Dental Implants

Dental implants were discovered and developed by a Swedish professor named Per-Ingvar Brånemark, when he noticed that he was unable to retrieve his bone anchored titanium microscopes, which he was using. He came to the realization that titanium bonds irreversibly with bone and that under certain given conditions, can be made to integrate with bone predictably. He named this process oseointegration. Since that time, oseointegration has been researched and perfected. Most studies that have been conducted by organizations such as the ADA and NIH, have seen success rates to be approximately ninety percent.

What are they?

Implants come in many shapes and forms. There are actually two types. Endosteal implants are implants that are placed within the bone. They come in different lengths, widths and shapes. A surgeon makes an opening in the bone to allow the implant body to be placed in. Sometimes extra bone is placed around it to secure it properly. Some implants screw into the bone, while others sit more passively in the surgical site. The tissue is closed around the implant body and it is allowed to heal for as long as six months to allow oseointegration to occur. At this point, when deemed ready for restoration, most implants will need a second piece called the abutment to be placed into the oseointegrated cylinder. This is the piece upon which the final dental restoration will be fitted. From this point on, the general dentist, will take impressions and have the final restoration fabricated to be fitted on the implant abutments, finishing the process.

A second type of implant, known as subperiosteal implants, is placed on the bone itself. The tissue is closed over it and small posts from the framework protrude through the gum tissue to hold or secure the dental restoration in place. This type of implant is usually used in cases when there isn’t adequate bone and the patient is unable to wear complete dentures. With the advent of newer bone grafting techniques, subperiosteal implants aren’t used as much anymore.

Candidates

A candidate for a dental implant needs to be in good health. Adequate bone and periodontal or gingival health needs to be in place. Immunocompromised individuals or those with uncontrollable diabetes are at risk for implant failure. Smoking and bruxing or grinding of teeth can also cause integration failures. The latter two can be circumvented with appliances and behavioral modifications. If the lack of bone is the problem, bone grafts can be done to increase the height of bone. If the sinuses are in the way, they can be lifted upwards and repositioned. This is a sinus lift procedure, which is done in conjunction with a bone graft to increase the quantity of bone, beneath the sinus. Both of these procedures may need to be done, prior to implant body placement.

Uses

Implants are ideal for many types of situations. They are good for restorations involving one or two teeth, without affecting the bordering teeth. They are also good for eliminating the need for partial or complete dentures, by having an implant-supported bridge. Dental implants are very good solutions for missing teeth. They feel natural, are strong and esthetic at the same time. They don’t sacrifice surrounding teeth for restorations, allowing them to last longer in the process. Implants are secure and give the patients more confidence when speaking or chewing in public. Finally the success rate and reliability are excellent.

Risks

There is very little risk, when implants and treatment are properly planned and placed. The most common risk is implant failure. Very simply, osseointegration doesn’t occur. This is minor and can easily be retreated. Other risks include infection at the implant site, adjacent tooth damage, the risk of nerve and blood vessel damage resulting in parasthesias or numbness, and nasal cavity or sinus problems, when the implants protrude into these sites.

Care

Once the implant is placed patients need to care for it, in a similar manner, to their own teeth. Implant restorations need to be kept plaque-free by doing adequate home care. Flossing and brushing are still important, to minimize tissue inflammation. Also the avoidance of eating hard foods is advised. Implants can fail when under excessive masticatory pressure.

Implant placement involves the patient, general dentist and surgeon. All three need to consult each other, for the best results to occur. Once placed successfully, the patient may be able to enjoy a lifetime of worry-free use.

References

http://www.perio.org/consumer/2m.htm

http://www.mayoclinic.com/health/dental-implants/HA00026

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