What is a Dental Implant?
Dental implants are designed to be a permanent replacement for a missing tooth or teeth and are a popular alternative to removable dentures or fixed bridges. They anchor artificial teeth directly into the jawbone which makes for a more functional and aesthetically pleasing restoration.
Implants are typically made out of pure titanium or titanium alloy. Titanium is non-toxic and is not rejected by the body so it bonds readily with new bone growth that penetrates into the titanium surface. The direct fusing of bone and an implant is called osseointegration so you may see implants described as osseointegrated implants.
Before any dental implants can be considered, your teeth, gums and jawbone must be in good health. During the preliminary examination, your teeth and gums will be examined for disease and decay to determine if you need any treatment prior to any implant procedures. X-rays of your jaw and possibly scans will be taken to analyse the teeth and bone structure to determine bone health, thickness and height.
If everything is in good shape you are good to go. You need to be prepared pay a big wad of money but implants should last a lifetime it you brush correctly and take care of your gums. Routine visits to the dentist and maintaining good oral hygiene are both required to maintain implants in the long term.
Advantages of dental implants
It’s easy to understand why dental implants are the best option for those with enough ready cash to be able to make that choice. They are simply the next best thing to healthy natural teeth and here’s why:
- implants are a long term solution and can last a lifetime
- can be more cost effective over many years
- they retain your natural face shape
- your smile is squeaky clean and white
- no embarrassing moments – you never “loose” your teeth when laughing or eating
- no jawbone deterioration caused by tooth loss
- no problems with your speech
- you become more self confident
- you get to keep your teeth where they belong; in your mouth; permanently
Types of dental implants
Dental implants can be categorized in numerous ways, the most important one from the patients perspective is how the procedure is performed.
Implants can now be performed in one stage but it’s usually a two stage process. Please note that a stage refers to a surgical procedure not the number of times you need to visit the dental surgery.
The two stage procedure requires two separate surgical procedures; but the complete treatment will require additional visits for measurements and fittings of the replacement teeth.
Periodontist’s and oral surgeons usually perform the implant surgical procedures, although an increasing number of general dentists are now qualified to perform the surgery. The operation requires some form of anesthesia including local, general, intravenous sedation or nitrous oxide.
Two-Stage Dental Implants
A two-stage dental implant procedure involves surgery to place the implant into the jaw bone. In the first stage, incisions are made into the gum to expose the bone. A hole is then drilled into the bone so that the implant can be placed.
The implant is then covered with a healing cap and the gum tissue is closed up (stitched).
Approximately three to six months later, your dentist will conduct a second surgery to cut through the gum that has healed over the healing cap and check that the implant is stable and has successfully bonded with the jawbone.
If the implant is stable and has bonded to the jawbone an abutment is connected to the implant. The abutment is a post that penetrates through the gums and connects the replacement tooth (or crown) to the implant. The gum is then closed up, around, but not over the abutment.
That’s the end of the surgery but there is still work to be done on taking impressions and having the artificial tooth or crown made and subsequently attached to abutment.
It takes about 2 weeks for your gums to heal before you can finish the procedure. As with any surgical procedure, there will be swelling, bruising, minor pain and bleeding during the healing process.
Next the artificial tooth is made from impressions of your teeth and a model of your bite to ensure that your new tooth fits naturally. Once your new tooth is ready it’s just a matter of attaching it to the abutment although it can take several appointments to get the fit just right.
Single-Stage Dental Implants
In some cases it is possible to install both the implant and the abutment during the same surgery since research has shown that doing so has no detrimental effects as long as adequate time is given for everything to heal.
A single-stage dental implant procedure involves surgically placing a longer implant into the jaw so it is on the jaw bone, leaving the top of the implant level with the gum tissue. The gum tissue is closed (stitched), leaving the implant head visible. Care must be taken not to apply any pressure to it during the healing process
After several months of healing, the dental implant abutment and temporary restoration can be attached without the need for minor surgery to expose the implant head.
Both single stage and two-stage implants have similar success rates and you should ask your dentist which systems they use and discuss how one or two-stage procedures might be appropriate for you.
While the track record of successful dental implant procedures is impressive, some patients do experience some complications. The following are a few of the possible causes and reasons behind dental implant problems:
- the bone not integrating with the implant
- bleeding, injury or numbness of the nearby muscles or sinus cavity due to nerve damage
- possible infection if the implant breaks
- the artificial tooth or crown becomes loose
Implant success rates
There is a chance of failure even when a patient’s teeth, gums and jawbone are in good health and there are no problems determined by the x-rays and/or scan results.
The success rate is around 90% for the upper jaw and 95% for lower jaw implants. This is because the bone in the upper jaw is less dense than the lower jaw which makes the bonding of the implant to the jawbone less successful.
All is not lost if a dental implant fails. In most cases the implant must often be removed and the area left to heal. An implant can be attempted once the area has recovered, which can take up to a year or until the dentist determines that the site is suitable.
Depending on how well the area heals, a bone graft might be required to provide a better foundation for the implant and improve the chance of success. It’s sometimes possible to save an implant by building up the bone & gum tissue surrounding it.
Dental implant holidays
Taking dental implant holidays has become a growing trend for people in the developed world and folks in the UK are not lagging behind in taking up the chance of getting implants done at a much lower cost.
There are plenty of compelling reasons to have your dental implants abroad, they include:
- massive savings up to 75%
- shorter or non-existent waiting lists
- same or even better quality of dental implants used
- highly experienced and educated practitioners
- a chance to combine your treatment and recovering at your leisure
I shall be covering implant holidays in much greater detail in a follow up post. It’s a controversial subject that needs a thorough examination of the facts, so please keep a look out for it.
It would love to hear from anyone who has had any dental implant procedures done. Are you pleased with the outcome? Would you go through it again?