処理

インプラント
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In a perfect world, your natural teeth are your best option. The reality is people get hurt or aren't born with a good set of teeth or just don't take proper care of what nature has given them.

Dental implants are the closest thing to nature's design and offer hope for re-creating a new, healthy, and confident smile. A dental implant is a small part made of titanium or titanium zirconium. It is placed in the jaw bone and replaces the missing tooth root. The implant can be surgically inserted under local anesthetic on an outpatient basis. Titanium is generally well-tolerated by the human body, and bone has been shown to bond well to titanium.

ContentOnce healed, the artificial root acts as a base for fixing individual crowns and multi-tooth bridges. The implant can also be used as an anchor for an entire dental prostheses.

1. Natural tooth
2. Dental implant
3. Tooth crown


A step-by-step guide to a new smile

A thorough diagnosis, individual consultation and competent dental treatment are vital for successful dental implantation. The journey towards a new smile may be less complicated and time-consuming than you would think.


The new teeth

 Crown, bridge or denture – the dental laboratory uses an impression to produce the individual restoration, which will be inserted after healing.


Diagnosis

Your dentist investigates and assesses your treatment options using X-rays. S/he discusses the advantages and disadvantages of various denture solutions. If implants are the choice of treatment, in most cases your dentist will refer you to a surgical specialist such as a periodontist or oral surgeon. Using X-ray images or computer tomographs (for three-dimensional imaging) and plaster models, the length and diameter of the implant are determined by the specialist.

Afterward, the position of the implant is established. Sufficient bone must be present for implantation. There are patients who have insufficient bone and require bone augmentation. This may happen, for example, if a tooth has been missing for a long time – the jaw may have slowly receded. As a result, the bone will be replaced by bone grafting material.

 


Healing

A healing period between six weeks and a few months is necessary to ensure the implant is securely attached to the jaw bone, After approximately one week, the stitches are removed. Patients should keep in mind that diligent oral hygiene is vital for healing.


Implantation

The dental implant (an artificial tooth root) is normally inserted under local anesthetic. The surgical specialist creates a suitable "bed" in the jaw bone in which the implant is placed. Depending on the individual case, a temporary restoration may be placed on the implant during the healing stage. This allows the patient to enjoy a natural looking smile early in the process.


The parts of a dental implant

  • Dental implants are nothing new. They have been used to permanently replace teeth since the mid 60s.
  • A small titanium screw is inserted into your jawbone. Titanium is a metal accepted by the body and heals together with the bone tissue to form a new, stable tooth root.
  • An abutment is a ceramic or titanium component that ensures a secure fit between the dental implant and the crown.
  • Once the dental implant and the abutment are in place, your dental professional fits the crown, the bridge or the prosthesis. 

 

すべての歯を交換する
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If all of your teeth are missing in the upper or lower jaw, dental implants are the best solution. You can choose a full bridge that is attached to several dental implants. Another option is a removable prosthesis that is attached via anchoring devices to two or more dental implants. The prosthesis remains securely in place in your mouth – yet it is easy to remove


Replacement of All Teeth

The situation 

The jaw is completely toothless. One option for replacing all teeth is a row of teeth which is anchored in the jaw by several implants (Fig. 1). Alternatively, a prosthesis is supported by implants and can be removed for oral hygiene (Fig. 2 and Fig. 3) 

The advantage

Dental implants have been developed to stay securely in place. Both solutions (Fig. 1 and Fig. 2/3) thus offer more stability than conventional prostheses. Additional benefits: an implant-supported row of teeth looks natural.

 


Treatment Overview

A thorough examination

The first step in dental implant therapy is a discussion with your dental professional, followed by a thorough dental examination. The jaw is x-rayed to check the condition of the bone tissue and to determine the placement of the dental implant. An impression is made of the jaw and existing teeth, forming an important platform for the treatment.

Inserting the dental implant

There are two options for dental implant placement depending on your clinical situation. In a one-step procedure, the dental implant is put in place and a temporary abutment is attached. In a two-step procedure, the dental implant is installed and then covered by the gum. The abutment is attached at a later date.

In both cases, a temporary tooth or prosthesis is put in place, followed by a maximum healing period of three months for the lower jaw and six months for the upper jaw. In some cases, the dental implant can be loaded immediately although this depends on your bone condition.

 

 


Attaching the abutments

In a one-step procedure, the temporary abutment is replaced by a permanent one after the dental implant has bonded with the bone tissue.
The second part of a two-step procedure involves making a minor incision to open the gum and put the abutment in place.

