Dental Implant
What is Dental Implant?
A dental implant is a structure that replaces a missing tooth. With screw-like devices, the surgeon inserts an implant into the jawbone, and it acts as an anchor for an artificial tooth, called a crown. A device called an abutment connects the artificial tooth to the dental implant. The crown is custom-made to fit the person’s mouth and match the color of their teeth. Crowns look, feel, and function like natural teeth.
When a tooth is lost due to injury or disease, a person can experience complications such as rapid bone loss, defective speech, or changes to chewing patterns that result in discomfort. Replacing a lost tooth with a dental implant can significantly improve the patient's quality of life and health.
Types of Dental Implants
Endosteum Implants
They are used to secure objects and resemble screws. They place something inside the jaw where the dentures will go. For most patients to qualify, the post must be able to fuse to a sound, healthy jawbone. Once the wound has healed, the artificial teeth can be attached to the implant to match the natural teeth. If the idea of having something implanted into your jawbone bothers you, you might be more interested in the second most common implant.
Subperiosteal Implants
Subperiosteal implants are surgically implanted outside of the jawbone. They sit atop the bone but beneath the gums. False teeth are attached to poles that stem from the gums. Under the gum is a metal frame with a post. As the gum heals around it, the structure remains in place. This procedure is performed if the patient does not have enough jawbone for an implant or does not want to undergo major oral surgery to add bone to the area. If this describes you, the following implant might be a good choice.
Zygoma Implants
The implant is placed in the cheekbone rather than the patient’s jawbone. Zygomatic implants have been documented as a an alternative for the rehabilitation of the atrophic posterior maxilla with both the classical two stage and immediate loading protocols. Zygomatic implants avoid grafting and sinus lift procedures and therefore contribute to a shorter and more comfortable treatment.
Benefits of Dental Implant
Better Ability to Chew
Dentures can slide around inside your mouth, which may make chewing difficult. Dental implants are fixed in your jaw, like your own natural teeth, which allows you to eat your favorite foods with confidence and without pain.
Better Ability to Talk
Dentures that slip in your mouth may cause you to mumble or slur your words. Dental implants allow you to speak without your teeth slipping around.
More Comfort
Your gums change shape to fill holes where you had teeth, and they continue to change shape over time, so dentures tend to become loose and shift around. Dentists recommend you get your dentures realigned every once in a while and completely replace your dentures every 5-8 years because of the way your gums change shape over time. Because they become part of you, implants can be more comfortable than dentures that slip around on top of your gums.
Improved Oral Health
Dentures that slip and slide in your mouth can make your gums sore or even make your gums infected. Bacteria and fungi can live in any cracks and crevices of your dentures, which raises your risk of getting an infection. On the other hand, implants allow easier access between your teeth, so you can continue to floss for good gum health. Also, you may need to have some of your teeth shaved down to wear a tooth-supported bridge. With implants, you don't need to have nearby teeth altered, which can improve your long-term oral health.
Better Appearance
The crown that fits over your implant is made to look like your own teeth. They can give you back your smile and help you feel good about yourself.
Durability
With good dental hygiene, your implants can last a lifetime.
Protection Against Bone Loss
The roots of your natural teeth are anchored in your jawbone. This stabilizes your jawbone, as a load-bearing wall does inside your house. When you have teeth removed without replacing them, your jawbone can get worse over time. This can change the shape of your face and mouth. Since implants are fixed in your jaw like your natural teeth, they stabilize your jawbone and prevent bone loss.
Uses of Dental Implant
Retaining or Replacing Dentures
Implants can be used to retain and support dentures which will stop your dentures from moving. If dentures are uncomfortable because they are bulky, move around, click or are painful, then implants can be used to retain and support them and hence improve your chewing and so, aid your digestion as well as give you greater self-confidence.
Supporting Crowns and Bridgework
In cases of deficient bone, we will need to rebuild the lost tissues. Various innovative surgical techniques are available for dealing with even the most complex problems. Some people who cannot wear dentures because they gag, find the denture too bulky in their mouth or indeed dislike the thought of anything foreign in their mouth are ideal candidates for implant therapy provided they satisfy the relevant criteria. Implants are so strong that they can be used to permanently replace bridgework. Implants do not pull on the surrounding teeth, nor do they have the disadvantages of increasing decay, gum disease and the chance of root-fillings or loss of teeth used to retain conventional bridgework.
