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Dental Implants

Over time there are a number of factors that can contribute to tooth loss. Daily wear and tear, physical trauma, or disease and infection can all result in tooth decay. When someone loses a tooth or several teeth, this can bring about unwanted changes to their appearance, negatively effecting their confidence and self-esteem. In addition, it can lead to further oral health complications. With the advent of implant dentistry, however, those who are missing teeth no longer have to accept a lifetime of embarrassment of inconvenience.

Dental implants are strong, durable, titanium posts that are rooted in the jawbone to serve as anchors for replacement synthetic teeth. These dental restorations improve the look of the smile, provide structure for the face, and prevent further infection. Below is an overview of dental implants, for more detailed information we invite you to explore our implant dentistry section.

What are Dental Implants?

Implants are small, titanium screws that are surgically implanted in the jawbone to provide a base for the placement of synthetic teeth, such as dentures or dental bridges. They can be used to replace a single tooth, or all of the teeth. Dental implants are the most comprehensive and durable restorative dentistry treatment available for patients with missing teeth.

Visit the DocShop gallery to view dental implant before and after photos.

Photo credit: Smiles on Broadway Dental Care

The Procedure

The placement of dental implants and dental restorations is a two-step process. The first step involves the surgical implantation of the titanium screws. A skilled dentist will insert the posts into the jawbone, and close the area with stitches. Once this has healed, typically in about three to six months, the patient can return to have their replacement teeth permanently placed on the implant.

Step 1: Oral Surgery

The actual oral surgery for the procedure is the most invasive portion of the entire procedure. This is performed under general or local anesthesia, depending on the number of implants being placed and the scope of the surgery. Patients can receive this care on an outpatient basis. The average surgery takes about one hour, but this varies on a case by case basis. During surgery your doctor will:

  • Make incisions in the gums where the implant(s) will be placed.
  • Use a special drill to make holes in the jawbone to accommodate the dental implant
  • Precisely place titanium rods into the created holes
  • Close the gums with stitches
  • Place temporary restorations, such as bridges or dentures over the implants, to last the duration of the healing process

Step 2: Recovery and Osseointegration

Recovery from surgery can take anywhere from three to six months, though it can take up to a year in some severe cases. During the time that the mouth is healing, a process known as osseointegration will take place. Osseointegration refers to the period of time when the titanium rod fuses together with the jawbone. Healthy bone actually begins to grow around the implant that is placed by your dentist. This creates a strong, durable root for the placement of a dental restoration.

Following post-operative instructions is imperative when it comes to dental implant surgery because this will ensure the success of the osseointegration process. In addition, this will ward off infection and speed up the healing process. If recovery is interfered with or if the titanium rods do not properly fuse to the jawbone, implant surgery may need to be repeated.

Some things that may hasten the recovery process include:

  • Thorough oral hygiene habits
  • A primarily soft food diet
  • Avoiding pressure on the jawbone
  • Avoiding teeth clenching and grinding, or gum chewing

It is recommended that you visit your dentist frequently during the healing process to be sure that no oral health complications are present. Once healing is complete, you can make an appointment for the third and final phase of dental implant surgery: implant restoration.

Synthetic teeth such as dental bridges or dentures are placed during the final phase of surgery, after the gums have healed from the initial procedure. During the healing process, your dentist will provide you with temporary restorations to preserve the appearance of your smile. Once osseointegration is complete, you can return to your dentist's office to complete treatment.

Step 3: Implant Restoration

Dental Implant Restoration

When the bone has successfully grown around the dental implant following oral surgery, the dentist will add an artificial tooth, or dental restoration, to the post. The dentist will begin by making an incision in the gum to expose the implant post, and then twisting the abutment (a small metal "connector" that holds the dental restoration) into place. Depending on the patient's needs, the dentist may suggest different types of dental implants to use.

Types of Restorations

Dental implants can be used to replace a single missing tooth or multiple teeth. If the patient and doctor decide to restore teeth with dentures - or even bridges, in some cases - several implants may be required for support.

Single Tooth Replacement

To replace only one tooth, the dentist will use a crown. The crown will be custom-crafted to blend seamlessly with the other teeth, in both shape and color. Crowns are composed of ceramic, porcelain, or metal. Metal crowns are more durable than porcelain or ceramic, and are usually placed on back teeth, which endure greater pressure from chewing and biting, and are usually hidden from view. Porcelain or ceramic crowns look more natural than metal, and are usually placed on front teeth.

