A dental implant is one option for replacing a tooth. Implants are manufactured devices that are placed surgically in the upper or lower jaw, where they function as anchors for replacement teeth. Implants are made of titanium and other materials that are compatible with the human body.
An implant-restored tooth consists of several parts.
The implant, which is made of titanium, is placed in the upper or lower jawbone.
The abutment can be made of titanium, gold or porcelain. It is attached to the implant with a screw. This part connects the implant to the crown.
The restoration (the part that looks like a tooth) is a crown, usually made of porcelain fused to a metal alloy (PFM), but also could be an all-metal or all-porcelain crown. The crown is attached either to the abutment or directly to the implant. It can be screwed or cemented onto the abutment. If the crown is screwed to the abutment, the screw hole will be covered with restorative material such as tooth-colored filling material (composite).
An implant looks and feels like a natural tooth. It fits securely when you chew and speak. A single-tooth implant is a free-standing unit and does not involve treatment to the adjacent teeth. With a dental implant, the surrounding teeth can remain untouched if they are healthy, and their strength and integrity may be maintained. The implant can stabilize your bite and help prevent problems with the jaw.
What Happens During the Tooth Implant Procedure?
Treatment generally is a three-part process that takes several months. Your dentist may provide the treatment, or you may be referred to a specialist – such as a periodontist, a prosthodontistor an oral and maxillofacial surgeon – for all or part of the treatment.
In the first step, the dentist surgically places the implant in the jaw, with the top of the implant slightly above the top of the bone. A screw is inserted into the implant to prevent gum tissue and other debris from entering.
The gum then is secured over the implant, where it will remain covered for approximately three to six months while the implant fuses with the bone, a process called “Osseo integration. “There may be some swelling and/or tenderness for a few days after the surgery, so pain medication usually is prescribed to alleviate the discomfort. A diet of soft foods, cold foods and warm soup often is recommended during the healing process.
In the second step, the implant is uncovered and the dentist attaches an extension, called a “post,” to the implant. The gum tissue is allowed to heal around the post. Once healing is complete, the implant and post will serve as the foundation for the new tooth.
In the final step, the dentist makes a custom artificial tooth, called a “dental crown,” of a size, shape, color and fit that will blend with the other teeth. Once completed, the crown is attached to the implant post.
And now, maybe most important part.
We’ll try to answer if dental implants are good choice for you.
- If you are missing a tooth, or teeth you could be an ideal candidate for implants, especially if your smile reveals missing teeth!
- If you are uncomfortable with the way your dentures fit. Loose dentures can cause sore gums because of friction or food trapped under the bridgework.
- Loose teeth from gum disease may need support.
- Dental implants can give you a new base to support new teeth to function and feel like natural teeth.
- In these instances, dental implants can help.
- Success and failure rates for dental implant procedure.
Dental implant success is related to operator skill, quality and quantity of the bone available at the site, and also to the patient’s oral hygiene. Various studies have found the 5 year success rate of implants to be between 75-95%. Patients who smoke experience significantly poorer success rates.
Failure of a dental implant is usually related to failure to osseointegrate correctly. A dental implant is considered to be a failure if it is lost, mobile or shows peri-implant bone loss of greater than one mm in the first year after implanting and greater than 0.2mm a year after that.
Dental implants are not susceptible to dental caries but they can develop a periodontal condition called peri-implantitis where correct oral hygiene routines have not been followed. Risk of failure is increased in smokers. For this reason implants are frequently placed only after a patient has stopped smoking as the treatment is very expensive. More rarely, an implant may fail because of poor positioning at the time of surgery, or may be overloaded initially causing failure to integrate.
Does it very 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.
In cases where there is prolonged pain, you should see your dentist right away. Prolonged pain is not a good sign with dental implants and although it does not always mean failure, the cause of the pain should be determined as soon as possible. If an implant is not properly integrating into the adjacent bone or if an infection develops, the implant may have to be removed.
What are the alternatives to implants?
The alternatives to implants are dentures or bridges. On the other hand, you may choose to simply accept the space where a tooth is missing.
A denture usually includes a metal and/or plastic base carrying plastic or porcelain artificial teeth. It is a removable replacement for a few missing teeth (partial denture) or a whole set of teeth (complete dentures). Dentures are very common but they can become loose, making it difficult to eat and speak. One or more implants can be fitted to help support and retain a denture.
A bridge consists of artificial teeth cemented onto adjacent natural teeth. 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 office to office, 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.