Dental implants are one of the greatest achievements in dentistry of the 20th century. Modern dental implants are just over 30 years old since Swedish professor Per-Ingvar Branemark discovered that titanium can be integrated with bone tissue, but the development of dental implants in the field of dentistry has been amazingly fast. Since 1965, when Prof. Per-Ingvar Branemark placed the first dental implant in a Swedish man, Mr. Gosta Larrson, about 7 million dental implants have been produced by Nobel Biocare alone and placed in the patient population. Currently there are more than 100 companies producing dental implants worldwide and the number is increasing at an alarming rate. Implant is an artificial tooth root made of pure titanium that is implanted in the patient’s jawbone, fused to the jawbone by means of osseointegration, and connected to the upper denture (Crown) by a structure called Abutment to function. History of dental implants The use of artificial teeth to replace missing teeth has been practiced since ancient Egyptian times, and shells were found on the lower incisors of the Mayan jaw in 600 B.C. 1647 M. Puont Louis, a 13-year-old attending physician, attempted to implant teeth in the missing areas 1685 Charles Alen proposed to implant the teeth of monkeys, dogs or sheep 1807 Jourdan & Magiollo used a root-shaped implant made of gold, but it lasted only 14 days. Thereafter, different materials such as gold, silver, ceramic, and ivory were tried, but all failed. It was in the 20th century that the clinical research and development of artificial teeth implants in bone began. What can be done with dental implants? In the past, the limitations of implant prosthetics were large, but with the continuous development of implant prosthetics, its superiority and its success in long-term clinical practice, the indications for implants have been broadened. In the early days of implant denture, it was mainly used for patients without teeth, but now it has developed to the point that any missing teeth can be restored by implants. At the same time, it is suitable for patients who have difficulty in retaining the denture due to various reasons, or for those who cannot be restored by traditional methods due to the dysfunction caused by psychological factors. In addition to patients with normal oral conditions, the following cases can also be treated with implant prosthesis: ① Insufficient bone in the alveolar bone, which can be solved by bone grafting. ②The problem of maxillary sinus and mandibular canal can be implanted with the guidance of X-ray and CT. Spiral CT can guide the direction more accurately. Select the appropriate implant length, and the accurate implant angle. ③Implantation is performed immediately after tooth extraction. ④For patients with insufficient economic conditions, the overdenture restoration method can be used. ⑤ For jaw bone defects, facial tissue and organ defects can also be restored by implantation. However, there is a certain range of adaptation for artificial dental implant restoration. Oral examination, panoramic X-ray and routine blood tests should be performed by a specialist before determining the suitability of the procedure. What are the advantages of dental implants? Dental implants have many advantages compared to traditional dentures. It has a realistic and beautiful appearance; good stability, chewing function is much better than the traditional movable denture; no need to grind the good teeth next to the missing teeth, the maximum protection of the patient’s healthy teeth; small size, minimize the impact of the denture on the pronunciation; comfortable and hygienic; not afraid of cold and not afraid of acid; easy to use. Whether the tooth decay is too deep, or the tooth needs to be extracted due to trauma, dental implants are the most comfortable and beautiful choice for you. The new and expensive thing about dental implants: If a tooth has to be extracted, the conventional restoration method is to extract the tooth first, and then start setting the tooth after 2 to 3 months of healing in the extraction socket. In the case of front teeth, it goes without saying that this is an unsightly period of time. Even if you do a plastic temporary dentures, will not be good to see where, and foreign body feeling obvious, wearing very uncomfortable. The next step is to choose whether to insert movable dentures or fixed dentures. The movable dentures have to be taken off and worn every day, which is really troublesome! Wearing uncomfortable, will also expose the ring (metal hooks), very affect the aesthetic. Fixed dentures are much better in terms of aesthetics and comfort, but they require grinding of the teeth on both sides of the missing tooth. Dental implants are as aesthetically pleasing and comfortable as fixed dentures, while not requiring the grinding of adjacent healthy teeth, making them a two-pronged choice. Sometimes implants can be performed at the same time as tooth extraction, so that there is no missing tooth time and social activities are largely unaffected. The suitability of immediate implants is determined by