Dental Implant Treatment

Tooth loss is not only an aesthetic problem; chewing, speaking and the health of the jawbone are also affected. Today the longest-lasting method closest to a natural tooth for replacing missing teeth is dental implant treatment. On this page you can find out what an implant is, how treatment proceeds, the pain and healing process, who it is suitable for and when it is postponed, and what to pay attention to after surgery. The information is based on the protocols in the daily practice of our clinic's Periodontology Specialist, Dt. Nergiz Hamamcı.

What is a dental implant?

A dental implant is a screw made of titanium or zirconium that imitates the root of a tooth and is biologically compatible with the jawbone. These screws are placed in the jawbone; depending on the structure of the implant, a waiting period follows so that it fuses with the bone (osseointegration). Once fusion is complete, the part visible in the mouth, that is, the prosthesis, is made. In this way the implant imitates a real tooth as a whole.

In traditional bridge treatment, the healthy neighboring teeth have to be reduced to fill the gap of the missing tooth. With an implant, the neighboring teeth are not touched. In addition, the bone loss that begins in the jawbone after tooth loss is stopped by the implant, preserving bone volume and facial structure.

How does implant treatment proceed step by step?

1. Examination and planning

The most important part of the process is accurate diagnosis and planning. With a panoramic X-ray and, when necessary, a 3D jaw tomography, the thickness and height of the bone and its distance from the nerves are measured. The diameter and length of the implant are determined individually according to this data. Your general health and oral hygiene are also evaluated at this stage.

2. Surgical procedure

The procedure is routinely performed under local anesthesia. The implant is placed in the socket prepared in the jawbone. If the bone is insufficient, bone augmentation procedures such as bone powder (graft) application or sinus lift can be planned in the same session or in a separate one.

3. Healing and fusion with the bone

Generally 2 to 4 months of waiting is needed for the implant to fuse with the jawbone, depending on the brand and bone structure. This period may be longer if a bone augmentation procedure has been done. Temporary solutions can be applied during this period so that you are not left without teeth.

4. Impression and making the prosthesis

When fusion is complete, the top of the implant is uncovered, healing caps are attached and an impression is taken as if there were a natural tooth in the mouth. Then a zirconium or porcelain prosthesis is fixed onto the implant. A digital intraoral scanner can be used instead of traditional impression paste. For prosthesis types, see our prosthetic treatment page.

Is implant treatment painful?

Implants are generally placed under local anesthesia. Before the injection, topical anesthesia in gel or spray form is applied to the area to reduce the pain of the needle's entry, so no pain is felt during the procedure. However, local anesthesia does not completely remove the sensation of touch, pressure and hot-cold; it only blocks the transmission of pain. For this reason you may feel pressure or touch instead of pain during the procedure. In some cases, general anesthesia may be preferred for patients with coordination problems, elderly patients or patients with a high degree of fear and anxiety.

Pain and swelling after the procedure

To reduce pain, in our clinic we recommend taking the prescribed painkiller about half an hour before the procedure, repeating it on a full stomach about 4 hours later depending on its type, and then continuing morning and evening. Most of our patients use the painkiller for 2-3 days. Additional procedures such as bone powder application, soft tissue transfer, multiple implants or placing an implant in the same session as a tooth extraction can increase the severity and duration of pain. Needing a painkiller for a week is also an acceptable period in these cases.

Swelling varies from person to person; it generally increases until the 3rd day and then begins to decrease. To reduce swelling:

• Apply ice to the treated area.
• If possible, do not lie on the side of the procedure.
• After procedures on both sides, lie on your back with two pillows and keep your head above heart level.

Who can have an implant and when is it postponed?

An implant can be placed in people whose jaw and facial development is complete, who have enough bone where the implant will be placed, who have good oral hygiene and who have no chronic condition that would prevent surgery. It is generally planned for ages 18 and over. In the following situations, treatment is postponed or the planning is reconsidered and the opinion of the relevant doctor is obtained:

• Uncontrolled diabetes: The implant is postponed until diabetes is brought under control.
• Cancer treatment: Postponement and the opinion of the doctor are recommended for those currently in treatment or who have recently had radiotherapy/chemotherapy.
• Severe bone loss (osteoporosis): Tests measuring bone density are requested; treatment is planned according to the doctor's approval.
• Immune system problems: Planning is re-evaluated for those who have had an organ transplant or who use drugs that suppress the immune system.
• Blood diseases: Treatment is re-planned for those with clotting problems.
• Growth and development not yet complete: Although some publications accept the age of 16, we plan treatment at age 18 and over.

