Implantology

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Dental implants, which are more modern than bridges or dentures, have not achieved widespread use in France. Close to 200,000 implants are placed each year, far less than in Spain or Germany. And yet, dental implants can restore a beautiful smile to those who have suffered the loss of one or more teeth. Details from Dr. Mithridade Davarpanah, Head of the Odontology and Stomatology Unit of the American Hospital of Paris.

 

What is a dental implant?

Developed by a Swedish surgeon in the 1960s, this technique entails inserting an artificial root into the jawbone, to which a restoration will be attached. 

The dental implant comprises three parts: 

- The implant itself, whose size is practically identical to that of a natural root. 

- The abutment, a prosthetic device that screws into the implant. It protrudes from the gum to provide anchorage. 

- The crown, which is screwed or cemented onto the abutment.

What are the different phases of placing an implant?

Before any surgical procedure, a completecheck-up of the mouth and teeth is required, to determine whether the bone is in good condition. In addition, an x-ray exam is performed to assess the exact quantity and quality of the bone. Sometimes a CT-scan or a cone beam (tri-dimensional exam) of the area to be treated is also necessary. Certain coronary diseases and uncontrolled diabetes may be contraindications. For osteoporosis patients being treated with bisphosphonates, the procedure is not contraindicated, but certain precautions must be taken. 

Following this medical check-up, the procedure generally takes place in two phases.

The first is surgical and is performed by a specialist in a dentist's office, under local anesthesia. The surgeon makes an incision in the gum and drills a hole in the jawbone into which the titanium implant and the healing abutment will be placed. The latter, as its name indicates, helps the gums to heal correctly. 

The second phase can begin once the bone has healed through a process called osteointegration, which can take from two to six months depending on the quality of the bone. In this phase, the dental surgeon places the titanium abutment, which serves as the interface between the restoration (dental prosthesis, crown or bridge) and the implant. The entire treatment results in a firm and permanent anchorage (ankylosis) between the surface of the implant and the bone.

Is post-operative pain to be expected?

Post-operative pain is rarely significant. Analgesics (pain-killers) and antibiotics are used to control discomfort and prevent infection.

Are there cases of dental implant intolerance? 

Dental implants are made of titanium, a completely biocompatible material. There is no intolerance because the implant does not behave like a foreign body. The implant success rate is over 95%, as long as all post-operative advice is followed. Good oral hygiene and regular annual check-ups will ensure the implant’s longevity.

What are the advantages compared to a bridge or dentures?

Certain forms of tooth loss can be treated with conventional methods (bridge or dentures). However, these techniques have several drawbacks. Bridges are anchored on both sides by the adjacent healthy teeth, and, unlike implants, bridges may damage these teeth over time. With removable dentures, the patient’s comfort level varies, while implants restore patients’ natural ability to chew and speak and ensure good cosmetic results. Sometimes patients even forget that they have a restoration held in place by an implant.

What is the cost? 

 

In France, this operation is not reimbursed by health insurance, unlike bridges and removable dentures. Certain supplementary insurance policies cover a portion of the fees, but costs remain high. The price mainly depends on the type and quality of the implant used. Plan to spend between €1000 and €1500 for an implant, including the healing abutment. On top of this, you will also be charged for the crown (between €500 and €1000), as well as the abutment (from €250 to €400 depending on whether it is made out of a gold alloy, titanium or zirconia). 


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