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Introduction
> Frequently Asked Questions
> Case Study
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. Whats 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?
12. What are Immediate Implants
or Same Day Teeth?
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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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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