Despite the fact that quality dental care is widely available today, toothpastes and brushes of various uses are available on the market, and people’s awareness of oral health care has increased significantly but tooth loss and its various solutions still remaining one of the most common problems in dental clinics. The reasons for tooth loss are different. Although they are usually associated with tooth diseases, caries and periodontal disease (periodontitis), loss can also be caused by trauma or a natural lack of one or more teeth, and dental implants have become an increasingly popular permanent solution to resolve the issue.
The name suggests that it is a replacement which is surgically implanted into the human body –they are placed in the bone of the upper and lower jaw in the oral cavity, using a type of screw with different lengths and widths. Its main parts, the implant and the prosthetic substitute surmounting it, correspond to the natural, anatomical structures of teeth. The implant itself (the screw) replaces the root of the tooth – the invisible part of the natural tooth that is in the bone. The crown of the tooth is substituted by making a prosthetic replacement. Between the implant and the prosthetic replacement there is a connecting element, the so-called abutment, which corresponds to the neck of a natural tooth, the connection between the crown and the root. The prosthetic replacement on the implant can be a crown, to compensate for one tooth, or a bridge or prosthesis when replacing a number of lost teeth or even all of them. The positive side of implantoprosthetic treatment is that implants look like natural teeth, have the same function, and when used as a support for dentures they provide a reliable cradle and offer far greater comfort and safety for the patient than conventional dentures.
The available literature often mentions interesting aspects regarding the historical development of implants. The earliest evidence of tooth implants - successful ones that is - goes back as far as the Maya civilization, 600 BC, given that tooth loss is a human affliction not limited by time or historical period. The mandible remnants found indicate that the Maya people filled and replaced gaps in their teeth with fragments of shells shaped like teeth. The most important discovery in modern implantology, which started the rapid development of dental implants, is associated with the work of Swedish orthopaedist, Pera-Ingvar Brånemark, who studied the phenomenon of bone healing and regeneration. In 1957 he found that bone growth and bone adhesion were possible when it came into contact with the metal titanium and he called this phenomenon osseointegration. Already in 1965, he placed the first titanium implants in a patient's lower jaw, and it is interesting to note that these same implants in the patient's mouth maintained their function until his death, 40 years later. For complete osseointegration, bone fusion with the implant, a period of 3 – 6 months is required after surgery, and only then is the visible part of the implant, the prosthetic replacement, added.
Implants of all types, whether orthopaedic, cosmetic or dental, must meet strict conditions confirming their safety. The term biocompatibility of a dental implant describes the behaviour of the titanium material in bone tissue, where it has to be non-toxic and does not induce a defensive response of the organism. Although data differs between the various studies, the five-year success rate and the stability of the implant is approximately 95%. One condition which implantoprosthetic therapy requires is excellent oral hygiene. That is to say that even though the implants are made of artificial material and are firmly connected to the bone in which they are located, tissue inflammation can occur around them, just like around a natural tooth. While the inflammation around the teeth is called gingivitis (inflammation of soft tissue) and periodontitis (deep inflammation of supporting tissues of the teeth), peri-implant mucositis (surface inflammation of soft tissue) and peri-implantitis (inflammation affecting the bone around the implant) can occur around the implant. It is extremely important to react to the inflammation in time while it is still localised around the soft tissue, because any loss of bone affected by inflammation is, unfortunately, irreversible.
The arguments against dental implant therapy are minor as they represent a permanent aesthetic and functional solution, and the surgical implantation procedure itself is relatively simple and fast. However, it should be borne in mind that long-term success of implantoprosthetic therapy requires a valid assessment, good cooperation between the doctor and patient, and regular monitoring.
