Dental Implants
NEW TEETH FOR A NEW SMILE
Do you avoid laughing aloud, smiling, or eating in public because your denture may slip or a space left by missing teeth may show? If so,
dental implants may improve the way you feel about your teeth. No matter
how many teeth you're missing, dental implants may make it possible for you eat and
speak with comfort and confidence again.
When Teeth Are Missing
You may have spaces in your mouth where teeth were lost or removed or never grew in.
Although these spaces may be embarrassing, traditional dental restorations aren't always
the best solution. You may not want to sacrifice the structure of surrounding good teeth
to bridge a space. Or, removing a complete or partial denture at night may be
inconvenient. Added to this is the discomfort and possible embarrassment caused by a
denture that slips.
Consider Dental Implants
If you want a dental restoration that looks and feels as though it's really part of
your mouth, dental implants may be right for you. Used successfully for many years, dental
implants anchor prosthetic (artificial) teeth into your jawbone to provide a secure,
stable fit. Implants can meet your individual needs can meet your individual needs whether
you're missing all, a few, or only one of your teeth.
Working Together
Your dental implants may be positioned and your prosthesis (artificial teeth)
constructed by one or more dentists. Your surgical specialist (an oral surgeon or
periodontist) prepares your jaw and places the implants, which will hold your new teeth in
place. Then your restorative dentist (a prosthodontist or general dentist) makes your
prosthesis. Your commitment, both during and after the implant process, is also important.
For the best long-term results, you'll need to have regular checkups and practice good
oral hygiene.
Are Implants for You?
Dental implants can improve the quality of life many people, but they aren't for
everyone. Use the checklist below to help determine how you feel about your dental health.
The more boxes you check, the more likely its that dental implants will be a good choice
for you.
How Your Mouth Feels
- Do complete or partial dentures cause discomfort when you eat?
- Do you wear a denture that slips or fits badly?
- Are the teeth holding your bridge loosening or moving?
How You Feel About Your Teeth
- Are you embarrassed about missing teeth or dentures when you smile or laugh?
- If you have a complete or partial denture, do you sometimes carry it in your pocket or
leave it at home?
Your Commitment to Dental Implants
- Can you wait three to nine months for the entire implant process to be completed?
- Are you willing to spend extra time caring for your dental implants?
- Will you follow up with regular dental checkups?
Knowing your dental history helps your surgical specialist and restorative dentist
decide if you're a good candidate for implants. A dental exam and tests help determine
where the implants should be anchored in your jaw. After developing a treatment plan, your
dentists present you with the information you will need to decide if implants are right
for you.
Your Dental and Medical History
Your surgical specialist and restorative dentist are likely to ask why you want dental
implants. What results do you expect? If you wear a denture, you may be asked how it fits
and if it causes you pain. Your surgical specialist will also want to know if you have any
medical conditions, such as diabetes or bleeding problems. You also may be asked if you
smoke or take certain medications, two things that can slow healing.
Your Dental Exam
Your surgical specialist examines the structure and health of your mouth, jaws, head,
and neck. The restorative dentist studies the shape of your mouth and bite (the way
your teeth meet when you chew). He or she also makes models (plaster molds) of your
upper and lower jaws to reveal their exact alignment. If you wear a complete or partial
denture, your restorative dentist may also evaluate the way it fits in your mouth.
Diagnostic Tests
X-rays and other types of imaging tests provide information on the health of your teeth
and jaws. A panagraphic x-ray provides a view of your entire mouth and can indicate bone
problems. Scans produced by x-ray tomography may help your dentures determine whether or
not you have enough jawbone to support a dental implant. If you have an ongoing medical
condition, such as diabetes, you may also have blood tests to make sure your condition is
under control before treatment begins.
Your Treatment Plan
After the valuation, your surgical specialist and restorative dentist will discuss a
treatment plan with you.
If dental implants are likely to work for you, the overall cost and time frame for the
procedure are outlined.
You'll also be told about any dental work or special surgical procedures you may need
before the implant process can begin.
You Have Alternatives
If dental implants aren't right for you now, consider your alternatives. You can keep
your current prosthesis as it is or have it adjusted for a better fit. Or, you can have a
new prosthesis made. If you're missing only one tooth, a bridge may be a good option.
Special Surgical Procedures
If your mouth isn't ideal for dental implants, your surgical specialist may suggest way
of improving the outcome.
Bone Graft
If your jawbone is not big enough to hole the implant, bone grafting may increase jaw
height or width.
Bone may be taken from other areas of your jaw or from your hip. After the new bone is
packed around your jaw, the gum is closed and the bone begins fusing with your jaw.
