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To put it simply a dental implant is a metal screw or framework installed into your jawbone that becomes a part of your jaw and holds an imitation of a tooth (the so-called dental crown). The screw itself is harmless and doesn’t cause any discomfort – the patient quickly forgets about it. As an artificial tooth, the crown is usually made of porcelain, ceramic, metal, zirconium or even gold. Some people go big and replace their teeth with gold, some just look for a nice imitation of their cracked, destroyed or lost teeth and chose zirconium, because it fits the natural colour of teeth best. Dental implants imitate natural teeth in colour, hardness and function. When properly cared for they can last a lifetime. After the troubles of daily eating without a tooth, imagine that you can finally enjoy crunchy meat or solid foods. That’s why dental implants come in so handy. A lot of people wonder how is this possible. So, let’s take a closer look at the whole process.
Dental implants anatomy model
The hole after the extracted tooth serves as a good fixture point for the implant (screw), which is carefully installed within and left for the surrounding gum tissue to absorb in a natural manner. The so-called abutment is necessary in order to secure the implant and enable its uncovering in the future. When the gum tissue heals properly, usually in about 3 up to 6 months’ time, the implantologist uncovers the screw and can finally attach the crowns to the implant, finalizing the whole procedure. Installing dental implants is the safest of all medical surgeries, it’s been performed for over 50 years now all over the world, so don’t stress out. When installed, no one will differentiate your own natural teeth from the implant, unless you love coffee and cigarettes too much! Then, the rest of your natural teeth will start to fade in colour – all except for the custom-made crown. The whole procedure, from installing the screw to mounting the crowns, requires at least 3/4 visits at a clinic and 3-6 months of time in order to finalize it, but believe me, it’s way riskier if you try to do it faster.
Installing the screws before treating any possible root canal infections, or mounting crowns before the screws had healed properly with the gum tissue may result in unpleasant complications. The success of a dental implant depends on one thing mostly: it should be fixed and immovable in order to function properly. Otherwise, it’s a risky thing and may result in swallowing the custom-made crowns and that’s something you would rather avoid at all costs. For this reason, it’s so important that only an experienced specialist should be allowed to dabble in your gum tissue. The implants should cause no discomfort during eating, chewing, grinding, or even smiling. Most importantly: they should never move. However, if the patient is reasonable and waits until the gum heals properly 3-6 months, then he will benefit from a new shining smile in 99% of cases. Mishaps in dental implanting are very rare and usually, they’re caused by the patient’s jawbone structure rather than the specialist’s shaking hand, so don’t fret. Generally speaking, the first three types of dental implants that you’ll hear about are the following:
The best candidate for dental implants is someone with a fully grown jawbone (an adult) and is of good health condition, especially when it comes to the dental, root canal, gum tissue and (sufficient) bone structure. Suffering from periodontal disease may exclude one from being a prospective candidate. The same applies to patients with malocclusion which has to be treated before implants can be mounted. Root canal infection may also pose problems if it spreads to the gum tissue disabling its natural regenerating quality. Also, patients after serious surgeries requiring time to heal may be advised to withhold any major dental operations until they recuperate enough. But if you hadn’t had any such surgeries lately, you feel well, never had any teeth falling out by themselves and people don’t run away scared from you because of your protruding fangs – then yes, you are indeed the ideal candidate for a dental implant. Remember that smoking slows down the healing rate of your organism, so try to quit beforehand and keep it so until all the incisions, gums, jawbone and implant integrate. Installing a few implants won’t immediately solve most common dental problems you may have with your other teeth in the future as well, proper hygiene is crucial. Some patients may have to undergo complicated treatments before they can have implants installed, especially those with an uneven bite have to straighten their teeth with metal or Invisalign braces, and those with gum diseases like the mild gingivitis have to fix gum tissue with proper oral hygiene, soft toothbrushes, mouth rinsing, flossing and regular checkups at the dentist.
There are many different types of dental implants which differ in quality, methods of implantation and cost of production. When it comes to dental implants’ brands some of the best are Nobel Biocare, Straumann, Dentsply Sirona, Zimmer Biomet, and MIS. Employing one of the brands of dental implants solely by a clinic means operating only on the basis of one implant system with its specific procedures and requirements. Some of these implant brands are especially suitable for the weak jawbone, others yet offer the so-called mini-implants with small screws for a cheaper price.
