Dental Implants

What are dental implants?

Dental implants are metal anchors placed in the jaw bone underneath the gum tissue to support artificial teeth where natural teeth are missing. Unlike other types of tooth replacements, such as removable dentures or fixed bridges that are cemented to remaining teeth, dental implants are actually placed into the jaw bone under the gum tissue. These implants are usually made from a space-age metal called titanium, which is readily accepted by the body, and artificial teeth that look like natural teeth are then attached to the implants.

Accepted by the American Dental Association, dental implants have been used for many years, and hundreds of thousands have been placed.

How do dental implants work?

Through a process known as osteointegration, bone attaches itself to the implant, providing a strong foundation that allows people with missing teeth to chew efficiently and comfortably. You can think of them as anchors to help stabilize artificial teeth.

Who needs dental implants?

Anyone who is missing teeth and can benefit from increased chewing efficiency, and improved appearance or speech, is a candidate for dental implants. Implants can be the solution when it has become difficult or impossible to wear a removable denture. Portions of the jaw that are missing due to an accident, disease or birth defect can often be reconstructed using implants.

How do I know if I need dental implants?

You are a candidate for dental implants if:

You have enough dense jaw bone to secure the implants
You do not have a disease or condition that interferes with proper healing after implant surgery (i.e. uncontrolled diabetes, or radiation/chemotherapy for treating cancer)

A discussion with your oral and maxillofacial surgeon and restorative dentist (who makes your new teeth) will determine if you are a good candidate for implants. As a rule, age is not a barrier to implant treatment if you are in good health. Thousands of people of all ages turn to dental implants to replace a single missing tooth, several teeth, or all teeth.

What can be restored with dental implants?

Missing front teeth have unique demands. The challenge is to replace your missing teeth for both appearance and function without harm to your remaining teeth or gum tissue.

Appearance: Ideal implants will look like your natural teeth both to you and to others. Our solutions offer the best appearance possibilities available in dentistry.
Confidence: The ideal replacement for your missing teeth must also feel like natural teeth and be easy to clean. Knowing your teeth are stable during eating and talking means a lot.
Security: The long term safety of replacing your lost teeth with dental implants is well established and your doctor will discuss with you a treatment plan for long term results.

What are known risks and complications?

Dental implant surgery has a high rate of success, but as with any surgical procedure, certain side effects or complications are possible. You should understand these before you consent to surgery, and ask your surgeon about the following possible risks:

Swelling: a normal reaction to any surgical procedure. The amount of swelling depends on how extensive the surgery was. Normal swelling should peak within 48 hours, then gradually subside. If swelling worsens after 48 hours, contact your surgeon.
Bruising occasionally develops in areas close to the surgical site. Any discolouration from bruising should disappear within a few days following surgery.
Moderate pain is common for 24 to 48 hours following surgery, and pain medication may be prescribed. If intense pain persists that cannot be relieved by prescribed pain medication, contact your surgeon.
Trismus, or stiffness of the jaw muscles, may be caused by swelling following surgery. As swelling decreases, trismus should disappear.
Infection is very rare following implant surgery, but occasionally an infection can occur. If fever, persistent swelling/pain or pus develops following surgery, contact your surgeon immediately.
Rejection: There is always a potential that an implant may fail, most commonly caused by inadequate maintenance by the patient following surgery.
Injuries can potentially occur to adjacent teeth and roots, fillings, or bridgework.
Sinus: drainage or pain occasionally occur if implants are placed in the upper jaw and the sinuses become involved. This may or may not require further treatment, but any sinus symptoms should be reported to your surgeon.
TMJ (jaw joint) pain or abnormal function is rare following implant surgery, but if it does occur, further treatment may be necessary.
Bone loss is very rare, but may occur around the implant if proper hygiene is not maintained or if excessive stress is placed on the implant.

how do I maintain my dental implants?

Your surgeon and restorative dentist will schedule periodic check-up visits to make sure your jaws are healthy and the implants and prosthesis are functioning properly. Just as important, however, is your own care of your implants and artificial teeth.

Practice meticulous home oral hygiene, following the instructions of your dentist and hygienist. Abutment posts, beneath the prosthesis, artificial teeth and gum tissue must be kept clean. Home care aids such as special brushes and floss holders will help you achieve this. If you do not keep your implants and prosthesis clean, they may fail.

Smoking and excessive alcohol consumption as well as chewing hard foods such as ice or hard candy may result in damage to your implants, or cause them to fail.

Steps in Obtaining Dental Implants

Consultation:

A thorough oral examination and medical consultation by your dental provider is necessary to determine if you are a candidate for dental implants. This team consists of your oral and maxillofacial surgeon, and your restorative dentist. Working as a team, the oral and maxillofacial surgeon places the implants and after healing takes place, the restorative dentist designs and places the artificial teeth that are supported by the implants.

During the examination, you will give a complete medical history. Be sure to give all information, including any health problems, allergies, or medications you are taking. Your examination may include several types of x-rays to show anatomy and models of your jaws. Based on the results of this examination, the dental team will discuss all aspects of your case with you. Together, you will decide if dental implants are appropriate for you.

Preparing for Implant Surgery:

Here are some tips to help you prepare for your implant surgery appointment:

Clothing: Wear loose, comfortable clothing with sleeves that can be easily rolled up. If intravenous anesthesia or sedation will be administered, tight sleeves can make this difficult.

