The following are critical when selecting the implant .

the firmness of the bone, and

the time at which the implant is inserted.

Shows a cylindrical implant,

a stepped threaded implant

and an apical threaded implant

(IMZ TwinPlus)

Shows a stepped threaded implant

and stepped cylindrical implants  (FRIALIT-2)

Who needs which type of implant?
Where can an implant be placed? Which implant system is suitable? Your dentist can only answer these questions after examining your mouth thoroughly. Among other things, he checks

A gap between the front teeth:

One single tooth is missing from between the teeth. The gap is bordered on both sides by natural teeth.

A wide gap between the teeth:

One or more teeth are missing from between the teeth. The gap is bordered on both sides by natural teeth.

Free-ends:

One or more teeth are missing from the end of the row. The natural teeth only border one side.

All teeth are missing:

All teeth are missing from the top and / or bottom jaws.

A gap between the front teeth
More young than elderly people suffer from gaps between their front teeth. These single tooth gaps are often caused by accidents but may also be due to diseased teeth (caries) or gums (periodontitis). In some cases, the tooth simply never grew. If the gap is in a visible area of the top jaw, the overall appearance of the face is disturbed considerably. Not only the aesthetics, but also the health of the teeth suffer. If a single tooth gap remains untreated for a longer period of time, the adjacent teeth grow into it. The upper and lower teeth are displaced and no longer interlock as accurately as they should. Chewing is adversely affected and, in the long term, the joints of the lower jaw may become painful.

              Conventional techniques involve the dentist closing the gap with a three unit bridge supported by the two adjacent teeth. These two teeth have to be trimmed and healthy tooth structure is sacrificed.

         Alternatively, an adhesive bridge can be fitted. J:.s its name implies, it is adhered into place. The adjacent teeth are not trimmed as extensively but the durability of the bridge is very limited.

         A drawback of bridge units is that as they only replace the crown and not the root, the chewing forces are no longer exerted on the underlying section of jaw. The bhne is not loaded and, in time, its volume is reduced. The width and height of the jaws are reduced. In time, the central unit of the bridge has to be extended toward the gums.
         In this case, an implant is a better alternative. As the teeth do not have to be trimmed, healthy tooth structure is preserved completely. In addition, the implant transfers the chewing forces into the jaw bone and its volume remains unchanged.

Shows a crown on an implant

A wide gap between the teeth
     In principle, a wide gap between the teeth has the same effects as a single tooth gap - beginning with the adverse aesthetics and ranging to the disturbed equilibrium of the chewing movements up to the pains in the jaw joints. As several teeth are missing, the complaints are more severe. Wide gaps also impede speech especially. If the dentist does not intervene, these unpleasant conditions will progress from year to year.

Free-ends
         If teeth are lost with advancing age, this process usually begins with the back, "grinding" teeth. This results in a so-called "free-end" or shortened row of teeth. This type of gap is bordered toward the front with natural teeth. The powerful back teeth, with their large, bumpy chewing surfaces are designed for grinding food and preparing it for digesting. If one or more of these teeth are missing, not only the chewing movements are disturbed. The remaining teeth move slowly toward the free-end, which loosens the contacts between the teeth. The teeth in the upper and lower jaws are displaced (refer to "single tooth gaps"). In the long run, the joints of the lower jaw may cause problems.

       Free-ends are difficult to restore with conventional restorative methods. Natural teeth are only available on one side for supporting a bridge. A "classic" bridge needs supports on both sides. However, bridges or removable partial dentures can be used which are. supported on "palatal bars" (upper jaws) or lingual bars (lower jaws).

       Palatal bars pass over the roof of the mouth, lingual bars pass beneath the tongue and over the inside of the lower jaw. These types 'of denture could be felt as foreign bodies. They also impede speech and chewing.
       An implant, instead of the tooth missing from the end of the row, may be inserted to ad as the second bridge support. This type of bridge is supported on one end by a natural tooth and on the other end by an implant. This type of bridge is a fixed restoration which really feels like natural teeth. Instead of being supported on an implant and natural tooth, a bridge can also be supported on implants only. A so-called tooth-for-tooth restoration is also excellent for closing free-ends. Every missing tooth is replaced with an implant and single crown.