the practitioner on a case-by-case basis. How long do implants stay? Depending on the clinical situation, the success rate of implant treatment can reach more than 95%. It is also possible to retain them for life. Implant dentures can be considered as natural teeth to some extent and function in a similar way. Excessive use can lead to damage and loosening of the implant, and poor oral hygiene risks infection of the peri-implant tissue. Regular post-operative oral examinations are a must. In addition, there are a large number of implant systems available and choosing a reliable implant system is key. How long does implant treatment take? Implant treatment can generally be divided into three phases: preoperative preparation, implant placement surgery and implant denture restoration. In the preoperative phase of implant treatment, a systematic specialist examination is performed, such as x-rays and systemic disease examination. In addition to this, the implant treatment plan and a series of preparatory works are carried out. It takes several days. Implant surgery is usually performed under local anesthesia. The surgery usually takes 1 to several hours. On the day of the surgery, the patient should eat normally before the surgery, and after the surgery, he/she should eat soft and liquid food. After surgery, the patient should take medication and follow up with the doctor as required, and pay attention to keep the mouth clean and remove the stitches in 7-10 days. Repair is usually performed three to six months after surgery. The second-stage surgery is performed first, followed by mold taking, denture making and tooth wearing. Treatment usually takes 2-3 weeks. What problems may occur with dental implants? In rare cases, there is poor healing between the implant and the bone, which can lead to loosening and loss of the dental implant. If infection occurs in the implant area, it may spread to other areas such as the maxillary sinus. When implants are placed in the posterior region of the lower jaw, there is a risk of nerve damage. There is a possibility of varying degrees of pain, edema or bruising after implant surgery. How long after tooth extraction can dental implant restoration be performed? Can dental implants be placed immediately after tooth extraction? Generally speaking, after 3 months of tooth extraction, the bone tissue in the missing tooth area has healed well and the resorption is stable, so implantation is more likely to be successful at this time. If the alveolar condition is good and there is no acute and chronic inflammation, immediate implantation in the freshly extracted socket can also achieve satisfactory results. Criteria for the success of dental implants 1. Gingivitis is controlled and there is no implant-related infection. 2. No damage to the supporting tissues of the adjacent teeth. 3. The implant performs the function of supporting and retaining the denture without any clinical motility. Good function. The chewing efficiency is more than 70%. 4. Aesthetic appearance, almost no difference in shade from neighboring teeth. 5.No continuous and/or irreversible damage to the mandibular canal, maxillary sinus, nasal floor tissue, pain, numbness, abnormal sensation and other symptoms after implantation, and good self-perception. 6. Bone resorption in the vertical direction does not exceed 1/3 of the length of the part implanted in the bone at the completion of the implant surgery (as shown by radiographs using standard projection methods). The horizontal bone resorption does not exceed 1/3 and the implant does not loosen. 7. Radiological examination, no translucent areas in the bone interface around the implant. Failure to meet any of the above criteria cannot be considered successful. Postoperative care of dental implants 1. Routine use of antibiotics after surgery. For simple implant surgery (small number of implants, short surgery time and good recovery of the patient), oral antibiotics should be taken after surgery, while complex implant surgery requires intravenous antibiotics to prevent infection. 2. Don’t brush your teeth and use water within 24 hours after surgery, because over-frequent rinsing may lead to tooth bleeding, but you can rinse your mouth with mouthwash after meals to prevent residual food residue in the mouth, you can eat and drink moderately 2 hours after surgery, and food should not be too cold and too hot. 3.Patients generally have only slight hidden pain or discomfort after surgery, no need to take painkillers, but if patients are sensitive or feel local pain, you can add painkillers on the day after surgery, the general normal situation is that 24 hours after surgery, patients will no longer have continuous pain sensation. 