What is Implant Dentistry?

It refers to a method of repairing missing teeth that supports and retains the upper dental restoration based on the underlying structure implanted in the bone tissue. It includes the lower part of the dental implant and the upper part of the dental prosthesis (implant-supported). It uses artificial materials (such as metal, ceramics, etc.) to make implants (generally similar to the root shape). It is surgically implanted into the tissue (usually the upper and lower jaw) and obtains solid retention support of bone tissue. Way to connect the dental restoration supporting the upper part. Dental implants can achieve restoration effects that are very similar to the natural tooth function, structure, and aesthetics, and have become the first choice for more and more patients with missing teeth.

Lin Ye	(Chief physician)	Department of Dental Implants, Peking University Stomatological Hospital
Zhang Yu	(Deputy Chief Physician)	Department of Dental Implants, Peking University Stomatological Hospital

Western Medicine Name: implanted teeth
Affiliated Department: Department of Physiology-Stomatology

Disease site: Mouth, teeth
Multiple groups: Middle-aged
Contagious: Non-contagious

Dental implant development history

As early as ancient times, people in Europe, the Middle East, and Central America tried to use various homogeneous or heterogeneous materials, including human and animal teeth, carved bones and shells, to implant jaws to replace missing teeth. In modern times, people have tried to use artificial materials to make implants of various shapes, and implanted in or out of bone to repair missing teeth or provide support for dental restorations. However, these implants failed to meet the requirements of the complex oral environment, and a large number of failures occurred. In the mid-20th century, the Swedish Brånemark observed that the bone tissue of animals could be tightly integrated with the implanted titanium device. He later defined this phenomenon as osseointegration. In 1965, he applied the developed osseointegrated titanium implant to the first clinical case and successfully repaired the cleft palate defect. At the Toronto conference in 1982, Brånemark reported a large amount of research work on osteointegration for 15 years, which was recognized as a breakthrough in dental medicine. It laid the foundation of a new branch of stomatology-dental implantology. In the following decades, dental implantology developed rapidly and matured. Dental implants, as a prosthetic method very similar to natural tooth function, structure and aesthetic effect, have become the first choice for the stomatology community and patients with missing teeth.

Dental implant

The discovery of osseointegration stems from accidental phenomena in scientific experiments. In 1952, Brånemark implanted an optical speculum made of titanium into the tibia and fibula of a rabbit for microscopic observation in vivo. At the end of the experiment, the implanted speculum was firmly bonded to the surrounding bone tissue and could not be removed. Brånemark referred to this phenomenon as osseointegration and began investigating the use of this phenomenon. Observed under a light microscope, the osseointegration manifests as direct contact between the bone tissue and the implant under normal reconstruction, without any non-bone tissue in between. This combination can bear the continuous conduction Load distribution function. Prior to the discovery of osseointegration, implants performed their functions through the principle of mechanical retention, usually using leaf-like implants or mandibular implants to strengthen retention. After the osteosynthesis theory was established, the columnar or root formation of the natural tooth root was simulated as the standard morphology of the implant. ^[1]

Dental implant system

Implant systems are generally classified according to the material, shape structure, surface structure, and connection method of the implant. The clinical practice of dental implantology makes contemporary dental implant materials and implant shapes tend to be unitized. The implants are mainly made of grade 4 commercial pure titanium. Threaded columnar and root-shaped implants have become widely accepted implant morphology worldwide. Studies have shown that moderately rough surface structures can increase implant surface area and osseointegration. Therefore, the implant systems currently used in clinical practice are generally rough surfaces with different roughness levels obtained through various surface treatments. The implant is connected to the prosthesis above it through a certain structure, which is mainly divided into two types: external connection and internal connection.

Dental implant implant supported dental restoration

It mainly includes crowns and bridges supported by various implants used in dentition defect repair, and fixed and mobile repairs supported by various implants used in dentition defect repair. The implant and the restoration are connected in two ways: screw fixation and adhesive fixation.

Dental implant indications and contraindications

Dental implant indication

With the application of various types of oral bone grafting techniques and bone grafting materials, the continuous improvement of the implantation system, and the development of imaging technology and digital technology, currently, patients with single tooth loss, multiple tooth loss, and edentulous jaws can theoretically accept implant restoration. treatment. ^[2]

Dental implant contraindications

Poor overall health. Severe endocrine and metabolic disorders, such as uncontrolled diabetes. Hematological diseases, such as erythrocyte or leukocyte blood diseases, coagulation disorders, etc. Cardiovascular disease, can not tolerate surgery. Those who take special drugs for a long time affect the ability of coagulation or tissue healing. Severe systemic immune disease. Excessive addiction to tobacco, alcohol, neurological and mental illness patients. Patients during pregnancy. Patients who are limited by local conditions of the oral and maxillofacial region.

Dental implant treatment process

Including: clinical examination and imaging examination, diagnosis and treatment design, surgery, denture production and restoration, and maintenance of implants and restorations. According to the time relationship between implant implantation and tooth extraction, implant surgery can be divided into immediate implantation, delayed immediate (within 3 months after extraction), and delayed implantation (3 months and longer after extraction). According to the time relationship between the weight of the restoration and the implant, the implant can be divided into immediate weight, early weight and delayed weight. With the development of oral implantology, the treatment cycle is significantly shortened, and it is possible to immediately wear implant dentures during implant implantation, or even to wear implant dentures immediately after extraction. ^[3]

Dental implant success rate

The success rate of implant restoration is related to many factors, including: the patient's whole body and local conditions, strict and standardized surgical operations, the choice of implant system, the design of the restoration and the production and maintenance of the restoration. Over the past 30 years, modern dental implantology has developed and improved rapidly. The 5-year success rate of implantation has greatly exceeded the standard of 80% in the upper jaw and 85% in the lower jaw of Albrektsson and Zarb in 1986. Domestic reports in recent years show that standardized oral implant treatment can reach a success rate or retention rate of more than 95% in 10 years.

Dental implant complications

Generally divided into biological complications and mechanical complications. Biological complications include: surgical-related bleeding, nerve damage, maxillary sinus perforation, adjacent tooth damage and postoperative infections, peri-implantitis, and shedding. Mechanical complications mainly include implant- and restoration-related screws, abutments, implant breakage, and restoration damage. ^[4]