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Dental Implant

Dental implants serve as artificial roots that firmly anchored into patient jawbone. It support fixed or removable tooth replacements. This treatment is considered as the nearest method of natural tooth function available in dentistry. Using the same principles and material used in joint replacement surgery, dental implants are securely anchored into bone and will attach to single or multiple replacement teeth. Implants are also used to anchor full-mouth dentures.

A dental implant designed to replace a single tooth is composed of three parts: the titanium implant that fuses with the jawbone; the abutment, which fits over the portion of the implant that protrudes from the gum line; and the crown, which is created by a
prosthodontist or restorative dentist and fitted onto the abutment for a natural appearance.

Nowadays, dental implant is considered the best treatment for patients who are missing permanent teeth. Rather than resting on the gum line like removable dentures, or using adjacent teeth as anchors like fixed bridges, dental implants are long-term replacements that your oral and maxillofacial surgeon surgically places in the jawbone. Ttitanium rod fixture fuses with the jawbone through a process that was called “osseointegration”. After fully fused, dental implant fixture will never slip or make embarrassing noises or never decay like teeth anchoring fixed dental bridges. Due to dental implant is fused with the jawbone, bone loss is not considered as a problem

Benefits of dental implants over dental bridges or dentures

Many people who are missing a single tooth choose dental bridge; but dental bridge may require the cutting down of healthy, adjacent teeth that may or may not need to be restored in the future. Then there is the additional cost of possibly having to replace the bridge once, twice or more over the course of a lifetime. Similarly, a removable partial denture may contribute to the loss of adjacent teeth. Studies show that within five to seven years there is a failure rate of up to 30% in teeth located next to a fixed bridge or removable partial denture.

  • Implants feel more comfortable, secure, and natural than removable tooth replacements such as a partial denture.

  • Implants allow you to eat what you want.

  • Implants give you the confidence to freely laugh and smile with ease.

  • Implants will stop the jawbone from shrinking, which in turn stops premature facial aging.

When you missing a tooth

Replacing a missing tooth: crown on implant. If you are missing one tooth including the root, the dental crown is attached to a dental implant. The implant serves as a foundation for a dental crown. This method does not affect your other healthy adjacent teeth.

 

When you missing several teeth
Bridge on implants uses modern technology. A durable bridge with natural-looking replacement teeth is securely positioned on dental implants. Healthy, adjacent teeth are left untouched. Dental implants are strong, biocompatible fixtures made of titanium, that act just like natural tooth roots.
When you have no tooth left
Removable overdentures on an implant bar. For an even more secure fit, a dental bar is fixed to your jaw bone with two or more implants, providing stronger support for your removable dentures. Your new teeth can be removed for cleaning and the need for denture adhesives is eliminated.
 

Who is a good dental implant candidate?

Not all people are good candidates to get dental implants. A person who is most suitable is someone who is in good health, has healthy gums, and has enough bone in his of her jaw to allow an implant to be placed in the jawbone. To determine if you are suitable to get an implant, you will have to be examined by a dental professional.

Some people are interested in getting dental implants to replace their missing teeth while some people may need it to replace extracted teeth from severe decay, periodontal disease, gum problem or infection. In many cases, your teeth need to be extracted while dental implant can placed at the same session. If you have a severe infection in your tooth, dentist might wait for serveral months after removing the tooth to perform dental implants because the area needs to be healed.

Before a dental implant is placed, you may need to have the bone in the area built up to increase the chance of success. This is a common procedure called bone grafting or augmentation. You may have the bone graft done and get the implants at the some time, but your dental specialist may decide to do the bone-graft procedure first and give the bone time to heal before placing the implant. If the bone graft is done first, you will need 4 to 12 months to heal before having the implants placed in you jawbone. However, you can wear your dentures or bridge during this time, so you won’t be without teeth.

Sinus augmentation – 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 augmentation’. 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.

Bone grafting – There are many ways in which bone can be added to, however one simple concept is to take a piece of gone 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, and implant can be placed in a more favorable position.

Frequently Asked Questions about Dental Implants

1. How long will a dental implant last?
Implants are a well-established, tried-and-tested treatment. 90 per cent of modern implants last for at least 15 years. After more than 20 years of service, the vast majority of dental implants first placed by oral and maxillofacial surgeons in the United States continue to still function at peak performance. More importantly, the recipients of those early dental implants are still satisfied they made the right choice. If properly cared for, dental implants can last a lifetime. Clincial research shows a lifespan of over 25 years for implant supported tooth restorations. As with natural teeth, good dental hygiene and regular checkups are most important to maintain healthy implants.
 

2. What are the success rates for dental implants?

Implant success rates throughout the world vary between 90-95% during the first 5 years. We can proudly say that our success rate is 98.3%!

3. Does the implant insertion procedure cause pain?

Placing the implants requires a small operation. This can be carried out under local anaesthetic with sedation or with a general anaesthetic. You will not feel any pain at the time, but you may feel some discomfort during the week following the surgery. This is usually due to having stitches in place, and the normal healing process. Although each patient reacts differently, most people experience minimal discomfort, which may or may not be accompanied by slight swelling that disappears with 2-3 days or so
 
4. Will I be able to chew with my implants just like with my natural teeth?

Absolutely! Chewing ability may even be increased due the replacement of missing or diseased teeth with implants.

5. I have some of my own teeth. Can I still have implants?

Yes. You can have any number of teeth replaced with implants – from one single tooth to a complete set.
 

6. Can implants always be used to replace missing teeth?

It depends on the state of the bone in your jaw. Your dentist will arrange for a number of special tests to assess the amount of bone still there. If there is not enough, or if it isn’t healthy enough, it may not be possible to place implants without grafting bone into the area first.
 