When it comes to bone structure and possible bone grafting involved due to lack of sufficient jaw bone, one can differentiate two specific types of dental implants:
Let’s see what are the differences between them.
The most common type of dental implants in use currently. Employed in most cases where sufficient bone structure is healthy and only if the patient doesn’t suffer from periodontal disease. It’s fixed into the jawbone in the place of an extracted tooth root and mounted with a metal abutment. Typically the set is made of titanium, but due to allergies arose the need to produce the abutment from zirconium. Recently, the screw itself, abutment and crown can be made of zirconium in order to allow for a completely anti-allergic quality of the entire implant. An endosteal dental implant can have two types of screws: cylindric – looking just like a common screw – and blade-like. The technique of endosteal implant placement is one of the most often used techniques and thus, safest to perform.
Subperiosteal implants differ when it comes to the plant type: it takes the form of a custom-made metal framework that needs to fit exactly to the patient’s jawbone and is installed onto the jawbone itself, not into it. In order to perform this, the specialist has to first uncover the bone structure with a scalpel and analyze it in order to design the fitting framework on which implants will be mounted. This type of implants is less frequently in use because they demand more work and gum healing time than the classic endosteal implants. As far as the endosteal implants are safe and shown to cause little if any complications, in the case of subperiosteal implants the failure or complication rate is rather high in comparison, from 30% to 50%, thus fewer specialists decide on installing subperiosteal implants.
Without the CT scans, X-ray pictures of your mouth you won’t be allowed to undergo any dental surgery. Jawbone structure and possible complications require attention and meticulous work beforehand and only an experienced specialist may provide such services. Better prepare for the rudimentary photos to be made, they provide the best information for the surgeon about the condition of your teeth, dental losses, damages and bone structure density – the stuff which isn’t visible clearly at first look. A panoramic X-ray, known in short as an ‘X-Ray’ shows the entirety of your jawbone from far left to the far right in two dimensions in one picture, it’s one of the most commonly employed methods of medical imaging. The other one that you will hear about during your visits to the dentist is the CT scan, computed tomography, which is another form of X-ray imaging. It is used when standard X-ray pictures fail to show the tissue, nerves, bones or teeth. A Ct scan presents them all in a 3D perspective. Then, the dentist will take imprints of your teeth, or you’ll digitally design your future smile. Consultations are the rudimentary part of any treatment but don’t last long.
Everything begins with broken teeth that are first extracted in order to make space for the new long-lasting implants. Usually, the back teeth need to be removed surgically. The more teeth have to be removed, the more time will the bone structure and gum tissue require to heal and regenerate and the more time it’ll take to finalize the extraction procedure. Extraction of more than a few teeth can be performed during one dentist visit. Don’t fret, this process is always performed under anaesthesia, so it’s not going to hurt.
There are several sedation techniques to choose from, including gas sedation. Some specialists will prefer to save the sick tooth with endodontic treatment rather than remove it. On the other hand, keeping dental gaps between your teeth may result in face, jawbone and cheek shape degradation owing to the natural process of filling these gaps.
If in due process of tooth removal it turns out that there is an insufficiency in bone structure or that it’s fractured, then the patient’s jawbone has to be rebuilt with the use of a most modern new-tech method called bone augmentation.
Bone grafting may be performed with the use of the patient’s own bone (autologous), obtained from another source – a bone bank (allograft), or with a synthetic substitute. Bone grafting usually takes up from 4 to 9 months’ time for the bone to integrate with surrounding it jawbone structure and allow for installing dental implants. Rushing any dental procedures before full reabsorption of the new bone, and regeneration of the fractured bone structure is strongly dissuaded.
Additionally, if the patient requires installing upper back molar implants or if the upper jaw hasn’t got enough place for dental implants, then the surgeon will have to perform the so-called sinus lift procedure, which is a ridge expansion with a scalpel done under local anaesthesia usually.
This is the reason why any dental procedure requires X-ray photography, or CT scan made beforehand. The possibility of bone grafting increases accordingly to the age of the patient and prolongs the total time needed for the dental implant to be mounted and crowned. Hence, it’s clear by now that dental surgeries, unfortunately, need some time to be finalized and heal in order to enjoy their effects fully.