Replacing Unstable or Infected Crowned Teeth
If an existing crowned tooth is becoming problematic and further expenditure on this tooth may only delay its demise for a short while, many patients are now choosing to have the problem tooth carefully removed and replaced with a much more reliable and stronger dental implant. In hindsight, many patients may wish that they had gone straight for the implant option after spending their money on a root-filling, post and crown only to need the tooth taken out a short time later.
Replacing Missing Second Teeth
Six percent of children have some second teeth that never develop. Professional help is advised as soon as missing teeth have been identified. Liaison between an orthodontist and an implantologist enables planning to minimise the impact of the missing teeth. Missing back teeth are less problematic as baby teeth can be left in situ for many years and may well last until the age of forty. Commonly, upper lateral incisors (second from the front) fail to develop. This situation requires careful planning with an orthodontic / implant team coordination.
The Components of a Dental Implant
Implant Screw
An implant screw or post is surgically inserted into the jawbone. It is designed to replace a natural tooth root and has a tapered end. An implant post is usually around 18mm long and gets much of its strength and stability from the post length. A huge range of implant posts is available, and they come in different diameters. Our experienced implant dentists will ensure that you receive the correct sized post, so, for example, if you need a small lower incisor replaced, we can fit a dental implant with a narrower body designed to fit into a smaller space.
Implant Abutment
There is a wide selection of implant abutments, and our choice depends on the implant system used and your final restoration. For example, the implant abutment fitted to support a single dental crown differs from those used to support a denture. An abutment used to hold a new implant crown protrudes above the gum, so it looks like a stubby tooth. Abutments used to support dentures can support a bar, so the denture clips onto the bar or fits into special attachments on the fitting surface of the denture.
Implant Restoration
An implant restoration can be a dental crown, bridge, or denture. If you only need a single implant, it will be restored with an implant crown. If you require multiple teeth restored and where they were originally side by side, we can fit an implant bridge, so not every tooth will need to be replaced with a dental implant. Dental implant crowns and bridges are made from precious metal covered by porcelain or can be entirely metal-free, depending on your preference and budget. Both these restorations are permanently fixed in the mouth and can only be removed by an implant dentist if any maintenance is needed.
What Are the Top Materials for Dental Implants?
Porcelain
A dental implant is made up of several different parts, one of these being the prosthetic tooth. Similar to dental crowns, this portion of the dental implant is usually made of porcelain. Since its colour closely resembles actual teeth in its natural look and its ease of eating and talking. Since each person has a unique smile, dental implants will be custom-made to complement the patient’s natural teeth.
Titanium
Underneath, porcelain Titanium is one of the most common materials used in dental implants. This is because it can be easily implanted into bone. Results suggest that implants made of titanium metal allow the bone to expand correctly during this period. The bone can grow next to them as it is put in contact with the bone and is not disturbed. In exchange, this would create a lasting affinity. An implant might not be solely Titanium. Instead, it will likely include a titanium alloy, including trace amounts of other metals like nickel, aluminum, molybdenum, vanadium, niobium, or zirconium. Titanium is crucial for dental implants since it is non-toxic, durable and light. The Titanium will act as a replacement root of the tooth and typically last for more than 30 years.
Ceramics
Although less common, all-ceramic implants can be an excellent esthetic result with no colour change. Unfortunately, ceramics are only recommended for some patients and must be placed with extreme care.
Zirconium
Compared to Titanium, Zirconia is a recent invention and has become one of the most promising future materials for dental implants since the 1990s. It was later, in 2003, that the first all-in-one Zirconia dental crown was released. Zirconia is becoming an alternative to Titanium since it is strong like metal and resembles real teeth like porcelain. These implants differ from the Titanium porcelain combination since these typically come in two pieces, whereas Zirconia only comes in one.
There are three distinct groups of methods through which implant surfaces can be modified at manufacture.
Mechanical treatments: These include grinding, blasting and machining to create rougher or smoother surfaces.
Chemical treatments: Conducted with acids, alkali, sol gel or through anodization, among other methods, chemical treatments alter the implant surface’s roughness and composition and enhance surface energy.5
Physical treatments: These treatments include plasma spraying and ion deposition.
Some of the more common titanium implant surface treatments used in recent years include anodization, sand blasting and acid etching. Anodization, which works by increasing the thickness of the implant’s TiO2 layer, moderately roughening it, and improving osteoconductivity, has been shown to enhance osseointegration. Sandblasting and acid etching, on the other hand, removes parts of the implant material, creating small irregularities and a roughened surface that can encourage rapid osseointegration.
How Are Dental Implants Made: A Step-by-Step Guide
The process of crafting the metal post begins with a long titanium rod. One 4m rod can be used to make around 200 implants.