Transportation: Arrange to have someone accompany you to your surgical appointment and drive you home afterward. You may be drowsy for awhile after anesthesia, and driving yourself is unsafe.

Diet: If intravenous anesthesia or sedation will be administered, do not eat or drink for at least 6 hours prior to your surgery appointment.

Medications: Adhere to any medication schedule that is prescribed prior to surgery.

Anesthesia: Modern anesthesia technology makes it possible to perform even complex surgery in the dental office with little or no discomfort. During surgery, either local anesthesia, nitrous oxide-oxygen, intravenous sedation, or general anesthesia will be administered by the oral surgeon or dental assistant.

Implant Surgery:

The placement of dental implants requires two difference surgical procedures:

Stage 1: Implants are placed in the bone
Stage 2: After the jawbone has fused to the implants, the fixtures are uncovered and special posts called abutments are attached to the implants. These abutments project above the gumline into the mouth, and the final artificial teeth will be fitted onto them.

What to Expect During Dental Implant Surgery

Stage 1 Surgery:

The first surgical procedure for implants involves placing the implants in the bone. The surgery can take place in the oral and maxillofacial surgeon's office, or in a hospital setting. Local anesthesia with a mild sedative may be used, or in certain cases, general anesthesia may be recommended. After you are anesthetized, the surgeon will lift back the gum tissue to expose the bone and place one precisely measured hole in the bone where each implant will be inserted.

The implant fixtures are inserted in the holes, then the gum tissue is replaced over the fixtures and sutures (stitches) are placed. The procedure may take several hours if multiple implants are placed, and following surgery you will spend some time in the recovery room before going home. Osteointegration (bone fusion) will begin taking place as healing progresses, and the fixtures should be firmly anchored by bone within four to six months.

Following Stage 1 Surgery:

Immediately following surgery you may be asked to bite on some gauze to stop any bleeding, and an ice pack may be used during the first 24 hours to help reduce swelling. Expect some swelling in the area of the implant surgery for up to 72 hours following your procedure, as well as some potential discolouration of the skin and gums for a few days. Pain medication prescribed by your surgeon will help alleviate any discomfort, and you should be able to resume normal activities within a day or two. Your surgeon may also prescribe antibiotics. Expect some minor bleeding on the day of surgery, but report excessive bleeding to your surgeon immediately.

During this time, a soft diet is recommended that doesn't place stress on your new implants, and your surgeon will give you important instructions on how to clean your mouth. If you have been wearing a denture, the surgeon or restorative dentist may place a soft lining in it so you can wear it comfortably during the healing period or it may be necessary to leave it out for a short period of time. If spaces due to missing teeth must be filled in while healing takes place, temporary teeth that appear natural can be made. Sutures that were placed after surgery will dissolve on their own within about a week.

Stage 2 Surgery:

The second surgical procedure takes place after healing from Stage 1 surgery is completed. For endosteal implants, healing usually takes four to six months. Areas of the mouth that undergo more chewing stress may require a longer healing period, perhaps up to eight months. At the second surgical appointment, usually performed in the surgeon's office using local anesthesia, the gum tissue is opened to expose the implant fixtures. The fixtures are examined to verify satisfactory osteointegration, then healing posts are attached to the fixtures. If sutures are placed, they will dissolve on their own within about a week.

This second stage of surgery is a relatively short procedure, and you can expect to return to normal activities within one or two days if not sooner.

Following Stage 2 surgery:

After returning home, eat a soft diet and follow your surgeon's oral hygiene instructions. Expect some minor bleeding, but report excessive bleeding or swelling to your surgeon. You will return to your surgeon within a few days so that healing progress can be monitored, and if you wear a denture, it may be placed immediately or shortly after surgery.

Making Your New Teeth

When your gum tissues have completely healed after Stage 2 surgery, you are ready to visit your restorative dentist and begin fabrication of your new artificial teeth. Your dentist will make impressions of your mouth, and bite registrations that record the way your jaws fit together, then the impressions are used to make models of your jaws and any remaining teeth. Your artificial teeth will be made based on these models.

Your artificial teeth will be either removable, fixed, or a combination of both:

Removable: similar to a conventional denture or partial denture, in that you can remove it from the mouth to clean it, but it has the advantage of being fastened to the implant abutments by clips, magnets or other devices. Artificial teeth and gum tissue are mounted on a metal framework, and the framework attaches to the implant abutments.
Fixed: Can replace one tooth, several teeth, or even all of your teeth. The artificial teeth are screwed into the abutments, or cemented onto the abutments, and held firmly in place. If some natural teeth remain in the mouth, parts o the prosthesis may be connected to some of these teeth. A fixed prosthesis can only be removed by your dentist, and it is specifically designed to allow you to clean it. If a fixed prosthesis is replacing many teeth, the artificial teeth will be mounted on a metal frame that must fit the implant abutments precisely. Your restorative dentist may have you wear the prosthesis for a while to make sure it fits properly, before final attachment to the abutments.

While there is no guarantee of 100% success with implants, current literature reports that 90% or more of implants have been successfully retained for up to 15-20 years. Thousands of people have rediscovered the joy of eating properly, speaking clearly and laughing comfortably through the use of dental implants.

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