Dental Implants – Replacing Missing Teeth

If one or more of your teeth are missing, there are a number of ways to replace them. An alternative to bridges, partials or complete dentures may be dental implants. Implants are used to replace missing roots and support artificial replacement teeth. They are comfortable and look like natural teeth.

Implants may also be placed for the purposes of supporting a full upper or lower denture. Although this procedure is somewhat different than the procedure described below, the basic principles remain the same: Two or more implants are placed within the bone and a special abutment is secured to it in order to attach to a set of acrylic teeth or a special support apparatus for multiple teeth (complete acrylic dentures, metal supported fixed dentures, etc). Talk to your dentist to see what options are available for you.

What are dental implants?

A dental implant is an artificial root made of titanium metal. It is inserted into the jawbone to replace the root of the natural tooth. An artificial replacement tooth is attached to the implant. The implant acts as an anchor to hold the replacement tooth in place.

Who does this procedure?

Our practice does include the placement of many dental implants as well as their accompanying restorations. The decision on whether you are a candidate for implant placement in our office is multifaceted, thus our dentists may refer your to a specialist for the placement of the dental implant. Often times this is either a specialist in the gingiva and surrounding bone, a Periodontist, or a specialist in Oral Surgery. After the implant has been placed and healed, you will be advised to return to your dentist to fabricate the final replacement prosthetic tooth.

Who can get dental implants?

If you are in good general health, have healthy gums and have enough bone in the jaw to hold an implant, dental implants might be right for you. If your jawbone has shrunk or if it has not developed normally, you may be able to have a bone graft to build up the bone. A bone graft is a way of adding new bone to your jawbone. Your dentist or dental specialist will tell you if bone grafting can be done.

• Your dentist or specialist will carefully examine your mouth and take x-rays of your head, jaw and teeth to find out if dental implants are right for you.
• During the first stage of surgery, your dentist or specialist will put a dental implant into your jawbone beneath the gum tissue. Often the second stage of surgery is often done at this time, whereby your dentist or specialist will attach a healing abutment to the implant. The healing abutment allows the gum tissue to heal without overlapping the implant. It is not uncommon for an x-ray to be taken at this point to verify the position of the implant within the bone. The gum tissue is then stitched back into place. As the tissue heals, the implant will integrate with the bone.
• In the event that the healing abutment is not placed, the gum tissue will be sutured over the implant, requiring the second stage to be performed at a later date.
• Implants require a varying length of time to solidify their attachment to the underlying bone depending on the type of implant placed and the quality of the bone it was placed into. Your dentist or specialist will advise you of the length of time they anticipate you will be required to heal prior to the next appointment where the process of fabricating the replacement tooth begins.
• After the healing period, your dentist or specialist may take a new x-ray to determine the degree of integration of the implant to the bone. If it is determined that the implant is ready to support a replacement tooth, the following steps are taken at your dentists office:

1. the healing abutment is removed, usually with no anesthetic required,
2. a special impression coping is attached to the implant and an x-ray may then be taken to verify its full seating to the implant to ensure the accurate fabrication of the replacement tooth,
3. an impression is taken of the implant and surrounding teeth, as well as the opposing teeth,
4. the impression coping is removed and the healing abutment is replaced back on the implant, and
5. the impression is sent to a dental lab to fabricate the final replacement tooth and its connection to the implant, the final abutment.

• Once the final abutment and replacement tooth are fabricated, you return to the office to have the healing abutment removed, final abutment attached to the implant, and final replacement tooth either screwed or cemented in place on the final abutment. It may take several appointments to properly fit the replacement tooth to the abutment and x-rays may be taken to verify its proper seating and position.
• When replacing several teeth or all of your teeth, a fixed bridge is anchored to your dental implants. A bridge is a dental restoration that replaces one or more missing teeth by spanning an area that has no teeth. The bridge is held firmly in place by dental implants on each side of the missing tooth or teeth.
• If the implants were placed for the purposes of supporting a denture, this process may differ and your dentist will discuss that procedure in detail.

Caring for my dental implant(s)

Because dental implants are placed in the jawbone, artificial replacement teeth attached to implants look and act much like natural teeth. Like natural teeth, implants need to be kept clean using a toothbrush and floss. Your dentist will show you the proper cleaning procedure for implants. Regular dental checkups are important so your dentist can make sure that your bite is right and that your implants are not loose.

What else should I know?

• Several visits to your dentist or dental specialist may be needed until the process is done.
• Checkups will be scheduled during the following year and thereafter so your dentist can be sure your implants are working properly.
• You will need to take very good care of your implants.
• Implants can cost more than other kinds of replacement teeth and might not be covered by your dental plan. But in most cases this is a one-time cost, unlike other kinds of tooth replacement procedures.
• Although rare, possible complications due to dental implants include bleeding, infection, numbness or injury to nearby muscles or the sinus cavity. In some cases, the implant may not be successful because it didn’t integrate with the bone.
• There are cases where research has shown a reduced prognosis for the integration of the implant to the bone including, but not limited to, use of tobacco, certain medications, diabetes, osteoporosis, or other medical conditions. It is extremely important for you, the patient, to provide your dentist or specialist with an accurate and complete description of your medical health, conditions, medications, and smoking status to best predict the success of your implant. Your dentist or specialist will discuss this with you in detail prior to the placement of a dental implant.