When the jawbone structure has been regenerated the next treatment phase begins: the implantation of the dental root – the fixture (screw) of the crown into the emptied already tooth socket. Depending on the dental situation and implant system employed these can be endosteal or subperiosteal and the whole procedure may last up to 2 hours.
After the implantation, the gum and bone structure of the jaw begins the so-called osseointegration process that is the bio-integration of the implant and the natural tissue into one. One can best understand how the process works by means of observing the effects of osseointegration prosthetics. Osseointegration again requires time, usually, it takes from 3 to 6 months’ time in order to heal completely and allow for the final phase of dental implantation: the crowning of the implants with zirconium, porcelain or metal crowns.
After the gum tissue heals properly the surgeon continues his work and places the healing ring (dental implant abutment) on the implant, which will heal and allow for dental crown fitting during the next visit. After the abutment is placed the final impression is taken for the last time and sent to the laboratory. It’ll take several days for the laboratory to prepare a matching in colour and shape crown.
The three-part titanium set of a dental implant may be complemented by various dental implant abutment types. Among other material they are made of, they can be made of titanium, zirconium dioxide, gold, and aluminium oxide-based ceramic. In case of dental bridge abutments, we call the two teeth on each side of the bridge holding the middle false tooth (the so-called pontic) the abutment teeth. Again, these can be made of several types of materials, but the one most often chosen from them is porcelain.
Fitting a crown requires expertise but is a simple and painless process, leaving space for adjustments of shape, but not colour. If you wish to have all your teeth in one colour you will have to either whiten the rest of them to match the implant or order a specific colour of the crown beforehand. Properly mounted and fitted crown shouldn’t budge or cause discomfort while eating or talking, with the exception of the attachable crowns that can be taken off for night or cleaning.
It’s not so straightforward when trying to predict what to expect after dental implant surgery in each and every individual case – it all depends on the particular dental settings.
Commonly, as it is in the case of any requiring incisions, or drilling surgeries, patients may be left with discomforts like swelling of the gum tissue, oozing, face, ridge membrane, bruises on the jawbone, pain, nerve tingling, infection, minor and passing bleeding, hypersensitivity and may be advised to eat with the remaining teeth, or eat soft foods solely. Don’t fret, however – all these are common symptoms of your organism healing itself.
A typical dental implant recovery time may vary from 7 days to 2 weeks’ time for the swelling, bruises, pain, tingling and hypersensitivity to recede and allow the patient to fully appreciate his new teeth and pearly smile. The bleeding typically subsides after the initial hour or two after the procedure, if this is not the case, you should consult your specialist. Swelling may be lessened by applying ice packs, bleeding secured by gauzes, saltwater will help you rinse mouth used 2-3 times per day, and brushing your teeth during the first two days should be done gently and with caution. In general, you should try to keep your oral hygiene as best as you can in case of infection.
Smoking is highly unrecommended as it slows down the process of healing, thus it’s suggested to quit before the procedure and continue not smoking until the whole process of healing ends. The same rule applies to drinking any alcohol-containing beverages, because they slow down blood circulation, and as such, should be avoided until at least 72 hours after the operation.
A lot of patients wonder what to eat after a dental implant surgery – but the answer is intuitive: the patient cannot chew, grind properly due to post-op pain, swelling and bruises, thus liquid and soft foods are recommended to eat with the opposite, healthy part of the jaw. Making use of straws is also recommendable.
After the dental implant surgery, the patient should try to keep his oral cavity and teeth clean with gentle brushing, rinsing the mouth with saltwater, applications of ice packs on the cheeks. Avoiding solid foods will also be necessary in order not to touch the implant(s), thus any crunchy foods, chips, fries, meats, fruits like apples, bitter fruits and their offshoot in the form of juices and sauces, especially spicy ones, should be avoided.
When the post-op side-effects will subside, the patient should maintain high hygiene of teeth, if he does so, he may expect implants to last for as much as 25-30 years. Every expert in dental implant surgeries offers as well his own time warranty for the job he’s done – usually, warranties for implants are valid for 15 years, be sure to check yours. Last, but not least, periodic dental check-ups are the best way to ensure your newly installed implant will work as new for as long as it can. Be sure to book them in advance in order to keep your regained confidence and enjoy your pearly white new smile for longer.
