Dental Implants – General Information
Dental Implants are one of the greatest and most revolutionary advancements in dentistry.
Dental Implants are artificial roots that replace missing natural teeth. They transfer the load directly to the jaws, unlike a bridge that relies on remaining teeth to carry the forces.
Dental Implants can be used to …
- Replace individual missing teeth. A dental implant is used to support an artificial crown.
- Replace multiple missing teeth. Two or more dental implants are used to support either individual crowns or a bridge.
- Support and stabilize a partial or full denture.
When dental implants are used to replace missing teeth, the other natural teeth are not involved. They can be placed in most areas of the mouth where teeth are missing. Dental implants can work independently of each other, unlike other types of replacements, which depend on several teeth for support.
The success rate for dental implants is in the 95-99% rate long term. Their success rate is so high that replacement of missing teeth with dental implants has become the treatment of choice in situations that used to involve complex dentistry on questionable teeth.
Dental Implants Case Example 1 – Single Tooth Replacement
This patient had fractured the root of her upper canine. A dental implant was placed to replace the extracted root. This photo shows the healing abutment in place.
Once the implant had integrated, the healing abutment was replaced with a Zirconium abutment, which was shaped to support the replacement crown.
A porcelain crown was cemented over the abutment, restoring her pretty smile.
Dental Implants Case Example 2 – A Bridge on Dental Implants
This patient was referred to me for dental implants. She had a fractured root on one of her teeth and two other teeth could not be restored.
I placed two implants that are supporting a three-unit bridge. She now has her smile restored and has avoided the need for a denture.
Dental Implants FAQ
What is a dental implant?
A dental implant is a titanium screw that is inserted into the bones of the jaws. The implant can support a single replacement tooth (dental crown) or a set of replacement teeth (dental bridge). The process by which the implant fuses with the jawbone is called ‘osseointegration‘.
What are dental implants made of?
All dental implants are made of titanium, usually with some sort of surface treatment to enhance the osseointegration. Titanium is the metal used in joints replacements, such as hips, knees, shoulders and other joints as well as for the reconstruction of shattered bones. The body tolerates titanium very well with no known instances of rejection or allergy.
What are the benefits of dental implants?
Dental implants are of great benefit to people requiring a solution to the problems caused by loss of teeth. These benefits include:
- restored ability to chew;
- improved speech;
- improvement of facial aesthetics;
- preservation of remaining jaw bone structure; and
- reduction of problems associated with teeth in poor health, such as gum problems, loose teeth and infections.
With these benefits, patients enjoy increased confidence and a great boost to their self-esteem
Who is a suitable candidate for dental implants?
Generally speaking, anyone in good health is a suitable candidate for dental implants. One’s suitability for dental implants is improved if one has a large volume of bone in the area into which the dental implant is to be placed. However, even in patients with some deficiency in the volume of bone, we have ways of building up (augmenting) the bone to allow the insertion of dental implants.
Who is not a good candidate for dental implants?
Unfortunately, some people are not good candidates for dental implants. A variety of factors may complicate the procedure and compromise the outcome, thereby rendering a patient unsuitable for treatment with dental implants. Examples of factors that might make a person unsuitable for dental implants are
- uncontrolled diabetes (controlled diabetes is generally not a contra-indication)
- significant bleeding disorders
- certain medications e.g. bisphonaes
- compromised physical and mental ability.
How does the dentist determine if I have suitable bone for a dental implant?
Various forms of radiographs (x-rays) are used to assess the intended implants site/s in terms of the amount, shape and quality of the bone. In some cases such as an implant for a single tooth, a regular dental x-ray will provide sufficient information. However, there are many cases where dentists prefer to use a Cone Beam CT scan to assess the bone. The CBCT provides three-dimensional information with no distortions, which simply cannot be achieved with regular radiographs.
What if I don’t have enough bone?
Dentists have a variety of materials and techniques available to augment bone. In most cases, we are able to build up the bone sufficiently to support dental implants
How successful are dental implants?