Implant Supported Bridges

If multiple teeth need to be replaced, the dentist may use a dental bridge that fits over several teeth. The implant-supported bridge is similar to a regular dental bridge, except that it is anchored to the implant instead of other teeth. The dental restoration will match the shade of the surrounding teeth so they blend in perfectly.

Implant Supported Dentures

In some cases, the dentist can attach a full set of dentures to the lower or upper jaw. Traditional dentures are crafted from either a durable plastic or porcelain. After the prosthesis is crafted and fitted for the mouth, the dentist will attach it to the abutment.

After the restorations have been placed, the entire procedure is complete. Patients are able to leave the dental office with a brand new, restored smile that they can feel confident about. These new teeth will look natural, feel comfortable, and allow for normal smiling, chewing, and speaking. The implant dentist will recommend regular appointments every few months to check the implant and perform a professional cleaning. This will ensure that the implants and dental restorations are long-lasting.

Types of Implants

For patients who are missing teeth, implant dentistry offers the opportunity to once again have aesthetically pleasing and functional teeth. A single dental implant or multiple dental implants can be secured to the jawbone and capped with natural-looking prosthetic teeth for a comfortable, confident smile. Although all dental implants serve the same goal, there are several different types of dental implants that can be used. Your surgeon can help you decide which option is best for you. This section contains information about the most common types of dental implants:

Root-Form Titanium Implants

Root-form titanium posts are what most people think of when they think of dental implants. These are also known as endosseous or endosteal imlants, because they are implanted directly into the bone. These tiny posts resemble screws, and are made of corrosion-resistant titanium. In order to receive root-form implants, you must have a sufficient amount of jawbone for the posts to be inserted. During a process known as osseointegration, the root-form titanium posts will fuse with the bone, creating a strong anchor for the placement of a dental restoration.

Sub-Periosteal Implant

Unlike other types of dental implants, sub-periosteal implants are placed on top of the bone, not inside. This is ideal for patients who do not have enough bone material to support an endosteal implant. A model of the jawbone will be created during an initial dental visit and sent to a laboratory where a custom implant will be created. During a second dental appointment, a qualified oral surgeon will place the implant on top of the bone, but under the gums.

Plate-Form Implant

Plate-form dental implants are usually recommended for individuals who have a particularly narrow jaw bone and are unable to undergo a bone grafting procedure. This type of dental implant is long and rectangular. In addition, it has two prongs on the end that stick up into the mouth and provide an anchor for the artificial tooth to be placed.

Ramus-Frame Implant

Commonly used in patients with a thin lower jawbone, ramus-frame tooth implants are placed in the jaw at the back of the mouth and near the chin. Full or partial dentures are then made to fit on the thin metal bar that is visible above the gum tissue, once it heals.

Visit the DocShop gallery to view dental implant before and after photos.

Photo credit: Dr. Dianna Lenick

Aftercare

The titanium screws that are implanted into the jaw bone are designed to last a lifetime when they are cared for properly. In addition, while dental restorations may become worn or damaged over time, this can easily be fixed without invasive surgery.

Special Instructions

One of the most important ways to avoid complications following implant dentistry is to closely follow your dentist's instructions for post-operative care. Being diligent about rinsing the mouth, brushing, and flossing is the only way to avoid implant failure. In the days after the dental implants procedure, your dentist will instruct you to:

  • Take a prescribed antibiotic
  • Rinse with medicated mouthwash
  • Consume only soft foods
  • Stay hydrated
  • Limit physical activity to avoid bleeding

The Importance of Implant Care

For implant dentistry patients, oral hygiene becomes even more important than it was with natural teeth. This is because the gums and bone have been altered, and symptoms of infection become much more difficult to detect. In addition to adopting daily habits that will preserve their restorations, patients should receive dental X-rays every 6 months to detect signs of dental implant failure. Other instructions that patients should follow, include:

  • Brush at least twice a day around the prosthetic teeth, gums, and abutments
  • Floss frequently to prevent plague from building up, which can lead to gum tissue inflammation and decay.
  • Visit the dentist regularly for check-ups, professional cleanings, and preventive care.
  • Avoid certain foods, including extremely sticky or sugary foods.
  • Avoid Smoking
  • Avoid teeth grinding and clenching, or any other movement that may put too much pressure on the implant.
  • Follow the instructions of their dental implant specialist.

