery. The first is the one-stage procedure, in which the gums are closed over the implant post so that it remains visible. The second is the two-stage procedure, which involves implant placement through two separate surgeries. In the two-stage procedure, the gums are closed over the implant to conceal the post, followed by a recovery period of 2 to 3 months. Afterward, once it is confirmed that the fixture has properly integrated with the bone, the abutment is inserted, and the gum is sutured again. Both methods are completed by placing a crown, which is an artificial prosthesis. The crown is made of porcelain shaped like a natural tooth and is secured with a screw upon insertion.
Implants can be categorized into intraosseous implants and transosseous implants depending on the surgical site. Intraosseous implants are the most commonly used method; unlike transosseous implants, they involve placing the post without penetrating the jawbone. Additionally, they are classified into blade-type, cylindrical-type, and screw-type based on the shape of the fixture, with the screw-type being the most widely used. Generally, the implant procedure takes about one hour, but the duration may be longer depending on the patient’s oral condition.
Just as the patient’s condition prior to surgery determines its start and progress, their health after surgery also significantly impacts the longevity of the implant. Various conditions, including cardiovascular disease, can negatively affect the post-operative recovery process; in particular, osteoporosis hinders the firm bonding between the fixture and the bone. Just as a building requires regular maintenance even after it is completed, patients who have undergone implant surgery also require ongoing care. Smoking and alcohol consumption should be avoided, as they can slow down or hinder post-operative recovery. Of course, this also applies before the implant procedure.
In most cases, the need for reoperation after surgery is due to infection. Failure to keep the surgical site clean delays recovery and increases the risk of complications. Therefore, not only is the doctor’s accurate diagnosis and treatment crucial, but the patient’s own self-care is also essential. In particular, because the oral environment is humid and conducive to bacterial growth, thorough oral hygiene is necessary. Additionally, it is advisable to avoid hard foods, as they can damage the prosthetic device.
Regardless of post-procedure patient care, the surgical site may occasionally become red and swollen, or skin discoloration may occur. While these issues usually resolve naturally, severe cases can lead to permanent disability. A prime example is nerve damage. The mandibular nerve canal, located in the lower jaw, is responsible for chewing movements; if this canal is damaged during surgery, sensation around the jaw may be lost. To prevent this, the length of the implant must be selected precisely, and care must be taken not to damage the nerve canal during the drilling process. Another example is maxillary sinus damage. This occurs when a hole is created in the maxillary sinus during surgery on the upper molars; like nerve canal damage, precise planning is required before the procedure. In rare cases, the prosthesis may become loose or the screw may come undone after the procedure; this is due to incorrect implant orientation or shape and may require reoperation.
The purpose of implant surgery is not simply to replace a damaged tooth. It is a process of implanting a new tooth to fully restore the function of the existing teeth. The procedure can only be successfully completed when the patient’s ongoing care and the dentist’s cooperation work in harmony. A well-maintained implant can last for nearly 20 years and is the result of a combination of the dentist’s treatment and the patient’s care.
Implant surgery remains expensive and is not yet a technology that is fully understood or trusted by the general public. However, implant technology is constantly advancing, and more diverse treatment methods will be developed in the future. Consequently, the accuracy of the procedure and patient confidence are expected to increase further.
