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Frequently Asked Question’s
A dental implant is nothing more than a metal screw that is placed into the jaw bone. It acts as an anchor for a false tooth or a set of false teeth. The slide to the left shows the replacement of a lateral incisor with a dental implant retained restoration. Roll your cursor over the image to see the implant.
Beginning in the 1950s researchers observed that the metal titanium, and some other materials, formed a very strong bond to surrounding bone, a process termed "osseointegration."
After years of careful research and study, dental implants (titanium cylinders placed into the jawbone to support replacement teeth) were refined with high success rates. There are now patients who have had implant supported teeth for more than twenty-five years.
Thus osseointegration began a revolution in dentistry, and at last, an answer to the many problems associated with missing teeth.
Anyone in reasonable health who wants to replace missing teeth. You must have enough bone in the area of the missing teeth to provide for the anchorage of the implants. Some people are missing all their teeth and most of those are excellent candidates for dental implants, but today, we use implants to replace small bridges, removable partial dentures and even missing single teeth.
This depends very much on where the implants are placed and what they will be called upon to do. The best case scenario is the placement of implants in the front portion of the lower jaw. Here success can be as high as 98-100%. In other areas of the mouth, success rates can drop significantly. According to figures that we have today, the success of implants in the front part of the upper jaw are anywhere from 90-95%. Success rates of implants in the back part of the upper and lower jaw can be in the 85-95% range. The success rate in my practice for the past five years has been 99+% for all implants placed.
There are really not too many things that can go wrong with dental implants. They can fail to integrate into the bone and come out. They can fracture or break. There can be problems with the connection between the implant and the prosthesis. There can be an infection or an inflammatory condition in the soft tissue and sometimes in the bone as a result of the implant placement. There can be damage to the nerves in the lower jaw and there can be damage to the maxillary sinus or the nasal cavity. All of these complications are rare and usually account for less than 5% of all dental implant treatments. These complications can usually be easily corrected.
The question is really who should you see about getting missing teeth replaced? Before implants, you went to either your general dentist or, if you wanted a specialist, to a prosthodontist. It's the same today. If you want to replace missing teeth, talk to the people who do that job and they will be glad to discuss the use of dental implants in that process. If you decide that dental implants are for you, then your general dentist or prosthodontist can either place the implants for you or refer you to a qualified surgeon, usually either an oral surgeon or a periodontist, for that phase of the treatment.
As our life span increases, the need for some type of permanent dental replacement system becomes very important to our overall health. Dentures and removable bridges have obvious problems: They are loose and unstable. Implants can provide people with dental replacements that are both functional and esthetic. The demand was always there, we just needed the tools to fulfill that demand.
The protocol that was originally developed clearly states that we must wait three months in the lower jaw and six months in the upper jaw before we can begin to construct the new dental prosthesis that will be supported by the implants. In recent years, however, there has been a movement within the profession to sort of speed up this process. Today we believe that it is possible in selected patients to accelerate the healing time. We are even loading implants in very specific situations right away. However, the general protocol that I favor is 3 months in the lower jaw and 4 months in the upper jaw.
If you, like millions of Americans, have lost one or more teeth, you may be all too familiar with the unpleasant consequences. For many, missing teeth lead to an unattractive smile, embarrassment from loose dentures, and pain or difficulty with eating.
Traditional dentistry can provide replacements for missing teeth using bridges, removable partials and dentures; however, each of these has its problems.
Bridgework usually involves altering natural teeth to provide a stable foundation for support of replacement teeth. Partials and dentures can, at times, be very unstable leading to denture sores or speech difficulties.
Another little known problem associated with tooth loss is a process known as "atrophy," a shrinking of the jawbone that can progress relentlessly over the years. Bone atrophy not only affects jaw function, but can cause adverse facial cosmetic changes.
Because of the remarkable advances in dentistry in recent years, dental implants offer an effective solution to many of these problems.
Dental implants are usually completed in two phases:
Phase 1: is the actual implant placement, a process generally performed in the office with local anesthesia or light sedation to help make the patient more comfortable. Using precise, gentle surgical techniques, the implants are placed into the jawbone for 3 to 6 months while osseointegration (bonding to bone) takes place. This helps ensure a strong, solid foundation for replacement teeth. During this time, temporary bridges or dentures may be used to minimize any cosmetic or chewing inconvenience.