Producing the teeth

When the abutment is in place, a new impression is made. It is then compared with the impression made during the initial examination. Based on a final model, a dental technician carefully crafts the crown, bridge or prosthesis. Special attention is given to ensuring the right color and shape so that your new teeth look like your natural teeth.

Fitting and re-examination

When the teeth are ready, your dental professional simply attaches them to the dental implants. This is usually followed by a few follow-up visits to check functionality and esthetics and to make sure you are completely satisfied with your new teeth. 

When you are ready for a dental implant, you will have a solution tailored to your needs, general state of health and the quantity and quality of your bone tissue. These factors also determine the total duration of the treatment. Consult your dental professional for your specific options.


Step by Step

Step 1

If you have lost all your teeth in one or both jaws, you can choose a permanently anchored dental implant bridge or a removable prosthesis that is connected to two or more dental implants. This is called an overdenture. This type of overdenture remains in place more firmly than a conventional removable prosthesis. For the most natural looking solution, the permanently anchored dental implant bridge is the answer when the prerequisites are met.

Step 2

For a permanently anchored dental implant bridge, several dental implants are installed to form a good foundation. Because the dental implants are anchored in the jawbone, they stimulate the bone tissue and help to maintain healthy bone levels and facial structures.

An overdenture involves installing two or more dental implants that will be used as a secure foundation to attach the prosthesis.

Step 3

The abutments are attached to the dental implants and the bridge is fitted in place. All dental work is performed according to your prerequisites and wishes.

For the overdenture, either ball abutments or a small bar between the abutments are used. The prosthesis is fitted with corresponding devices underneath.

Step 4

The dental implant bridge, or the overdenture, is now in place. It looks and functions like normal teeth. You can now eat whatever you like and laugh without having to worry about the prosthesis falling out.

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If you have lost several teeth there are two solutions: separate crowns on dental implants or a bridge attached to several dental implants.


Treatment Overview

A thorough examination 

The first step in dental implant therapy is a discussion with your dental professional, followed by a thorough dental examination. The jaw is x-rayed to check the condition of the bone tissue and to determine the placement of the dental implant. An impression is made of the jaw and existing teeth, forming an important platform for the treatment.

Inserting the dental implant

There are two options for dental implant placement depending on your clinical situation. In a one-step procedure, the dental implant is put in place and a temporary abutment is attached. In a two-step procedure, the dental implant is installed and then covered by the gum. The abutment is attached at a later date.

In both cases, a temporary tooth or prosthesis is put in place, followed by a maximum healing period of three months for the lower jaw and six months for the upper jaw. In some cases, the dental implant can be loaded immediately although this depends on your bone condition.

 

 

Attaching the abutments 

In a one-step procedure, the temporary abutment is replaced by a permanent one after the dental implant has bonded with the bone tissue. The second part of a two-step procedure involves making a minor incision to open the gum and put the abutment in place.

Producing the teeth

When the abutment is in place, a new impression is made. It is then compared with the impression made during the initial examination. Based on a final model, a dental technician carefully crafts the crown, bridge or prosthesis. Special attention is given to ensuring the right color and shape so that your new teeth look like your natural teeth.

Fitting and re-examination 

When the teeth are ready, your dental professional simply attaches them to the dental implants. This is usually followed by a few follow-up visits to check functionality and esthetics and to make sure you are completely satisfied with your new teeth.

Healing period

When you are ready for a dental implant, you will have a solution tailored to your needs, general state of health and the quantity and quality of your bone tissue. These factors also determine the total duration of the treatment. Consult your dental professional for your specific options.


Step by Step

Step 1

Some people loose teeth in the back of the mouth. This is typically caused by gum infection (periodontitis) or by teeth cracking due to previous fillings.

Step 2

Between two and four dental implants are installed for a dental implant bridge. This solution does not affect your own teeth. The bridge will function for many years, regardless of the condition of your existing teeth.

Step 3

Abutments are attached to the dental implants. The next step is to fit a bridge; the new set of teeth is placed on the abutments.

Step 4

The dental implant bridge is now in place and can withstand the strong chewing forces that occur in the back of the mouth. It feels and functions like natural teeth.

 

毎日の手入れ
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Receiving implant teeth brings back the esthetics and function you once experienced with your natural teeth. Just as well as natural teeth, implants require regular maintenance care to ensure a healthy tissue environment.

Follow-up visits

Looking after your new teeth also includes visiting your dentist for regular check-ups.
At those visits, you and your dentist and/or dental hygienist will discuss the necessary maintenance procedures.
Your dentist and/or dental hygienist will suggest the appropriate interval for future examination and maintenance visits.

