Dental implants in Madrid

In order to calculate the exact price of the implants, it is necessary to have a CBCT, which is a CT scan of the maxilla or mandible, where the implantologist can study the dimensions and quality of the bone where the implant will be placed.

In order to calculate the exact price of the implants, it is necessary to have a CBCT, which is a CT scan of the maxilla or mandible, where the implantologist can study the dimensions and quality of the bone where the implant will be placed.

Dental implants are titanium or zirconium fixtures that are placed in the maxilla or mandible to replace the roots of teeth that have been lost. After placement, the implants are attached to the bone in a process called osseointegration, which usually lasts between 2 and 4 months. After this time, they are then fitted with fixed crowns or bridges to replace the lost teeth.

• Removable prostheses: these are known as dentures or "removable" prostheses and are a treatment that is less and less common. For many people they are not comfortable because they move when chewing, produce "chafing" and nausea.
• Removable prostheses: these are known as dentures or "removable" prostheses and are a treatment that is less and less common. For many people they are not comfortable because they move when chewing, produce "chafing" and nausea.

To begin the treatment with dental implants it is essential to have healthy gums, so that the implants do not become infected after the placement. For this, it is very important to visit the clinic to clean the teeth and implants periodically and to have a good oral hygiene habit.

According to scientific studies, implants can last more than 30 years, but they can also be lost much sooner if proper care is not taken.

To avoid diseases of the tissue surrounding the implants or peri-implant diseases (mucositis or inflammation of the implant mucosa and peri-implantitis or loss of the bone supporting the implant), it is very important to carry out the following:

• Have a proper oral higiene

  Bacterial plaque, which forms on our teeth and gums from food debris if there is no good oral hygiene, is the main risk factor for peri-implant diseases. Therefore, after placing the prosthesis on the implant, it is extremely important to explain to each patient how to clean it, not only with a toothbrush but also with interdental hygiene devices (dental floss or interdental brushes). It also plays a fundamental role to place the implants in their proper position and to design a prosthesis that allows this proper cleaning of the implants, since it has been shown that, otherwise, there may be an increased risk of peri-implantitis or infection of the implant. For this, it is crucial that the professional who makes the crown or structure on the implants is perfectly trained and has the appropriate knowledge for its preparation in order to prevent peri-implant diseases. Dr. Nerea Sanchez specializes in dental implant treatment, a discipline she has been practicing for many years and is also a professor of implant therapy in several university masters.



• ·Pre-treatment of Periodontitis

  The presence of periodontitis, gum disease, in the mouth can increase the risk of gum disease on dental implants, which is why it is so important that the gum specialist, the periodontist, checks the gums beforehand and treats and monitors this disease before starting implant treatment. Once the disease is stabilized and periodontal maintenance visits are scheduled, where periodontitis is controlled in the long term, implants can be safely placed.

• Visit the dental office for cleaning of the implants.

  The scientific literature has also shown that it is essential to attend so-called "peri-implant maintenance visits", which are appointments every 6 months or so, where the health of the gum surrounding the implant is monitored by taking a graph called a "periodontal chart", periapical x-rays are taken if necessary, and the implants are cleaned to remove any bacterial plaque that may have accumulated despite oral hygiene.

There are other factors such as smoking that also affect the gum surrounding the implants and are associated with inflammation and bleeding, so it is highly recommended to stop smoking before undergoing implant treatment.

An implant is the closest thing to a tooth, since it is a "fixed" treatment, which allows us to chew as if we had our teeth, but also, another of its advantages is that it is not necessary to wear down the adjacent teeth as it would be required to place a bridge. Therefore, it is the most advisable individualized treatment as long as we carry out all the necessary care to ensure its long-term maintenance. With an implant you can eat all kinds of food and you do not have to take any of the precautions that are taken when using dentures or "removable" prostheses, such as avoiding biting into fruit, sandwiches and other foods, with which dentures tend to move and do not allow easy chewing of food.

The esthetics can also be very similar to that of a natural tooth, since nowadays we have materials and techniques to simulate that we still have our tooth. In addition, while the implant is healing in the bone in which it is placed (usually 2 months in the lower arch and 3 months in the upper arch), we can place provisional teeth with which we can simulate that we have not lost any teeth.

In short, our quality of life will be better and we will be able to eat and smile as with our teeth.

• Types and materials of dental implants

  The vast majority of implants are made of titanium. This metal is highly biocompatible because when it comes into contact with atmospheric air it oxidizes, which prevents the release of ions from its surface. For implantology, grade IV titanium has the best mechanical properties, and is therefore the most commonly used today for the manufacture of dental implants.

