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Some Useful Information About Dental Implants

Dental Implants are artificial tooth roots made of bio-material which is placed in the socket of the lost teeth to carry a tooth replacement.
The material is generally pure, unalloyed titanium, which is completely accepted by the human body.

Procedure

Firstly, the titanium implant is placed in the jawbone during a minor surgical procedure. The implant will remain covered under the gum for 3-6 months, during this time bone cells grow into the micro-pores created on the surface of the implant. This process is called osseointegration, and ensures the implants fix in place and become able to support a normal biting load long-term without any damage.

Once osseointegration has taken place, the ends of the implants are uncovered and connections are attached so that replacement teeth can be put in place.

Since implanted teeth are fixed in the mouth like natural teeth rather than being removable like dentures, they allow the patient to return to the functions associated with natural teeth.

Why do we need to replace missing teeth?

Our teeth are an important part of our digestive system as it is needed for chewing food. It plays a role in speech. It is also an important part of our appearance. Finally, it prevents gaps and spaces from appearing between our teeth when a tooth is lost.

Why have implants?

• Implants are an alternative to conventional bridges and partial dentures. 
• If you find that your full dentures move around a lot, implants will help to anchor the denture in place. 
• When teeth are lost, the jawbone may start to shrink. Implants can help slow this process down.1 
• Your dentist may recommend using implants to support a bridge rather than cut into healthy teeth either side of a gap.

What are the advantages over conventional replacements?

The conventional methods of replacing missing teeth are Bridges or Dentures.

Bridges usually involve sticking false teeth onto our existing teeth. This may involve filing down healthy teeth to act as retainers which may compromise the health of these teeth. Bridges can also only be provided when there are sufficient strong remaining teeth. They are however a permanent replacement, although they are likely to need replacement every 10 to 15 years.

Dentures are teeth attached to a plastic or metal plate. They can often be cumbersome as they have to be taken in and out every day and for cleaning. They may not always retain in place well if the shape of the gums and bone in the mouth is not appropriate.

Though bridges and dentures can serve us satisfactorily, Implants provide better support and usually results in more comfortable and stable replacement teeth. It provides better chewing efficiency and allows us to have permanent fixed teeth without trimming our own natural teeth for support, or having to remove the teeth every day. Implants also slow down the shrinkage of our jawbone which occurs as a result of tooth loss.

The Implant Placement Procedure

The Two-Stage Procedure

First Stage - Surgical placement (can be done with a local anesthetic)
Second Stage - Uncovering of the implant

Step 1
The implant is screwed or tapped into a surgically prepared site. The gum tissue is closed over the implant.

Step 2
The implant remains under the gum for 3 to 6 months. The patient continues to wear their denture during this period

Step 3
(3 to 6 months later)
The implant is exposed by removing a small amount of gum tissue. An insert can be screwed or cemented down into the implant.

Step 4
The secured insert can accommodate various attachments upon which overdentures, bars, crowns, or bridges may attach.

The One - Stage Procedure

In step 2, the implant, which is placed, has an additional component which protrudes through the gum tissue. This extension of the implant then does not become covered over during the healing phase. Step 3 (above) is therefore not needed. Step 4 is readily achieved (3-6 months later) by unscrewing the additional component which was placed at the surgery and replacing it with the type of insert that is needed for your case.

If you do not have enough bone what can be done?

Sinus lift - In the upper jaw above the back teeth, it is possible to increase the height of bone available by creating new bone in the sinus. This procedure is called a ‘sinus lift’. A skilled surgeon can deliver very predictable results in this location and without the general success of this technique many patients would be unable to have implants in a part of the mouth where teeth are so commonly missing.

Onlay grafting - There are many ways in which bone can be added to, however one simple concept is to take a piece of bone from somewhere else and secure it as an ‘onlay graft’ to a deficient area. The new piece of bone will slowly join to the underlying region and when healed and mature, an implant can be placed in a more favourable position.

Where can you get extra bone from?

Bone can be harvested from posterior regions of the lower jaw. When you use your own bone to create new bone in another area of the mouth you will have to contend with the discomfort created by the donor site as well as the surgical site. Many people feel this is well worth any additional discomfort as your own bone is normally considered the ‘gold standard’.

Missing tooth	Gap filled with implant without filing good teeth