Implant

Implant

There are different types of artificial teeth. You can have anything from one tooth to an entire row of teeth replaced. The artificial teeth can be fixed or removable.


Lost teeth do not always have to be replaced. Ask the dentist if you need to replace the tooth or teeth or can do it later.


The treatment for replacing teeth differs depending on what suits you and what is possible to do. If you need a prosthesis, it is good to know that a fixed prosthesis with implants is more expensive than a removable prosthesis.


In this text, you will learn which treatments you can choose from. It deals with dentures that are attached to one's own teeth, removable prostheses or dentures that are screwed onto implants in the jawbone.


Why might I need artificial teeh?

There are several reasons why you may need to repair or replace your teeth:

  • You have knocked out or knocked out one or more teeth.

  • The teeth have been worn down by the impact of, for example, squeezing and acidic drinks.

  • You have lost teeth due to periodontal disease.

  • The teeth have been damaged by caries and dental fillings so that they have to be extracted and replaced.

  • You are missing certain dental structures or have teeth with a deviant shape.


Many people can get used to having a dental gap, especially in the sides of the jaw where the gap is not so visible. The important thing is that the balance in the tooth row remains so that the teeth do not start to tilt or move.


Crowns and bridges are common treatments

A repair is made by replacing the part of the tooth that is broken with one of the following:

  • A glued filling of plastic.

  • A glued facade which is a thin shell of porcelain.

  • An inlay that is stuck into a ground pit in the tooth.

  • A glued cap with a porcelain or metal core.


Crown

If a tooth is so broken that it can no longer be fixed with a smaller repair, the dentist may need to grind more on the tooth and make a new crown. A crown is an artificial part of a tooth that covers most of the tooth like a cap. The crown is attached to the ground tooth with a so-called cement, a ceramic material that holds it in place.


Bridge

A bridge is fixed in the mouth and replaces one or more teeth. The bridge is sometimes called a bridge and is assembled in one piece. If a tooth has to be extracted, it can be replaced with a bridge that rests on the teeth on either side of the gap.


In order to replace lost teeth with a fixed bridge, there must be enough teeth left in the jaw to provide good support for the bridge. The teeth must also not be too far apart.


The bridge can be attached in two ways. Either directly on unground teeth or the dentist grinds the teeth so that the bridge can be slipped on and secured with a cement.


Implant attaches artificial teeth

Dental implants are usually screws made of the metal titanium that are operated into the jawbone. The titanium screws act as artificial roots in the jawbone. Once the implant has healed into the jawbone, the crown or bridge can be attached to it.

It is possible to replace a single lost tooth with a crown on an implant. If several teeth are missing, it is fine to attach a bridge to several implants.


Bridge testing

You usually need to visit the dentist several times before you have your bridge or crown in place. First, the tooth or teeth are ground and the dentist takes an impression to be able to make a model. Then you decide together the color of the artificial tooth or teeth.


The impression is sent to a dental technician, who makes the crown or bridge. The replacement teeth are made of different materials.


You sometimes need to do one or more tests in the mouth for the fit to be perfect. While you wait for the finished crown or bridge, you usually have a temporary plastic replacement. When everything is ready, you can try the crown or bridge in your mouth for a few days to feel that everything feels good before it is attached. Finally, the dentist places a cement into the crowns and secures them in place on the teeth.


Keep clean around crowns and bridges

An artificial crown or bridge does not protect the teeth from cavities or tooth decay. Bridges can sometimes create spaces between the teeth that can be difficult to clean. For example, bacterial deposits easily stick to the transition between the own tooth and the artificial crown.


The most important tools to keep your teeth clean are a soft toothbrush and fluoride toothpaste. Often you need extra fluoride in the form of tablets, chewing gum or mouthwash. You may also need extra small brushes and floss to get everywhere.


You should see a dental hygienist regularly if you have many crowns or bridges in your mouth. The dentist or dental hygienist can advise you on the best way to care for your teeth.


The lifespan of crowns and bridges

Studies show that bridges generally work well for 15-20 years. If you grind or squeeze teeth, crowns and bridges wear faster. You may then need a bite splint that protects teeth, crowns and bridges.

Most dentists provide a financial guarantee that a crown or fixed bridge will last for two years.


Removable prostheses

If you are missing many teeth, it can be difficult to replace those teeth with artificial teeth that are stuck. Then you can get a removable prosthesis, either a full prosthesis or a partial prosthesis.


In addition to artificial teeth, a prosthesis also consists of an artificial material that replaces the gums and jawbone. You can insert and remove the prosthesis from your mouth yourself.


The partial denture can be attached with staples or any other attachment device to teeth that remain in the jaw. A complete denture replaces the teeth in a completely toothless jaw.


A full prosthesis in the upper jaw attaches like a suction cup to the upper jaw and palate. A full denture in the lower jaw rests on the toothless jaw. It can also be snapped onto ground teeth or implants and is then called a cover prosthesis.


A partial denture usually fits better than a full denture.


If you have teeth left

It can happen in two different ways when you get a new prosthesis. It depends on whether you have teeth left or not.