7. How soon can I have the new teeth?
The implants need to bond (integrate) with the bone after they have been put in. This takes at least 3 months in the lower jaw and 6 months in the upper jaw. Sometimes the implants may be stable enough when they are fitted for the artificial teeth to be attached much sooner than this.  If you are having one, two or three teeth replaced, you will have a temporary restoration in the meantime. If you have complete dentures, then these can be worn throughout the healing period once they have been modified after the surgery.
 
8. Are the teeth difficult to clean?

Cleaning around the teeth attached to the implants is no more difficult than cleaning natural teeth. However, there may be areas that give you problems and you’ll be shown methods to help. If I had gum disease when I had my own teeth, will I get it with the teeth attached to the implants? Yes, if you don’t care for them well enough. If you keep them clean, and don’t smoke, then you should not have any problems.
 

9. Can I take the teeth out if they are fixed to implants?

Most artificial teeth attached to implants can only be placed and removed by the dentist. However, if you have complete dentures fixed to the implants by bars, then you’ll be able to take them out for cleaning.
 

10. Do the implants show?
Your dentist will make sure that the implants won’t show during all normal movements of the mouth and lips. You will need to be able to see them, so that you can clean them properly.
 

11. What happens if the implant does not bond (integrate) with the bone?

This happens very rarely. If the implant becomes loose during the healing period or just after, then it is easily removed and healing takes place in the normal way. Once the jaw has healed, another implant can be placed there. Or, the dentist can make a bridge, using the implanted false teeth that have ‘taken’.
 

Dental Implant Procedures

Timeframe of dental implant and crown completion depends on many factors. For conventional method of dental implant, the shortest timeframe that include surgical phase and phothesis phase are around 3 to 4 months. However, all procedures can be last upto one year, if jawbone need to be builtup first.

For implant treatment, each case is different. So, it is difficult to evaluate any case without direct oral examanm. In conentional method, two surgical visits are required, with 3 to 6 months in between, During the 1st surgery, an incision is made in patient's gum where dental implant will be placed. A hole is drilled into jawbone. Then, dental implant is inserted into the hole, and the incision is stitched to close.

At the end of the healing period, 2nd surgery start. It involves of making new incision to expose the dental implant. A collar that is called dental abutment is screwed on the top of the implant. The abutment will be used to support the crown and bridge

One-stage implant – The dental implant is installed into a new, healing extraction site and is visible above the gum immediately after placement. The advantage of this method over second surgical stage is not necessary to expose the implant. In this procedure, your dentist can place the dental implants and temporary crown or bridge all in one session visit. The dental implant won't be ready to support a tooth for several weeks.
 

Two-stage implant – Dental implant is placed into a new healing extraction site and then covered by a layer of gum so that it cannot be seen. At the 2nd stage some weeks of months later, dental implant is uncovered and components added bringing it above the gum ready to begin placing a new tooth.

Same day implants – This technique is most often used to treat the lower jaw and requires considerable planning before the actual day of surgery. Several dental implants are installed in a few hours later a complete arch of temporary of permanent teeth can be also installed at the same session. If temporary teeth are used, they will genderally be replaced with a permanent bridge after a suitable healing period. Not all patients are suitable for this style of treatment.

Immediate implant – For this technique a tooth is removed and an implant placed immediately into the extraction site. Depending upon the local bone tissue conditions, dental implant surgery may be one or two stage procedure.
Immediate implant and early loading – This is totally different from an immediate implant placement. It is effectively a one-stage technique. Dental implant is installed into a new, healing site and is fitted with a new tooth at the same session. This initial tooth will typically be kept out of direct contact with opposing teeth for a healing period for 3 months, after which it is finally restored. This technique tends to be more common when esthetic aspects are the most important. Likewise, not all patients are suitable for this approach.

Replacing a missing tooth by crown on implant. If you are missing one tooth including the root, the dental crown will be attached to a dental implant. Dental implant will serve as a foundation for a

 

PATIENT SELECTION

It is neccesary that a candidate for implants be evaluated for potential contraindications to their placement. There are still no report of absolutemedical contraindications for placement of implants, but relative contraindications are exist. There are several adverse effects for dental implant survival like post-irradiated jaws, diabetes, alcoholism, heavily smoking, bad oral hygiene. However, a patient who have a strong susceptibility to periodontitis can be treated successfully by dental implants.

Patient's age is not important factor of implant survival. Nevertheless, age will be considered as importance in dental implant treatment plan. When dental implants are placed, it is avised that it shpuld be monitored closely and restored with a dental prosthesis that is designed for adaptation to a developing jaw bone. Moreover, it has been also suggested that dental implants implementing for patient girls at 15 and boys at 18 are more likely to have a superior prognosis over dental implant placed in lower age. Because of other periodontal or prosthetic procedures, a patient could be emotionally stable, cooperative and willing to keep the appointments required for the treatment and post maintenance. Every candidates for dental implant should be understand that not all implants will be successful. If failure, there might be no an alternative treatment.

SUMMARY AND FUTURE RESEARCH

Dental implants have been revolutionized the fields of implantogolist and periodontist. For a past decade, a lots of information are generated about the effectiveness and predictability of endosseous implants. Dental implant placement is a viable option in the treatment of partial and full arch and become an integral facet of periodontal treatment. The available of dental implants are greatly successful. However, there is no ideal implant system and brand. There are many areas that still need to be studied such as edentulous sites with inadequate bone, splinting of implants to a natural tooth, longterm effects of occlusal stresses, the prevention of peri-implant infections and diseases, effective of dental implantson alveolar ridge maintenance and routine maintenance protocols. Equally important are research efforts to determine the predictive ability of biomechanical markers to identify peri-implant bone loss. Dental implant surface characteristics also are being studied for its effect to jawbone and implant fixture contact and their possibility to decrease the healing period.

 

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