Dental Implants – A Patient’s Guide to Understanding Treatment
Dental implants are becoming increasingly popular today for several reasons and they have transformed the landscape of dentistry. Over the last two decades, dental implants have revolutionized teeth replacement practices in dentistry.
Historically, the first recorded attempts of implant dentistry dates back to 600 AD during the period of Mayan civilization. In cases where natural teeth have been extracted or are missing, dental implants offer you a stable base for new restorative teeth. An implant provides stability and comfort. By virtue of the artificial tooth it supports, an implant is a restoration that is closest to natural tooth. In addition, these implants do not decay and are relatively free from developing gum diseases.
As much as implant dentistry is about science, it is about art and experience too. It is a combination of research, discovery, understanding, and more importantly, application in clinical practice. Dental implants are considered the standard of care in dentistry for any edentulous area. This guide will provide an overview of dental implants to help equip yourself with the knowledge you will need to make an informed choice together with your dental care expert.
What is a Dental Implant?
Your natural tooth is made of two main parts: a crown, the part which shows above your gum line and a root, the anchor that is suspended in the bone by a ligament. When a tooth is missing, a dental implant serves to replace the root and is anchored in the jaw bone. Dental implants are manufactured anchors that resemble small screws or cylinders. These implants integrate or fuse into the bone through a process called as osseo-integration. After attaching to the jaw, implants serve as the foundation for fixing one or more artificial teeth (termed dental crowns).
Implants have been around in dentistry for several decades to replace one or several missing teeth in patients of all ages. They have also been utilized to support full or partial dentures. The implant and the crown together help patients gain back the ability to chew food comfortably and restore sunken facial features that missing teeth might have caused. Implants and crowns, unlike dentures, do not have to be removed for cleaning and soaking every night. No adhesives are required either.
Dental implants are artificial replacements for natural teeth roots and can be used for both upper and lower jaws. Pure titanium is the most common type of metal used for manufacturing dental implants. Titanium is osteophilic and is easily accepted by the body. Having become the new standard of care for tooth replacement, dental implants can look and feel like natural teeth, and last a lifetime with proper care.
Advances in Implant Dentistry
Since dental implants were introduced into dental practice in the late 1970s, they have undergone various improvements, especially in terms of design. Research and clinical use have led to:
Improvements in aesthetic design – Dental implants, as they emerge from the gum tissues, have an improved appearance and resemble natural teeth. The improved connections from implants to crowns and the materials used for fabricating the crowns mimic those of the natural teeth exactly while providing the same level of functionality, aesthetics, and durability.
Improvements in shapes and sizes for different tooth size replacements –Dental implants are manufactured to fit different widths and together with improved surface characteristics, they facilitate maximum contact between the implant and bone. Teeth in different areas of the dental cavity are designed to perform different functions. Mimicking these accommodating abilities of natural teeth, dental implants are designed to mirror the functions as closely as possible.
Improvements in surface characteristics – Nanotech, sandblasted, acid etched surfaces have replaced the traditional smooth and polished design. This novel improvement increases the microscopic surface area of the implants resulting in a significant improvement in the degree of attachment with the bone. The technical advance also improves the success rate of the osseo-integration process even in those patients with low bone density.
Types of Implants and Restorations
There are over 40 types of standard or traditional implants in use today. Your dentist will choose the appropriate type of implant based on your dental condition. The common types of implant restorations include:
- Single tooth replacements – use one implant and supports one crown.
- Multiple tooth replacements – replace multiple missing teeth through multiple implants. To replace a full arch of missing teeth, four to eight implants may be required.
- Temporary bridgework – utilizes micro implants that are removed after permanent implants heal and the teeth are permanently replaced. This is a socially comfortable and a fully functional option which ensures the patient has teeth at all times.
- Anchorage for tooth movement – involve standard, mini, or micro implants that serve as stable and non-movable units for easier and quicker tooth movement.
- Over-dentures – standard or mini implants, where more than two are required, are placed to offer stability for the denture and preserve underlying structure.
- Fixed and removable bridgework combinations – involve implants to support a section of bridgework to which a removable fixture (such as a removable partial denture) is attached.
The Implant Process
The implant procedure is generally the same whether you have one or all missing teeth. Treatment is a three part process that happens over a period of several months.
1. Diagnostic Steps
As the first step, your dentist will follow routine procedures to assess your overall general health and medical status. The dentist will then examine your mouth, assess potential sites for placing the implant, study models of your mouth to understand bite, take photographs in case there is an aesthetic concern, obtain x-rays of the site to determine bone quality and quantity, and if necessary make surgical templates to ensure precise implant placement. He will also discuss the risks and benefits of the procedure with you.
2. Surgical Steps
Dental implant surgery is carried out under anesthesia. The step-by-step procedure that follows is briefed here:
- Preparing the site – The gum tissue is opened to expose bone and the underlying bone is prepared using a drill to receive the implant.
- Placing the implant(s) – After the site and the bone have been prepared, the dental implant is fixed and the tissue is joined with a suture.
- Osseo-integration or the healing process – The healing process typically takes 3 to 6 months and the implant gradually becomes part of the lower jaw. Your dentist will however remove the suture within a few weeks after surgery.
- Attaching the post – After the site has completely healed, a special post is attached to the implant. This post serves as a support for the crown. Today, zirconium abutments are often attached to the posts to ensure the new crown possesses translucent properties closely matching natural teeth. After it heals, the implant and the post serve as the foundation for the new crown.
- Placing the crown – Once your dentist takes impressions of your teeth, crowns are made to match the color, shape, size, and fit of your natural teeth. The crown is attached to the implant post.
The completed prosthetic crown looks and functions like natural tooth.
Success of Dental Implants
Dental implants are one of the most successful techniques in the field of dentistry. When implants are used in the right situation, the success is in high nineties. The following factors decide how successful an implant will be:
- Careful diagnosis and understanding of the site where the implant is going to be placed and how the site relates to the functioning of the remaining teeth
- The clinical experience and joint efforts of the implant team including the dental surgeon, dentist, and technician.
Once the implant is integrated and begins to function completely, these tooth replacements can last a lifetime.
If you have missing teeth which is affecting your confidence and quality of life, don’t hesitate to get in touch with your implant dentist as soon as possible.