Dental Implants

Replacement of missing teeth is a major focus of restorative dentistry. The replacement of missing teeth improves normal functions of eating, chewing, speaking and how we relate to others. In the past, missing teeth traditionally have been replaced with fixed bridgework, removable partial dentures, and dentures. This often required sacrificing the integrity of adjacent teeth to provide the prosthesis for the missing teeth. Dental implants are one of the most exciting advances to occur in restorative dentistry and surgery in the past 20 years. As technology improves, we will be able to offer even better options in the future for these difficult problems. Implants can be used as single tooth replacements, as abutments for bridges, in appliances to stabilize removable dentures or partial dentures. Implants give the restorative dentist options which simply were not available in the past or better options of ways to replace missing teeth.

Restoring missing teeth with dental implants is a cooperative effort between the patient, the surgeon and the restorative dentist.Dental implants are screw-like metal devices made of titanium {the same metal used in artificial joint replacements} which are placed in the bone to serve as platforms for the replacement of missing teeth or stabilization and retention of an existing denture.After the implants are replaced, there is a period of time required before implants bond to the surrounding bone.Following the integration of implants to the bone, these become dependable anchors for replacement teeth which function, feel and look like natural teeth. Implants provide superior ability to chew almost anything and restore confidence.Dental implants also stabilize and prevent further bone loss in areas where teeth are missing.Recent studies have shown that implants allow for the restoration of proprioception or the ability of the body to “feel” with the teeth as they function in chewing.

Dental implants have four distinct advantages over conventional dentistry when it comes to the replacement of a single missing tooth.

1. Replacement using a fixed bridge requires the removal of the entire outside covering {the enamel} of the teeth on either side of the missing tooth.This can result in the nerve dying requiring a root canal.This is avoided with implant placement.

2. The actual cost of replacing a single missing tooth with a dental implant and crown is cheaper than the cost of a three-unit bridge.

3. The worse case scenario is always better with implants.If a three-unit bridge is placed and if it fails{usually due to decay of gum disease}, the result is frequently the loss of an abutment and a larger, more expensive bridge to replace it.If a dental implant fails, you have the same hole you started with, generally not any worse off.Furthermore, after the bone heals you usually can replace it with another implant and crown.

4. The success rate is better with implants.Research has shown success with dental implants replacing the back lower jaw teethbetween 98 and 100% over a 10 year period.In upper teeth in the back of the mouth implants are 92% successful over a period of 10 years.Fixed bridgework has a success rate of 79 to 80% over a period of 10 years regardless of the location.This difference is generally attributed to the difficulty in keeping a bridge clean because it is made in one piece making homecare more difficult resulting in loss of the abutment teeth.Metal implants are susceptible to gum disease but will never decay.

5.The location of a missing tooth is important.The loss of the last back tooth in the arch usually means it is not practical to replace it with conventional dentistry.It is easily replaced with a dental implant often restoring function to the tooth in the opposing arch as well.There are some applications where implants are the only solution.

CHOICE OF IMPLANT SYSTEMS

There are multiple choices of implant systems which can be used to replace missing teeth.These vary in the best application for each situation.There is often considerable difference in the cost of different implant systems making implants affordable for almost anyone.Our surgeon will be glad to discuss with you the advantages of each system and help you determine the best type of implant system for your situation.

THE SURGICAL EXPERIENCE

The placement of dental implants is usually a short, uncomplicated procedure which can easily be accomplished under a local anesthetic or nitrous oxide analgesia and local anesthesia.There is generally limited discomfort with the placement of implants because they frequently do not require an incision in the gums.After implant placement, minimal pain should be expected{less than when the tooth or teeth were removed}.If implants are being placed in an esthetic area, a temporary appliance, used only for esthetics, will probably be made by the restorative dentist which should not be used for chewing or biting to avoid applying pressure on the implant during integration.Reasonable care and hygiene is critical in the healing phase after surgery to the success of integration.

RESTORATIVE EXPERIENCE

Following the time for integration to occur, the permanent restoration can be placed.In one piece implants, this can occur 4 to 6 months after placement of the implant and the temporary crown.In two piece implants, this can occur after 4 to 6 months and the placement of an abutment inside the implant by our surgeon or the restorative dentist.

INSURANCE CONSIDERATIONS

Currently most insurance companies pay nothing or a limited amount on implants. However, they still may pay for the crown restoration which must be placed even though they don’t cover the implant itself.Because of the increased success, the often lesser expense, and the better prognosis even in failure of the implant when compared to conventional dentistry, most agree that in the future insurance will undergo a flip in preference of payment for implants over convention dentistry to replace missing teeth.Regardless of payment options, dental implants still remain the best replacement for missing teeth.

FREQUENTLY ASKED QUESTIONS ABOUT DENTAL IMPLANTS

Please visit 3M and BioHorizons for more information about dental implants.