4, due to the different physical and surgical procedures of patients, there may be different degrees of surgical reactions, some patients have lighter reactions or no discomfort reactions, some will have local edema and ecchymosis, which usually lasts about 3-5 days. 5. The stitches will be removed in 7-10 days after the normal operation. Timely removal of stitches can prevent local infection. Who are suitable for dental implants? Generally speaking, healthy adults under the age of 80, patients with single tooth loss, partial tooth loss, or complete tooth loss can have dental implant restoration if they meet the conditions after clinical examination. Patients with the following diseases are not suitable for dental implants: severe bleeding disorders, uncontrollable hypertension, certain heart diseases, diabetes with poor blood sugar control, severe osteoporosis, malignant tumors, mental disorders and high levels of chemotherapy, hormones, anticoagulants and other drugs that have an impact on the metabolism and integration of bone, cannot undergo dental implant surgery. Local gum inflammation and inflammation of nearby teeth can affect the integration of the implanted root and even lead to the failure of the procedure. Things to note after implant surgery 1. Take the prescribed medication received in accordance with the prescription. 2. After 40 minutes, take out the medicated cotton that you bite in your mouth. If there is still blood coming out from the surgical site, you should bite on a new cotton pad. (Usually, a small amount of blood flows out on the day of surgery versus the second day.) 3. Patients who have undergone surgery to elevate the floor of the maxillary sinus should not blow their nose vigorously. 4.At the surgical site, sometimes temporary swelling, discomfort, pain and abnormal sensation may occur, which are symptoms of the normal healing process, and most of the symptoms will disappear on their own after a period of time. 5. Within 24 hours after the surgery, you can apply cold compresses with ice (20 minutes interval). The swelling will last for 48-72 hours and then slowly subside. 6.The day after the surgery, use oral disinfectant to maintain oral hygiene, about 4 times a day. (Just hold the antiseptic solution in your mouth for 1 minute and then spit it out.) 7.For the site that did not receive surgery, brush your teeth normally from the day after surgery. 8.During the initial period of healing (about 1 week), alcohol and smoking are absolutely prohibited. 9. On the day of surgery, please drink cold liquid food (milk, etc.) (do not drink through a straw as it may cause bleeding). Within a week, please eat soft food such as porridge, and absolutely forbid to eat tougher and harder food. 10.For 3 days after the surgery, avoid hot baths, sauna, etc., avoid strenuous exercise or heavy labor, and ensure proper rest time. 11. The sutures should be removed within the 7th to 14th day after the surgery. During this period, do not lick the surgical site with your tongue or touch the surgical site with your hands. Things to note before implant surgery 1. On the day of surgery, try to arrange a chaperone to come with the patient. 2.Before the surgery, do not drive the vehicle or operate the machinery. 3.The night before the surgery, you should ensure sufficient sleep. 4.Before the surgery, excessive exercise, work, alcohol consumption and smoking are prohibited. 5.If you have high blood pressure, diabetes and other disorders (angina pectoris, myocardial infarction, heart murmur, bleeding abnormalities, history of anticoagulation, asthma, lung disease, hepatitis, venereal disease, kidney disease, discomfort with steroids, allergies, pregnancy, lactation, etc.), you should consult with the attending physician. 6.In order to reduce the uneasiness as well as the pain during the surgery, medication can be taken as needed. 7.For special drugs with allergic effects and side effects, you should consult with the attending doctor. 8. For women, it is best not to wear makeup on the day of surgery. For men, you should come back after shaving on the day of surgery. What is the discomfort during the implant surgery? The dental implant procedure is very small and can be done in the dental chair, usually in 15 to 30 minutes. In particular, immediate implantation is done at the same time as tooth extraction and there is no added pain. However, if the implant is placed after a long-term tooth loss, there will be bone resorption and bone loss, and then the procedure will be relatively complicated and painful. Modern anesthetic techniques and good postoperative care measures can minimize patient discomfort. The intra-oral wound heals in about 7-10 days. In implant treatment, implant placement is performed in a precise manner and all steps of the procedure are very gentle. The trauma of placing a single implant is similar to a simple extraction; the trauma of placing multiple implants is similar to a more complex extraction. In general, it is much less invasive than a wisdom tooth extraction. There may be some mild swelling after the surgery, which can generally be relieved in 2-3 days; there may also be some pain, which can be relieved by taking common oral painkillers, and painkillers are usually not needed for more than 2 days. During the healing period, care needs to be taken to clean the wound area and avoid chewing hard objects in a timely manner. Many patients feel that the discomfort of implant placement surgery is a little less than tooth extraction.