      The only conventional type of treatment for this condition is a removable full denture. This type of denture is relatively easy to stabilize on the upper jaw because a large palate can be included which sucks the denture in to place. despite this, patients often consider the denture a foreign body: It impedes chewing and specking and may cause chocking.
       It is much more difficult to fit a stable full denture to the lower jaw. The denture is held in place by its arched base which fits over the ridge of the jaw. The volume of the jaw ridge decreases with age and the denture slowly loses its grip.

         The dentist has to reline it, which flattens the curvature of the denture base and reduces the retention. If the denture has to be relined several times, it will become loose and chewing / specking will be more and more difficult.
         The dentist can use implants to stabilize full dentures. For example, a bar can be constructed which is supported on two or four implants and retains the denture securely. Even a fixed restoration can be fitted - this method has been in use successfully for decades for lower jaws. It involves fixing a bridge to six or eight implants inserted around the entire lower jaw.

        A doctor can diagnose whether growth has been concluded.

        The patient should also be informed in advance that implants require particularly conscientious and thorough oral hygiene. Also important: smokers must do without cigarettes for the first few months after implant placement. Otherwise, the implant healing process will be endangered.

Pre -operative examination and treatment
Your dentist checks your general medical condition - usually using a questionnaire -, asks about previous or acute diseases and weather / which medication you take. If in doubt, he will contact your family doctor.

           He examines your gums, teeth and jaw bones. X-rays and models of your jaws are required for this thorough evaluation. Depending on the result of his examination, he starts with the first stages of the treatment, such as cleaning the teeth professionally, which involves removing all plaque and tartar, treating diseased mucous membranes or carious teeth. In certain cases, he may enlarge the volume of the bone.

During the first week .

Expose your implants
      Once the healing period has elapsed, the implants are exposed under local anaesthesia. The sealing screws are then removed from the implants. A special gum former is screwed in to ensure that the gum forms neatly and the membrance stitched around it tightly. You should also observe a few guide lines after this operation.

       If single crowns are to be fitted, the dentist screws medically pure titanium crown fittings into the implants. The visible crown, which is usually coated with porcelain, is either cemented to the crown fitting or screwed to it with a tiny screw. Your dentist can also provide you with a temporary restoration until your own restoration is ready.
       If bridgework is fitted to IMZ TwinPlus components, elastic buffers called intra mobile elements can be screwed in. They cushion the chewing forces exerted on the bridge. This safeguards the bone beneath the implant. These buffers are advisable during the first two years after delayed implant placement because, during this period, new bone forms around the implant which first has to adapt to the chewing forces

The be-all and end-all:

                      Perfect oral hygiene
          The most important aspect for ensuring that the implant lasts is that you cooperate! Perfect oral hygieneis essential for achieving long term success. It is much more important to clean implants thoroughly than natural teeth. The gums are connected smoothly than natural teeth to create a bacteria-proof seal for the jaw bone. After implant placement, this border is permeable and bacteria can penetrate it.
          Therefore, you must clean your crowns, bridges and dentures after every meal! This is the only method of preventing plaque, which infects the gums and jaw bone and endangers the implant.

Use a toothbrush to clean the surfaces of crowns, bridges and dentures. A normal toothbrush cannot reach the spaces between single crowns and bridge units. An inter dental brush is recommended for these areas. If the inter dental spaces are even too narrow for an inter dental brush, use dental floss - or cotton cleaning strips for bars.

Once you have loosened the deposits with a toothbrush and dental floss, they are easily rinsed off with a water jet. Please note that the use of a water jet alone is not sufficient.

It's good to know that everything you need for perfect oral hygiene isin the practical FRIATEC EasyClean hygiene set which FRIATEC assembled specifically for implant patients. This set is ideal for home use and traveling.