Restoration Replacement

How old a restoration is, the amount of pressure it is succumbed to, and overall oral health all affect how long a crown, bridge, or denture will last. Even with excellent oral care, there are some instances in which a restoration may become worn or damaged. Replacing the restoration is also an important part of preserving your oral health. Should a restoration crack or break, it can be easily replaced by a qualified dentist. Unlike the initial surgery, this does not require opening the gums, and is a non-invasive, pain-free procedure.

Can Dental Implants Fail?

When placed by a qualified dentist or oral surgeon, nearly 90 percent of dental implant procedures are successful. However, as with all other surgical procedures, there is a risk of failure. A lack of insufficient bone or infected tissue can cause complications with the procedure. Caring for your oral health after dental implants are placed will significantly increase the chances of success.

Cost

In addition to being the most comprehensive restorative dentistry treatment, implants are among the most costly as well, ranging from $2,000 to $4,000. The total cost of the procedure will vary based on the number of teeth being replaced, the type of restoration being used, the geographical location of the surgeon, and the experience of the surgeon. Fortunately, financing is available for people who require this procedure, and many dentists work with their patients to develop payment plans. 

What Makes a Good Dental Implant Candidate

Although the main characteristic that would cause a patient to receive dental implants is to be missing several or all of their teeth, there are many other factors to consider before undergoing dental implant surgery. In addition to being in good general health, dental implant candidates should:

  • Have sufficient jaw bone structure to support an implant
  • Address any gum or tissue infection prior to surgery
  • Be able to follow through with the entire procedure, which takes place over several months
  • Adopt good oral hygiene habits
  • Understand the risks involved with oral surgery

Visit the DocShop gallery to view dental implant before and after photos.

Photo credit: Smiles on Broadway Dental Care

Determining Candidacy

Only a certified dentist can identify whether a patient is truly qualified for dental implant surgery. Prior to receiving dental implants, patients should be thoroughly examined by a dental implant specialist. This will include CT scans to check on the condition and density of the jaw bone, x-rays to identify any decay in existing natural teeth, and an examination to search for lingering signs of gum disease. Patients who wish to receive dental implants must first receive treatment for tooth or gum decay. This will help ensure successful implantation.

Bone Grafting

The most crucial requirement of dental implant candidates is for them to have adequate bone structure to support the titanium posts. Dental implant surgery actually involves a process known as osseointegration, in which the post fuses to the bone, preserving its structure and giving strength to synthetic teeth. In the event that a patient who has lost their teeth does not have sufficient bone, bone grafting may be performed. This procedure rebuilds the jaw, by moving bone from one area of the body to the mouth. The bone that is being moved typically comes from the actual implant patient, either from their mouth or other areas of the body such as the hip or leg. In instances where bone cannot be taken from the patient, a dentist may use synthetic bone. The bone grafting procedure is done several months prior to implant surgery to ensure the area is healed before implantation. A successful bone grafting surgery makes dental implants available to patients who have experienced significant bone deterioration.

Who is Not a Good Implant Candidate

While dental implants are perhaps the most durable and aesthetically-pleasing option for patients who are missing teeth, they are not right for everyone. Some habits and conditions can put patients at risk both during and after the actual surgery. Individuals who may not be candidates for the procedure include:

  • Smokers or heavy drinks, as both may inhibit healing time
  • Minors whose jawbones have not fully developed
  • Individuals with auto-immune deficiencies or diseases such as diabetes
  • Patients with irreparable bone loss

Benefits and Risks

Dental implants have cosmetic and functional benefits. In addition to restoring the appearance of the smile, implants provide strength for daily activities such as chewing and talking. They also improve the overall health of the mouth and prevent jaw disorders such as TMJD. However, the procedure does carry some risks, such as implant failure. It is important to undergo a thorough examination prior to receiving implants in order to determine if you are a viable candidate.

Alternatives

Although implant dentistry is an effective treatment, they may not be right for everyone. It is important to know that there are other options for restoring your smile after tooth loss. These options include full and partial dentures, and fixed dental bridges.

Find a Dentist Near You Through DocShop

DocShop presents the above information as an overview of this life-changing treatment. For more detailed information, we suggest that you use our online directory to contact a dentist experienced in implant dentistry. Let DocShop provide you with a list of implant dentistry professionals who are geographically convenient to you.

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