There are of course clinics that offer immediate placement of dental implants after extraction, so-called ‘one-day-implants’ or ‘teeth in a day’, which will perform the whole procedure (excluding bone grafting) in a day’s time, resulting in a full mouth dental implants.
However, these kinds of procedures should be approached with maximum caution, because clinics offering them are fully aware that the rate of failures and complications of such procedures is highly increased in comparison to the standard surgeries. Sometimes the impatient patient, however, forgets about this simple fact. Overall, it’s really worth to be a ‘patient’ patient – statistics show clearly that it pays off in the long run, the longer the healing process, the fewer complications and the higher the success rate.
In contrast to the typical medical class implants, mini implants are almost as small as a toothpick, having 1,8 to 3 millimetres in diameter. In case of a whole tooth missing a standard implant would be recommended, despite the cheaper price of the mini-implants. This is due to the reasons that the failure rate of mini-implants installing is larger than the standard bigger implants. They usually last for 3,5 years, then need to be exchanged.
The mini dental implants cost in the UK around 50-60% less than the standard implants. However, they do have advantages as well. Instead of the invasive and painful surgery needed for installing regular implants, always involving drilling, stitches and gum surgeries, in the case of mini or midi dental implants, the surgeon has only to attach a small anchor to your jawbone. This, in turn, results in a much faster healing process and fewer visits to the dentist. The installation and mounting of dentures or false teeth on mini-implants can be performed during one visit.
On the other hand, mini implants are a more safe manner of filling teeth deficiencies than regular, attachable but often falling out dentures, because the false teeth are permanently fixed to a titanium anchor. So they provide both, more stability with the less invasive procedure and cost much less. In cases of patients with insufficient jaw bone mini implant is a great alternative to regular implants which require an additional bone graft.
As the name suggests All on 4 refers to a new set of artificial crowns made of porcelain, metal, gold, or zirconium supported by either 4 dental screws/implants. The number of screws mounted depends on the density and health of the jawbone. If the jawbone is too weak and easily eroded a bone grafting treatment (reconstruction of the bone tissue) is necessary in order to continue with installing the implants. The procedure is performed under local or general anaesthesia and the patient doesn’t feel much.
First surgery usually involved getting rid of your rotten or cracked teeth, then installing the screws. After that, the gum needs to heal. Since titanium and zirconium are the best biocompatible materials we know, there are mostly no complications and the screws heal up to 3 months’ time and are ready to attach the glimmering pearl crowns to them. The crowns and screws are made of such materials that offer density, hardiness and last long.
If the patient requires more implants in order to achieve stability of his new teeth, more than 4 implants are suggested. Then he can have not only All on 4, but All on 5, or All on 6 installed. These systems offer more stability and safety to a weakened jawbone. Usually, though, they’re unnecessary for patients with healthy bone tissue, so fewer people ask for them, especially that they also cost more.
There are more alternatives to fixed dental implants on the market. One of the most popular of these is the so-called dental bridge, which is installed on two or more implants with the upper part mounted on them technically called a tooth-supported fixed bridge, or else a dental bridge. Their goal is to hide the gap composed of more than 2 missing teeth. The false teeth in-between which are unsupported by implants are called pontic teeth and are cemented to the abutment and each other.
A traditional dental bridge uses only 2 implants to support the entire bridge with the pontics, but two natural teeth are rudimentary for side support. Such bridges characterise with durability and strength, lasting sometimes more than 10 years. Their drawback is the necessary presence of supporting natural teeth on both sides of the bridge, and can’t be employed in every medical case.
Another type of dental bridge is a version of the traditional dental bridge. Whereas the traditional tooth-supported fixed bridge with a pontic is fixed by only 2 implants on sides, the implant-supported dental bridge is reinforced with additional implants below the visible gum line. So the implant-supported system is based on a one-to-one ratio of implants and crowns, one missing tooth is replaced by one implant, though sometimes there may happen exceptions to this rule.