The rod is inserted into a holding device and fed into a lathe system where it spins as computerised tools shape it and cut threads into the outside. These threads help to anchor the implant securely into the patient’s jawbone.
The rod is then cut to the correct length.
A drill hollows out the rod and cuts more threads, this time inside the freshly-hollowed out rod. These threads help to secure the artificial tooth to the implant.
Once the newly-shaped dental implant has been cleaned, it is taken to a vision measuring system where a camera takes pictures of it from all angles. These pictures are analysed by a computer to ensure the dimensions are perfect.
When a selection of implants have been cut and measured, they are placed in a special cleaning machine where they are enveloped with solvent vapour which cleans off any residual oils left on the implant from the cutting process.
The different parts of the dental implant then go through a process called anodisation. First, the inside of the implant is anodised to colour-code it. Then, the outside is anodised to make it porous, which allows for better osseointegration.
Finally, the piece is cleaned and sterilised before it is sent to the dentist to perform the dental implant surgery.
What is the Process of Getting Dental Implants?
Step 1: A Thorough Examination
The first step involved is a thorough examination and development of a treatment plan.
Step 2: Placing The Dental Implant(s)
Following an examination, the placement of the implant and final restoration includes several steps:
A titanium, screw-shaped implant post is surgically placed in the jawbone and allowed to heal.
● For a single-stage procedure, the dental implant is placed and a temporary abutment is attached.
● For a two-stage procedure, the dental implant is inserted, covered by the gum tissue, and given time to heal.
As healing occurs, the implant will “osseointegrate” or fuse with the bone to form a strong, long-lasting foundation for the overlying prosthesis. This can occur within weeks to months. At times, a temporary prosthesis can be used to restore the area while the implant is healing.
Step 3. Attaching The Abutment
Once the implant has integrated, an abutment that passes through the gum tissue is screwed onto the implant. The final prosthesis, which may be an individual tooth, a bridge, or a denture containing multiple teeth is then attached to the abutment.
● For a single-stage procedure, the final (or permanent) abutment is placed and an impression (or 3D scan) is taken from which a crown will be created to match your natural teeth.
● For a two-stage procedure, a secondary surgery is performed to reveal the dental implant for abutment placement.
Step 4. Fitting And Re-Examination
When the crown is ready, it is attached to the abutment. This is usually followed by one or more follow-up visits to ensure a good fit, look and functionality. The last step is to maintain at home care, and schedule regular dental visits (as recommended by your dentist) to maintain implant health.
Other Procedures You May Have With Implants
Bone Augmentation
If you don’t have enough natural, healthy bone in your jaw, it may not be able to support your dental implants. Your doctor may recommend bone augmentation to restore or regenerate the bone so it can support implants. This may involve bone additives and growth factors.
Sinus Lift
One of the hardest places to put dental implants is your upper back jaw. That’s because you may not have enough bone quantity or quality there, and it’s close to your sinus. Your doctor can correct this with a sinus lift, which is also called a sinus augmentation or a sinus elevation. This raises your sinus floor to make room to add bone that can hold dental implants.
Ridge Expansion
Your doctor may recommend a ridge expansion or modification if your jaw is too narrow to support implants. This involves adding bone graft material to a small space along the top of your jaw, which is also called a ridge. If you have deformities in your upper or lower jaw, your doctor may recommend a ridge modification. It may improve your chances of a successful implant and also how your jaw looks.
Factors to Consider When Choosing a Dental Implant
Bone density is critical in determining the type of implant suitable for an individual. Patients with low bone density or poor bone quality may require additional dental procedures, such as bone grafting, for successful implant placement. These additional procedures help provide enough natural bone to support the implant and promote healing. Without adequate bone, the implant may not be stable or fail altogether.
Before undergoing implant placement, it is essential to have good oral health. Gum disease and other oral health issues can affect the success of the implant procedure. The gum tissue and nearby teeth may also be affected during the implant placement process, so it is vital to have any underlying issues addressed before proceeding. This may involve additional procedures, such as deep cleaning or periodontal treatment, to make gums healthy and be able to support the implant.
Aesthetic preferences also play a role in the choice of a dental implant. The appearance of the final restoration, such as the crown’s colour, shape, and size, can influence the type of implant selected. Patients may choose from various materials and designs to achieve their desired look and feel.
Dental implants can be costly, and the cost varies depending on the type of implant selected. Patients should consider their budget and insurance coverage when choosing an implant type. Different implant types may cost differently, such as implant-supported bridges or single-tooth implants. Understanding insurance coverage and out-of-pocket expenses can help patients decide which implant type is right for them.
