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Dental Implants

Are you aware that dental implants are generally the best option to replace missing teeth?  Instead of resting on the gum-line like traditional removable dentures/ using the adjacent teeth as anchors just like fixed bridges, these implants are a long-term solution that your oral & maxillofacial surgeon positions in the jawbone, surgically.

Statistics indicate that 69% of adults in the age range of 35- 44 have lost  a minimum of 1 permanent tooth to a gum disease, an accident, failed root canal/tooth decay. In addition, by the age of 74 years, 26% of adults end up losing all their permanent teeth.

The Conventional Options

Till a couple of decades ago, the only option for a person who had lost all his/her teeth was to get removable dentures or a fixed bridge to help them eat and speak clearly & smile. But these conventional methods are not an ideal solution and there are a number of problems associated with them.  Removable dentures tend to slip and also make clicking sounds while the person is speaking or eating, which can be very embarrassing and uncomfortable.

The even bigger concern is that fixed bridges tend to affect the healthy teeth that are adjacent to them. Removable dentures can cause bone loss in the area where there is a tooth/teeth missing. The other factors that can have a negative impact on fixed bridgework are periodontal disease etc. This is exactly why removal dentures & fixed bridges have to be replaced every 7-15 years.  Now there is another option for people who are missing any permanent teeth. 

The Benefits

Dental implants do not rest on the gum-line like removable dentures and neither do they use the adjacent teeth as anchors.

- These dental implants are essentially long-term replacements that the oral & maxillofacial surgeon will surgically place in the jawbone. The implant has a titanium “root” that fuses with the jawbone via the process of "osseointegration".

- Dental implants do not slip/make any embarrassing noises which make public  the fact that you are wearing "false teeth".

- They do not decay like the teeth that anchor fixed bridges.

- Since dental implants fuse with the jaw-bone, there is generally no problem of bone-loss to deal with.

Even most of the dental implants that oral & maxillofacial surgeons in the US had first placed for their patients, continue to function perfectly. What’s important to note is that the people who got those  implants continue to be satisfied and happy that they opted for them. Proper maintenance ensures that dental implants last for a lifetime. 

Anatomy of a Dental Implant

Dental Implant

A dental implant designed to replace a single tooth is composed of three parts: the titanium implant that fuses with the jawbone; the abutment, which fits over the portion of the implant that protrudes from the gum line; and the crown, which is created by a prosthodontist or restorative dentist and fitted onto the abutment for a natural appearance.

Many people who are missing a single tooth opt for a fixed bridge; but a bridge may require the cutting down of healthy, adjacent teeth that may or may not need to be restored in the future. Then there is the additional cost of possibly having to replace the bridge once, twice or more over the course of a lifetime. Similarly, a removable partial denture may contribute to the loss of adjacent teeth. Studies show that within five to seven years there is a failure rate of up to 30% in teeth located next to a fixed bridge or removable partial denture.

Fixed Bridge Fixed bridges may require the shaping or cutting down of adjacent healthy teeth.

Bone Loss Bone is maintained by the presence of natural teeth or implants (a). Bone loss occurs with the loss of teeth (b).

Further, conventional dentures may contribute to the loss of bone in the area where teeth are missing. As illustration (a) indicates, the presence of natural teeth preserves the jawbone. When a tooth is missing, as in illustration (b), the bone may erode and weaken until it may be necessary for your oral and maxillofacial surgeon to graft bone to the area to strengthen it for placement of a dental implant. When a missing tooth is replaced by a dental implant, the fusion, or osseointegration, of the implant and bone provides stability, just as the natural tooth did.

If you are missing several teeth in the same area of your mouth, you may still enjoy the confidence and lifestyle benefits that come with dental implants. Your oral and maxillofacial surgeon will place two or more dental implants, depending on the number of teeth that are missing. Your replacement teeth will be attached to the implants to allow excellent function and prevent bone loss. The implants will serve as a stable support that tightly locks into your replacement teeth and dentures to prevent slipping and bone loss.

