Dental implants - the "third set of teeth" of humans

Author: Lin Shichen, deputy chief physician, Beijing Electric Power Hospital, State Grid Corporation of China

Reviewer: Lu Zhiyue, Chief Physician, Beijing Hospital

Liu LinChief Physician, Anzhen Hospital, Capital Medical University

Duan Shaoyu, Chief Physician, Beijing Electric Power Hospital, State Grid Corporation

Around 6 months after birth, the baby's deciduous teeth begin to erupt. At around 2 years old, all 20 deciduous teeth have erupted, which is the first set of teeth for humans. At the age of 6, permanent teeth begin to erupt to replace deciduous teeth, and all of them will erupt around the age of 12, becoming the second set of teeth for humans. In theory, permanent teeth will accompany a person throughout his life, performing functions such as chewing, language, and aesthetics. However, in the long-term use process, permanent teeth are often lost due to caries, periodontal disease, trauma, splitting, etc.

The current level of technology cannot allow humans to regenerate a set of teeth, but a set of teeth can be implanted in the patient's mouth to achieve the same aesthetic and chewing effect as real teeth. This is what we call dental implants. Dental implants, also known as implant dentures, refer to the use of bionic tooth roots made of highly biocompatible materials implanted in the human jawbone, and crowns installed on top of them to restore aesthetics and chewing function. Dental implants are not only beautiful and lifelike, and feel comfortable, but can also fully restore chewing function. With the continuous advancement of technology, the long-term survival rate of dental implants is getting higher and higher, so they are called the "third set of teeth" of humans.

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Ancient Egyptians, Babylonians, and Chinese people all used gold, gemstones, ivory and other materials to carve into the shape of teeth and implant them into the jawbone. In the first half of the 20th century, people discovered through continuous attempts that cylindrical or root-shaped implants were more similar to our natural teeth and had better performance in terms of force, gradually forming the prototype of modern dental implants. It was not until the 1950s that Professor Branemark of Sweden accidentally discovered that titanium metal could form a tight biological bond with the rabbit's tibia when observing bone healing in rabbits, and thus proposed the "bone bonding" theory. In 1965, Professor Branemark successfully used the titanium implant he developed in the first clinical case. By the time the patient died in 2007, his dental implants had been in good use for 42 years. At the Toronto Conference in 1982, Branemark reported his 15-year implant research work, which laid the foundation for modern oral implantology.

Oral implant research in my country began in the early 1980s, first at West China University of Medical Sciences. In the late 1980s and early 1990s, medical schools such as the Fourth Military Medical University, Shanghai Second Medical University, and Peking University Medical College began research one after another. In 1995, the Chinese Stomatological Association held the "National Oral Implant Academic Seminar" in Zhuhai, and formulated the "Zhuhai Consensus" on implant technology specifications and success standards, which played a milestone role in the development of oral implants in China. Since then, especially since 2005, oral implants in my country have made rapid progress. At present, whether in terms of clinical technology, basic research, or clinical effects, my country has basically approached the level of developed medical countries.

So, compared with the traditional method of toothless restoration, what are the advantages of dental implants? Traditional fixed restoration requires grinding off a part of the natural teeth in good condition on both sides of the edentulous area as required, leaving space for installing fixed dentures (also known as "braces"), and then installing and bonding a set of personalized crowns on the natural teeth to perform aesthetic and chewing functions. Once natural teeth are damaged, it is impossible to restore them, and caries, pulpitis, gingivitis, etc. may occur in the long term. The biggest advantage of dental implants compared to traditional methods is that they do not require grinding off the tooth tissue, thus avoiding damage to natural teeth. At the same time, the chewing force of dental implants is borne by the implants implanted in the jawbone, not the adjacent natural teeth, so that the natural teeth will not be overloaded. Traditional removable dentures have poor stability, poor chewing effect, obvious foreign body sensation, and poor aesthetics, while implant dentures do not have these problems. Even for some patients with poor jawbone conditions, planting a small number of implants to make attachment overdentures will be more stable and comfortable than traditional removable dentures. The following two pictures are the traditional fixed restoration method and the implant restoration method

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Except for a few implant surgeries that require complex bone grafting, general dental implant surgery is not very technically difficult and risky, and the equipment requirements are not harsh. Therefore, many dental clinics are also equipped to carry out dental implant surgery. Of course, implant surgery is still highly technically sensitive. Improper operation may cause poor implant position, damage nerves or adjacent teeth, and may cause complications such as lower lip numbness, peri-implantitis, implant or abutment fracture, loose crowns, and even loose implants. The medical level in various regions of my country is uneven, and various regulatory systems are not perfect enough. There are still a large number of medical institutions and doctors who do not meet the requirements and conduct dental implant business in violation of regulations, which can easily cause harm to the health of patients. Therefore, patients must choose regular medical institutions and strictly trained doctors to carry out dental implant treatment, and should not easily believe in false media advertisements and diagnosis and treatment services that are significantly lower than market prices.

For patients who need dental implants, as long as they do not have serious systemic diseases (such as severe hypertension, heart disease, diabetes, etc.), they can undergo simple imaging and laboratory tests and pass the doctor's evaluation. They are not absolutely restricted by age factors. After the implant restoration is completed, scientific care is also required during the use of the implant, and even more care should be taken than for real teeth. The first thing is to brush your teeth correctly, and secondly, use dental floss and water flossers to ensure the cleanliness and health of the gums around the implant. Finally, insist on annual checkups to detect and solve problems in a timely manner.

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In order to enable the general public to enjoy the excellent chewing and aesthetic effects brought by the "third set of teeth" of mankind, in the first half of this year, my country included dental implant consumables into centralized procurement in accordance with the law, and made strict regulations on the service prices of dental implants, which reduced the overall cost of dental implants by 1/3 to 1/2, greatly benefiting the public. In the future, dental implants will surely be popularized on a larger scale in my country.