Dental implant or dentures

Tooth loss is about more than just cosmetic issues. Tooth loss, whether partial or complete, has a significant impact on your overall health.  

Poor digestion, speech difficulties, bone resorption or changes to facial appearance are just some of the problems you may face due to missing teeth.  

Dental implants and dentures are two of the solutions available when a person wishes to replace one or more missing teeth. However, the right decision regarding the choice of the most suitable option depends on the clinical situation, the cost of a dental implant or the price of a denture, as well as individual preferences.

A dental implant is an artificial root made of titanium or ceramic materials that is placed in the jawbone to replace a missing tooth.

The procedure involves several stages:  

• specialist consultation
• insertion of the implant (screw and abutment)
• the healing period (osseointegration), which can take approximately 2–6 months
• fitting of the dental crown or other prosthetic element.

If you’re wondering how long dental implant treatment takes, the answer is that it varies depending on the complexity of the case. On average, the entire process from insertion to crown fitting takes between 2 and 6 months.

Risks of dental implant treatment

It is important to know that, following the insertion of a dental implant, certain adverse reactions may occur, as well as more serious complications.  

These reactions and conditions may occur after the completion of dental implant treatment if recommendations regarding oral hygiene and diet are not followed.

“The most common conditions encountered are mucositis and peri-implantitis, both of which are inflammatory in nature. Clinical studies have shown that, in situations where patients do not maintain proper oral hygiene for several weeks, bacterial plaque accumulates in a similar manner on both natural teeth and around implants. Furthermore, the gums’ reaction to bacterial attack is comparable in both cases, highlighting the importance of rigorous oral hygiene following the insertion of dental implants,” explains Dr Marina Băjinaru, Specialist in Dento-Alveolar Surgery at DENT ESTET clinics. 

A dental prosthesis is an artificial tooth or set of artificial teeth designed to replace one or more natural teeth, with the aim of restoring chewing function and aesthetics.

Types of dental prostheses differ in terms of the anchoring technique and the materials used. A simple classification helps to understand the advantages:

• Fixed dentures: these are supported by implants or, in some cases, by the surrounding teeth;
• Fixed dentures on implants, such as the All-on-4 prosthetic restoration, which is fixed to the dental arch using four dental implants;
• Removable dentures: these can be removed daily, which simplifies cleaning, but may affect stability due to reduced adhesion to the oral tissues;
• Partial dentures: designed to fill gaps in an arch where some teeth remain;
• Skeletal denture: incorporates a metal substructure;
• Full dentures: replace all missing teeth in an arch (upper, lower or both), and are recommended in cases of complete edentulism.

Dental prostheses can provide an oral rehabilitation solution for people with chronic conditions who might suffer surgical complications; however, it should be noted that, in recent years, significant progress has been made in the development of dental implants for patients suffering from diabetes or other systemic conditions.

New research in implantology and digital dental technology shows that people with diabetes have roughly the same chances as those without diabetes in terms of implant success rates, the only difference being that the healing period required is longer.

For example, the Swiss dental implant manufacturer Straumann has developed new surfaces, such as SLActive®, which has the major advantage of promoting rapid healing after treatment. 

Dental implants – benefits and risks  

Dental implant treatment offers numerous advantages, but it also involves certain risks that you should be aware of before the procedure.

Benefits of dental implant treatment:

• Excellent stability during chewing: because it integrates directly into the bone, the implant functions just as well as a natural tooth root;
• Preservation of bone volume: the implant stimulates the jawbone, which helps prevent the bone loss that often occurs after tooth loss;
• Protection of adjacent teeth: there is no need to grind down the neighbouring teeth, as is the case with dental bridges;
• Greater comfort when speaking: the crown fitted onto the implant is precisely fitted, facilitating correct pronunciation and eliminating the risk of displacement;
• A very natural appearance: the restoration blends in visually with the rest of the teeth;
• Long-lasting: research indicates a success rate of over 90% even more than 10 years after placement.

Points to consider:

• Possible medical contraindications: conditions such as diabetes, advanced osteoporosis, excessive tobacco use or immunosuppression may affect the chances of success;
• The success rate is closely linked to the dentist’s expertise: the final outcome of dental implant treatment is closely linked to the specialist’s experience and the clinic’s technical facilities.
• Higher cost: the price of a dental implant is generally higher than that of a traditional denture. This is due to the quality of the innovative materials used to manufacture premium dental implants, as well as the innovative technologies employed. Thus, the surgical guide and the Osstell Beacon® device, used to check primary stability, are just some of the digital technologies utilised within DENT ESTET clinics to ensure the success of dental implant treatment.
• Longer treatment duration: compared to a dental prosthesis fixed to the teeth adjacent to the edentulous site, in the case of a dental implant the osseointegration period lasts several months;

Complications (risks) following dental implant placement:

• Local pain and inflammation: these are normal reactions in the first few days, but if they persist or worsen, they may indicate a problem;
• Peri-implant infection (peri-implantitis): this can affect the tissues surrounding the implant and, if left untreated, may lead to its loss;
• Prolonged bleeding: slight bleeding is normal immediately after the procedure, but persistent bleeding requires re-evaluation;
• Implant mobility: there are situations where the implant is rejected by the body or does not fuse properly with the bone (insufficient osseointegration) and becomes loose. In this case, the implant must be replaced. In extremely rare cases, some people may have reactions to the implant materials (e.g. titanium), leading to symptoms of dental implant rejection. 

