Implant therapy involves replacing one or multiple teeth that have been lost to infection or decay, or simply those teeth that are congenitally missing. Implants are extremely versatile, and can be used to support single crowns, fixed bridges, dentures and even full mouth fixed prostheses. It is important to be evaluated for implant therapy prior to any extractions, as ridge preservation is typically used to maintain bone support for future implants.
What is a dental implant?
A dental implant is a titanium screw that replaces the root of a tooth. Following healing of the implant, the implant can be put into function. The final restoration looks and functions just like a natural tooth and prevents effects of single tooth loss.
Implant vs. Natural Tooth
Do I really need to replace missing teeth?
Occasionally it is not necessary to replace a missing tooth. However, If you choose not to, it is important to know the consequences of that decision. Changes following single tooth loss include:
- Tooth movement
- Occlusal problems
- Loss in vertical dimension (premature aging)
- Bone resorption
Effects of Single Tooth Loss Bone Resorption Loss of Vertical Dimension
How can dental implants be used?
Dental implants can be used in a variety of ways. They are an extremely versatile tool in restoring single missing teeth, multiple missing teeth, and even full edentulous (denture) cases. A few of the ways dental implants can be used are listed below. Videos corresponding to these treatments can be found in the side bar.
- Single tooth restoration
- Fixed bridge restoration
- Implant retained denture
- Implant supported denture
- Implant supported full arch hybrid prosthesis
Videos of these treatments can be seen below:
Single Tooth Restoration Single Tooth Restoration Implant Fixed Bridge
Implant Retained Denture Implant Supported Denture Implant Supported Partial
Implant Fixed Prosthesis All-on-4 Hybrid - Lower All-on-4 Hybrid Upper
What is the process of placing an implant?
Once the site is read for the implant (following extractions and/or ridge augmentation), the implant is placed in an appointment that typically lasts 1 to 1.5 hours under local anesthesia - a process that feels no different to the patient that getting a filling or crown. Following the placement of the implant, the body forms a biomechanical retention with the implant in a process called osseointegration. This process takes anywhere from 3 to 6 months. During this healing phase, temporary interim restorations are used for esthetics and function. Following osseointegration and stabilization of the implant, the implant can be put into function - whether that is to replace a single tooth or part of a multiple implant treatment to support a fixed bridge or full arch prosthesis (denture).
This process can be seen in the video below
Will I just have a missing tooth while the implant heals?
No! We have excellent ways of providing temporary fillings. One of the most common ways to temporize a missing tooth during implant healing is an Essix Retainer or Provisional Partial Denture ("flipper"). A video of this can be seen below.
Essix Retainer Provisonal Partial ("Flipper")
What about implant supported dentures in a day that I see on billboards?
In some cases, immediately loaded implants can be utilized. However, this cannot always be done and it is important to evaluate existing bone availability and patient health, as well as the type of restoration planned. The dental profession consistently pushes the envelope on how quickly we can place and restore implants. While this mentality has been beneficial in advancement of techniques, sometimes it is simply not possible to rush human biology - the body takes time to heal, period. It certainly benefits everyone - patient and surgeon alike - when implants can be immediately loaded. The patient has reduced surgery time and a quicker end result. The surgeon receives the same compensation for less chair time, which results in less overhead cost. However, when it comes to immediately loaded implants, the question is not whether it can be done, but whether it is a predictable and effective treatment for the specific individual. Any complication with implants will cost ten-fold to fix than what it cost to place, and that cost will be placed on the patient and not the surgeon. At Emerald Coast Periodontics, our main concern is to provide the patient with an end product that will last decades, not years. Our philosophy is an oft-quoted statement from John Wooden:
"If you don't have time to do it right, when will you have time to do it over?"
Does it hurt to get a dental implant?
The most discomfort a patient will feel during the process is ridge augmentation or the extraction of the tooth, which will need to be done regardless of whether an implant is used or not. Implant placement itself is an extremely easy and relatively pain-free process. Local anesthetic is used and patients do not feel anything during the procedure. Following implant placement, there is little discomfort. This is due to the intimate fit of the implant into the site preparation, resulting in no appreciable change in hard or soft tissue architecture and therefore no significant discomfort. The only discomfort felt is typically from the small incision made in the gums.
What are the success rates of dental implants?
The success rates for dental implants are well-documented, and have been shown to be in the 95-99% range. This success rate depends on site location and patient medical history, as well as surgeon experience. Patients who have impaired healing (diabetics, smokers) have a reduced success rate with dental implants, and this increased risk should be discussed and addressed prior to any implant placement.
While the success rate is high, 95% success rate means 1 in 20 patients will have an implant fail. This is a very real number and one to consider. Make sure to ask your surgeon questions regarding your individual risk, what the complications could be and the cost associated with treatment to fix them, which may be much more than the implant cost itself.
Can I have a dental implant even though my dentist said I don't have enough bone?
Yes! Sinus Lifts and Ridge augmentation, a process of bone grafting to gain bone volume and density, has advanced leaps and bounds in the past 20 years, and we now have the capability to predictably grow bone in areas we never could before. Depending on your specific medical history and anatomy, there is a very good chance that ride augmentation can be done to make you a candidate for a dental implant.
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