Dental implant

Dental implant
A titanium dental implant with a crown attached used for a single tooth replacement
ICD-9-CM23.5-23.6
MeSHD003757
Dental Implant
Dental implant, 3D illustration

A dental implant (also known as an endosseous implant or fixture) is a prosthesis that interfaces with the bone of the jaw or skull to support a dental prosthesis such as a crown, bridge, denture, or facial prosthesis or to act as an orthodontic anchor. The basis for modern dental implants is a biological process called osseointegration, in which materials such as titanium or zirconia form an intimate bond to the bone.[1] The implant fixture is first placed so that it is likely to osseointegrate, then a dental prosthetic is added. A variable amount of healing time is required for osseointegration before either the dental prosthetic (a tooth, bridge, or denture) is attached to the implant or an abutment is placed which will hold a dental prosthetic or crown.

Success or failure of implants depends primarily on the thickness and health of the bone and gingival tissues that surround the implant, but also on the health of the person receiving the treatment and drugs which affect the chances of osseointegration. The amount of stress that will be put on the implant and fixture during normal function is also evaluated. Planning the position and number of implants is key to the long-term health of the prosthetic since biomechanical forces created during chewing can be significant. The position of implants is determined by the position and angle of adjacent teeth, by lab simulations or by using computed tomography with CAD/CAM simulations and surgical guides called stents. The prerequisites for long-term success of osseointegrated dental implants are healthy bone and gingiva. Since both can atrophy after tooth extraction, pre-prosthetic procedures such as sinus lifts or gingival grafts are sometimes required to recreate ideal bone and gingiva.

The final prosthetic can be either fixed, where a person cannot remove the denture or teeth from their mouth, or removable, where they can remove the prosthetic. In each case an abutment is attached to the implant fixture. Where the prosthetic is fixed, the crown, bridge or denture is fixed to the abutment either with lag screws or with dental cement. Where the prosthetic is removable, a corresponding adapter is placed in the prosthetic so that the two pieces can be secured together.

The risks and complications related to implant therapy divide into those that occur during surgery (such as excessive bleeding or nerve injury, inadequate primary stability), those that occur in the first six months (such as infection and failure to osseointegrate) and those that occur long-term (such as peri-implantitis and mechanical failures). In the presence of healthy tissues, a well-integrated implant with appropriate biomechanical loads can have 5-year plus survival rates from 93 to 98 percent[2][3][4] and 10-to-15-year lifespans for the prosthetic teeth.[5] Long-term studies show a 16- to 20-year success (implants surviving without complications or revisions) between 52% and 76%, with complications occurring up to 48% of the time.[6][7] Artificial intelligence is relevant as the basis for clinical decision support systems at the present time.[8] Intelligent systems are used as an aid in determining the success rate of implants.[9]

  1. ^ "Dental Materials | AMERICAN ELEMENTS ®". American Elements: The Materials Science Company. Retrieved 2024-02-14.
  2. ^ Papaspyridakos P, Mokti M, Chen CJ, Benic GI, Gallucci GO, Chronopoulos V (October 2014). "Implant and prosthodontic survival rates with implant fixed complete dental prostheses in the edentulous mandible after at least 5 years: a systematic review". Clinical Implant Dentistry and Related Research. 16 (5): 705–17. doi:10.1111/cid.12036. PMID 23311617.
  3. ^ Berglundh T, Persson L, Klinge B (2002). "A systematic review of the incidence of biological and technical complications in implant dentistry reported in prospective longitudinal studies of at least 5 years". Journal of Clinical Periodontology. 29 (Suppl 3): 197–212, discussion 232–3. doi:10.1034/j.1600-051X.29.s3.12.x. PMID 12787220.
  4. ^ Pjetursson BE, Thoma D, Jung R, Zwahlen M, Zembic A (October 2012). "A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years". Clinical Oral Implants Research. 23 (Suppl 6): 22–38. doi:10.1111/j.1600-0501.2012.02546.x. PMID 23062125.
  5. ^ Cite error: The named reference bozini was invoked but never defined (see the help page).
  6. ^ Simonis P, Dufour T, Tenenbaum H (July 2010). "Long-term implant survival and success: a 10-16-year follow-up of non-submerged dental implants". Clinical Oral Implants Research. 21 (7): 772–7. doi:10.1111/j.1600-0501.2010.01912.x. PMID 20636731.
  7. ^ Chappuis V, Buser R, Brägger U, Bornstein MM, Salvi GE, Buser D (December 2013). "Long-term outcomes of dental implants with a titanium plasma-sprayed surface: a 20-year prospective case series study in partially edentulous patients". Clinical Implant Dentistry and Related Research. 15 (6): 780–90. doi:10.1111/cid.12056. PMID 23506385.
  8. ^ Lyakhov PA, Dolgalev AA, Lyakhova UA, Muraev AA, Zolotayev KE, Semerikov DY (2022). "Neural network system for analyzing statistical factors of patients for predicting the survival of dental implants". Frontiers in Neuroinformatics. 16. doi:10.3389/fninf.2022.1067040. ISSN 1662-5196. PMC 9768332. PMID 36567879.
  9. ^ Liu CH, Lin CJ, Hu YH, You ZH (May 2018). "Predicting the Failure of Dental Implants Using Supervised Learning Techniques". Applied Sciences. 8 (5): 698. doi:10.3390/app8050698. ISSN 2076-3417.