What are dental implants?
 
Dental implants are basically metal posts made of Titanium, which is biologically accepted by your body, surgically inserted in your jaw bone in the site of the missing tooth. It can replace one or multiple missing teeth.
After the implant has been placed, a healing period of 4-6 months will be needed to allow a strong bonding to occur between the implant and the jaw bone in a process called “osseointegration”. After the implant has been integrated, your restorative dentist will attach a porcelain crown to the implant which will match the color of your adjacent teeth.
Implants are highly successful, with a success rate of 95-98% and are now considered to be the best option for replacing missing teeth.
 
 
 
 
 
 
Benefits of dental implants:
 
Dental implants look like and function like natural teeth. They provide you with an attractive smile and eliminate many of the problems associated with partial and complete dentures.
 Implants placed immediately, or shortly after tooth extraction, help to preserve jaw bone and prevent a process called “atrophy” which is a progressive phenomenon associated with tooth loss. It leads to progressive shrinkage of jaw bone which makes it more difficult to place dental implants.
 Implants also help preserve the integrity of the adjacent teeth which are normally filed down and reduced is size to serve as anchors for bridgework.
Two or four implants can also be placed in the atrophic jaw bone in order to make a loose denture more stable and improve the chewing ability.
 Implants will help you chew your food more efficiently and comfortably without the pain and discomfort associated with partial or complete dentures.
 
  
 How long will dental implants last?
 
Once successfully integrated, dental implants can last over 25 years, or can last a lifetime if well maintained with good oral hygiene and regular checkups. However, implants failure can occur and this will vary with each patient’s situation. Implants may not be a good option for uncontrolled diabetic patients, heavy smokers and those with different types of bone diseases.
 
Is everyone a candidate for dental implants?
 
The answer is NO. Although most people may qualify to have dental implants, there are patients who are not considered good candidates for implants placement.
There are local and systemic factors which will help your doctor determine if you are a good candidate for dental implants.
 The clinical and radiographic exams will help your doctor determine if you have adequate bone with good quality to accommodate the implant. Bone grafting with some other complicated procedures may sometimes be necessary to regenerate adequate bone before implants can be placed.
Your general health and the presence of certain systemic conditions may contraindicate the placement of dental implants.
 
 
 Implant placement:
 
 
 
 
 
 
 
 
 
 Figure 1
 
Placement of a dental implant is usually a painless procedure and can be performed in one, or two phases (Figure 1). Implants that replace the front teeth are most often placed in two phases due to cosmetic considerations. In such cases, the implant is totally covered by the gum tissue and a temporary false tooth is fabricated and worn by the patient for four to six month to allow adequate time for the implant to establish a strong bond to bone. In the second phase, the top of the implant is uncovered and a healing attachment is attached to the implant and kept for a three to four weeks period.
 When the procedure is performed in one phase, the healing attachment is attached to the implant during implant placement. This is usually done in the posterior (back) areas.
After the implant has successfully integrated to the surrounding bone, the restorative dentist will remove the healing attachment and replace it with a titanium post, called the abutment .He will then proceeds with the fabrication of the porcelain crown which has a matching color and shade of the adjacent teeth.
If you are missing multiple teeth, multiple implant adjacent to each others can be placed or implant carried fixed bridges can be placed. Your periodontist and your restorative dentist usually make this decision during the treatment planning phase.
 
    
 
 
 
 
 
 
 
 
 
    Implant placedRadiographic         Implant uncovered
   image of implant               Healing attachment placed
 
 
 
 
 
 
 
 
 
 
          Temporary false toothTemporary false tooth (Flipper)
 
 
 
 
 
 
 
 
 
 
 
  Permanent abutmentPermanent abutment
 
 
 
 
 
 
 
 
 
 
 
 
   Final crown placed
Immediate implant placement:
 
 
In certain situations, an implant can be placed immediately after tooth extraction. This is mostly done to replace a front tooth especially if adequate bone exists. If the tooth socket has severely resorbed, it should be grafted and the implant will be placed four to six months later.
 
 
 
 
 
 
 
 
 
 
 
 
    Immediately after toothImmediate implant
    extraction
 
 
Sinus augmentation:
 
The upper back jaw area is one of the most challenging areas of the mouth for placement of dental implants due to the softer quality of bone and the close proximity to the maxillary sinus. Tooth loss in this area may result in insufficient bone to place dental implants without penetrating into the sinus. To avoid this potential problem, a procedure called “sinus lift” or “sinus augmentation” is performed.
This procedure can be done during the same appointment of implant placement or can be done as a separate procedure before implant placement. If done as a separate procedure, a healing period of six to nine month should be allowed before implants can be placed.
The procedure involves raising the sinus floor by lifting the inner membrane of the sinus, which is called the Schneiderian membrane, and placement of a bone graft in the space provided under the membrane.
One technique for lifting the sinus floor is done during the drilling procedure where a special instrument, called “the osteotome” is inserted into the drilled site and tapped gently until the sinus membrane is lifted about 2-4 mm. A bone graft is then placed followed by immediate placement of the implant.
If the jaw bone is severely atrophied, a different technique, called “a lateral window” is used. In this technique, the gum tissue is lifted to expose the jaw bone. A circle is then cut in the bone to gain access to the sinus membrane. The sinus membrane will then be gently raised into the sinus cavity and a bone graft is placed in the space provided. The graft is then covered by a special dissolvable membrane and the gum tissue is sutured over the grafted site.
 
 
Post-operative implant care:
 
Dental implants are like natural teeth and they require the same home care in term of brushing and flossing. Home care is extremely important for the long-term survival of dental implant and inadequate home care will eventually result in failure and loss of implants. Periodic follow up in our office is of utmost importance to monitor the implants and your gum tissues.

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