What can dental implants do for me?
If you are missing one or more of your teeth or require extraction of one or more of your teeth, implant dentistry can provide you with replacement teeth that look and feel much like your very own. One implant can be placed to support a fixed (non-removable by patient) single crown attached to the implant. Additionally, multiple implants can replace multiple missing teeth with a fixed bridge (non-removable) supported by the dental implants. You can have the confidence to pursue an active lifestyle without the aggravation or possible embarrassment of removable loose dentures. Unlike many removable prostheses, implants may enable you to enjoy the simple pleasures of unrestricted eating. Implants will not only provide you excellent function but in most cases the esthetic result will be as good or better than any other treatment available to restore your missing tooth or teeth. Dental implants may also be used to help stabilize removable dentures and therefore allow for improved function and retention of your denture usually at less cost than a fixed bridge.
Are implants safe and how long will they last?
Dental implants are extremely safe and long-lasting. They are made of titanium. Titanium is a naturally occurring element and has been proven very biocompatible and extremely hypoallergenic. Decades of documented scientific evidence has revealed a very high success rate for titanium root form implants. Recent long-term studies have shown dental implants survival rates to be well over 90%.
Our experience has shown an implant survival rate about 95%. Most dentists believe dental implants will last for many decades to a lifetime in the vast majority of patients. This excellent longevity occurs because dental implants do not decay and in most cases does an excellent job of preserving the bone adjacent to them. This longevity is one of the biggest advantages of implant dentistry over other forms of conventional dentistry. In the rare instance of a lost implant, the bone usually fills the area in a manner similar to bone filling into an extraction socket.
What are the advantages and disadvantages of dental implants?
Dental implants may have the following advantages:
1. Allow the avoidance of removable dentures
2. Eliminate the need to crown teeth if used in lieu of a fixed bridge
3. Superior longevity to conventional dentistry
4. Often less long term cost
5. Greatly increase stability of a removable denture
Dental implants may have the following disadvantages:
1. Greater initial cost
2. Minor surgical procedure required
Am I a suitable candidate for dental implants?
Almost all individuals may have dental implants. Examination and radiographs will be necessary to see if you have sufficient quantity and quality of bone. Any medical condition that significantly limits your healing capabilities or may compromise your bones ability to grow onto the implant will require careful assessment.
Is having dental implants placed painful?
Dental implant placement requires a well controlled minor surgical procedure. The majority of patients describe the procedure as comparable in magnitude to the extraction of a tooth. Most patients who have had both teeth extracted and implants placed have found they experience similar minor post treatment discomfort. Local anesthetics and analgesics should control any discomfort during and after implant placement. Patients who are inclined to have a short-acting general anesthetic or sedation for the extraction of teeth may elect to do the same for implant placement.
Is dental implant treatment more expensive than other ways of replacing missing teeth?
Initially dental implant treatment may be more expensive than other forms of conventional dentistry, but because of the excellent longevity of dental implants in the long term, implant treatment will often be less expensive. Most conventional dentistry such as fixed bridges or removable dentures, requires replacement in ten to twenty years. Re-treatment of conventional dentistry will add up over the years with regard to time in the dental chair and money. Patients who are prone to decay or periodontal disease will be at higher risk for the repair or re-treatment of conventional dentistry over the years and these patients, in particular, should evaluate the long-term impact of implant treatment versus conventional dentistry. If a patient is replacing numerous teeth and does not mind wearing a removable prosthesis, then the cost of using implants to stabilize a removable prosthesis will usually be less than a fixed (non-removable) implant bridge.
Are there any drawbacks to not placing dental implants?
Yes, there may be drawbacks. When teeth are lost the bone around those lost teeth begins to shrink. As bone loss progresses, less bone is available for placement of an implant. If too much bone is lost, a bone graft may be required to create enough bone to place an implant. Often, the more bone that is lost the more difficult it becomes to create an aesthetic restoration. The sooner one has implants placed, the easier it will be for the dentist to achieve a good result. Patients with advanced periodontal disease who are loosing bone around their teeth should consider earlier extraction of these teeth. If they wait too long, there may be less available bone for the implant to be placed. Again, either a graft may be required and/or the aesthetics may be compromised. In general, the only patients who should consider waiting before placing implants are ones whose jaws are not fully grown. Jaw growth is usually complete in females by their mid to late teens and for males by their late teens to early twenties.
What are the clinical procedures involved in implant treatment?
Implant treatment is a complex form of dentistry. Proper diagnosis and treatment planning is essential. There is the surgical phase of treatment and the restorative phase of treatment. Although some individuals perform both of these procedures, most times two individuals working closely as a team will be responsible for your implant treatment.