Tissue Regeneration
To encourage proper healing after a bone graft, an artificial membrane may be placed
along the bone edge.
This membrane slows soft tissue growth, giving the new bone time to fuse with your jaw.
Sinus Lift
If your upper jaw ridge is too low, the implant my puncture the sinus cavity. This can
be avoided by lifting the sinus membrane and adding height to your jaw with a bone graft.
Risks and Complications
The possible risks and complication of dental implants include the following:
- Bleeding, infection,
numbness, or injury to nearby muscles
- Injury to a nearby sinus cavity
- Incomplete healing of the bone around the implant, leading to implant failure
Implants Are Like Teeth
Your natural teeth are stable biting and chewing surfaces because they are supported by
your jawbone. This will also be true of your dental implant. Successful dental implants
become firmly embedded in the jaw, providing a chewing surface almost as secure as that of
natural teeth.
Roots Hold Crowns
The crowns of your natural teeth are held in place by roots. Roots not only secure your
crowns, they also help keep your jaws healthy by stimulating the growth of new bone. This
provides good support for your teeth.
Implants Hold a Prosthesis
The prosthesis is held in place by implants, which are usually made of titanium.
Because this metal is well accepted by the body, titanium implants rarely cause reactions.
Like the roots of natural teeth, implants also stimulate new gum growth in your jaw.
| The
Crown
The
Root
The
Ligaments |
|
The
Prosthesis
The
Abutment
The
Implant |
The crown is the tooth's hard surface, which is visible above the gumline
The root is the supportive base of your tooth and is fixed in the jawbone.
The ligaments are tough fibers that fasten the root to the jawbone.
The prosthesis is the artificial crown, which is visible above the gumline.
The abutment is the small piece of metal that connects the prosthesis to the
implant.
The implant is the supportive base of the prosthesis that becomes fixed in the
jawbone over time.
Implants Have Different Shapes
An implant may be threaded like a screw or may be cylindrical in shape with a slightly
rough or textured surface. Implants often have small holes at their lower ends. Over time,
bone grows into these surface irregularities (Osseo integration), locking the
implant in place.
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| A threaded implant |
A cylindrical implant |
A PROSTHESIS TO FIT YOUR NEEDS
Using dental implants, a new prosthesis can be made to fit your individual needs. No
matter how many teeth are being replaced, the basic process is the same. Only the number
of implants changes. If you are replacing a complete set of teeth, though, you may have
the option off either a removable or fixed prosthesis.
Types of Prostheses
Depending on your needs, a prosthesis can replace on one more teeth. The number of
implants you'll need depends on whether you're having a partial, complete denture, or
single prosthesis made. The more teeth being replaced, the more implants your prosthesis
requires. These implants are placed to follow the shape of your jaw.
*Partial Prosthesis
This type of prosthesis can replace two or more teeth. It is the most commonly
performed implant procedure, and my require only tow or three implants.
*Complete Denture Prosthesis
This type of prostheses replaces all the teeth in your upper or lower jaw. The number
of implants varies, depending on the type of prosthesis you choose.
Choosing a Complete Denture Prosthesis
A prosthesis that is used to replace a complete set of teeth may be removable or fixed. You and your restorative dentist may discuss which option is best for you.
With a removable prosthesis, you can take your teeth out of your mouth to make cleaning
easier. With a fixed prosthesis, your new teeth can only be taken out by a dentist. In
some cases, a fixed prosthesis may offer increased stability for more effective chewing.
With a removable prosthesis, your new teeth can be joined to the abutments by a
connecting device, such as a clip bar. This type of prosthesis my use two to four implants
per jaw.
Single Prosthesis
This type of prosthesis is used to replace one or two missing teeth. Each prosthetic
tooth attaches to its own implant.
With a fixed prosthesis, your teeth are fitted to a metal frame, which is then
secured to the abutments. A fixed prosthesis may use five to six implants, which are
placed to follow the contour of your jaw.
The Implant Process
The implant process is a three-step procedure. The first two types are surgical. The
third type involves making and attaching your new teeth.
During your first surgery, the implants are placed.
During your second surgery, the abutments are attached.
During the last step, your new prosthesis is attached.
YOUR FIRST SURGERY
During your first surgery, the surgical specialist places the implants in your jawbone.
Much of the success of the entire implant process depends on how tightly your jawbone
grows around the implants (Osseo integration). You can help the implants "take hold:
by avoiding pressure on your jaw and by keeping your gums and teeth especially clean over
the next three to six months.
