Services
Periodontology, implants and dentures
The periodontology, implants and dentures department trains (postgraduate) students and provides clinical patient care. Patients can come to the department for treatment of gum problems. These can be very varied and involve bleeding and inflamed gums, loosening of teeth due to gum recession or bad breath.
Also, lost teeth can be replaced with implants. The department has built up expertise in prosthetic restoration using removable teeth, implant-supported crowns, bridges or implant-supported click or overdentures
The department provides specialist care for the above problems and is coordinating trainee centre for the specialist periodontology course. There is multidisciplinary cooperation with other departments of the Clinic for Dental, Oral and Maxillofacial Diseases or of UZ Gent, especially in complex or compromised problems.
Patients can visit the department after being referred by the home dentist or on their own initiative.
Periodontology
Treatment of gingivitis
The treatment of gingivitis involves thorough cleaning of the teeth above the gums, and improving oral hygiene. This can almost always be done without anaesthesia. Soon after treatment, the gums will regain their healthy, pink colour and stop bleeding when brushing.
Treatment of periodontitis
Periodontitis involves thorough cleaning of the teeth both above and below the gums. During the procedure, the gums are locally anaesthetised so that the treatment can be completely painless. This is usually done in two sittings, first treating the left and then the right side of the mouth.
When periodontitis is more advanced, it may be necessary to open the gums between the teeth to properly remove all inflammation. This involves placing some stitches, which are removed after a week.
After treatment, the inflammation will disappear from the gums. This may result in part of the tooth neck being exposed, which may be accompanied by increased sensitivity to hot and cold. However, the tooth adapts itself, and the sensitivity therefore usually disappears after a few weeks.
Successful periodontal treatment is always the result of good cooperation between the treating dentist-parodontist and the patient. Dentist appointments are completely useless if the teeth are not properly maintained afterwards. The dentist makes the mouth infection-free, but it is up to the patient to keep the mouth infection-free
Implants
A dental implant is a titanium artificial root, usually screw-shaped, that is placed in the jawbone. Titanium is a material well accepted by the body. It is also used in other medical applications such as pacemakers, hip and knee replacements and in stabilisation of fractures.
Implants can replace one or more teeth:
- solitary tooth
- partial bridge
- full bridge
- overdenture with immediate loading
Preparation
The placement of dental implants is preceded by a thorough examination. A dental implant can only be placed in a healthy, inflammation-free mouth. This is important to prevent long-term problems. After all, around an implant a 100 times less bacteria are needed to cause an infection than around a tooth. Bacteria can easily move from other places in the mouth to the implant surface via saliva. Hence the importance of treating any periodontal problems or caries first.
In many cases, implants are the first choice to replace a missing tooth in patients who go for fixed restoration. After all, the often intact neighbouring teeth do not need to be grinded down to make a classical bridge. But there are also indications where a classical tooth-supported bridge is the better option. During the initial examination, all factors are taken into account and the best solution is sought together with you. This is therefore not necessarily a dental implant.
To safely place a dental implant, a cone beam CT is also taken. These 3D images allow us to evaluate the implant placement site in detail. Sometimes there is insufficient jawbone present and the jawbone has to be widened with bone particles to obtain a good result. The main advantage of this technique is that anatomical structures such as nerves, blood vessels and the sinuses can be exactly located. This reduces the risk of a complication to an absolute minimum.
Placement of an implant
A one-hour appointment is scheduled for implant placement. Sterile work is performed at all times to prevent foreign bacteria from entering the jawbone.
The gums are anaesthetised locally, as with a tooth filling or an extraction. Afterwards, a hole is prepared in the jawbone into which an implant is inserted and the gums are then stitched around the implant. In ideal cases, a temporary tooth can be placed on the implant immediately. This is often done when incisors are lost so that aesthetics are restored as quickly as possible.
Evaluation
Depending on the quality of the jawbone, the implant should grow or integrate for 2-3 months. After that period, a check-up takes place. If the implant has grown in well, we can proceed with fabricating the dental crown on the implant.
In 1 to 2 per cent of the cases, this healing may be disrupted causing the implant to be rejected. If this happens, a new implant is placed under warranty.
Aftercare
Placing an implant is well tolerated by most people. However, painkillers may be necessary for the first few days. It is important to take some precautions on the day of the procedure to avoid post-operative bleeding (do not rinse, do not eat or drink too hot, no physical efforts). If these precautions are followed, the risk of post-operative bleeding is low. After a week, we see the patient again to remove the threads and check the healing.
The implant will integrate into the jawbone for 2-3 months. This integration is monitored both clinically and radiographically. If everything goes well, your dentist can start fabricating the dental crown. After dental crown fabrication, good oral hygiene is very important to maintain the obtained result in the long term. Especially daily cleaning with interdental brushes is essential.
Dentures
Dental replacements can be placed permanently on existing teeth (crowns and bridges on your own teeth) or on artificial roots (crowns and bridges on implants). However, sometimes there are insufficiently strong teeth or there is insufficient jawbone to place multiple implants. In these cases, removable prosthetics can offer a worthy alternative. Moreover, it is often a budget-friendly solution, and removable prosthetics are partially reimbursed by the RIZIV for those over 50 years of age. In addition, the combination of a limited number of crowns or implants with a removable prosthesis is also possible.
There are two types of removable dentures
- The total prosthesis
- The partial prosthesis