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A guide to Dental Implants

Loosing teeth is a common occurrence. It happens ever day, in every part of the world. Tooth loss can occur via trauma (ie. where the teeth are knocked out) or as a result of tooth decay, gum disease or simply old age. When teeth are lost, they need to be replaced, for functional and aesthetic reasons. The most common treatments for replacing missing teeth involve getting a denture or a fixed bridge. A must more attractive option for replacing missing teeth, and an alternative that is definitely becoming more mainstream and popular, are dental implants. Dental Implants provide a long term solution, they prevent bone loss and preserve nearby healthy tooth tissue.

What is a dental implant?

A dental implant is an artificial titanium screw, which acts as a substitute for the root portion of your natural tooth. The dental implant is anchored into a socket, which is pre-drilled into the jaw-bone, and it supports a crown, bridge or secures a denture firmly in place. As mentioned above, implants are made from titanium, which is well tolerated by the bone and integrates very well with the bone tissue. During placement of a dental implant, the goal is to attain as close contact as possible between the outer surface of the implant and the bone tissue which surrounds the implant so they can fuse together. This fusion process is called osseointegration. This creating a secure and stable support for the new teeth.

How is a dental implant placed?

Before any implants are placed, it is important for your dental implant specialist to assess the level of your tooth and gum health. If your dentist finds any signs of decay or gum disease, these must be treated first. After this, your dental implant specialist will take several x-rays and perhaps a CT scan to determine your bone quality and check for nearby anatomical structures to avoid before drilling, before commencing surgery. The dental implant procedure is usually carried out under local anaesthesia, IV sedation is sometimes used if it is a long procedure or the patient is very anxious, however, this is usually not necessary.

The gum where the implant is to be placed is cut and lifted. A small hole is then drilled inro the jaw-bone at the exact location where the intended implant is to be placed. The titanium implant (which looks like a screw) is then tightly and securely fitted into this newly dilled socket and the gum is stitched back over the implant. If, upon x-ray examination, it is discovered that there is not enough bone material to accommodate the implant, a bone graft may be required, or the implant specialist may use a smaller sized implant, called a mini implant, if this is deemed suitable.

Once the implant has been placed, it is left to heal and integrate into the jawbone for about six weeks to six months. During this time, the bone tissue will grow and attach itself into the microscopic rough surface of the implant.

During the healing period, patients are given temporary teeth, such as bridges or they may continue to wear dentures. It is vital that temporary teeth do not exert any force on the healing implant. After the healing period, the gum is again lifted and a post is attached to the dental implant with a temporary crown. Four to six weeks later, when the surrounding gum tissue has healed and matured, the final permanent tooth restoration (false tooth) can be attached to the implant, giving you a fully functional, comfortable, permanent and aesthetically pleasing teeth.

What are the advantages of dental implants over dentures and bridges?

  • Reduced bone loss
    Under normal circumstances, the bone tissue which surrounds the root of your tooth is maintained by ones body’s natural renewal process. If you loose a tooth, you are left with a hole where the root of the tooth used to reside. As a result, the bone around this area will gradually begin to disappear. This process is called atrophy, and could change the shape of your jaw, causing it to shrink. This unfortunately has the effect of making one look older, as the area around the mouth can sag as bone is lost. Certainly not a desired effect! A dental implant placed in this area can stimulate bone growth and production, which prevents loss of this extremely valuable bone structure. In some patients who have lost a substantial amount of bone, a bone graft could be required before placing the implant. Bone loss is usually a problem for those who have dentures, and because the jaw shape changes slowly, dentures need to be re-adjusted or re-made to fit the new shape of the jaw.
  • Better function
    Once implants are integrated into the jaw-bone, they function just like natural teeth. You can eat any food your heart desires, as well as speak with utter confidence. The disadvantages of dentures are that eating hard foods like an apple can be a problem. The dentures can become loose and the forces biting can cause pain in the gums. As a result of this, irritation and inflammation of the gums is a common discomfort amongst denture patients. Dentures can be supported by dental implants or mini-implants. These will vastly improve denture function, thus enabling patients to eat the food they want with confidence without having to worry about bone loss and loose dentures falling out.
  • Greater dental hygiene
    Bridges and dentures require special cleaning instructions and extra attention, this can be a pain. Dental implants on the other hand only need regular brushing, flossing and dental hygiene appointments, just like your natural teeth.
  • No need to drill away at healthy teeth
    When replacing missing teeth with bridges, the teeth next to the gap need to be prepared and healthy tooth structure is removed in order to accommodate a crown or bridge abutment to fit over the top of the tooth. In the future, if one of the supporting teeth is damaged, the entire bridge restoration will also be compromised. With a dental implant, the restoration is completely independent of your other teeth. By replacing lost teeth with a dental implant, no support is required of the surrounding teeth, and your natural teeth do not need to be altered in any way
  • Improved aesthetics
    When performed correctly, a dental implant is indistinguishable from your adjacent natural teeth. Dentures can come loose and look unnatural if they do not blend with your gums, and some bridges and dentures have ugly metal clasps that hold them in place. Dental implants provide a much better cosmetic and functional result.