Most dental implants are called “root form implants” because they resemble the shape of a tooth’s root. Essentially, a carefully sized space is prepared in the bone by a series of shaping instruments. Many times an extraction socket is modified to create this space. Next, the dental implant is placed into the space. Over the next several weeks, the bone grows into intimate contact with the implant, a process referred to as osseointegration. Various types of temporary and final restorations may be attached to the implant(s) at various times. The following outlines the various techniques with regard to timing for the replacement of a single tooth with a fixed implant crown. Additionally, all these techniques can be used to treat multiple implants or even the restoration of a full arch.
When may implants be placed with regard to the extraction of teeth?
Implants may be immediately placed into fresh extraction (immediate implant placement) sites or may be placed days, weeks or years after extractions are completed (delayed implant placement).
Immediate implant placement: This procedure involves the extraction of the tooth and the immediate placement of an implant into the extraction site. The area is left to heal for several weeks while the bone bonds to the implant. During this time a temporary restoration is placed if required for function or esthetics. This temporary restoration may a removable prosthesis or a temporary tooth is bonded to the teeth adjacent to the extraction site or it may be an immediate fixed temporary restoration. This temporary restoration is used until the bone bonds to the implant at which time the final crown is connected to the implant.
Delayed implant placement: This procedure involves the extraction of the tooth without placing an implant. The extraction site is usually grafted and then the area is left to heal for several weeks so it may heal enough to have the implant placed. During this time a temporary restoration is placed if required for function or esthetics. This temporary restoration is either a removable prosthesis or a temporary tooth is bonded to the teeth adjacent to the extraction site. The implant is placed after the several weeks of healing and either the original temporary restoration is used while the bone bonds to the implant or an immediate fixed temporary restoration is placed. This temporary restoration is used until the bone bonds to the implant at which time the final crown is connected to the implant.
What types of temporary restorations may be used during the time the bone is bonding to the implant ?
Removable temporary prosthesis: As the name implies it is a prosthesis that can be removed from the mouth. They have artificial teeth on them for function and esthetics. As they require some bulk to the prosthesis for strength and stability hey take up space in the mouth. This may lead to the feeling of bulkiness and interfere with speech. They will move somewhat under function and some food will accumulate under them, necessitating their removable and cleaning at times. They require occasional adjustment and periodic soft relines as the bone and gums remodel after the tooth is extracted and/or when the implant is placed. This temporary restoration is used until the bone bonds to the implant at which time a final crown is connected to the implant.
Fixed temporary prosthesis: As the name implies it is prosthesis is fixed into the mouth and cannot be removed by the patient. They are artificial teeth that are functional and esthetic. They are similar in size and shape to natural teeth and any lost gum and bone structure that they are replacing. They do not move under function. This temporary restoration is used until the bone bonds to the implant at which time a final crown is connected to the implant.
When can a fixed temporary prosthesis be inserted with regard to the implant placement ?
Immediate fixed temporary prosthesis: The temporary is placed at the time the implants are inserted or uncovered if the case was done with delayed implant placement.
Delayed fixed temporary prosthesis: The temporary is placed after the implants have bonded to the bone. The patient has usually been wearing a removable temporary prosthesis during the time the implant has been bonding to the bone.
Is it true that dental implants will help preserve other natural teeth?
Yes. When a conventional fixed bridge is fabricated, the teeth on either side of the missing tooth or teeth must be crowned. This necessitates significant reduction of tooth structure. Dental implants can eliminate the need for a conventional fixed bridge and thereby preserve this tooth structure. Also, the bridge supporting teeth that are crowned become more vulnerable to dental decay and/or root canals. Because these two teeth are now tied together, should one crown fail at some point in the future the entire bridge may need to be replaced. Also, in patients that have lost a significant number of their natural teeth, adding some dental implants alleviates some of the forces being placed on these remaining teeth. This decrease in forces on the remaining teeth will usually improve their long-term prognosis.
I’ve been told I do not have enough bone for implants, what can I do?
As prosthodontists, we routinely consult with individuals who have been told they have no bone to place implants. These individuals with minimal bone have the most difficulty wearing a conventional removable prosthesis and therefore are the patients who would benefit most from dental implants. Great advances have been made in the last few years and with CT scans, 3 dimensional models, and coordinated treatment planning with surgical dentists. Upon collaboration with our most experienced surgeons, we often find available bone for implant placement even in advanced bone lose cases. Zygomatic, pterygoid plate and vomer implants may be used in these extreme bone loss cases to allow patients the benefits of dental implants and eliminate or minimize the need for grafting. Our practice in collaboration with experienced surgeons, take pride in finding long term solutions with dental implants with minimal or no grafting treatment in patients who were told they required extensive grafting procedures.