In the case of the so-called cantilever bridge, only one natural tooth next to the crown is necessary, and one abutment teeth supporting the crown. In many cases, patients with missing teeth resort to this type of dental bridge due to deficiencies in their dentition. Simply speaking it’s a two-teeth unit composed of one false tooth (pontic) and a fixed on an implant crown. Cantilever implants can, however, take the form of a three-unit set of two pontics on each side of the fixed by implant crown. The cantilever bridge is not recommended in the back of the mouth.
A Maryland bridge also fills in a gap of a missing tooth by means of a removable pontic, attached to and supported by two natural teeth on each side by small resin wings. In this way, a Maryland bonded bridge can be removed in order to be cleaned and doesn’t require a dental implant. In this way too, the resin-bonded bridge is cost-effective and causes no problems in installation and post-op usage if attached properly. Maryland dental bridge may be funded also by the English NHS in rare cases it is deemed medically necessary.
Another alternative to dental implants is the removable false tooth or prosthetic that patients wear for one or two arches without any fixture in the jawbone, held in place either by the tissue of the oral cavity or by bonding to the natural teeth. The upper prosthesis is called a maxillary arch, the lower a mandibular arch. They may be complete, or partial, and serve mainly aesthetic and facilitating eating purposes.
In comparison to standard implants, they are a completely non-invasive method of filling the gaps in the dentition. Their main drawback is that patients need to adapt and accustom to wearing them for several weeks’ time and the fact that over longer time they tend to slot out due to jawbone and gum tissue natural changes, hence requiring exchanging. On the other hand, they are much cheaper than implants and when got used to becoming comfortable and easily removable for cleaning purposes. They can be made of several materials such as:
How much dental implant costs for one tooth in the UK depends on many factors, some of them are often forgotten by patients. At first glance, it would seem that the total cost of dental implants in the UK (cost per tooth) is as follows: Dental implants in the UK (data collected by WhatClinic in 2016).
Newcastle Upon Tyne
So, are there cheap dental implants in the UK on offer? This might be true at least for several dental practices in the United Kingdom, however, the typical marketing price of a dental implant in the UK includes implant, abutment and crown, but excludes (hides) the costs of consultations, CBCT scans (which are rather expensive), extractions, bone graft, sinus lift, sedation and root canal treatment if necessary. These, alone, can cost you at least an additional few hundred pounds. The patient usually is informed about them at the consultations in the clinic, which is a big misunderstanding. A trustworthy clinic should be able to give its patient at least a rough estimate beforehand for the complete treatment if he provides them with an X-ray or CT scan.
Undoubtedly, there are cheap dentist practices in the UK that offer these details at a much lower rate. Such exceptions to rules exist and offer implants from £1500, but usually, they’re located outside main agglomerations and patients need to travel to them, and booking a visit with them can be very difficult.
When it comes to the cost of a full set of dental implants in the UK – with crowns and abutments – the prices can get really high, sometimes costing as much as a small car. With the upper jaw of implants costing from 9000 GBP. The lower jaw procedure is usually cheaper even up to 40% because it’s easier to install the implants, contrary to the complicated upper jaw bone structure.
Commonly dental treatment on the NHS in the UK is conditioned by the patient’s medical need, priority and benefit of the treatment to patients. Medical needs include inborn defects of the oral cavity, jawbone or dentition, but as well may be a result of cancer changes in the mouth, accidents that damaged dentition or ineptness to wear regular dentures. It helps if the patient proves that the treatment will be a major change to his dental health.
However, owing to the great demand for NHS treatments it may not be easy to obtain NHS funding. The NHS groups dental treatments by the so-called bands, which comprise of packages of medical services:
Similarly to the NHS-funded optometrist services, dental treatments offered by NHS England are not completely free but require paying fixed NHS dental charges starting from £22 for the Emergency Care and Band 1 procedures, £60 for Band 2 services, and £270 for Band 3 treatments. NHS Wales offers different fees for Welsh citizens.
Additionally, braces for adults, teeth whitening, veneers, implants aren’t considered clinically needed, treated more as cosmetic changes and they are funded by the NHS only in extreme cases. The NHS criteria for funded dental implants are based on the approved clinical need – that means a shown rudimentary medical need for the patient’s health and wellbeing, not to be mistaken for an aesthetic change owing to lifestyle goals.