Choosing an experienced dentist is essential for a successful implant procedure. Your dentist’s expertise and recommendations can guide your decision-making for optimal outcomes. Patients should discuss their options and preferences with their dentist to make informed decisions about their dental implant treatment.
Dental Implants vs. Dentures
If you are deciding between traditional dentures or an implant-supported restoration, here are some things to consider:
● Dentures often have to be kept in the mouth by using a dental adhesive. This sometimes requires re-glues after meals. An implant-supported denture requires no adhesive.
● Dentures have to be removed for cleaning. With the exception of a removable implant-retained denture, your implant-supported restoration can be cared for by brushing and flossing.
● Dentures cover the roof of the mouth. With implants, there’s nothing covering the roof of your mouth to interfere with your sense of taste or other normal activities. Implant-supported dentures can also be fabricated without a palate.
● Dentures can slip out while eating or speaking. Implants and implant-supported dentures are securely anchored and won’t slip out.
● It’s hard to chew with dentures and you can’t eat a lot of food you like or need. Dentures can move while you chew, which is annoying, and also makes it difficult to chew! In fact, dentures generally have only 10% or less of full chewing power. Dental implants have full chewing power and implant-supported bridges or dentures also considerably increase the chewing power.
● Dentures may click while eating. With implants or implant-supported dentures, there’s no annoying clicking sound.
● Dentures don’t provide the stimulation needed to prevent bone loss. The jawbone needs to have the stimulation of high-pressure chewing to keep its volume. Implants ensure no jaw bone is lost.
● Progressive bone loss as a result of wearing dentures can cause facial collapse. Over the years bone loss can cause the collapse of the lower third of your face, creating excessive wrinkles, sagging skin and jowls, thinning lips and a sunken-in look. This can considerably age a person’s appearance. Implants prevent bone loss.
How to Extend the Life of Your Dental Implants?
Visit Your Dentist Regularly
First and foremost, ensure that you see your dentist on a regular basis. Dental implants benefit from routine cleanings in the same way your natural teeth do. Not only will your dentist be able to identify any early signs of implant failure, potentially making a decisive intervention, but your hygienist will carefully remove plaque that has built up around your gums. This significantly reduces your risk of implant infection.
Brush Your Teeth
Again, it is important to care for your implants like you would care for your natural teeth. That means brushing at least twice daily using a soft-bristle brush. A low-abrasive toothpaste with tartar control is recommended, and your dentist can recommend a specific brand if need be.
Floss Twice Daily
In addition to brushing, also be sure to floss. Get in between the teeth and the abutments. (Abutments are the connective pieces that attach the implant to the dental prosthesis.) You may benefit from using an oral irrigator, also known as a water flosser. Water flossers are especially recommended for patients who have been treated with the All-on-4 dental implant method. Your periodontist can provide further detail.
Use a Mouth Rinse
Antimicrobial mouth rinses can help prevent the buildup of bacteria in your mouth. In doing so, these mouth rinses can reduce your risk of implant infection. Talk to your periodontist about whether a mouth rinse is right for you.
Abstain From Smoking
Smoking can be detrimental to your dental implant recovery, as it slows the body’s natural healing processes. For this reason, we urge patients to stop smoking before and immediately following their dental implant procedure. However, to ensure the best long-term results, it is best to simply give up tobacco products altogether.
Be Careful with Your Diet
One of the great things about getting dental implants is that you can eat and drink practically anything you want, without making many lifestyle adjustments. However, we recommend letting your coffee and tea cool a bit before you start drinking. Steer clear of super-hard foods, including raw vegetables. Also, avoid sticky candies, like taffy and gum.
Stop Chewing on Ice
Along with hard foods, we recommend that dental implant patients refrain from chewing on ice. Ice is a very hard substance, and it can cause your replacement tooth to become damaged.
Be Alert
Vigilance is one of the best lines of defense against implant failure. Make sure you know some of the common signs of implant failure and seek treatment at the first sign that something is wrong. Often, early intervention can save your implants. In particular, seek dental care if you notice pain or swelling around your implants or if you sense that your implants have become loose.
Follow Aftercare Instructions Carefully
After your initial dental implant procedure, you will be provided with a full list of directions to ensure a speedy recovery. You must follow these guidelines carefully for as long as your surgeon tells you. Compliance with these recovery guidelines can ultimately help you prevent early implant failure, resulting from improper healing.
Ultimate FAQ Guide to Dental Implant
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