Preparing for Surgery
Most dental implant surgeries are performed in a dental office. Be sure to wear
comfortable clothes and arrange for a family member or friend to drive you home. Depending
on the type of anesthesia used, you may be told not to eat or drink for several hours
before your appointment. Before surgery, you may be asked to take oral antibiotics, brush
your teeth, and rinse with an antiseptic mouthwash to help prevent infection.
During Surgery
You may have medication to help you relax or to make you sleepy. Then, you'll be given
an anesthetic to numb the area where your surgical specialist will be working. You may
hear sounds or feel vibrations during the surgery. If you are uncomfortable at any time,
tell your surgeon. The entire procedure may take a couple of hours.
Making the Incision
A small opening is made in your gum, exposing the jawbone. This incision will be
stitched closed after the implant is in position.
Preparing the Bone
A precise hole is slowly and gently drilled into the bone. The hole is deep and wide
enough to hold the implant.
Placing the Implant
The implant is twisted or gently tapped into position. Then a temporary cap is placed
over the implant and the gum incision is closed.
After Surgery
After surgery, you'll probably rest awhile, bite on gauze to stop any minor bleeding,
and hold a cold pack to your face to reduce swelling. You can go home as soon as you feel
able. At home, follow your surgical specialist's instructions about taking pain
medications and antibiotics. Drink only clear liquids for the rest of the day. By the next
morning, you may be able to eat soft foods.
Caring for Your Mouth
Use a soft-bristled brush to clean both your teeth and gums. Be sure to follow any
special instructions on cleaning near your incisions. To aid healing, you may be asked not
to wear your complete or partial denture for the next several days.
Use a small, soft toothbrush to gently clean the area near your incisions.
Follow-up Care
Over the next several months, your surgical specialist routinely examines your mouth
and monitors how well your jaw is healing. If you wear a complete or partial denture, the
restorative dentist will place a new lining in it so you can wear it during the rest of
the healing process.
When to Call Your Surgical specialist
Call your specialist if you have any of these signs:
- Extreme swelling near your jaws or under your tongue
- Fever or ongoing bleeding
- Pain in your jaws, mouth, or sinuses that isn't relieved by your prescribed medication
Relining your current denture provides cushioning for greater comfort
YOUR SECOND SURGERY
You'll be given an anesthetic to numb the area where your surgical specialist will be
working.
Temporary abutments may be used if swelling in your gums needs to go down before an
appropriate, permanent abutment can be attached. The second surgery is usually shorter
than the first, often lasting no more than an hour.
Exposing the Implant
A small incision is made in the gum, exposing the top of the implant. The temporary cap
is removed.
Attaching the Abutment
The abutment is twisted into the implant.
The Abutment in Place
In most cases, a permanent abutment is placed at this time.
After Surgery
After surgery, you'll rest and bite on gauze to stop any minor bleeding. You may be
given a prescription for pain medication and scheduled for a follow-up visit. Follow your
surgical specialist's instructions about when to begin cleaning your abutments. Gently
cleaning around the base of each abutment helps prevent infection.
When to Call Your Surgical Specialist
Call your specialist if you have any of these signs:
- Extreme swelling
- Fever or bleeding
- Pain in your mouth, jaws, or sinuses that isn't relieved by your prescribed medication
You can aid healing by gently brushing all around the abutment near the gumline.
MAKING YOUR NEW TEETH
Your restorative dentist begins making your prosthesis when your gums have healed
around the abutment, usually tow to four weeks after surgery. Several visits may be spent
analyzing the new structure of your mouth. Then, it may take several more weeks or months
to create the prosthesis.
Forming Your Prosthesis
 First, your restorative dentist makes impressions (molds of your teeth,
abutments, and jaws) and bite registrations (imprints of how your teeth fit
together). then, these molds are used to create a model of your mouth. Your new prosthesis
will be built from this model.
The Prosthesis in Place
The prosthesis is attached to abutment with a screw.
Fitting Your Prosthesis
You'll have several "trial fits: before the prosthesis is finally attached to the
abutments. With a fixed prosthesis, this fitting process may take a little longer. Once
the prosthesis is in your mouth, the restorative dentist makes any final adjustments
necessary to provide you with a pain-free, stable bite. You may be told to avoid eating
hard or crunchy foods for a few weeks after your prosthesis is in place.
When to Call Your Restorative Dentist
Call your restorative dentist if you have any of these problems:
- You have pain in your jaws.
- Your bite feels wrong.
- The implant feels loose.
- The prosthesis feels loose, chips, or breaks.
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