Doctors from Peking Union Medical College say: Here is everything you want to know about dental implants~

Missing teeth can cause many problems, such as affecting chewing and language functions, causing tooth displacement, bone resorption, soft tissue atrophy and other consequences. Missing teeth not only affect function and appearance, but also damage physical and mental health. In recent years, with the development of modern science and technology and the advancement of dental technology, the public has paid more and more attention to oral health. Are you worried about what treatment plan to choose to repair missing teeth? Are you worried about the risks of implant restoration? Do you know how long the recovery period of dental implants is? ...Don't worry, today, the dentist of Peking Union Medical College Hospital will tell you about dental implants——

About the author: Li Qian

Deputy Chief Physician of the Department of Stomatology, Peking Union Medical College Hospital. Specializes in oral implant restoration, oral laser treatment, etc.

He is currently serving as the standing member and academic secretary of the Oral Laser Medicine Committee of the Chinese Stomatological Association; a member of the Oral Implant Working Committee of the Stomatological Branch of the Chinese Medical Doctor Association; a director of the Cosmetic and Regenerative Medicine Branch of the Chinese Association of Plastic and Aesthetic Surgery; and a member of the Oral Aesthetics Committee, the Oral Laser Committee, and the Oral Biology Committee of the Beijing Stomatological Association.

Restoration methods for missing teeth

There are three main methods for restoring missing teeth: removable dentures, fixed dentures and implant dentures.

The advantages of removable dentures are that they do not require surgery, take a short time to repair, cause less trauma, and reduce bruxism. However, they need to be removed for cleaning, and there are also certain disadvantages, such as possible damage to adjacent teeth, and the possibility of local caries or periodontal loosening and bone resorption in the long term.

The advantages of fixed dentures are that they are quick to install and more comfortable. The disadvantages are that they will cause the loss of the hardest enamel on the surface of the teeth, and it is more difficult to clean under the bridge. Over time, it may cause local caries and even periodontal problems and tooth loss.

Denture implants can be traced back to ancient times, when ivory was sculpted into the shape of teeth and embedded in the jawbone. In modern times, various metal implants have appeared, and teeth are placed on them, but due to the limitations of implant materials, manufacturing and clinical technology, the failure rate is high. In modern times, high-precision implants have appeared, and the titanium alloy material with specially treated surface has good adaptability to the human body.

Indications for dental implants

Oral implants are suitable for people with edentulous jaws, multiple missing teeth, single missing teeth, and poor function of removable dentures.

When the alveolar bone of edentulous patients is relatively good and there is enough area for implantation, the method of implant-supported fixed restoration can achieve good coordination of function and aesthetics, but the cost is relatively high. If the alveolar bone condition is not good enough or there are many soft and hard tissues missing, and the appearance is not full, implant-supported overdentures can be made. Although this type of denture can be removed, its firmness is comparable to that of fixed dentures, and the cost is lower than that of implant-supported fixed dentures. Secondly, it has a special support base to repair the missing tissue, with a fuller visual effect and a younger and more beautiful appearance. At the same time, it is easy to remove and more convenient to clean.

If multiple teeth are missing continuously, removable dentures or implant dentures can be made. For implantation, two implants can be implanted at the front and back ends of the gap to complete an implant-supported fixed bridge; or implants can be implanted for each number of missing teeth, and single crowns supported by implants can be restored, so that dental floss can be used for cleaning and maintenance between teeth. If the bone condition is not good enough and bone grafting is not desired, short implants and narrow-diameter implants can be implanted to appropriately increase the number of implants.

If a single tooth is missing, it can be restored with an implant-supported single crown. The front teeth can also be restored with an implant-supported all-ceramic restoration for a more aesthetic look.

Local contraindications

1. Severe bone defect: If bone grafting is not acceptable, the alveolar bone cannot accommodate the available implants, which means that implants cannot be performed.

2. Poor occlusion or inter-jaw relationship: The occlusion relationship between the upper and lower jaws needs to be adjusted first, and then implantation can be performed when there is enough space.

3. Pathological changes occur in the jaw.

4. Pathological mucosal lesions: They need to be treated first before implant restoration.

5. After head and neck radiotherapy: trauma or infection may affect implant bone integration.

6. Sjögren's syndrome: These patients may have poor oral self-cleaning function, and long-term systemic medication may affect implant restoration.

7. Uncontrolled periodontal disease or extremely poor oral hygiene: These patients need to undergo periodontal system treatment first, followed by implant restoration.

Factors related to overall health

Implant restoration needs to comprehensively consider the patient's general condition, nutritional status, age and other factors, such as whether there are endocrine and metabolic disorders, blood system diseases, cardiovascular system diseases, etc., as well as whether special medications are taken for a long time, and whether there is a history of smoking and drinking.

Both e-cigarettes and cigarettes contain nicotine, which can affect tissue healing. It is recommended to quit smoking or reduce smoking before and after surgery.

Things to note after implant surgery

1. For patients with routine implants, oral antibiotics should be taken for 5 days after surgery. Patients with bone grafting may need to take antibiotics for 7 days and receive intravenous antibiotics when necessary.

2. Ice compress is required immediately after the operation, and hot compress can be applied after 48 hours to reduce swelling, pain and local bruising.

3. After the operation, you should rinse your mouth to keep your mouth clean; if oral hygiene is not maintained well, local infection may easily occur.

4. After the operation, you should eat cooler and softer foods, try not to eat food near the surgical site, and avoid eating hard foods.

5. Good rest helps to recover as soon as possible.

Postoperative diet

After surgery, you should avoid eating hard foods (such as French fries, nuts, apples, etc.), acidic foods (such as tomatoes, lemons, limes, orange juice, etc.), and spicy foods.

Eat: Oatmeal, noodles, rice, eggs, avocado, bananas, and healthy juices or smoothies.

Will there be complications with implants?

The complications and postoperative reactions associated with implant surgery include: infection; damage to natural teeth, blood vessels or nerves; local numbness, swelling, pain, bruises of gums, lips and cheeks, etc. After a period of use, implant restorations may cause peri-implantitis or peri-implant mucositis, which may be accompanied by local pain, redness, swelling, bleeding, odor, etc., and even adverse reactions such as fever. Therefore, after implant restorations, you should pay attention to oral hygiene, brush your teeth, rinse your mouth, and use tools such as interdental brushes and dental floss to clean your teeth. In addition to daily maintenance, professional maintenance is also required, including regular follow-up examinations and cleaning.

How to maintain dental implants

1. Maintain oral hygiene and rinse with non-alcoholic mouthwash 2 to 3 times a day after surgery.

2. For areas that a toothbrush cannot reach, use dental floss, interstitial brushes, oral irrigators, etc. to assist in thorough cleaning.

3. Visit the dentist regularly, and have a follow-up checkup 1 week, 1 month, 3 months, 6 months, and 12 months after the restoration is completed. After that, it is advisable to have a follow-up checkup every six months or a year.

4. Do not eat hard food to avoid damaging the crown and implant.

5. Avoid smoking.

Content from: Dr. Li Qian from Union Medical College Hospital