Dental prosthesis – Risks and benefits

Advantages of dentures:

• Easy removal: they can be taken out for more effective cleaning;
• People with chronic conditions involving an increased risk of surgical complications can use dentures as a solution for oral rehabilitation;
• Adaptability: they can be adjusted or remade to accommodate anatomical changes in the oral cavity;
• Dental prostheses are less expensive than dental implants;
• There are also situations where the patient requires rapid treatment to regain the ability to chew and speak properly within a short timeframe; the process of making dentures takes less time than dental implants.

Dental dentures – Disadvantages:

• Reduced stability: removable dentures depend on the shape of the gums and the dental arch, which is why they can cause discomfort or move around;
• Progressive bone resorption: the absence of a fixture embedded in the bone leads to bone loss over time;
• Adjustment period: painful areas, irritation or difficulty speaking may occur initially;
• Inconsistent aesthetic appearance: not all dentures look natural; furthermore, some metal components may be visible;
• Requires periodic adjustments: anatomical changes necessitate adjustments (re-fitting) or even replacements, which increases costs in the long term;
• The process of making dentures takes less time than dental implants. However, there is a significant adjustment period when learning to wear full dentures, including learning to chew and speak, so it is important to be patient with yourself and your dentist as you go through this period;
• Reduced chewing efficiency: the lack of anchorage in the bone makes chewing hard foods more difficult compared to dental implants.

Although technological advances have improved the appearance of dentures, it is important to remember that they are usually removable. Even though dentures are less expensive than dental implants, the fact that they often need to be secured with denture adhesive – otherwise they may slip out of place whilst eating or speaking – is a major inconvenience. 

The cost of a dental implant is determined by several factors, including the manufacturer’s brand, the materials used to make the implant, as well as other elements such as the initial specialist consultation, X-ray and CT scans, and medical tests.

There are situations where, on the doctor’s recommendation, an additional procedure is required—namely, bone augmentation—which may be reflected in the final cost of the dental implant treatment.  

The price of a dental implant also includes its components, namely the prosthetic abutment, the analogue, the transfer abutment and the temporary dental crown.  

On the other hand, if you are facing total edentulism (the absence of all teeth in one dental arch), the specialist may recommend treatment using the All-on-4 implant system. The price of this type of treatment can be found in the DENT ESTET price list.

It is true that the cost of implants may be higher than that of dentures, but the benefits are numerous. 

Dental dentures are subject to daily wear and tear and may require frequent adjustments, as bone structure changes over time. Potential risks include yellowing, cracking or damage.  

Even with proper care, most dentures need to be replaced after a few years to ensure comfort and functionality, and their instability can affect chewing and speech.

Dental implants, on the other hand, replace the tooth root and integrate directly into the bone, providing long-term stability. Premium implants, such as those from the Nobel Biocare and Straumann ranges, used in DENT ESTET clinics, are designed to withstand daily wear and tear and maintain functionality for years to come.  

With proper oral hygiene and regular check-ups, a dental implant can be a durable, predictable and comfortable solution, superior to traditional dentures in terms of stability and quality of life. 

To understand more precisely why we might ‘lose’ an implant, we need to understand what its integration into the bone entails.

In the 1980s, the Swedish doctor and researcher Per-Ingvar Branemark defined osseointegration as a connection between the patient’s bone and the surface of the implant, leading to the formation of a single unit comprising the implant and the bone. This connection between the implant and the patient’s bone is known as osseointegration.  

The factors contributing to the normal progression of the osseointegration process are extremely important and are key to the long-term success of implant treatment:

• Biocompatibility between the material from which the dental implant is made and the bone;
• The quality and quantity of bone tissue;
• The patient’s immune system;
• Vascularisation;
• Dental hygiene.

“The success of a dental implant depends on several factors, and the absence of even one of them can increase the risk that the implant will not osseointegrate properly and will be lost in the first few months after insertion. That is why it is important for the patient to choose a dental implant with proven clinical results. At DENT ESTET, we recommend implants from established manufacturers, backed by years of research, robust clinical studies, longevity and high success rates in practice,” explains Dr. Marina Băjinaru. 

Dental bridges are a commonly used treatment option for replacing multiple missing teeth. They are often chosen by patients who are unable or unwilling to opt for dental implants, either for financial reasons or because of the more complex procedures involved.  

The initial costs are, in most cases, more affordable than those of implants. However, dentures do not prevent bone resorption as there is no element to transmit direct stimulation to the bone.

The choice of the appropriate treatment for tooth loss must be made on an individual basis, based on a clinical consultation and imaging tests. Dental implants provide excellent stability, an aesthetic result close to that of natural teeth, and help maintain bone volume, but they involve a greater financial investment and require a surgical procedure. Dental dentures, on the other hand, are characterised by lower costs and a non-invasive fitting process.

“Although the patient makes the final decision, it is our responsibility to clearly outline the benefits and limitations of each option, tailored to individual circumstances. I believe that the decision to opt for implant treatment is a decision for life. This treatment method offers compelling advantages over conventional denture treatment,” explains Dr. Marina Băjinaru. 

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