Phase 2: involves creating and attaching the new tooth or teeth to the anchored implant(s) in your jaw. Dental implants can replace a single tooth, several teeth or complete dentures. Your dentist can recommend the best choice for you.
Dental implants are an effective, safe and predictable solution to the problems resulting from missing teeth. Many patients report exciting benefits from dental implants, such as:
One additional and very important benefit can be the reduction or elimination of bone atrophy or shrinkage, commonly associated with loss of teeth.
Dental implants are truly a revolution, solving an age old problem safely and predictably. Implant dentistry can change the smiles and lives of millions for years to come.
Interestingly, dental implants have been performed for thousands of years. Egyptian mummies have been found with gold wire implants in the jawbones. Pre-Columbian skeletal remains exhibit dental implants made of semi-precious stones. Recently, a Roman soldier was unearthed in Europe with an iron dental implant in his jawbone. In the Middle East, implants made of ivory have been discovered in skeletons from the Middle Ages.
Modern implantology began in the United States at the beginning of the 20th century. However, popularity really grew in the 1980’s with the increased success of the titanium cylinder. Since then, many brand name implants with minor variations have been approved.
Long-term success depends on multiple factors. First off, success will depend on the quality and quantity of bone. The better the bone and the more available, the greater the chance of long-term success. Secondly, the experience and ability of the dental surgeon will be a factor. As with any surgical procedure, there is no substitute for the experience and individual talent of the dentist. And finally, the quality of the restoration placed on top of the implant will play a big role in long-term success. If the design of the implant crowns or overdentures are poorly constructed, and biting forces are not balanced, even the best-placed dental implant will have a compromised survival rate.
A periodontist, an oral surgeon, or an implantologist places dental implants. The periodontist and oral surgeon are teamed with a restorative dentist. They will place the implants and then the patient will be seen by a restorative dentist for completion of the crowns or overlying appliance. There will be two dentists during the course of treatment. An implantologist is trained in both dental implant surgery and restoration of the dental prosthesis. An implantologist will do both the surgery and the restoration, and there will be only one dentist during the course of treatment. Click here to find an implantologist near you.
A general dentist trained to restore implants, an oral implantologist, or a prosthodontist can restore teeth. It is the choice of the patient to use a "one doctor approach," whereby the oral implantologist does both the surgery and the restoration, or the "two doctor approach," whereby the surgery and restoration are performed by two different clinicians. Click here to find an implantologist near you.
No. Any person at any age can have dental implants as long as there is enough bone available in which to place the implants.
There are some medical factors that might prevent a person from being a good candidate for dental implants. Some of these may be uncontrolled diabetes, chemotherapy or radiation therapy, parathyroid disorders, blood disorders, rare bone disorders or bone marrow cancer. Some physical factors may include insufficient or poor quality bone, low sinuses or nerve bundles.
The success of your implants will depend greatly on how well you maintain them. They will need to be professionally cleaned by a hygienist and examined by your implant dentist every three to four months. This hygienist should be trained in the specific procedure of maintaining dental implants. Also, brushing and flossing daily is absolutely necessary for long-term success.
No. An effective local anesthetic is used during the surgery so that you do not have any discomfort during the placement of the implants. The mild discomfort you might experience after surgery can be controlled with medications.
You can go to work the next day, unless some particular surgical circumstance arises. Your implant dentist will discuss all postoperative instructions with you.
The treatment time is about the same as with normal (labial) braces. Depending on the complexity of the problem, the treatment can take between 6 to 24 months.
Age does not limit the use of a lingual brace. However, it may be more difficult to provide lingual braces for children since their teeth may not have fully erupted. If the teeth are very small it is more difficult to place the brace. If your teeth and gums are not healthy, braces are not suitable.
The actual procedure to surgically place a dental implant is done under local anesthesia and is generally not at all painful. When the anesthesia wears off about three or four hours later, you might expect some discomfort. The level of discomfort is quite different from patient to patient, but most patients do not have significant problems. Some patients do have varying degrees of pain or discomfort which may last for several days. Swelling and black & blueing may also develop.
In cases where there is prolonged pain, you should see your dentist right away. Prolonged pain is not a good sign with dental implants and although it does not always mean failure, the cause of the pain should be determined as soon as possible. If an implant is not properly integrating into the adjacent bone or if an infection develops, the implant may have to be removed.