The dentist takes an impression of the jaw and the teeth if there are any teeth left in the jaw. The dental technician builds up a prosthesis that imitates one's own teeth and that has an approximate fit to the jaw.


When the bad teeth are extracted, you can get your new denture with a temporary fit until the gums and jawbone have healed. Then the shape changes and the prosthesis is adjusted until it fits perfectly.


With this method, you will not be without teeth after they have been extracted.


If you have no teeth left

The dentist takes an impression of the toothless jaw to make a wax model. It is used to be able to measure where the new teeth should sit. Together with your dentist, you choose the color and shape of your new teeth.


You need to visit the dentist four to five times before the prosthesis is completely ready. With this method, the fit of the prosthesis becomes good immediately and you usually avoid major adjustments for a couple of years.


The prosthesis must be checked

Det är viktigt att du regelbundet låter kontrollera protesen, minst en gång varje år. Den kan behöva justeras. En protes som inte sitter bra kan ge skavsår.


Käkbenet förändras snabbt den första tiden efter att tänderna dragits ut. Protesen kan behöva anpassas till det. En tandtekniker behöver högst ett par dagar på sig för att göra de justeringar som behövs. Under tiden får du vara utan protes.


Ibland måste protesen göras om. Du kan låta göra en kopia av en protes som fungerar bra och som du tycker om. Det brukar bli bra om den du kopierar inte är för sliten. Du kan också beställa en extra kopia av din protes att ha i reserv.


How do removable dentures work?

It is different for each person how long it takes to get used to a prosthesis.


It is more difficult to have a removable prosthesis in the lower jaw than in the upper jaw. Dentures in the upper jaw can often be attached to the palate. In the lower jaw, the tongue and other muscles can move the prosthesis out of position.


If you have a removable full prosthesis in the lower jaw that does not work well, it may help to insert two implants. The implants have clasps that hold the prosthesis better in place, a so-called covering prosthesis. If it works well, it is usually possible to insert more implants and make a bridge that is attached to the implants.


Certain diseases such as Parkinson's disease, Sjögren's syndrome or stroke can make it more difficult to have removable prostheses. Cover prostheses can then work well.


Clean the prothesis with a brush

A removable denture is easy to clean because you can take it out and brush it. It is fine to use a protestant brush and unscented dish soap. You can brush the gums in your mouth gently with a soft toothbrush and lukewarm water.


Do not use toothpaste to clean the denture. Toothpaste contains abrasives that can scratch the plastic material and make it easier for bacteria to stick to the prosthesis.


Implant

On a dental implant, a new artificial tooth or a row of teeth is connected directly to the screws that have been operated into the jawbone. Sometimes the teeth are attached to small extensions of titanium or other material that stick out of the gums. The extensions are called spacers.


You can count on an implant to last about as long as your own tooth if you take good care of it.


Different degrees of toothlessness require different implants

Before an implant treatment, you will be examined by your dentist. You have a conversation about your health and go over how the treatment is done.


There are different treatments depending on which teeth are missing:

  • If you are only missing or have lost a tooth, usually only an implant needs to be operated on. The implant then carries a single artificial tooth. It is called a single-tooth implant.

  • If you are missing a tooth far forward in the tooth row, it is not enough for the implant to be attached to the jawbone. The surrounding tissue must also have a shape that gives a natural appearance. Sometimes it is so difficult to get it right that a bridge that supports the surrounding teeth is needed instead.

  • If you have lost several teeth, you can get several implants to support a fixed bridge. If you have lost large parts of the jawbone, the dentist sometimes needs to expand the bridge with the artificial teeth in order for the face to look as it did before.

  • If you are completely toothless in one jaw, four to six implants are usually needed to be able to support an entire row of artificial teeth. Sometimes more implants are needed.


When is an implant inappropriate?

There are diseases that prevent you from getting implants and sometimes the dentist needs to consult with a doctor before the operation. The treatment may need to be postponed, for example, in these situations:

  • You have osteoporosis.

  • You are taking certain medicines.

  • You are being treated for cancer with radiation.

  • Your jaws have not fully grown.

  • You have too little bone in your jaw to be able to insert implants.


If you have any cardiovascular disease and use blood-thinning medication, an assessment by a doctor is needed.


Preparations for an implant operation

Pretreatment is usually not needed if you have a healthy and strong jawbone. If you have bad teeth, they may need to be extracted. Then the jawbone may need to heal before the treatment.


If you are a smoker, you should stop smoking well before the operation.


You can get a temporary denture if you are missing teeth. It fills in gaps in the teeth and makes chewing easier.


Sometimes the jawbone needs to be builts up

You can get a bone build-up or bone graft if you lack enough jawbone for the implants to attach. It is most common that the operation is performed in the upper jaw.


First, an x-ray examination of the jaw is made to investigate the possibilities of operating on implants. Sometimes it is done with computed tomography, X-ray.


Then an oral surgeon operates on bone from another part of the body. Artificial bone replacement materials are sometimes used.


For a minor operation, you will receive local anaesthetic. If the leg is operated from, for example, the hip, it is done under anesthesia.


