DENTAL IMPLANTS
 

A dental implant is a life changing and successful procedure that restores a full set of teeth. It is an artificial replacement for a tooth or many teeth that have been lost. Noone will ever know that you have had a replacement tooth. There are a number of restorative options for missing teeth but implants are designed to provide a foundation for the replacement teeth that look, feel and function like normal teeth. You will be able to talk, laugh, smile and eat as normal but with greater confidence. Dental implants are probably one of the most expensive of dental procedures that you can have. The reasons for this is firstly that the implants themselves can be expensive and require the experitse of a skilled dental surgeon.

Reason for implants
1. To increase confidence when speaking, smiling and eating.
2. Implants are stronger and more durable than most restorative options.
3. To improve chewing and eating habits which may lead to malnutrition.
4. Implants offer a permanet solution to tooth loss.
5. Implants may be used in conjunction with other restorative procedures e.g. Suppor a crown, dental bridges and with dentures to increase stability.
6. Eliminate the need to invove adjacent teeth which are left untouched
7. Reliable - success rate of implants is highly predictable.
 

There are two types of common implant used today and the dentist will advise which is the most suitable at the consultation:  I. Endosteal (in the bone). The most commonly used type of implant and each one holds one or more prosthetic teeth, it is generally used for patients with bridges or removable dentures.

 II. Supperiosteal (on the bone) placed on the jaw, the metal framework posts protrude through the gum to hold the prothesis. These types of implants are suitable for those who are unable to wear dentures and who have minimal bone height.
 

For dental implant procedure to work there must be anough bone in the jaw and this bone must be strong enough to hold and support the implant. If there is not enough bone then more may be added ' with a bone graft. A thorough assessment will be made in advance including xrays and possibly CT scans and then under local anaesthetic the gum where the implant is to be placed will be cut and lifted. A small hole will be drilled into the jaw bone at the exact spot of the implant. A rough surfaced titanium implant is set tightly into the jaw bone to replace the missing root and the gum is stitched back over the implant.

The operation can take antyhing from 30 minutes for a single implant to many hours if the procedure involves sinus lifting, bone grafting and multiple implant placements. After the placing of the implants they will need to bond with the bone and this can take 3 months in the lower jaw and up to 6 months in the upper jaw.

The reason it takes so long is that the implant must integrate and assimulate into the jaw by the bone cells growing into the micropores on the surface of the roughened implant. It is a natural process and the time span varies from person to person. During this time a temporary tooth replacement can be worn over the site.

The next step is to uncover the implant, attach an abutment extension this completes the foundation , on which your new tooth will be built. Impressions will be made at this stage to form the new tooth. Your gums will be allowed to heal for about 10 days following this procedure and then finally the replacement tooth, crown, bridge or denture will be attached to the abutment.

Recovery from implants.
Implantation is painless and performed under local anaesthetic however, after surgery there may be some dull pain, the bone may feel sore and the surrounding gums tender and swollen. During the first week this will gradually subside.

Possible complications.
Dental implants have been used for many years to replace missing teeth and can last a lifetime depending on how you treat them. They can still be affected by trauma, gum disease and poor oral hygiene programme.

How many teeth can a single implant support?
Usually an implant placed into the bone supports a single crown however, if there are several missing teeth then it is not necessary to have an implant for every missing tooth. An implant can support several teeth vai a bridge or a denture. In the event of a full mouth reconstruction where a number of teeth need supporting a miminum of 5 or 6 implants in each jaw will be needed. The number of implants depends on the volume and density of bone tissue available at each implant site and each individual case.

Complimentary procedures.
Sinus lifting - The quantitiy and quality of the bone where the implant is to be placed is the key to the success of an implant. Traditionally the upper back jaw is one of the most difficult areas to place implants successfully due to the lack of sufficient bone quantity and quality and close proximity to the sinus. Sinus augmentation can help correct this problem by raising the sinus floor and developing bone ready for the implants.

Ridge modifications- this is necessary where there is a lack of bone to securely integrate the root like implant into the jaw. To correct this problem the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or substitute bone to build up the area. The incision is closed and the area left to heal. The bone will be left to develop for anything from 4-12 months before implants are placed.

RISKS OR COMPLICATIONS ASSOCIATED WITH IMPLANTS
• Infection or inflammation - the bone and gums surrounding a dental implant are very sensitive just after treatment and require a high standard of oral hygiene. There is always a small chance that the tissues can become infected of inflamed. The nerves may be damaged, even permanently. There may be a risk of Osteomyelitis (infection of bone or bone marrow). This is why careful follow up is required.
• Rejection - Titanium is a material that has been shown over many years to be well tolerated by living bone. This is why it is used in dental implants. However, there is always a chance that the body may reject it, treating it as a foreign body.
• Overload - You should take care, in the first few weeks after a dental implant, to go easy on the biting pressure that you place on your restored tooth. Bear in mind that placing two or three teeth on one implant can cause overload as well. As in nature, each restored tooth crown should ideally have its own implant foundation.
• Breakage or failure - Most dental implants today are made out of high performance titanium metal. However there is a small chance that the metal fixture coming out of a dental implantcan break. This is easily corrected. Another worry can be having the jaw bone fracture over time because the implant has been badly fitted.
• Sinus cavity - the dental implant process bores a hole in the bone surrounding the teeth. Behind this is a cavity that leads to the sinuses. Great care must be taken in drilling to ensure that the sinus tissue is not penetrated.