Occasionally dental implants do fail or, as some people say, they are rejected. In many instances, they can be replaced with another implant, usually of a slightly larger size. Failure rates should be about 1-2%. Each year I place 400 to 500 implants and each year 3 or 4 of them fail. I replace those at no additional charge.
Once again, the original protocol called for patients to go without wearing their dentures for at least two weeks after implant placement. Over the years, this has been modified considerably and in most situations, patients leave the office wearing their teeth the day the implants are placed. Every patient and procedure is evaluated separately and there might occasionally be a recommendation that a patient go without their prosthesis for a short period of time. You may also have to be on a soft diet for a period of time after implants are placed.
Sometimes when a dental implant is placed, it is necessary to build up the bone in the area to insure success. The procedure of building up the bone is known as Bone Grafting. Bone grafting is a very common procedure in dentistry and it is used quite a bit for dental implants and in periodontal procedures around natural teeth. In order to do bone grafting, we need a source of bone to place in the site. The bone that we use can be one of three types. The best bone is bone that is taken from the patient that we are working on. This bone can be taken from other areas of the mouth or collected in our suction apparatus as we drill into the bone to prepare the sites for dental implants. Occasionally this bone is taken from areas outside the mouth, such as the hip. When bone is taken from the hip, it is usually done in the hospital by an orthopedic surgeon and transferred to the dentist doing the implant procedure in the OR.
Another very common source of bone is bone taken from cadavers. This bone is harvested under very strict supervision at several bone banks around the country and it is used in many dental and medical procedures. There has never been a case of a transmitted disease with this type of bone. It is very safe and very useful in our work to help patients. A third type of bone is a synthetic type of bone taken. This has some use in dentistry but it does not seem to be as useful as the first two types of bone.
In some situations today, we still pay for these services according to the number of implants used. Dentistry, however, has realized that the number of implants used for a given restoration is most important in terms of the success of the restoration, not the overall fee and we have begun to start charging patients according to the complexity of the overall procedure. It is certainly much more cost effective when the same dentist both places and restores a patient's dentition, but this is not always possible. In the future, as dental implants are incorporated into the scope of general practice, implants will be not only much more widespread in their use, but much more cost effective for the patients.
As with many surgical procedures, dental implant fees will vary from doctor to doctor. Frequently, a more experienced implant dentist will charge higher fees. Each individual implant dentist will be able to quote you his fees.
It is important to remember that there are three components to a tooth being restored by an implant dentist, and each component has its own fee structure:
There may be other costs as well; for instance, the use of synthetic bone material during surgery might be an added fee.
Find out if financing is available. Many offices participate in a plan, which allows a qualified patient to finance up to 100% of the cost of the procedures!
Ask your implant dentist to explain in detail what all the costs will be, and be sure to understand what fees you will be paying for each particular procedure. There should never be any financial surprises once a commitment to your treatment has begun.
Perhaps one of the most frequently asked questions on this site is whether or not to use a fixed ("permanent") bridge or a dental implant to replace one or two missing teeth. Suppose you are missing your lower left first molar. If a fixed bridge were to be used, your dentist would cut down the adjacent teeth (the second molar and the second bicuspid) and fit a three unit fixed bridge over those two teeth. The missing tooth would be called a pontic and it would be effectively replaced by the three unit bridge. If your dentist were to use an implant with a crown on it, he would place an implant in the site of the original first molar. He could do this immediately or at some date after the first molar was removed. There is no time limit here. The implant will take about 3 months to connect with the bone and then at that time, your dentist can construct a single crown on the implant to replace the missing first molar.
The cost of each one of these procedures varies from office to office, but a three unit fixed bridge costs about the same as an implant and a crown. The actual decision to do one over the other rests with you and your dentist. One technique is not inherently better than the other and each depends upon how you present and your dentists skills. All things being equal, I would usually prefer to place the implant and crown over the bridge.
Most people notice a change in their speech, particularly over the first few weeks. This generally improves after an initial period of adaptation.
You do need to spend more time to cleaning your teeth. It is important to maintain a good standard of oral hygiene. You may need to visit the hygienist to have your teeth cleaned professionally every 3-4 months during treatment.
Yes! Book an appointment now for a detailed assessment and consultation.
Dental implants have given countless patients many amazing benefits.
Dental implants are also a great value for your investment. You will be getting a product that you will be using 24 hours a day, 7 days a week, 52 weeks of the year, probably for many, many years of your life.
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