How many teeth can a dental implant support?

Traditionally, a dental implant placed into your jaw-bone supports one crown. This is called a single tooth implant. If on the other hand, you have numerous missing teeth, you do not necessarily need a dental implant for every missing tooth. One dental implant can actually support several teeth, through a bridge or denture. The number of implants you need will depend on the volume and density of the bone tissue that is available on each implant site. It is often the case that  smaller-sized mini-implants are used in order to secure dentures in place.

Where one needs a full mouth reconstruction, where numerous teeth, usually ten or more are missing, an arch needs to be supported, a minimum of five to six implants in each jaw is required in order to support the load. The number of dental implants needed depends on the individuals case and the implant surgeon would be able to advise you on the optimal solution having performed a thorough examination and assessment of your individual case.

Am I a suitable candidate for dental implants?

Anyone at any age is eligible for dental implants as long as they have a fully developed jawbone, and a sufficient quality and quantity of bone tissue available. Most healthy individuals that maintain a good oral hygiene routine are suitable dental implant candidates. Instances that have an increased risk of implant failure, or circumstances where dental implants may not be the best option, include:

  • Heavy smoking – hinders and slows down the healing process.
  • Excessive alcohol intake – this disrupts the gums from healing.
  • Periodontal gum disease – gum disease has be treated prior to any implant procedure in order to ensure the long term success of the treatment. Periodontal disease is a major cause of bone loss, which would hinder the success of the implant procedure.
  • Immuno-compromised individuals -anyone on steroids, any auto-immune diseases, or patients undergoing radiation treatment.
  • Teeth grinders (bruxism) – a night-time splint should be fitted to treat this.

How will I know if I have enough bone for implants?

Your dentist can asses your bone volume and density as well as adjacent anatomical structures to avoid, such as nerves, by performing a combination of X-rays and a CT scan.

What if I don’t have enough bone for dental implants?

Your alternatives include dentures and bridges for replacing missing teeth. There are several bone grafting and tissue regeneration techniques that can be performed to enable you to get the dental implants that you deserve:

Sinus augmentation – in the case of implants being required at the back of the upper jaw, new bone in the sinus can be created, which increases the height of the bone available for the implants, this is called a sinus augmentation.

Onlay grafting – this is where a piece of bone is taken from another part of the body and is secured over the area deficient in bone. With time, the newly placed bone fuses with the underlying bone. This creates a better environment for the implant to be placed.

Where can bone be taken from for the graft?

The best source of bone for your graft is your own bone tissue from somewhere else in your body. Bone can be taken from the chin, the back of the lower jaw, the hip and the tibia. Bone taken from your own body is the most suitable and heals faster compared to alternatives. Often, a combination of artificial bone substitutes and your natural bone is used. In any bone grafting procedure, the grafted bone provides an anchor and stimulus for the existing bone to grow onto, thus providing an environment suitable for the placement of implants.

How long do dental implants last?

Dental implants have been used for over 30 years and can last a lifetime. This all depends on how well you look after them. Like any other restoration, your implant supported teeth can still be damaged by trauma and can be affected by gum disease or poor oral hygiene.

How much do dental implants cost?

Dental Implants USA, a dental implant specialty practices, you can get your dental implants at wholesale price. This makes Dental Implants even more attractive, since the main drawback to getting dental implants is their cost. Call (310) 278 66 30 for further information.

About the Author

Dr. Shlosberg received his dental training in England and maintained a private practice in London’s West End before continuing his training at the University of Indiana where he specialized in Prosthodontics. He was appointed to full time academic positions in restorative dentistry at Harvard University School of Dentistry, Boston and the University of Southern California over the subsequent eight years. Dr. Shlosberg’s private practice in Beverly Hills is devoted solely to prosthodontics and implant dentistry, focusing on planning, placing, restoring and maintaining dental implants. He has been exclusively in Beverly Hills prosthodontic practice for over ten years.

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  1. Implants are placed to restore teeth, which are missing or have been extracted. The dental implant offers the opportunity to regain normal function of the tooth with out being forced to resort to a bridge or partial denture. Dental Implants are becoming more popular in today’s society and are a wonderful option to restore your smile.

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