  Implants are also made from titanium alloys, probably the most widespread is the alloy of titanium with zirconium, another metal that seems to give the alloy greater strength.But in addition, all-ceramic zirconium dental implants are commercially available, which would be indicated for people with an allergy to titanium, which according to statistics, is an extremely rare allergy. Although several studies have shown that it is a valid alternative to titanium, it seems that the incidence of fractures could be higher.

• Depending on its connection.

  The implant connection is the area where the prosthesis and the implant are joined. Two types of connection can be differentiated: internal and external. The first endosseous implants were made with a hexagonal external connection that prevented the prosthesis from rotating on the implant. With the passage of time, implants began to be manufactured with the so-called internal connection, where the prosthesis or the intermediate component between the prosthesis and the implant was placed in the inner part of the implant, which had a morse cone shape. Nowadays, implants with internal connection are more commonly used, since certain research has indicated that they are associated with less marginal bone loss.

• Depending on the number of pieces that compose it

  Implants can be 1) monophasic, or in one piece, where the implant consists of the artificial root that is inserted into the bone and has incorporated in one piece the intermediate component on which the prosthesis or crown is placed, or 2) biphasic, the most commonly used, where first the implant is inserted into the bone and then a second piece that can be an intermediate component together with the prosthesis or directly the prosthesis.

Usually, there is no need to place as many implants as teeth have been lost. What is clear is that third molars (wisdom teeth) do not need to be replaced, and many times, second molars either, depends on each patient and the work philosophy of each professional; therefore it is very important to study in detail the situation of each one of our patients.

In addition, as a general rule, 2 implants can be placed and with them 3 prosthetic pieces are replaced.

Before starting the planning, it is necessary for the patient to undergo a CT or CBCT (Cone Beam Computerized Tomography) to evaluate the number of implants that can be placed in the mouth. It all depends on each patient. It is necessary to make an individualized study to know how many implants the patient needs and the size of each one. This study is made on the basis of a dental CT scan that the patient must undergo beforehand.

The implants to be placed will be determined according to the number of missing pieces, there is no minimum number of implants to be placed.

For example, if all the teeth are missing from one arch, for example, from the upper arch, all the implants can be placed in the same procedure. Some of our patients demand to perform these interventions with a greater number of implants under sedation, for which we have our anesthesiologist to perform it, an expert in sedation in oral and implant surgery. We recommend it in people with a more delicate general state of health or in patients who are somewhat nervous. For this, the anesthesiologist will perform the preoperative and will ask a series of questions about medical history, medication and allergies among others. On the day of the implant placement, you will be asked not to have eaten for two hours, you will be given oxygen and a series of drugs will be administered through an IV so that you, being always awake, will be totally relaxed.

Although the option of sedation is available, most of our patients do not need it and are very calm and comfortable during implant placement, since the procedure is performed under local anesthesia and without any pain.

We have to keep in mind that dental implants require the same care as our teeth, but being an artificial element where the surrounding tissues are arranged differently from those of the tooth, we have to take care of them very meticulously.

To take care of the implants is a must:

• ·Carry out an adequate oral hygiene: both the manual toothbrush and the electric toothbrush are indicated for the cleaning of implants. It is recommended to clean them after each meal, not only with the toothbrush but also with interdental hygiene devices, such as interdental brushes or floss. In other words, in addition to sanitizing the front and lingual part, it is essential to clean between implants or between tooth and implant, and for this purpose the prosthesis that is placed on top must facilitate it.
• ·Attend peri-implant maintenance visits to the dental office, which are performed approximately every 6 months, to evaluate the health of the tissues surrounding the implant, detect complications if any, and clean the implants in order to remove food debris and bacterial plaque that may have accumulated.
• ·In case we notice that the prosthesis placed on the implants moves, we must go quickly to the office to evaluate what is happening. It may be that the screw that joins the prosthesis to the implant has loosened and it is urgent to tighten it to avoid fracture of the implant, or it may be necessary to diagnose any other unforseen event that requires treatment.
• ·Avoid smoking: Smoking is a risk factor for gum disease but is also associated with inflammation in the implants (or mucositis), which is the precursor to infection. Therefore, we strongly recommend our patients to stop smoking.

There are other factors such as smoking that also affect the gum surrounding the implants and are associated with inflammation and bleeding, so it is highly recommended to stop smoking before undergoing implant treatment.