Dental implants are changing the way people live. They are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything, knowing that teeth appear natural and that facial contours will be preserved. Patients with dental implants can smile with confidence.
Once a tooth or teeth are lost, the patient has four options to restore the space or spaces left:
- No treatment -Teeth on either side of the space, where a tooth was removed, will often tilt or move partially into this space. If this occurs and later you decide on an implant, the space has to be regained and this usually requires orthodontia to some degree. The opposing tooth may elongate or supraerupt over time causing potential gum or periodontal problems on it and its adjacent teeth. If this occurs and later you decide on an implant, this supraerupted tooth may require restoration or recontouring to get the bite plane correct. No treatment allows the bone to atrophy and causes bone loss in vertical and horizontal planes. This bone loss that may make implant placement later more difficult and more costly due to possibly requiring bone grafting PRIOR to placing of implants. Tooth sockets take 6 weeks to fill in with bone. You can lose up to 50% of alveolar (bone housing tooth) width within 12 months of tooth removal. You can lose 3-5mm of vertical alveolar height within the first 6 months after extraction of a tooth.
Extractions, Atrophy and Bone Grafting
3D Denture Bone Loss
- Restore with a removable prosthesis – This is a partial denture, flipper, or Essex Retainer. All of these are different prostheses to keep the space open after removal of a tooth. Some patients will chose this as a long-term solution to fill in a space where teeth have been removed.
- Restore with a Bridge -This is an option if there is an anterior and posterior tooth to the space where a tooth was removed and these surrounding teeth are healthy and capable of supporting a bridge.
See Bridge vs. Implant tooth replacement (Please click on Implant 1 and then the video).
- Placement of an implant or implant(s).
Dental Implant Presentation
To provide you with a better understanding of dental implants, we have provided the following multimedia presentation. Many common questions pertaining to dental implants are discussed.
Having trouble? Please make sure you have version 9 of the Flash browser plugin in order to correctly view this presentation. This software is available as a free download. Other videos on implants and procedures related to implants are on the Consult Pro Video List.
What Are Dental Implants
The dental implants themselves are tiny titanium posts that are surgically placed into the jawbone where teeth are missing. The bone bonds with the titanium posts (osseo integration), creating a strong foundation for artificial teeth. These metal anchors act as tooth root substitutes. Small posts that protrude through the gums are then attached to the dental implant. These posts provide stable anchors for artificial replacement teeth. Refer to Consult Pro Videos for more information (after clicking the link above, click on “Implant 1”, then “Single Tooth Implant Tooth Replacement”, or “Tooth Removal and Immediate Implant”)
Dental implants also help preserve facial structure, preventing further bone deterioration that occurs when teeth are missing.
The Surgical Procedure
Dental Implants can be placed as a two-stage procedure or a one-stage procedure depending on the quality of the bone the dental implant is placed into and other factors that are present.
In a two-stage approach implant(s) are placed within your jawbone and lie beneath the surface of the gums for four months gradually bonding with the jawbone. You should be able to wear temporary dentures and eat a soft diet during this time. After the dental implant has bonded to the jawbone, the second stage begins. Dr. Rotas will uncover the dental implant(s) and attach small posts that protrude through the gums to allow your dentist to easily access the implants for placement of the final restoration or prosthesis. The entire procedure usually takes about four to five months. Most patients experience minimal disruption in their daily life.
In a one-stage approach the dental implant(s) are placed in the jawbone and have a small post protruding through the gums. These dental implants do not require a second procedure to uncover them. While these dental implants are healing the post sticking out of the gums should not affect the patient. These posts require cleaning, as do your natural teeth. These posts should not be used to chew on as the dental implant below the post is still healing and micro movement of the dental implant may cause it not to heal and to fail.
Implants are a team effort between an oral and maxillofacial surgeon and a restorative dentist. While Dr. Rotas performs the initial tooth extractions, bone grafting (if necessary) and actual dental implantplacement surgery, the restorative dentist fits and makes the permanent prosthesis. Your dentist will also make any temporary prosthesis (i.e. flipper; Essex retainer) needed during the dental implant healing process.
Socket or Ridge Preservation
This technology is for a patient who has a non-restorable tooth and knows that he or she definitely wants a dental implant. With this technique the tooth is removed, and a graft (cadaver bone) is placed into the socket to preserve the boney architecture of the socket. This graft takes 4 months to heal. At the 4-month follow-up visit, a Galileos 3D CT scan is taken to evaluate the quantity of the bone grafted in all dimensions. With this scan, an assessment can be made as to the proximity of implant site to the maxillary sinus (if an upper back tooth is being replaced with an implant) or the inferior alveolar nerve (if a back tooth in the lower jaw is being replaced with an implant). This in depth radiographic study helps us to accurately treatment-plan the size and type of implant as well as proximity to important anatomical structures. This study also has CAD/CAM drawings of most implant systems on the market so these can be dropped into your Galileos study to see very accurately how the implant(s) fit your existing bone. Please take a moment to review videos below to help understand the concept of Socket or Ridge Preservation. Once the implant treatment is planned, surgery can be scheduled. Once the implant(s ) are placed, they will take an additional 4 months to heal (osseointegrate) and attach to the bone prior to restoration or fabrication of a crown or prosthesis on the implant.