 

 Fixed prosthesis or single tooth - Daily care

Your toothbrush is the key to a confident and bright dental future. Brush your implant teeth as you would brush your natural teeth, above and below the gumline, using a soft toothbrush.
When using toothpaste, a small amount of low-abrasive toothpaste used with the brush is recommended.
The implant teeth must be thoroughly cleaned daily if they are to be a long-term success. It is therefore a good idea to follow a routine each time you brush your mouth, to ensure that all surfaces are cleaned.

Daily care

Important areas to clean

  • Your implant-supported tooth, above and below the gumline
  • In between your neighboring teeth

 


Single tooth

 

 

1. Toothbrush

It may be necessary to modify the brush for the inner side of the teeth and hard-to-reach areas. A power brush can be a good alternative and an easy-to-handle complement. If you have a bridge, make sure to clean under the bridge. 

2. End-tufted brush

A soft end-tufted brush (interspace brush) is suitable for hard-to-reach areas around your implant supported tooth or the lingual surfaces (inner side of teeth) and around the implant posts facial side (outer side) of your implant supported teeth. 

3. Interdental brush

The use of an interdental brush (interproximal brush) helps in cleaning the sides of the implant-supported tooth, crown, abutment posts and the surface under the bridge. Use the brush with a back-and-forth stroke, gently pressing it against the side of the implant-supported tooth or abutment posts.

The brush should not be too small, decreasing the cleaning effect, or too big, causing discomfort when brushing. A plastic-coated threading is recommended. Ask your dentist or dental hygienist for advice on the technique, size and shape for your interdental brush.

Note: Never use toothpaste in combination with the interdental brush. 

4. Floss

In narrow areas, where the interdental brush is hard to use, floss is recommended. Clean the sides of your implantsupported tooth and abutment posts by passing floss (thick floss) back and forth between the implant tooth and the neighboring teeth, or through the space next to the abutment posts. Clean the bridge adjacent to the gumline using a sideways stroke. 


Bridge daily care

1. Toothbrush

It may be necessary to modify the brush for the inner side of the teeth and hard-to-reach areas. A power brush can be a good alternative and an easy-to-handle complement. If you have a bridge, make sure to clean under the bridge. 

2. End-tufted brush

A soft end-tufted brush (interspace brush) is suitable for hard-to-reach areas around your implant supported tooth or the lingual surfaces (inner side of teeth) and around the implant posts facial side (outer side) of your implant supported teeth.

3. Interdental brush

The use of an interdental brush (interproximal brush) helps in cleaning the sides of the implant-supported tooth, crown, abutment posts and the surface under the bridge. Use the brush with a back-and-forth stroke, gently pressing it against the side of the implant-supported tooth or abutment posts.

The brush should not be too small, decreasing the cleaning effect, or too big, causing discomfort when brushing. A plastic-coated threading is recommended. Ask your dentist or dental hygienist for advice on the technique, size and shape for your interdental brush.
Note: Never use toothpaste in combination with the interdental brush.

4. Floss

recommended. Clean the sides of your implantsupported tooth and abutment posts by passing floss (thick floss) back and forth between the implant tooth and the neighboring teeth, or through the space next to the abutment posts. Clean the bridge adjacent to the gumline using a sideways stroke.


Removable prosthesis - Daily care

our toothbrush is the key to a confident and bright dental future. It is just as important to clean the removable prosthesis as it is to clean your natural teeth.
When using toothpaste, a small amount of low-abrasive toothpaste used with the brush is recommended.
The implants and prosthesis must be thoroughly cleaned daily if they are to be a long-term success. It is therefore a good idea to follow a routine each time you brush your mouth, to ensure that all surfaces are cleaned.

Bar attachment - Daily care

Important areas to clean

  • Abutment posts (the metal posts attaching the denture to your jaw) and bar
  • Underneath the prosthesis
  • Areas around the gums

1. Brushing the prosthesis

Clean the prosthesis and its attachments carefully, including the underneath area, using a denture brush or a regular toothbrush. A power brush can be a good alternative and an easy-to-handle complement.

Other important areas to clean are the gum side of the prosthesis, where the attachment fits over the bar or ball abutments.

2. Brushing the bar abutment

Clean the gum side surface using a soft regular toothbrush. Additional attention should be paid to the abutment posts and bar in the mouth.

NOTE: Never use a denture brush in your mouth.

3. End-tufted brush

A soft end-tufted brush (interspace brush) is suitable for cleaning the areas around the abutment posts.

4. Interdental brush

The use of an interdental brush (interproximal brush) helps in cleaning the sides of the abutment posts and the surface of the bar. An interdental brush with plasticcoated threading is recommended. Ask your dentist or dental hygienist for advice on the technique, size and shape for your brush.

