A Viable Solution to a Beautiful Smile
By Kalil Abide, DDS and Chris Carlton, DMD
It’s not uncommon these days to ask around and find a friend or colleague who has had a dental implant. Over the past five years dental implants have become the industry standard for replacing missing teeth. With the advancements in bone augmentation or “adding bone” dentists are now able to offer dental implants where virtually no bone existed before. Dental implants have become a viable option for replacing both missing teeth, and teeth failing from endodontic therapy and periodontal disease.
What is an implant?
A dental implant is a titanium screw, which is placed in the site of a missing tooth or where a tooth has been removed. This titanium screw functions as the root of the tooth, and for that reason it is referred to as a “root form” implant.
How does the dental implant stay in place?
The dental implant fuses to the bone in a process called osseointegration (“osseo” – bone; “integration” – fusion or joining with). Unlike the root of a natural tooth, the root form implant has a direct union with the bone, where as a natural tooth’s root is joined to the bone by a periodontal ligament or fiber. This accounts for the slight difference in feel between an implant and a natural tooth.
How does your dentist determine if a dental implant is right for you?
When your doctor is considering if you’re a candidate for an implant, he will first take a look at the amount of bone that is present by gathering appropriate clinical information and relying on specific radiography. It is necessary for your doctor to address both the height and the width of bone. If the bone is deficient in either of these areas, there is the option to offer bone augmentation. Augmentation is a procedure where bone is added back to a defective area. This procedure may be done at the time the implant is placed or, in some cases it may take place even before the implant can be considered. The bone height and width also play a vital role in determining the size of the implant to be placed. The upper back jaw has traditionally been one of the most difficult places to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. Augmentation can help correct this problem by raising the sinus floor and developing additional bone for the placement of dental implants.
How long does it take to complete an implant?
After implant placement, the healing time varies before the implant can be restored or fitted with a crown. If the implant was placed without augmentation the general rule is about three months. After implant placement, there is an option to temporize or place a temporary crown on the implant immediately. This is the preferred treatment if the implant locks in after placement. It allows for better adaptation of the tissue or gum to the implant, which leads to a nicer cosmetic result upon crown placement. If augmentation is needed it is customary to wait six to ten months before the implant placement occurs. Following that there is another three-month period that is required for implant healing. During this time a patient usually will wear a removable temporary appliance to prevent other teeth from moving.
What steps are required for the implant?
There are multiple components to the implant process. The first step is the surgical placement of the screw or root form. Then after healing and before the crown is placed, an abutment is screwed down into the implant. This abutment serves as the tooth or base that will retain the crown. A crown is then cemented over the secured abutment. In some situations if space is limited, the abutment stage can be skipped and the crown fitted directly to the implant. Once an implant is osseointegrated, the rate of long-term success is outstanding.
Are dental implants at risk of the same problems associated with natural teeth?
Implants are not subject to decay, but they are still prone to periodontal (gum and bone) problems, or peri-implantitis. Hygiene appointments are a critical part of preventive care for implants, just as they are for natural teeth.
Are dental implants an option for many people?
Actually, many people are candidates for dental implant placement, however there is a select group that is considered “contraindicated” or for whom this procedure is not generally recommended. People suffering from specific forms of heart disease, who have active cancer, and who suffer from certain immunological diseases should consult with their physician before considering dental implants. Individuals who are taking bisphosphonate drugs for treatment of osteoporosis and cancer also fall under the contraindicated group.
Who can provide dental implants?
The implant, or the root form, is placed by a general dentist, oral surgeon and/or periodontist, and the actual restoration of the implant, or placement of the crown, is performed by a general dentist. Implants have gained in huge popularity due to their reliability. They may be used for the replacement of one tooth or multiple teeth. Because of their natural look and feel, they have given new life to individuals who previously would have been forced into dentures.
Dental implants are nothing new… in fact the first implants can be traced back to the Mayan civilization, 600 A.D. But, today’s implants have advanced tremendously and have taken their place as a routine solution for the replacement of missing, damaged or diseased teeth giving more people a permanent solution to a beautiful smile.