Dental Implants
Dental implants are a permanent and appealing solution to replace missing or extracted teeth. They are better than other alternatives like bridges because no additional teeth need to be altered to place the new tooth.
The entire implant process is performed over the course of a few months. The first part of the process is to install the implant itself, where a screw is placed into the jaw bone. An incision is made in the gum so that the implant can be inserted. Multiple implants can be placed at once if necessary. After the implants are placed the gums are sutured.
The implant must be allowed about 3-6 months to heal, and during this time the jaw bone will form around the implant in a process called osseointegration. During this healing time you can have temporary crowns installed so that you can eat and speak normally and maintain a proper aesthetic appearance for your smile.
After the implant has healed it is time to place an abutment on the implant. The abutment serves as the base for your new tooth. One this is placed an impression of the abutment is taken and is used to create your permanent restoration. Some offices have an onsite lab to create the crown, but others will have to send it to an outside lab. Once the restoration is completed you can return to the office to attach the restoration permanently. Your smile will look just like it used to, and after a short period of getting used to the implant it will feel just like one of your own teeth.
Frequently Asked Questions
1. Who are candidates for dental implants?
Any one in reasonable health
2. Is age a factor?
Implants should not be placed in young adults whose facial structures are still growing. Old age is not a concern.
3. What are contraindications for implants?
There are few absolute contraindications; disorders that interfere with healing increase risk factors, as does vascular disease and smoking. Generally speaking, if disorders are controlled the patient is a candidate for implants. Good medical history and consulting with the physician is essential.
4. What is the success rate of dental implants?
Dental implants have the highest success rate of any implanted device in the body. Reported success rates are 90 to 98%, however this may vary based on location, bone density and prosthetic design.
5. How long do implants last?
Based on 40 years clinical evidence, dental implants could last for a patients lifetime, however revisions may be necessary. Orthopedic implants have a current life span of 5 to 10 years.
6. What could cause an implant to fail?
- Early Failures Late Failures
- Overheating bone Occlusal forces/overload resulting in bone loss
- Too much pressure during insertion Lateral Load
- Contamination, Infection, pathology Infection/ perimplantitis
- Poor quality bone Screw loosening
- Movement during healing phase Implant factor
- Prosthetic fracture
7. Are revisions possible?
Absolutely, If an implant fails to bond with the bone, it can easily be replaced with another implant. The site may need to be grafted and allowed to heal prior to placing another implant. Prosthetics can always be re-visited.
8. How much pain will there be?
Some people report minor pain and swelling immediately after the procedure, but most experience no change in their daily routine. The more extensive the implant surgery and/ or grafting procedure, the more likely there will be post operative pain and discomfort.
9. Are pre-operative & post-operative pain medications necessary?
Your doctor should determine the regimen of pre-and post operative pain medication. Clearly written and oral instructions increase patient compliance and comfort.
10. Are there risk to adjacent or opposing teeth?
Provided the implant is placed properly and the occlusal scheme is ideal, there is no risk to adjacent or opposing teeth.
11. Can smokers be treated with implants/
Yes, nut because of inhibited healing, their success rate is reduced.
12. Could a patient be allergic to titanium?
An allergic reaction to titanium is extremely rare.
13. Will Dental Insurance pay for implants?Most dental coverage is designed to ensure patients receive regular preventive care. They limit the amount of care given in a year by placing a cap on benefits. Plans require patients to assume a greater portion of the costs for treatment of dental disease.It is up to the plans sponsor (usually the employer) if an insurance company pays (contributes toward the cost) of implants. If implants are covered the reimbursement is limited to the annual maximum allowed.
Some companies pay the same benefit that would be covered for the lowest cost alternative treatment option.
14. Are risks increased if an implant is placed in an endo extraction site?
If all pathology is removed, no. However, the most prevalent problem with immediate extraction/implant placement is poor position. The implant may be placed too facial/buccal.
15. What if an implant is placed next to an endodontically treated tooth?
Not relevant if the adjacent tooth is treated successfully. The question is: Will the tooth fail within the first couple of months of the implant placement? The pathway to the implant site is easiest to penetrate. The risk is less than 1%.
16. What about paresthesia?
The risk of numbness is only related to implants placed in the posterior mandible. A zone of safety should be followed to remove the risk of impinging on the mandibular neurovascular bundle.
17. What are the risks associated with implant placement in immediate extraction sites?
If no pathology is present, the most common complication is poor position of the implant.
18. Is there a difference in the success rate if a socket is grafted, allowed to heal, and then an implant is placed:
No, the success rate of this healed grafted site is the same as placing an implant in virgin bone. 90 to 98%.
19. What is the risk when replacing a failed implant with a larger implant at removal of the failed implant?
There is a 20% higher risk associated with this procedure
20. What is recommended hygiene?
Office visits should be every 3 months. Special hygiene instruments are necessary. Patients need to be informed of their home care responsibilities for the long-term success of their implant treatment.
