Implant

Dental implants

A dental implant is nothing more than a titanium screw that is placed into the jaw bone. It acts as an anchor for a false tooth or a set of false teeth. When a dental implant restoration is perfectly constructed, neither the patient nor anyone else should have any hint that an implant is there... All people should see is the "tooth".

Who is a candidate for dental implants?

Anyone in reasonable health who wants to replace missing teeth. You must have enough bone in the area of the missing teeth to provide for the anchorage of the implants. Some people are missing all their teeth and most of those are excellent candidates for dental implants, but today we use implants to replace small bridges, removable partial dentures and even missing single teeth. If a patient does not have enough bone to support a dental implant, bone grafts can be placed.

What is the success rate of dental implants?

The success rate is very high, normally between 90-98%. From case to case it can be different outcome. The dentist will inform you after your first examination, including scan and x-rays to see the quality of your bone. Then he will be able to tell you more about the conditions in your case. Unsuccessful cases are very rare and are mostly depending on bone quality or body rejection due to infection.

Why have dental implants become so popular?

As our life span increases, the need for some type of permanent dental replacement system becomes very important to our overall health. Dentures and removable bridges have obvious problems as they are loose and unstable. Implants can provide people with dental replacements that are both functional and aesthetically pleasing. The demand was always there, we just needed the tools to fulfill that demand. Patients usually say it is the best thing they have got since they lost their teeth.

Does it hurt to have dental implants placed?

The actual procedure to surgically place a dental implant is done under local anesthesia and is generally not at all painful. When the anesthesia wears off about three or four hours later, you might expect some discomfort. The level of discomfort is quite different from patient to patient, but most patients do not have significant problems. Some patients do have varying degrees of pain or discomfort which may last for several days. One or two paracetamol is usually enough to deal with the first discomfort experienced. Swelling and bruising may also develop.

What happens if I have dental implants and they are rejected

Occasionally dental implants do fail or, as some people say, they are rejected. In many instances, they can be replaced with another implant, usually of a slightly larger size. Failure rates should be about 1-5%. This might be somewhat higher in smokers and people with compromised immune systems. The key element to determining implant success is proper diagnosis and treatment planning.

Do I have to go without my "teeth" while the implants are bonding to my jaw

Once again, the original protocol called for patients to go without wearing their dentures for at least two weeks after implant placement. Over the years, this has been modified considerably and, in most situations, patients leave the office wearing their teeth the day the implants are placed. Every patient and procedure is evaluated separately and there might occasionally be a recommendation that a patient go without their prosthesis for a short period of time. You may also have to be on a soft diet for a period of time after implants are placed.

Bone Graft

Sometimes your bone needs more support to carry the implant. The procedure of building up the bone is known as Bone Grafting. Bone grafting is a very common procedure in dentistry but it does not mean you nessecarily need it. The dentist will inform you about your needs after a proper examination.

A Bridge or a Dental Implant

Perhaps one of the most frequently asked questions on this site is whether or not to use a fixed ("permanent") bridge or a dental implant to replace one or two missing teeth. Suppose you are missing your lower left first molar. If a fixed bridge were to be used, your dentist would cut down the adjacent teeth (the second molar and the second bicuspid) and fit a three unit fixed bridge over those two teeth. The missing tooth would be called a pontic and it would be effectively replaced by the three unit bridge. If your dentist were to use an implant with a crown on it, he would place an implant in the site of the original first molar. He could do this immediately or at some date after the first molar was removed. There is no time limit here. The implant will take about 3 months to connect with the bone and then at that time, your dentist can construct a single crown on the implant to replace the missing first molar. The cost of each one of these procedures varies from practice to practice, but a three unit fixed bridge costs about the same as an implant and a crown. The actual decision to do one over the other rests with you and your dentist. One technique is not inherently better than the other and each depends upon how you present and your dentist's skills. All things being equal, I would usually prefer to place the implant and crown instead of the bridge.

Teeth in A Day. . .

Competition among dentists has resulted in developing ways in which we can make dental implants more attractive to our patients. Dentists have come up with things such as "Teeth in a Day", "Teeth Today" and even "Teeth in an Hour". The goal of all of these protocols is to get the patient their "Teeth" fast and efficiently. The problems with these protocols are that they are directly against the original 'Brånemark' protocols that gave us the first really successful dental implants and they bypass the basic tenets of sound implant placement and good prosthodontic judgment.

True, these procedures do work out in some cases, but they always carry a higher failure rate and a greater overall expenses. They may lead to an actual time of treatment that is much longer than more consevative protocols. Over the years, I have done a number of these cases with fairly good results. I picked my patients very carefully to use only the ones who I felt would lend themselves to these techniques and have generally avoided the failures that some of my collegues experience.

When all is said and done, I recommend to my patients to do this with the tried and true conservative method which, while it takes a little longer, always results in a superior restoration and a happier patient.