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How To Determine Implant Sizes?

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Implant Sizes

Dental implant is an effective treatment that prevents loss of function by acting as a natural tooth root in the mouth. In implant treatment, which is applied by taking into account many factors such as the jaw structure, functional needs and aesthetic expectations of the person, the prosthesis required by each patient is different from the other.

Therefore, it is of great importance that the implants to which the prosthesis will be attached are preferred within various biomechanical and aesthetic rules.

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Determining Implant Sizes

In implant-supported prosthesis treatment, the use of implants with the appropriate quality and structure is very important in terms of the use and life of the prostheses to be added later. In implants that are placed in the jaw and serve as roots for prostheses, the part to be used as support is called abutment. There are two methods that can be applied to measure the abutment structures and for both methods, the implants must be moved to the model during the measurement phase:

1. Standard Measuring Spoons Method

This method, known as the closed spoon technique or indirect impression method, is performed by screwing impression posts onto the implants, similar to the method used in traditional fixed prostheses. For this purpose, the impression material is filled into a special impression spoon without a hole and spread over the entire jaw, and the material removed from the mouth at the end of hardening serves as a model to take measurements that are fully compatible with the requirement.

An implant analogue is attached to the impression post, paying attention to its location in the mouth, so that the tissues around the implant can be imitated in the best possible way. After these guide surfaces are modelled with plaster in the laboratory environment, the impression posts are removed from the models and the exact measurements of the implants to be used permanently are taken.

2. Open Spoon Method

The main difference of the open spoon method from the other method is that the impression posts used for impression taking have longer screws. In order to ensure that the long screw posts do not interfere with the placement of the impression spoon, holes are drilled on the spoon at the points where the posts come in, so that the impression material can be easily removed from the mouth after hardening.

The screws connecting the impression post and the implant are loosened at the end of hardening and the spoon is removed from the mouth. In this way, the impression post is removed together with the spoon without any displacement and the implant impression can be taken more easily. It is a frequently preferred method especially in impression procedures that require the use of multiple and non-parallel implants.

Things To Consider When DeterminingImplant Size

In implant treatment, many factors need to be taken into account in order to optimally meet functional and aesthetic needs. In addition to the previous evaluations based on bone volume in terms of height, width and length, there are now more detailed criteria affecting implant selection:

Application Force

Implant treatment is planned in line with the number of teeth to be replaced, prosthesis preference and aesthetic demands. Afterwards, the magnitude and type of force to be applied to the restoration is evaluated and the bone density in the application area is taken into consideration for this.

For example; longer implants are generally preferred to make areas with less bone stronger against forces such as biting, chewing and tearing. Thus, the stress in the area can be better transferred to the surrounding surfaces and distributed evenly.

Implant Diameter

When determining dental implant sizes, clinical problems are first identified and these problems must be solved to meet the desired aesthetic expectations. For this purpose, in addition to the bone density, the space opening should be addressed and the implant diameter should be fully compatible with the region.

In general, the ideal implant width in areas with less dense bone is directly related to the functional surface area and has a diameter range of 3-6 mm. However, the exit angle, direction and position of the teeth closely affect the diameter requirement.

Abutment Selection

The part called abutment or support is the part placed on the implant and is preferred according to the location and type of the natural tooth, the position of the implant in the bone or the depth of the pocket.

However, another important criterion affecting the choice of abutment is the material. Today, there are three commonly used materials: titanium, ceramic and zirconium. Abutment material is an issue that should be taken into consideration as it affects the quality of the surrounding tissues surrounding the implant.

Titanium and Ceramic

Titanium abutment is a popular material that has been used since the first implant studies. Most dental implants are made of pure titanium because titanium is a biocompatible material that is accepted by the body and prevents loss of function by replacing missing teeth in a strong and stable manner. It is therefore extremely successful in locking the implant in place, bonding itself to the new teeth and providing a solid foundation for the teeth.

Ceramic abutment is a material introduced after titanium in order to meet the increasing aesthetic requirements and is preferred due to its excellent aesthetic harmony.

Although it is less successful than titanium in absorbing force, it is excellent at reflecting light and offers vibrant, beautiful, natural-looking teeth. It is also biocompatible and successful in long-term fixation.

Zirconium

Zirconium, which has become frequently preferred in recent years, is as strong as titanium in terms of integration with bone and as successful as ceramic in terms of aesthetic harmony. In addition, thanks to its biocompatible structure, it eliminates metal allergy and sensitivity concerns and reduces the risk of corrosion to zero.

However, since its usage area is more limited, it requires a close evaluation of functional requirements and sequential openings in the mouth before choosing zirconium material. Today, implant treatment, which is widely used to eliminate functional deficiencies and aesthetic deformations in the mouth, is a multi-stage treatment that requires expertise and competence.

In addition, many factors such as personal needs, expectations and structural features closely affect the treatment plan. For this reason, it is extremely important to choose the right clinic and physician in order to make material and size determination processes with precision and to receive the most ideal treatment for the needs of the person.

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