What is a Dental Implant?
A dental implant is a procedure that replaces the roots of a tooth with artificial teeth that look and function like real teeth. Dental implant surgery can offer a welcome alternative to dentures or bridges that don’t fit well, and it may be a solution when the lack of natural tooth roots prevents the construction of dentures or the replacement of teeth with a bridge.
The way the dental implant procedure is carried out depends on the type of implant and the condition of the patient’s jaw. Dental implant surgery may involve several procedures. The main benefit of implants is the strong support they provide for your new teeth – a process that requires the healing of the bone around the implant. Since this bone healing takes time, the process can last several months.
A dental implant is a prosthesis that connects to the jawbone to support a dental prosthesis such as a crown, bridge, denture, or facial prosthesis, or to act as an orthodontic anchor. The foundation for modern dental implants is a biological process called osseointegration, where materials like titanium or zirconia form an intimate bond with the bone. The installation of the implant is initially positioned so that it has the potential to osseointegrate, after which a dental prosthesis is added. A variable amount of healing time is required for osseointegration before the dental prosthesis (a tooth, bridge, or denture) is attached to the implant or an abutment is placed to hold the prosthesis/crown.
Planning the position and number of implants is key to the long-term health of the prosthesis, as the biomechanical forces created during chewing can be significant. The position of the implants is determined by the position and angle of adjacent teeth, by laboratory simulations, or by using computerized tomography with CAD/CAM simulations and a surgical guide called a stent. Prerequisites for the long-term success of osseointegrating dental implants are healthy bones and gums. Since both can atrophy after tooth extraction, pre-prosthetic procedures such as sinus lifts or gingival grafts may be required to restore ideal bone and gum conditions.
The final prosthesis may be either fixed, where the patient cannot remove the prosthesis or teeth from their mouth, or removable, where the prosthesis can be taken out. In both cases, a support is attached to fix the implant. Where the prosthesis is fixed, the crown, bridge, or denture is attached to the abutment either with screws or dental cement. Where the prosthesis is removable, a matching adapter is placed in the prosthesis so that both parts can be securely attached.
The risks and complications associated with implant therapy are divided into those that occur during the surgery (such as excessive bleeding or nerve damage), those that occur within the first six months (such as infection or failure to osseointegrate), and those that occur long-term (such as peri-implantitis and mechanical failures).
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Why are dental implants a good choice?
Dental implants are surgically placed in your jaw, where they function as the roots for missing teeth. The titanium in the implant fuses with the jawbone, preventing the implant from slipping, making noise, or causing bone damage, which can happen with bridges or dentures. The material cannot decay like natural teeth.
In general, dental implants may be suitable in the following cases:
- You have one or more missing teeth.
- You have a fully grown jaw.
- You have enough bone to secure the implants or are capable of undergoing bone grafting.
- You have healthy oral tissues.
- You do not have medical conditions that would affect bone healing.
- You are willing to commit several months to the process.
- You do not smoke.
Risks
Like any surgical procedure, dental implant surgery carries some health risks. Problems are rare, however, and when they occur, they are usually minor and treated easily.
Risks include:
• Infection at the implant site.
• Injury or damage to surrounding structures, such as other teeth or blood vessels.
• Nerve damage, which can cause pain, numbness, or a tingling sensation in your natural teeth, gums, lips, or chin.
• Sinus problems, when dental implants placed in the upper jaw penetrate into one of your sinus cavities.
Preparation for Implantation
The process of planning dental implants may involve several specialists, including a doctor who specializes in conditions of the mouth, jaw, and face (oral and maxillofacial surgeon), a dentist specialized in treating structures that support teeth, such as the gums and bones (periodontist), a dentist who designs and fits artificial teeth (prosthodontist), or occasionally a specialist in ear, nose, and throat (ENT).
Implantation Process
Because dental implants require one or more surgical procedures, you need a comprehensive evaluation to prepare for the process, which includes:
• Comprehensive dental checkup.
• Panoramic X-ray and 3D scan.
• Models made from your teeth and jaw.
• Review of your medical history. Inform your doctor about any medical conditions and medications you’re taking, including prescriptions, over-the-counter medicines, and supplements. If you have certain heart conditions or orthopedic implants, your doctor may prescribe antibiotics before surgery to help prevent infection.
• Treatment plan. Tailored to your situation, this plan takes into account factors such as how many teeth you need to replace and the condition of the remaining jawbone.
Dental implant surgery is a staged procedure with healing time between steps. The process of placing a dental implant involves multiple stages, including:
• Removal of the damaged tooth.
• Preparation (grafting) of the jaw, if necessary.
• Placement of the dental implant.
• Bone growth and healing.
• Placement of the abutment.
• Placement of the artificial tooth.
The entire process can take several months from start to finish. Most of this time is spent healing and waiting for new bone growth in your jaw. Depending on your situation, specific procedures or materials used may sometimes be combined.
Results
Most dental implants are successful. However, sometimes the bone fails to properly integrate with the metal implant. Smoking, for example, can contribute to implant failure and complications.
If the bone doesn’t properly integrate, the implant is removed, the bone is cleaned, and you may try the procedure again after about three months.
To maintain healthy teeth and long-lasting implants, you should follow these recommendations:
- Practice excellent oral hygiene for both natural teeth and artificial teeth over implants, and do not neglect your gums.
- Use brushes specifically designed to clean between teeth, gums, and metal fittings.
- Regularly consult with your dentist.
- Schedule dental check-ups to ensure the health and proper functioning of your implants and follow advice for professional cleaning.
- Avoid habits that damage teeth, such as chewing hard objects or consuming tobacco and caffeine.