NOTE: Never use toothpaste in combination with the interdental brush.

5. Floss

Clean the abutment posts by passing floss (thick floss) around them. "Shoe-shine" the posts by passing the floss from side to side, polishing from top to bottom and allowing the floss to slip under the gumline. Follow this procedure for each abutment post. Make sure to pass floss around the bar with vertical movements.


Ball attachment - daily care

Important areas to clean

  • Abutment posts (the metal posts attaching the denture to your jaw) and bar
  • Underneath the prosthesis
  • Areas around the gums

1. Brushing the prosthesis

Clean the prosthesis and its attachments carefully, including the underneath area, using a denture brush or a regular toothbrush. A power brush can be a good alternative and an easy-to-handle complement.

Other important areas to clean are the gum side of the prosthesis, where the attachment fits over the bar or ball abutments.

2. Brushing the abutment

Clean the gum side surface using a soft regular toothbrush. Additional attention should be paid to the abutment posts and bar in the mouth.

NOTE: Never use a denture brush in your mouth.

3. End-tufted brush

A soft end-tufted brush (interspace brush) is suitable for cleaning the areas around the abutment posts.

 

4. Floss

Clean the abutment posts by passing floss (thick floss) around them. "Shoe-shine" the posts by passing the floss from side to side, polishing from top to bottom and allowing the floss to slip under the gumline. Follow this procedure for each abutment post. Make sure to pass floss around the bar with vertical movements.

オール・オン・4
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All-on-4 Upper and Lower Implants

All-On-4 is an advanced technique whereby a whole arch of teeth is supported by only 4 implants. Its success rates are similar to those of traditional implant techniques but it differs in that the back implants are deliberately tilted towards the back of the mouth. For the vast majority of patients all-on-4 overcomes several of the problems associated with previous techniques.

  •   Load distribution is maximized. A functional arch of teeth can be supported by a reduced number of implants.
  •   Bone deficiencies at the back of the jaw are avoided. Complex grafting procedures and extended healing times are no longer necessary.
  •   The replacement teeth can be placed immediately (within one to three days of implant placement). Immediate oral rehabilitation is now       possible without patients having to go through an intermediate removable denture phase.
  •   Using only 4 implants means reduced initial cost, reduced surgical complexity and long term, easier cleaning and maintenance.

Patients who are not suitable for all-on-4 are generally those with a very heavy bite or with insufficient bone. These patients can still often be treated in the conventional manner using 6 or more implants, generally with grafting. Zygomatic implants are also available where bone is minimal.


All-on-4 Stages

Preliminary - Assessment, radiology and diagnostic work-up

The first step is to make an appointment with the prosthodontist for an assessment and to discuss appropriate treatment options. Special CT scans are required to assess bone availability and determine optimal implant position. Photos and models are used to plan the replacement teeth for optimal function and aesthetics. A surgical guide records this information and directs the surgeon as to where to best position the implants. The dental laboratory also uses this information to make other special guides to help us record the implant and proposed tooth position at the time of surgery.


Implant placement

Where necessary, remaining teeth are extracted and the jaw bone is reshaped using a procedure called 'alveolectomy'. The implants are installed, resorbable sutures are placed, impressions of the implants are taken, and temporary plastic caps are used to cover the implants. While the patient sits back quietly and relaxes, elsewhere in the office models are fabricated and the replacement teeth set in wax. About two hours later the teeth are tried in the mouth with any necessary adjustments being made before the patient goes home. The patient can approve the final look and knows exactly what to expect when the new teeth go in 3 days later.


At the laboratory

The teeth are now set in acrylic and the base is reinforced with a metal framework. All the fine detail needed to make your replacement teeth and gums look natural is incorporated.

3 days later

The temporary caps are unscrewed and the replacement teeth are gently inserted. Biting on the new teeth doesn't put pressure on the healing gums beneath and patients can smile with confidence, sometimes for the first time in years. Avoiding hard foods for the next few months will allow the bone to heal properly around the implants.


Short term follow up and adjustment

One of the great things about this procedure is that it usually requires minimal postoperative adjustment. It's true the first days are spent at home without teeth but at least there is no painful or loose denture to rub against and cause pain to the treatment area. Providing they take proper care, patients usually report minimal swelling or pain. There is usually a little bruising but it is generally not a big problem.

The sutures dissolve away by themselves and are usually completely gone after two to three weeks . Function and aesthetics are checked at day 7 and then again a month later.


Long term - Replacement

Every case is different but the initial replacement teeth can function for up to 5 years.