Thus, dental insurance in the UK covers dental implants formally for free in extreme cases of inborn dentition, palate distortions, acquired cancer changes, or accident resulting damages, but in fact, dental implants on NHS cost is appropriate for Band 3 medical services. That means the patient not only needs to get approval from the NHS for the dental implant procedure but also needs to pay for it at least £270. Consequently, the free NHS dental implants are offered mainly in the UK NHS hospital settings, to children under 19, pregnant women, or women that had given birth 12 months before the treatment. In all such cases of funded dental treatments, the NHS covers them with a 12-month guarantee, with replacement at the same dentist for free.
US healthcare doesn’t offer such systems as the English NHS, or its German or Dutch systems. American healthcare system comprises of Medicaid, Medicare and ACA or requires private insurance in order to cover for medical services. Some companies offer private insurance packages including medical travel for financial reasons.
The EU healthcare card, EHIC may not be accepted at most UK medical practices, only in emergency situations. Sometimes it’s more likely to be accepted through your travel insurance, be sure to ask about it before you undergo any treatment. Usually, travellers from within the EU have to apply for medical care officially filling in appropriate forms accessible on the NHS website.
One rarely mentioned issue with the NHS dentists, except for the prices, is the lack thereof in some regions of Great Britain. In 2016 a report has been published by Channel 4 News on this topic, sharing stunning data.
Interestingly enough, dental implants abroad can save up to 50 or even 60% of costs. In the 2019 year countries like India, Thailand, Mexico and Turkey were the best countries for cheap dental implants. Just check the costs of a whole implant, abutment and crown procedure in these exotic countries below, but bear in mind though that dental implants installed there might be of diverse brands than those preferred and recommended in Western countries. Check the below table for prices for full sets of an implant with a crown, not the marketing numbers given only for the implant, or the crown.
£330 - £550
£640 - £730
£380 - £600
It’s easy to deduce that the prices depend mostly on the cost of living and the brands of dental implants. However, if you’re living in Europe or the Middle East and dream of the safest and quickest there-and-back type of medical travel then you should focus on the Eastern European countries, where it’s possible to find the best quality-to-price ratio. Additionally, flights to these countries are often served by cheap airline providers so it’s common to find really cheap two-way flight tickets to one of the following places:
It’s worth considering why the shown above countries offer dental implants cheap. It’s mostly not the material factor, the materials used are in majority the same as you would find in your own local clinic in UK or US, the high-tech imaging machines cost the same to purchase and maintain. What is more, the costs of production of dental implants are very similar regardless of the place you’re at – only the specialist’s charge varies from country to country and may result in more cost-effective deals. Why is it so? Is it because of lower standards at clinics abroad? You may be surprised, but some of them are as well, if not even better equipped than your local dental practice. The specialists are also very well-educated and known in their fields of specialization not only domestically. So why is there such a big price gap with regard to the same procedures?
Mainly, it is due to the costs of living and renting a place for a dental centre. In big cities like London, Paris, Berlin the costs of living are high, thus dentists try to accommodate this by raising their fees. Some decide to go for compensating costs by attracting more patients with lower prices, but these are rather few on the market. In countries like Hungary, Poland or the Czech Republic the costs of living are rather low in comparison to the UK or Germany, owing to diverse currencies in these countries and lower minimum wages.
Before planning any dental work in your jaw however, you should know what are the pros and cons of dental implants. It’s easy to assume that they would look great and workmates would die of jealousy, but dental implants have more pros than just the looks. Quite the opposite can be said about the most common consequences, side-effects, after surgery complications and problems involving dental implants – they should never be underestimated.
Dental implants cons should also be taken into consideration:
All these dental implant post-op complications should be monitored and managed by a specialist in order to repair the possible damages.
Till recently the first choice in case of deficiencies in dentition was to install a removable denture, either acrylic or metal. Nowadays, with the advancement of science and technology, the most reliable and long-lasting option became dental implants.
Who knows? Perhaps in 20 years’ time, there won’t be a need for any of them, 3D printers may print one-to-one replicas of our fallen out teeth with the same materials as they are made of. But surely, titanium, zirconium and porcelain dental implants will still be in use owing to their durability and resilience to physical damage.
For now, there are no better means of regaining your self-confidence, ability to eat again whatever you wish, talk clearly without constantly being scared that your prosthesis may fall out at the least appropriate moment.
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by admin, on 02.01.20
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