Success rates vary a little, depending on where in the jaws the implants are placed and what sorts of restorations they support. The area in the jaws that gives the highest success rate for dental implants is in the front section of the lower jaw. Here, success rates can approach close to 100%. In other areas, success rates tend to be a little bit lower, but they are still extremely high – usually in the mid to high 90% range.
Do all dentists provide dental implant treatment?
Most dentists should be able to assess the suitability of dental implants as part of their patient’s dental health plan.
There are two phases in dental implant treatment
- Surgical – inserting the implant into the bone, and all the associated bone-augmentation and other procedures
- Restorative – providing the crowns, bridges or other restorations that attach to the dental implants
Not all dentists are trained in the surgical aspects of implant dentistry. Most dentists should be able to manage the restorative phase of the treatment.
Dentists who don’t have sufficient training in implant dentistry usually refer their patients to other dentists who are suitably trained, or to specialists.
In some of the more complicated cases, even a dentist trained in implant dentistry will refer those patients to specialists (usually oral surgeons or periodontists).
Who should I consult about dental implants?
Your general dentist should be able to assess what role dental implants can play in the management of your dental health and he or she should be the person you consult first. The dentists will often adopt a team approach, where the expertise of other specialists (eg, oral surgeons, periodontists and orthodontists) might be called upon to help formulate and provide ideal treatment for you.
Why do dentists recommend implants?
People are becoming increasingly aware of the importance of healthy teeth in their overall well-being, ability to enjoy life and even in improving their employment prospects. While missing teeth can be replaced with dentures, they are usually not ideal because they are relatively loose and unstable. In some cases, fixed bridges (supported by natural teeth) cannot be provided. Dental implants offer a way to overcome all of those problems, and they can provide people with replacements for missing teeth that are functional, comfortable and aesthetically pleasing.
How long after a dental implant is placed can it be used to anchor my new teeth?
In some instances, we can to use the dental implant immediately after placement to support a temporary crown or other restoration. Examples of factors that could cause a delay in restoration are poorer quality bone, grafting and augmentation, etc. Each case needs be assessed on its merits. Your implant dentist or specialist will advise you as to what interval would be best in your particular situation.
Does it hurt to have a dental implant?
The majority of patients say that there was far less discomfort from the implant placement procedure than there was when they had the tooth or teeth extracted.
Most dental implants are usually inserted under local anaesthesia and the process is generally not at all painful. When the local anaesthesia wears off (usually about three to four hours later), you might expect some mild discomfort. The level of discomfort varies from patient to patient, but most patients do not have significant problems. Usually, only a short course (one or two days) of very mild analgesics (eg, ibuprofen and paracetamol) are needed, if they are needed at all.
Naturally, there are exceptions, and some patients require analgesics for a few days more. Swelling and bruising may also develop, but these usually only follow the more complicated and longer surgical procedures.
Most patients report being surprised at how little discomfort or swelling they experienced
What happens if my dental implants are ‘rejected’?
Dental implants cannot be ‘rejected’ in the traditional (immune response) sense of the word. However, a very small percentage of dental implants may fail to integrate with the bone and some people refer to this as ‘rejection’.
Should an implant fail, in most instances, after a short period of healing, they are replaced with another dental implant and the replacement implant usually successfully integrates with the bone.
Do I have to go without my "teeth" while the implants are integrating with the bone?
The provision of some sort of temporary replacement for the missing teeth varies greatly with the individual circumstances of each patient.
Where the teeth are missing in the area of the visible smile, in most cases patients leave with some form of provisional restoration or prosthesis in place. Every patient and procedure is evaluated on an individual basis and the dentist might sometimes recommend that the a patient go without a prosthesis for a short period of time.
How much do dental implants cost?
Because of the great variance in patient needs, implant brands, additional component needs and laboratory fees, it is not be possible to mention actual dollar amounts here. Where implants are used instead of conventional bridgework, the costs tend to be quite similar.
In some cases, two or more implants are placed to provide a means of stabilising an otherwise conventional denture (commonly referred to as an ‘over-denture’). In this situation, the implants are usually charged for on a per-unit basis, with a small additional charge for the components that fit in the denture itself. This form of treatment is extremely cost effective, giving the patients a dramatic change in comfort for a relatively low cost.