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Can children and youngsters also get implants?
In the case of young people, implants are used to support the dental adjustment. Implants in the palate or behind the alignment can replace more complex equipment.
The replacement of lost teeth through implants in the case of young people is, however, problematic because the growth process of the jawbone is still incomplete. The jaw around an implant will no longer grow normally. This is why implants should not be inserted before the big growth spurt. That is, not before the age of 14 for girls and 16 for boys. I would wait even longer (until the age of 18 for girls and 20 for boys), because even after the big growth spurt, the jaw can still grow 1 to 2 mm in height. (for young men, until 25 years of age!)
If an alternative to the implant is not available, then it is possible to cosmetically compensate for the growth of the jawbone through modifications to the visible crowns, with the help of removable crowns (crowns that can be unscrewed).
Must I be completely healthy in order to get an implant?
No, but there are illnesses that present a higher risk than others. Some of these illnesses are: diabetes which requires insulin shots, leukaemia, the patient's condition after the irradiation of the jawbone, and serious cardio-vascular problems. In each individual case, an accurate evaluation of the risks involved can be made after consultation with your family doctor. Each time, you have to carry out a risks and benefits analysis. For instance, an implantation will not be ruled out in the case of a patient with gastrointestinal cancer who undergoes chemotherapy, because the gastrointestinal tract needs foods rich in dietary fibre. In such cases, the risks and benefits analysis should take place always in the triangle patient - family doctor - implantologist.
How often will I have to have checkups after getting an implant?
Examinations of the implants at regular intervals of time are imperative and extremely necessary, because it is much easier to treat potential inflammations at an early stage. Moreover, serious inflammations can lead to the destruction of the bone and thus to loss of the implant.
After the insertion of the implant it is necessary to have checkups: after 2 days, after 7 days, after 3 weeks, and from then on, monthly.
After the completion of all the dental work: the first time after 6 weeks, then twice every three months, then twice every six months, and later once a year.
When is preliminary surgery necessary before the insertion of the implant?
The basic principle of implant insertion states that the implant must be fixed firmly into the bone. If this requirement is not met, then it is necessary to build up the bone first. This takes place a couple of months before.
If the implant is fixed firmly after insertion, but a part of its body is still not covered by the bone, then it is possible to cover this part with a filler material in the same intervention.
Optimal for the insertion and the covering of the implant is of course your own bone, because it cannot generate reactions of rejection and it stimulates the regeneration of bones more than artificial materials. Those parts of the bone which are still alive after the transplant become gametes for new bones. The bone material for the transplant is usually obtained from adequate parts of the jawbone. The drawback of this method is the more extensive surgery required. In the case of a more serious loss of bone, parts of the pelvic bones may also be used. This requires a general anaesthesia. It is also possible to remedy smaller flaws by filling them with special membranes and bone replacement material. To avoid the surgery in which your own bone is extracted for transplantation, new bone replacement materials are constantly being developed (Munich Symposium 1999). So far though, independent long-term research has shown that none of these materials can replace the bone in terms of optimal qualities.
However, more recent research results give us a reason to be hopeful. For instance, research on the so-called 'distraction osteogenesis' suggests very promising results. This is a process through which a bone that is too small is constantly being expanded and enlarged.
Please get individual advice and information from your dentist or oral surgeon.
I have heard about special materials with which degenerated bones can be built up without undergoing surgery. What is your opinion?
This refers to proteins which are purported to help the regeneration and reproduction of bones (BMP: Bone Morphogenetic Protein). These materials have been on the market for about 10 years now.
An interesting article on this topic could be found in the Official Journal of the German Medical Society on July 19, 1999. According to the article, there are as yet no clear results about standardised use on humans.
You would be well-advised to follow the research on this site (but not only here, of course), because the good results of the experiments on animals suggest that the future might bring good news for us too. In the meantime, scientists have managed to grow human BMP (in other words, bone-regenerating protein). However, a carrier substance which could keep the BMP on the spot where its action is needed, has yet to be found, because once the BMP enters the bloodstream, it decomposes very quickly. We are looking forward to the homologation of some of these bone-regenerating proteins in Europe this year, after the United Stated have already approved the first ones.
I have heard that implants will heal better if one gives a blood sample before the intervention and then has this blood reinjected into the drill hole.
The blood contains various elements. In the blood plasma, besides the (oxygen-carrying) red blood cells, there are also many proteins, which help the regeneration of the bone. For this, before the intervention the doctor will draw blood from your arm, place it in a centrifuge where the various elements are separated, and finally reinject this plasma containing a higher concentration of useful proteins back into the wound. According to current research, patients have exhibited wounds which have healed strikingly fast and without problems. But one has to wait for more in-depth research before one can assume that implants in which own plasma has been used can endure the strain immediately.
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