Dental Implantology today

Definition

Following the work and publications of the Swede P.I. Brånemark in the 1970-80s, dental implantology has become a discipline wholly separate from dentistry. It aims to replace one or several missing teeth by inserting one or more artificial roots in the bone on which the prosthesis is fixed. This operation, apart from esthetic replacement of one or several missing teeth and offering a more comfortable solution and alternative to moveable appliances, may also be used in orthodontics as an anchorage point. The implant then acts as an anchorage point to replace one or several teeth. In some people who have no teeth, a moveable prosthesis can also be stabilized by surgically inserting two implants.

To summarize, the operation is carried out in three stages

  1. 1- The practitioner makes an incision in the gingiva and prepares the bone cavity bone to insert the implant  (artificial titanium root). He closes up the gingiva to allow bone healing to occur. This waiting phrase is called the" nursing period” and aims to enable bone healing around the implant to occur. This healing is called osseointegration
  1. 2- After this waiting period, the practitioner inserts a titanium abutment to which the temporary prosthesis will be attached
  1. 3- Finally, a metal-ceramic prosthesis is attached to the implants by screws fixed into the abutments previously put in place.

 The main condition is to have the bone in good condition. Some contraindications should be noted: patients with heart disease, renal failure, smoking, hypertension, and uncontrolled diabetes.
Another method called " at a surgical pace/en un temps chirurgical” helps avoid the phase of burying the implants after the healing stage called osseointegration The healing implant screws in this method are not recovered by the gingiva, which heals around the healing screws. Although it gives the same results as the traditional method, it is contraindicated in unsuitable cases: heavy smokers, risk of infections, etc. Finally, some techniques may overcome the lack of bone (shorter but wider implant, bone graft, sinus lift, etc.).

Therefore dental implantology, because of its many advantages, is a booming industry, as these figures attest: 120 000 implants are inserted in France every year, compared with 185 000 in Spain, 410 000 in Italy and 420 000 in Germany (where the technique is reimbursed by the Health Authorities). These figures will increase significantly in the years to come, with the growing ageing of western populations.

Therefore, it is incontestably a guaranteed source of development for the various participants in this sector. That is both for dentists specialized in this technique and, still more, for manufacturers of implants. It is also a real challenge, for public authorities, to check the quality of dental practices and products.