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Prosthetic Dentistry

Implants

What are implants?

A dental implant is a small cylindrical metal screw that is surgically inserted into the jawbone to replace the roots of missing teeth. The form of the dental implant is made to approximate the shape and size of the roots of natural human teeth.

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Where are they used?

Dental implants are used to replace a single tooth or a number of missing teeth. Implants can also be used to support complete dentures. It acts as an anchor for a false tooth or a set of false teeth.

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How do implants compare with removable dentures and bridges?

Removable dentures can be difficult to eat with because they provide only a fraction of the chewing force of natural teeth. Complete dentures are bulky and hard and if ill fitting can cause pain and discomfort to the gum tissue and bone on which it rests. Jaw and tongue movements easily dislodge them and upper dentures can result in a persistent "gaggy" feeling. Partial dentures, which replace a few missing teeth, can also promote tooth decay around their clasps and the forces exerted by them may weaken the adjacent teeth.

Using implants to support dentures keeps pressure off the bone and tissues. It also increases the stability of the dentures and prevents their dislodgement by the tongue and cheeks.

Bridges look and feel more like real teeth and provide near-normal chewing forces. However, when a bridge is made, the teeth adjacent to the missing tooth gap are drilled to accommodate for crowns. This tends to compromise the teeth to some extent. A fixed bridge that spans too wide a gap exerts a lot of force on the teeth to which it is cemented. Occasionally, this may loosen the teeth it's cemented to.

Implants generally provide about the same amount of biting force as fixed bridges but are kinder to neighboring teeth.

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How do dental implants work?

The implant is surgically placed in the jawbone in the same place that once had the natural tooth. The surgeon creates a "hole" in the jawbone, which has the exact size and shape of the implant to be placed. The implant is then screwed into the prepared hole and gum tissue is closed over the top of the embedded implant. This permits the artificial root to heal, protected from the fluid and debris present in the mouth.

For the next 6 months the implant is left embedded in the jawbone during which time new bone grows and matures over its surface, firmly anchoring it in its bony crypt. After this time a small area of the gum tissue covering the top of the implant is removed and an artificial crown is fitted over the buried implant.

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Does it hurt to have dental implants placed?

The actual surgical procedure is done under local anesthesia and is generally not at all painful. Once the anesthesia wears off, you might experience some discomfort the level of which varies from patient to patient. In some people varying degrees of pain or discomfort may last for several days while others may develop swelling and bruising.

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Who is a candidate for dental implants?

Implants can be placed in any patient who is in reasonable health and wants to replace missing teeth. The most important criterion is that there must be enough bone in the area of the missing teeth to provide for the anchorage of the implants. Certain drugs and diseases that compromise healing, steroids or uncontrolled diabetes, for instance, can lessen your chances of a good result. Smokers and heavy drinkers may also not get good results.

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How long do implants last and why do they fail?

Implants can have a very long and successful life if the patient fulfills all the necessary requirements and the surgery is done following all the established guidelines.

Most failures occur early on due to inadequate treatment planning and poor surgical management. This results in an implant that fails to integrate with the bone and comes loose.

Implants also fail because of poor oral hygiene. An implant patient needs to maintain an extremely high standard of oral hygiene. You will need to floss and brush diligently, into the openings and around fixtures, using special brushes. You'll also need to be seen by your dentist as often as four times a year.

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