With an overall success rate of about 95% and almost 50 years of clinical research to back them up, dental implants are frequently the best treatment option for replacing missing teeth.

Dental Implants vs. Conventional Dentures

Dental Implants Implants can be used to replace one missing tooth so that the replacement looks and feels natural (a). Also, two or more implants can serve as a stable support for the replacement of many teeth (b).

Many patients who have selected dental implants describe a quality of life that is much more comfortable and secure than the lifestyle endured by those with fixed bridges or removable dentures. Dentures often make a person feel and look older than they are, cause embarrassment in social situations when they slip and click, and restrict the everyday pleasure of eating comfortably.

When they count the benefits they enjoy as a result of their dental implants, patients say their implants eliminate the day-to-day frustrations and discomfort of ill-fitting dentures. They allow people to enjoy a healthy and varied diet without the restrictions many denture wearers face. With a sense of renewed self-confidence, many people rediscover the excitement of an active lifestyle shared with family and friends and the chance to speak clearly and comfortably with co-workers. For all these reasons, people with dental implants often say they feel better... they look better... they live better.

Dental Implants are a Team Effort

Dental implants use the latest modern science & technology, and a team approach is required, that spans several disciplines. A successful implant necessitates that all the parties involved i.e. the patient and the restorative dentist (who actually makes the crown for that implant) as well as the oral & maxillofacial surgeon (who surgically fits the implant), all follow a very careful plan for the treatment.

All the members of this implant team stay in close contact to ensure that everyone very clearly understands what is required to be done to meet their patient’s expectations. This team is organized once the decision for placing the dental implant has been taken.

Post-evaluation which includes a very detailed examination, x-rays & a consultation with the patient & members of the expert implant team, the oral & maxillofacial surgeon will surgically place the dental implants in the patient's jaw.

Once the implants have fused well in the patient’s jaw, the restorative dentist will then prepare an impression of the lower & upper jaws. This particular impression will then be used to make a model from which dentures/crowns are created.

The teamwork also continues long after this implant & the crown have been positioned. It is critical that the patient have follow-up examinations with his/her oral & maxillofacial surgeon and the restorative dentist; the progress is also very carefully charted. The oral & maxillofacial surgeon as well as the restorative dentist continue to closely work together and provide the highest levels of aftercare.

Are You a Candidate for Dental Implants

Regardless of whether you are a young/middle-aged/ an older adult or whether you have to replace one tooth/several teeth/all your teeth, dental implants are an ideal solution for you. Dental implants cannot be used for growing children, but with that exception, it is possible for people of different ages to have dental implants. Even people with some specific health concerns can get dental implants:

Existing Medical Conditions- If you are permitted to have any routine dental treatment, generally you can also have a dental implant. Though it is important to follow precautions in certain condition, dental implants may also be used for people who have diabetes or high blood pressure.

Gum Disease/Problem Teeth- A large majority of dental implants that have been used in patients who have lost their teeth to decay/periodontal disease, have been successful

Currently Wearing Partials/Dentures- Dental implants can replace removable dentures/ bridges. They can also be used to stabilize & secure the denture, which makes it much more comfortable

Smokers- Even though  smoking tends to lower the success rate of dental implants, it does not eliminate the possibility of actually getting them

Bone Loss- It is not uncommon for individual that have lost teeth/had periodontal disease to have bone loss. Oral & maxillofacial surgeons are well-trained & experienced in grafting the bone to safely & permanently secure the dental implant.

Dental Implants in young children is generally deferred until the growth of their jaw is complete. However, in some instances a dental implant might be appropriate. For e.g. - when it is part of theorthodontic treatment plan for a child. Your family dentist/orthodontist can guide you fully in this instance.

© 2005-2012 American Association of Oral and Maxillofacial Surgeons (AAOMS). All rights reserved.

Reprinted with permission from American Association of Oral and Maxillofacial Surgeons.