Implantology

The spaces left by dental extractions should always be rehabilitated. Failure to do so will lead to the migration of adjacent teeth, altering function and occlusion stability.

Currently, it is the therapeutic option that allows for oral rehabilitation that most closely resembles natural teeth in terms of physiology and comfort.

Dental implants are not permanent, just like any other rehabilitative treatment in Dentistry.

However, with recent advancements, you can expect a lifespan of over 15 years, and in the case of prosthetics supported by implants, a minimum of 10 years.

It is important to note that when there is an infectious pathology or mechanical issue with the implant/prosthetic combination, this estimated duration drastically reduces. Most of the time, these problems occur almost exclusively due to poor maintenance of these types of treatments.

Dental implants can only be placed once growth has been completed. Therefore, they should only be placed after the age of 18, when craniofacial growth has finished.

Dental implants can only be placed once growth is complete. Therefore, they should only be placed after the age of 18, when craniofacial growth has finished.

In patients with good oral and systemic health, the success rate of dental implant treatment ranges from 90% to 98%.

Naturally, as with other medical and dental treatments, the success of dental implants depends on several factors, such as individual anatomical and physiological characteristics, oral hygiene habits, smoking, and others (feel free to consult with us about the success rates you can expect in your case).

Absolute contraindications:
Certain general conditions make the placement of dental implants inadvisable:

• Recent heart attacks (less than 6 months ago), severe heart failure, and recent strokes
• Active neoplasms (cancers)
• Some bone diseases (osteomalacia, Paget’s disease, etc.)
• Some immunological diseases (Leukemia)
• Immunosuppressive treatments
• Uncontrolled mental disorders
• Radiation therapy
• Osteoporosis treatments or certain types of cancer treated with bisphosphonates (particularly injectable ones)

Relative contraindications:
Other situations are evaluated on a case-by-case basis:

• In most cases, dental implants can only be placed after certain preliminary treatments
• Uncontrolled diabetes (especially insulin-dependent)
• Angina pectoris
• Significant tobacco use
• Drug and alcohol dependence
• Pregnancy

The surgical procedures associated with implant treatment do not cause any discomfort and/or pain. It is usually performed under local anesthesia.

In the post-operative period, you may experience mild discomfort, slight inflammation, and swelling in the area where the surgery was performed. You will be given instructions and prescribed medication to reduce any discomfort and/or pain.

Orthodontic treatment for partially edentulous patients is challenging, especially when a significant number of teeth are missing.

With tooth loss, adjacent or opposing teeth typically shift, creating spaces that are not ideal for replacing the lost teeth. Orthodontic correction of these spatial relationships will provide better rehabilitation with implants, restoring both function and aesthetics.

Orthodontics, therefore, helps normalize tooth positions, recover desirable spaces, and create the necessary conditions for subsequent implant rehabilitation.

Another indication is the use of implants for anchorage.

Most orthodontic procedures require anchorage, and your orthodontist relies on your teeth to provide this anchorage. Dental anchorage is generally effective in facilitating tooth movement.

However, in some partially edentulous patients, dental anchorage may be insufficient; in these cases, implants can provide additional anchorage.

Using implants for orthodontic anchorage requires an interdisciplinary approach and precise planning to achieve the best results.

As long as the hygiene and maintenance instructions for the implants are strictly followed, and regular visits every 6 months are kept, the warranty provided by the implant brands used at The Lisbon Smile Clinic is lifetime. This applies only to the implant itself, not to the prosthetic components.

The maintenance phase is one of the most important, if not the most important, part of the entire treatment because it ensures that everything previously done remains healthy during the duration of the implants.

In fact, it is during this phase that the oral hygiene care performed by both the patient and the dentist will have the greatest impact on the longevity and quality of the treatment.

There are specific protocols for each case of rehabilitation with implants.

Bone regeneration is a surgical procedure that uses graft materials and barrier membranes to stimulate and guide the growth of new bone.

After a tooth extraction, the process of resorption of the alveolar bone (which supports the teeth) begins. In the first 6 months, up to 40% of the total bone volume can be lost, and this process continues over the years, with intensity varying from person to person.

This technique is used to replace the bone lost after an extraction that took place some time ago, enabling the placement of implants or preventing bone resorption after tooth extraction in deficient alveoli.

Scientific advancements now allow for the use of biomaterials that stimulate the production of human bone or the harvesting of bone locally, all with local anesthesia and a faster recovery time.

The maxillary sinus is a pneumatic cavity located bilaterally above the upper jaw. In some patients, when posterior teeth are extracted in the upper jaw, the sinus cavity expands, making it impossible to place an implant to replace the lost teeth.

In these situations, before placing implants, a maxillary sinus lift surgery needs to be performed. This is a straightforward surgical technique that involves placing a bone graft material beneath the sinus mucosa, with the aim of stimulating bone formation where there is none.

It is a routine procedure with a high predictability and clinical success rate.

When osseointegration of the implant does not occur (the process by which the implant surface forms a stable biological union with the bone), it must be replaced with another implant. It is a simple procedure and does not involve any cost to the patient.

Complete osseointegration is a process that can take between 3 to 6 months. It is during this period that the prosthetic rehabilitation of the implant (placement of the crown) is performed.

Currently, there are numerous techniques that allow us to solve this problem, depending on the location:

• Bone grafting and the use of biomaterials
• Maxillary sinus lift, in the posterior area of the upper jaw
• Straumann Pro-Arch and Neodent Neo-Arch techniques (teeth on the same day)
• Zygomatic implants (in cases of maxillary atrophy, maxillary bone loss, or limited maxillary bone)

Although titanium is currently the preferred material in dental implantology, the demand for alternatives has been increasing.

At The Lisbon Smile Clinic, we use the Straumann Pure Ceramic implant as an alternative. This implant is made from Yttrium-stabilized Zirconia, 100% metal-free. Its white and opaque color, along with reports of good biocompatibility, make it a suitable material used as an alternative to titanium.

These implants are primarily used in:

• Situations where very high aesthetic standards are required;
• Titanium allergies;
• Patients who desire “metal-free” reconstructions.