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Introduction
> Frequently Asked Questions
> Case Studies
1. What is a Dental Implant?
2. What are the benefits
of Dental Implants?
3. Are Dental Implants
safe?
4. What is the success rate of Dental Implants?
5. Does it hurt to have dental implants placed?
6. How long will the treatment take?
7. Do I have to go without my teeth while the implants are osseointegrating?
8. Am I a candidate for Dental Implants?
9. What's the cost of
Dental Implants?
10. Why have Dental
Implants become so popular?
11. What is a bone graft
and why may it be needed?
A dental implant is an artificial tooth root made of
titanium. It is placed in the position where the missing
tooth used to be in the jaw bone and acts as an anchor
for a new tooth or teeth. They behave like tooth roots
by bonding to the underlying jaw bone. Some months after
placement, titanium posts called abutments are connected
to the implant to allow support for the replacement
tooth or teeth.
Dental implants should only be placed
in a healthy mouth and thus it may be necessary to have
other remedial treatment prior to commencing implant
treatment. This may include control of gum disease and
hygiene, root canal therapy and treatment of tooth decay.
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Teeth may be lost due to gum disease, injury such as
a traumatic accident, previous surgery or failure of
old dental treatment. If teeth are lost, implants placed
in their place can help to arrest the inevitable gum
and bone loss that occurs due to disuse of the residual
jaw bone. Loss of the jaw bone can make people look
aolder than they really are. Implants will help prevent
these changes.
If single teeth or group of teeth are
missing, implants can help replace these missing teeth
without having to prepare and grind down the neighbouring
teeth thereby preserving natural teeth and maintaining
their life.
Patients who wear removable partial dentures
can have these replaced by fixed teeth using dental
implants. This enables a better quality of life, confidence
to smile and speak as well as an improved ability to
eat a much wider range of foods. It’s like having
your natural teeth back again!
Missing back teeth often cause loss of
support for the facial muscles giving a ‘sagging’
effect. Back teeth can be replaced with implants thereby
improving facial support to provide a more youthful
appearance as well as making eating your favourite foods
a pleasure again.
Patients with all their teeth missing
can also benefit from dental implants. Implants can
be used to support or to replace dentures altogether.
If dentures are uncomfortable because
they are bulky, move around, click or are painful, then
implants can be used to support them and hence improve
their function. This is a very cost-effective solution
to an age old problem of loose dentures.
Of course, using implants it is possible
to replace all the teeth and get rid of dentures altogether.
This depends on availability of bone for implant placement.
In cases of deficient bone, we will need to rebuild
the lost tissues. Various innovative surgical techniques
are available for dealing with even the most complex
problems.
Some people who cannot wear dentures because
they gag, find the denture too bulky in their mouth
or indeed dislike the thought of anything foreign in
their mouth are ideal candidates for implant therapy
provided they satisfy the relevant criteria.
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Implants are made from titanium or titanium alloys and
these are materials that have been thoroughly tested
for many years to be inert and are easily accepted by
the tissues of the body. There is no scientific evidence
to suggest that titanium dental implants are not safe
in any way.
There are always risks associated with
surgery rather than the implants and these should be
discussed with the implant surgeon prior to implant
placement.
Millions of implants have been placed
around the world and these people now enjoy the benefits
that fixed teeth can provide including transforming
a person’s confidence and improving the appearance.
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With the rapid advances in implant dentistry, dental
implants can be expected to function indefinitely. However,
like any dental restoration, there is wear and tear
associated with constant use and these restorations
supported by implants will need to be repaired or replaced
from time to time.
It is generally well accepted that late
problems with the implants themselves are due to changes
in the health of the patient which may result in implant
loss.
Success also depends very much on quality
of the bone into which they are placed. For example,
implants placed in the front portion of the lower jaw
can have a success rate as high as 98-100%. In other
areas of the mouth, success rates can drop due to the
thinness of bone. According to figures that we have
today, the success of implants in the front part of
the upper jaw are anywhere from 90-95%. Success rates
of implants in the back part of the upper and lower
jaw can be in the 85-95% range.
Occasionally dental implants do fail.
In many instances, they can be replaced with another
implant, usually of a slightly larger size. Failure
rates in our practice are very, very low.
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Placing an implant is a very gentle procedure and is
usually done with local anaesthetic, much like when
having a filling. After implant placement most patients
experience minor discomfort after the anaesthesia has
worn off and this is usually controlled by simple painkillers.
The level of discomfort is quite different from patient
to patient, but most patients do not have significant
problems. Some patients do have varying degrees of discomfort
which may last for several days. Very occasionally there
may be some swelling around the site.
