What is a dental implant? Dental implants are not like planting crops, planting a seed to grow teeth, but rather, a titanium implant (artificial tooth root) is surgically implanted into the jawbone, and after a period of time, when the implant is firmly bonded to the jawbone, a crown is installed at the upper end to create a kind of denture. Oral implant technology was firstly proposed by Dr. Brånemark of Sweden in the 1960s and used in the clinic, and after decades of joint efforts of many scholars, it has developed into an interdisciplinary technology for restoring missing teeth. The development and application of dental implant technology provides a more scientific, reasonable and perfect restoration method for missing teeth. Zhang Dong, Department of Oral and Maxillofacial Surgery, Qilu Hospital, Shandong University The human life has two sets of teeth, milk teeth and permanent teeth, and the loss of permanent teeth cannot be regenerated. Loss of teeth can have many adverse effects on health: ① The gap caused by missing teeth affects the chewing function, and the teeth adjacent to the gap will constantly tilt and move towards the gap, and at the same time, due to the elongation of the opposite jaw teeth, the occlusal relationship is disordered, which can lead to the occurrence of temporomandibular joint disorders. In addition, the gap can form food impaction, so that the incidence of dental caries and gingivitis increased. ②Once a tooth is lost, the bone around it is degraded, and the longer the missing tooth lasts, the more severe the bone resorption becomes. With the prolongation of time, severe bone resorption not only affects the quality of life of patients, but also increases the difficulty of dental restoration. ③Missing teeth will make people look old. Therefore, missing teeth should be restored as early as possible, which is conducive to maintaining oral health, slowing down the process of bone resorption, preventing the movement of neighboring teeth and caries, and at the same time, the improvement of the appearance will help to improve the patient’s self-confidence in social activities. Traditional restorations Traditional denture restorations include active and fixed restorations. The movable denture is fixed on the neighboring teeth and mucosa by hooks and brackets, which has wide range of application, less abrasion of dental tissues, easy to repair, and lower cost. However, its disadvantages are poor stability, low chewing efficiency, large size, foreign body sensation, easy to cause nausea and affect the pronunciation. In addition, movable dentures need to be removed every meal, cleaning, improper use can cause damage to the abutment teeth and mucosal tissues, caries, periodontitis, alveolar bone resorption and temporomandibular joint disorders and other adverse consequences. Fixed denture is to neighboring teeth as piers, like a bridge to repair missing teeth, can better restore the patient’s oral function and aesthetics, more comfortable. The disadvantage is that as the “abutment” of the abutment tooth tissue grinding large, often need to be inactivated, and at the same time, due to the edge of the denture crown and the abutment tooth is difficult to achieve an ideal state of closure, prone to secondary caries, which will lead to the failure of the entire bridge restoration. Advantages of dental implants Dental implant technology has been called the fourth revolution in dentistry since 1840. It avoids the shortcomings of traditional restorations such as instability, wear and tear of adjacent teeth, and weak chewing, etc. Implants made of pure titanium can be directly implanted into the dental bed, and can be firmly bonded with the alveolar bone in just a few weeks. After restoration, not only the appearance is lifelike, but also the way of chewing force conduction is similar to natural teeth, clinically proved that it can completely replace single, multiple teeth and even the whole mouth teeth, known as the “third” teeth after milk teeth and permanent teeth, which has the following outstanding advantages: strong function: it can well restore the function of the teeth, and the efficiency of mastication is greatly superior to other traditional dentures. No tooth grinding: rely on artificial tooth roots for restoration, no need to grind the healthy teeth next to the adjacent teeth, no harm to the neighboring teeth; good retention: artificial tooth roots and alveolar bone are closely integrated, rooted in the oral cavity like real teeth, with strong retention and stability; aesthetically pleasing: crowns can be made according to the shape of the patient’s face, the shape and color of the other teeth, to achieve overall coordination and aesthetics; comfortable and convenient: do not use the hooks necessary for movable dentures, and do not need to use the hooks necessary for movable dentures, and do not use the hooks necessary for movable dentures. Comfortable and convenient: without the hooks and brackets necessary for movable dentures, there is no sense of foreign body, which is very comfortable, convenient and easy to maintain oral hygiene; easy to operate: dental implant surgery is a small alveolar surgery, similar to tooth extraction, using local anesthesia, less traumatic, and you can eat after the operation, almost painless. Generally speaking, implant placement can be completed in just a few minutes. As the implant is made of biomaterials with excellent compatibility with the human body, the implant will not have adverse effects on the human body. If the implant fails, the implant can be removed and the bone trauma can be healed before the implant is placed again, or restored by other methods. Although the treatment cost of dental implants is high, in view of the improvement of aesthetics of dental implant restoration, the restoration of chewing function, and the improvement of the patient’s overall self-confidence, dental implants are indeed the first choice of dental restoration for patients with certain economic conditions. The scope of application of dental implants The scope of indications for dental implants is very wide, and can be used in almost all kinds of missing teeth, but the patient must meet the following conditions: age over 18 years old; the missing teeth site has enough bone (including height and width), insufficient bone needs to be increased through other methods of bone and then implant restoration; there is no serious periodontitis, periodontal disease and other oral diseases; the gap between the upper teeth and lower teeth can not be less than 0.5 centimeters when occlusion. The gap between the upper and lower teeth should not be less than 0.5 centimeters when biting. Patients with severe diabetes, kidney disease, heart disease, coagulation disorders, mental disorders, osteoporosis, bone metabolism diseases and patients who are undergoing radiation therapy to the jaw and neck should not undergo implant surgery. Dental implantation process Dental implantation needs to be done by specially trained and experienced dentists, and the treatment process is roughly as follows: 1. Initial consultation: prepare information for consultation ① Understand the general condition and medical history of the patient, and clinical examination; ② Take X-ray surface tomography, and if necessary, oral CT examination, to assess jawbone equivalence, and predict the length of implant, etc.; ③ Take the occlusion record, and check the occlusal relationship; ④ Study models ③ Take occlusal records to check the occlusal relationship; ④ Study the model and carry out oral implant design. 2. Follow-up: Oral surgery, prosthetics and related specialties will discuss together to determine ① the indication of implantation; ② the implant site; ③ the implant restoration method; ④ the number and specification of implants; ⑤ the need for bone augmentation surgery, such as bone grafting, maxillary sinus lifting, etc. 3. 3. Perform implant surgery and implant the artificial tooth root; 4. Perform denture restoration after 6 weeks, and perform second stage surgery if necessary; 5. Maintain oral hygiene, regular maintenance and review. Maintenance of dental implants Dental implants are not natural teeth after all, in order to ensure the service life of dental implants, we should pay attention to daily maintenance. After the implant treatment is completed, you should pay attention to the following issues: eat fluids or semi-fluids on the day of surgery; brush your teeth within a week to avoid the surgical area; pay attention to observation within two weeks, and contact the doctor in time when you find any abnormality; don’t eat hard or tough food within three months; maintain good oral hygiene; regular review; and avoid accidental injuries. After more than 40 years of development, oral implant technology has formed a complete theoretical system, which is widely used in the restoration of single tooth, multi-tooth and full-mouth tooth loss, with a success rate of more than 97%. Dental implants are natural, beautiful and functional, and are now considered the preferred restoration method for missing teeth in developed countries. In addition, implant technology has also been extended to orthodontic support, intermaxillary fixation, and even the fixation of oral and maxillofacial and limb (finger) prostheses.