Single Tooth Grafting Ridge Preservation
Ridge Preservation-Bone and Membrane
What Types Of Prosthesis Are Available?
Locator attachments are where two implants are placed in the lower jaw (usually) in the canine or cuspid areas. We choose this area as patients who usually need this treatment plan have minimal bone width or height posterior to where inferior alveolar nerve is located. This nerve is the feeling nerve for the lower jaw, lips, cheek, teeth, gums and tongue. If implants are placed further back in the jaws, we risk damage to this nerve and possible permanent numbness. This is a two-stage implant procedure. Implants are placed at time of tooth removal (if possible) or well after the teeth have been removed. These implants are allowed to heal unloaded for four to five months. After healing or Osseo integration, the locator attachments are placed at a second stage surgery. The dentist then retrofits the denture to accommodate the housing that snaps onto locator attachments. If the dentist is not able to retrofit the denture, a new denture may need to be made to accommodate and snap into the locator attachments. The denture in this case is REMOVABLE but firmly attached. Cleaning of the implants is done after denture is removed and the locator attachments are brushed and flossed like teeth. Refer to Consult Pro Videos for more information (after clicking the link above, click on “Implant 2”, then “Denture Stabilized with Two Implants and Upper Removable Denture on Implants”).A single prosthesis (crown) is used to replace one missing tooth each prosthetic tooth attaches to its own dental implant. A partial prosthesis (fixed bridge) can replace two or more teeth and may require only two or three dental implants. A complete dental prosthesis (fixed bridge) replaces all the teeth in your upper or lower jaw. The number of dental implants varies depending upon which type of complete prosthesis (removable or fixed) is recommended. A removable prosthesis (over denture) attaches to locator attachments or a bar, whereas a fixed prosthesis is permanent and removable only by the dentist.
The prosthesis best suited for you will be treatment planned by your restorative dentist and Dr. Rotas.
Implant surgery is performed in our office in a hospital-style operating suite, thus optimizing the level of sterility. Inpatient hospital dental implant surgery is for patients who have special medical or anesthetic needs or for those who need extensive bone grafting from the jaw or hip.
Why Dental Implants?
Once you learn about dental implants, you finally realize there is a way to improve you life. When you lose several teeth, whether its a new situation or something you have lived with for years, chances are you have never become fully accustomed to losing such a vital part of yourself.
Dental implants can be your doorway to renewed self-confidence and peace of mind.
A Swedish scientist and orthopedic surgeon, Dr. Per-Ingvar Branemark, developed this concept for oral rehabilitation more than 35 years ago. With his pioneering research, Dr. Branemark opened the door to a lifetime of renewed comfort and self-confidence for millions of individuals facing the frustration and embarrassment of tooth loss.
Why Select Dental Implants Over More Traditional Types Of Restorations?
There are several reasons: Why sacrifice the structure of surrounding good teeth to bridge a space? In addition, removing a denture or a partial denture at night may be inconvenient, not to mention that dentures that slip or move can be uncomfortable and rather embarrassing.
Are You A Candidate For Implants?
If you are considering dental implants, your mouth must be examined thoroughly and your medical and dental history reviewed. If your mouth is not ideal for dental implants, ways of improving outcome, such as bone grafting, may be recommended by Dr. Rotas.
More information and Videos on Dental Implants are presented with different clinical scenarios in the following attached links. Each case is individual and Dr. Rotas can assess which treatment plan is best for your situation at an implant consultation appointment. More videos on dental implants can be viewed at Implants 1 or Implants 2.
What Type Of Anesthesia Is Used?
The majority of dental implants can be performed under local anesthesia (numbing of the areas); local anesthesia with oral premedication; or local anesthesia with IV anesthesia (intravenous general anesthesia).
Do Implants Need Special Care?
Once the dental implants are in place and restored, they should serve you well for many years if you take care of them and keep your mouth healthy. This means taking the time for good oral hygiene (brushing and flossing) and keeping regular appointments with your dental specialists. Hygiene by a professional (Dentist or Dental Hygienist) is mandatory to ensure the health and stability of the implant(s) once restored. The dental hygiene cleanings are required two to four times a year (depending on your situation, ability to maintain proper hygiene, or your susceptibility to periodontal disease). These appointments will be done at your restorative dentists office.Bone Grafting