Of course, if a patient is particularly
nervous, it is possible to have the procedure with sedation
to alleviate any anxiety during the procedure.
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This depends on the density of bone into which the implants
are placed.
Generally we wait 3-4 months for implants
placed in the lower jaw and 4-6 months in the upper
jaw due to the difference in bone densities.
During this healing time, OSSEOINTEGRATION
takes place. This is the process whereby the bone fuses
with the titanium implant which is placed into it hence
anchoring it firmly.
After this time, posts are connected to
the implants and temporary teeth are constructed. These
are usually left for 4-6 weeks to allow the gum to mature
and form a natural contour. The final teeth can then
be made and fitted.
Treatment in most cases where there is
no grafting is usually completed in 6-9 months.
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At the Harley Dental Implant & Cosmetic Centre,
our protocol is to progress our patients to fixed provisional
teeth as soon as possible, usually before the implants
are placed. Thus these provisional teeth then act as
the temporary teeth whilst healing is taking place and
therefore patients leave the practice on the day of
the implants being placed with their teeth in place.
In patients wearing dentures, the old
dentures can be usually be modified around the newly
placed implants and patients leave the office wearing
their teeth the day the implants are placed. Every patient
and procedure is evaluated separately and there might
occasionally be a recommendation that a patient go without
their dentures for a short period of time but this is
very rare in our practice.
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Anyone who is in good health and has teeth missing is
a suitable candidate for implant therapy. Age is not
a limitation to implant treatment except that under
18s are not usually treated due to growth considerations.
Patients with underlying medical conditions need to
undergo a thorough medical examination with special
attention paid to patients with conditions that affect
the healing of bone and soft tissues.
There must be enough bone present to provide
suitable anchorage for the implants. The implant surgeon
can determine your suitability when he examines your
mouth. A full medical history check is mandatory as
are x-rays and models of the jaws. A CAT scan is sometimes
required in special cases which provides a 3 dimensional
image of the jaw bone. The surgeon can then advise you
more fully about the suitability of implants and implant
treatment options.
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Modern dental implantology is an exacting field where
there are many considerations to be made. The cost reflects
the level of skill and training required in order to
carry out such complex reconstructions. A single tooth
at the front of the mouth is probably the most complex
case requiring high levels of skill and ability to create
a natural result and this must be reflected in the final
cost to the patient.
It must be borne in mind that dental implantology
is akin to hip and knee replacement and thus the skills
required to carry this out are reflected in the costs.
Various materials are available for the
construction of crowns and bridges and this is a consumer
choice offered by us to our patients. Hence there are
variables in cost at this level.
As well as the surgical skills required,
implant reconstructions require a highly skilled team
of dental technicians such as metalworkers who craft
the titanium components as well as making the metal
supports for the new teeth. We also need skilled ceramists
who can create the natural contours of the teeth with
porcelain.
Because each individual case is dependent
on a number of factors, it is not possible to give an
indication of fees. Once a comprehensive examination
has been carried out by the implant surgeon and initial
x-rays have been taken, only then can a treatment plan
be provided with costings as appropriate for that particular
case.
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Due to the huge advances in medicine, we are living
longer and longer and hence the need for permanent dental
replacement becomes very important to our overall health.
Dentures and removable bridges have obvious problems
such as looseness, unstablity and bulkiness. Implants
can provide people with dental replacements that are
both functional and aesthetic. Implants are not new,
they have been around for a thousand years. But within
the last 40 years, they have become increasingly predictable
and are now the most successful form of dentistry including
root canal treatment.
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If there is insufficient bone for the placement of dental
implants, it becomes necessary to ‘create’
the bone in this area prior to placing implants. This
procedure of building up the bone is known as Bone Grafting.
Bone grafting is a very common procedure in dentistry
and it is used commonly for dental implants and in periodontal
procedures around natural teeth.
In order carry out bone grafting, we need
a source of bone to place in the deficiency. The best
bone is the patient’s own bone (autogenous bone)
and this can be taken from other areas of the mouth
usually the chin or the back of the lower jaw. Occasionally
this bone is taken from areas outside the mouth, such
as the hip. When bone is taken from the hip, it is usually
done in the hospital by an orthopaedic surgeon and transferred
to the dentist doing the implant procedure in the theatre.
Another very common source of bone is
bone taken from cadavers (irradiated bone). This bone
is harvested under very strict supervision at several
bone banks in the United States and it is used widely
in many dental and medical procedures. There has never
been a case of a transmitted disease with this type
of bone. It is very safe and very useful in creating
bone especially in the back of the upper jaw. Synthetic
bone is also available and has some use in implant dentistry
but it is not as commonly used as the autogenous or
irradiated bone.
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