Surgery of implants

You are operated on once or twice when you are to receive implants, depending on how many implants are to be inserted.


The operation is usually done with local anesthesia and is painless. You may be given sedatives if you are worried about the operation. If you are very worried, you can have the entire treatment done under anesthesia.


The first operation takes one to two hours, depending on how many implants are to be inserted.


First, the gums are folded away and holes are drilled in the jawbone. The surgeon then attaches the implants to the jawbone. The gums are then sewn over the implants so that they are not visible.


For about a week, you do not use the prosthesis and should not chew where you have had surgery.


Spacers are attached to the implants

In the second operation, the mucosa is opened at each implant and small extensions, called abutments, are attached to the implants. The spacers go up through the mucous membrane. On them, the new artificial tooth or bridge can later be screwed or fixed with cement. Usually the second operation is faster than the first.


Treatment in just one step

Sometimes a treatment is done with just one operation. Surgery takes one to two hours, depending on how many implants are to be inserted.


By and large, the same technique is used as during the first operation. But instead of sewing over the mucosa and covering the implants, the implants or abutments are allowed to protrude a few millimeters from the mucosa right from the start. Then no other operation is needed.


After the surgery of implants

The titanium implants need to grow firmly into the jawbone. How long it takes for the implant to grow in depends, among other things, on the type of implant used and in which part of the jaws the implants sit. It can take up to six months.


In the meantime, you have a prosthesis and do not have to be toothless. If the implants are very stable, the dentist can sometimes build the artificial teeth on the implants the same day or weeks after the operation.


Seven to ten days after surgery, you can again use your old prosthesis that has been reshaped to fit the jaw. In smaller gaps, you can sometimes get fixed, temporary teeth that rest on the neighboring teeth immediately after the operation.


Fabrication of the teeth

When the implants are firmly established and when the mucous membrane has healed, the new artificial teeth are attached.


The dentist first takes an impression of the jaw and implant so that the dental technician gets a model. The dental technician builds the bridge on the model. It is important that the artificial teeth fit exactly on your implants.


It usually takes about two to four weeks to make the artificial teeth. The dentist attaches the artificial teeth to the implants.


You cannot remove the new teeth yourself.


Keep your teeth clean 

Smoking can make it more difficult to heal after implant surgery.


You are often given antibiotics after surgery. Sometimes you may need painkillers. Because the surgeon drilled into the jawbone, you often get an inflammation that soon goes away. It is usually swollen, tender and sometimes there is bleeding.


To keep it clean, you can rinse your mouth with saline and chlorhexidine solution. If you have had surgery on a whole jaw, you may need to eat a liquid diet for a few days.


It can feel unusual to get solid teeth after being toothless for a long time. The artificial teeth can feel new and unfamiliar. Sometimes speech is affected so that you read, for example. But you can work that out by reading aloud.


Keep your teeth clean

It is just as important to keep the implants and the new teeth clean as it is to keep regular teeth clean. The shape of the new teeth can make it easier for food residues and bacterial deposits to stick around the implant and bridge. Ask the dentist or dental hygienist for advice.


You can check your implants and artificial teeth yourself every day when you brush your teeth. Check that bridges and crowns feel stable, that they are whole, that the gums are not bleeding or swollen and that they do not hurt.


Follow-up and checks

To check the jawbone around the implants, the dentist must take an X-ray. It is followed by more so that the dentist can compare with previous X-ray examinations that the implants are seated as they should be. During the first two years after the operation, it is important to check whether the implants change.


After approximately two years, the time between X-ray examinations can be extended to, for example, five years if the bone around the implants is healthy.


During regular check-ups with the dentist or dental hygienist, this is checked:

  • What the mucous membrane around the implants looks like.

  • If there are bacterial coatings, so-called plaque, around the implants and on the artificial teeth.

  • What the bite of the artificial teeth looks like.

  • How the bite fits when you bite together.

  • How well the bridge or crown is secured.


Complications and sequelae of implants

Implants can often work well for a long time. But you can get an infection or the pressure from the prosthesis causes the implant to become overloaded and the implant loosens. If you smoke, it can impair both healing and increase the risk of complications after a while.


Implants that come off

It is unusual for implants to loosen. If the implant loosens within a few months after the operation, it is often because they have not grown properly into the bone.


If you lose the implant later, it may be because you have chewed too hard. To reduce the risk of overload, you can use a bite splint at night.


Bacterial coating

You can get infections around the implants. It can be compared to tooth loss. Bacteria can collect around the implants and cause a breakdown of the bone around the screw. It can be very difficult to get rid of the bacteria. It may then be necessary to remove the implant.


The implant may need to be replaced

If you need a new implant for any reason, a new operation is required. The hole in the bone left by the lost implant must heal and the tissues must be healthy before a new implant can be surgically inserted. It may take several months.


Guarantee

Most dentists provide a financial guarantee that the crown or bridge that sits on the implants will last for two years.


The implants have a guarantee of at least two years. After that, the manufacturers provide various long guarantees. If it is a lifetime warranty, it means that you can get a new implant from the manufacturer if it breaks or comes loose. Then you have to pay for the operation and adjustment yourself.