In patients with controlled diabetes, blood pressure or heart conditions, implants can be placed safely with the approval of the relevant doctor.

Care after an implant: what should you pay attention to?

After the anesthesia wears off

The effect of local anesthesia varies from person to person but generally wears off completely within 4-6 hours. After that, you can eat warm, soft foods with no grains (for example, soup). Even if you have no pain, try to eat soft, warm foods with no grains for a week. Going back to hard and hot foods too early, after feeling better following the third day, can result in pain, food buildup, soft tissue irritation or a torn stitch.

Brushing and mouthwash

• You can brush your teeth the same day; however, do not spit the liquid in your mouth, let it flow slowly out of your mouth. Spitting can disrupt wound healing and cause pain, delayed healing and bleeding. We recommend not spitting for a week.
• For daily care, small-headed, soft post-operative toothbrushes can be used.
• Do not use mouthwash for the first 48 hours; afterwards apply it for 30 seconds and again let it flow out slowly without spitting.

Other rules

• Do not use a straw; pressure fluctuations in the mouth affect the wound negatively.
• Do not smoke for 2 weeks after surgery.
• The gauze placed after the procedure stays in the mouth for half an hour; once the time is up it is removed and there is no need to put in a new one.
• Avoid lying in the sun, hammams and saunas.
• Do not take a hot shower on the day of the procedure and the next day.

If bone is insufficient: sinus lift

When placing implants in the back of the upper jaw, the floor of the sinus (the air space above the upper jaw) guides us. If the sinus floor hangs down low, which may be genetic but is also seen with early tooth loss, there may not be enough bone for an implant. In that case, bone augmentation is done first; the implant is placed in the same session or in a later one. Two techniques are used depending on bone height:

• Closed sinus lift: Applied if there is about 5 mm of bone. After the implant socket is prepared, the sinus floor membrane is lifted with special instruments and the implant is placed in the same session. If needed, bone powder is placed underneath. With this technique only a few millimeters (generally 1-2 mm) of gain is achieved.
• Open sinus lift: If the bone loss is more advanced (about 4 mm and below), a small window is opened on the side of the jawbone, the membrane is lifted, bone powder is placed underneath and the area is closed. Depending on the remaining bone, the implant can be placed in the same session followed by a wait of 4-6 months, or one can wait 4-6 months first and then place the implant.

For the gain, our clinic mostly uses large-particle bone grafts; where possible, a small amount of the patient's own bone is mixed in, and the area is closed with a protective membrane prepared from the patient's own blood. After the procedure, avoid blowing your nose, do not use a straw and keep your mouth open when sneezing. These restrictions end once the bone has matured.

What to pay attention to when choosing an implant

There is no single answer to the question of the best implant brand; the choice should be made together with your dentist according to your bone structure, the type of prosthesis targeted and your clinical condition. While European brands have long been in the lead, Korean and domestic brands have also come to the fore recently. When choosing a brand, it is important to look not only at its name but also at your dentist's experience with that system and the sustainability of spare parts and prosthesis support.

Types of implant-supported prostheses

Implant-supported prostheses can be fixed or removable: a single crown for one missing tooth, a bridge for several missing teeth, fixed solutions such as All-on-4 / All-on-6 for complete tooth loss, or removable overdenture prostheses that sit on implants. For details, see our prosthetic treatment page.

In every surgical and invasive procedure, results may vary from person to person. It is recommended that you always get detailed information from your dentist before the procedure.

Your Reliable Address for Dental Implant Treatment in Ankara

When looking for dental implant treatment in Ankara, it is your most natural right to have a treatment experience that is transparent, informative and supported by modern technology from start to finish. At Klinik 99 Oral and Dental Health Polyclinic, we are by your side to protect your oral and dental health and to replace your missing teeth in the closest way to natural. You can contact our clinic for a personalized treatment plan and a detailed examination.

Klinik 99 Oral and Dental Health Polyclinic Address: Güvenevler, Güvenlik Cd. No: 99 A-B, 06690 Çankaya/Ankara Phone: 0540 640 6006

Highlights of This Service

• Natural look
• Long-lasting solution
• Comfortable use
• Prevents bone loss