Did you know that dental implants are frequently the best treatment option for replacing missing teeth? Rather than resting on the gum line like removable dentures, or using adjacent teeth as anchors like fixed bridges, dental implants are long-term replacements that your oral and maxillofacial surgeon surgically places in the jawbone.
What are Dental Implants?
The implants themselves are tiny titanium posts which are inserted into the jawbone where teeth are missing. These metal anchors act as tooth root substitutes. They are surgically placed into the jawbone. The bone bonds with the titanium, creating a strong foundation for artificial teeth. Small posts which protrude through the gums are then attached to the implants. These posts provide stable anchors for your General Dentist to reconstruct your bite with artificial replacement teeth. If you have a denture, it can be connected to implants to improve stability and function. Implants also help preserve facial structure, preventing the bone deterioration that occurs when teeth are missing.
Anatomy of a 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.
A Solution of Choice for Replacing Missing Teeth
Statistics show that 69% of adults ages 35 to 44 have lost at least one permanent tooth to an accident, gum disease, a failed root canal or tooth decay. Furthermore, by age 74, 26% of adults have lost all of their permanent teeth.
Twenty years ago, these patients would have had no alternative but to employ a fixed bridge or removable denture to restore their ability to eat, speak clearly and smile. Fixed bridges and removable dentures, however, are not the perfect solution and often bring with them a number of other problems. Removable dentures may slip or cause embarrassing clicking sounds while eating or speaking. Of even greater concern, fixed bridges often affect adjacent healthy teeth, and removable dentures may lead to bone loss in the area where the tooth or teeth are missing. Recurrent decay, periodontal (gum) disease and other factors often doom fixed bridgework to early failure. For these reasons, fixed bridges and removable dentures usually need to be replaced every seven to 15 years.
Before (left) and after a dental implant
Today there is another option for patients who are missing permanent teeth. Rather than resting on the gum line like removable dentures, or using adjacent teeth as anchors like fixed bridges, dental implants are long-term replacements that your oral and maxillofacial surgeon surgically places in the jawbone. Composed of titanium metal that “fuses” with the jawbone through a process called “osseointegration,” dental implants never slip or make embarrassing noises that advertise the fact that you have “false teeth,” and never decay like teeth anchoring fixed bridges.
After more than 20 years of service, the vast majority of dental implants first placed by oral and maxillofacial surgeons in the United States continue to still function at peak performance. More importantly, the recipients of those early dental implants are still satisfied they made the right choice. If properly cared for, dental implants can last a lifetime.
Bridge Vs. Dental Implant
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 bridges may require the shaping or cutting down of adjacent healthy teeth.
Bone is maintained by the presence of natural teeth or implants
Bone loss occurs with the loss of teeth
Further, conventional dentures may contribute to the loss of bone in the area where teeth are missing. As the illustration indicates, the presence of natural teeth preserves the jawbone. When a tooth is missing, 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 by your general dentist, 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
Implants can be used to replace one missing tooth so that the replacement looks and feels natural. Also, two or more implants can serve as a stable support for the replacement of many teeth.
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 combine the best of modern science and technology, including a team approach spanning several disciplines.
A successful implant requires that all parties involved — the patient; the restorative dentist, who makes the crown or denture for the implant; and the oral and maxillofacial surgeon, who surgically places the implant, follow a careful plan of treatment. All members of the implant team stay in close contact with each other to make sure everyone clearly understands what needs to be done to meet the patient’s expectations.
The team is organized as soon as the decision for placing a dental implant is reached. Following an evaluation that includes a comprehensive examination, x-rays and a consultation with the patient and members of the implant team, the oral and maxillofacial surgeon will present the treatment plan. At times, if there is a large amount of bone destruction due to infection or because a tooth has been missing for a long time, bone grafting (either from donated bone or bone taken from your own body) is placed four months prior to the implant in order to replace missing bone and provide enough of a foundation for proper implant placement. Most times, however, the implant can be placed in the patient’s jaw without the need for bone grafting as long as conditions are optimal. This is all determined by the oral surgeon based on the quality of the bone as well as the width and height of the bone. A good analogy is that you would not want to plant a tree in a planter that is only half full with poor quality soil. If bone grafting prior to implant placement is needed, there is a healing period (period of osseointegration) of four months prior to implant placement. If no pre-implant bone grafting is required, the implant(s) can be placed.
When the implants have stabilized in the jaw, usually in about 4-6 months, the implant is uncovered by the oral surgeon and a healing cap is placed to help contour and shape the tissues and gums around the implant. After two weeks of healing, the restorative (general) dentist prepares an impression of the upper and lower jaws. This impression is used to make the model from which the dentures or crowns are created. Usually, it takes anywhere from 10-14 business days for the laboratory to complete the abutment and crown or dentures. Your general dentist will then place the final abutment and crown or abutments and denture after the laboratory has returned them.
The teamwork continues long after the implant and crown have been placed. Follow-up examinations with the oral and maxillofacial surgeon and restorative dentist are critical, and progress is carefully charted. Both the oral and maxillofacial surgeon and the restorative dentist continue to work together to provide the highest level of aftercare.
Fees for treatment vary from case to case, however the above chart can serve as a rough estimate of implant vs. bridge costs. Of course, each case is different and it is impossible to determine with accuracy.
- Dental implants are 95% to 98% successful for decades, if not a lifetime (if placed by surgeons and restored by dentists.)
- Success rates for dental implants do not decrease over time.
- Success rates for bridges decreases steadily after 10 years.
- At 15 years, 1 in 3 bridges will typically fail.
- Success rates decrease further if root canal teeth support bridges.
- There are fewer complications with implants than bridges.
Are You a Candidate for Dental Implants?
Whether you are a young, middle-aged or older adult; whether you need to replace one tooth, several teeth, or all your teeth, there is a dental implant solution for you. With the exception of growing children, dental implants are the solution of choice for people of all ages, even those with the following health concerns:
Existing Medical Conditions. If you can have routine dental treatment, you can generally have an implant placed. While precautions are advisable for certain conditions, patients with such chronic diseases as high blood pressure and diabetes are usually successful candidates for dental implant treatment as long as the conditions are controlled under the care of a primary care physician. However, patients with uncontrolled diabetes are at a high risk of infection and implant failure, so your oral and maxillofacial may ask that your physician control the diabetes prior to any surgery.
Gum Disease or Problem Teeth. Implants placed in patients who have lost their teeth to periodontal disease or decay have been successful. It is important to carefully clean the implant as well as schedule routine cleanings and check ups with the general dentist.
Currently Wearing Partials or Dentures. Implants can replace removable bridges or dentures, or they can be used to stabilize and secure the denture, making it much more comfortable.
Smokers. Although smoking lowers the success rate of implants, it doesn’t eliminate the possibility of getting them. However, you may be asked to quit smoking at least 2-4 weeks prior to implant placement as well as during the healing period.
Bone Loss. Bone loss is not uncommon for people who have lost teeth or had periodontal disease. Oral and maxillofacial surgeons are trained and experienced in grafting bone to safely and permanently secure the implant.
Implant tooth replacement in children is usually deferred until their jaw growth is complete. There are, however, some instances when a dental implant may be appropriate, such as when it is part of the child’s orthodontic treatment plan. Your family dentist or orthodontist can guide you in this instance.
Dental Implants are designed to provide a foundation for replacement teeth, which look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat practically anything and can smile with confidence know that the teeth appear natural and facial contours will be preserved.
The Surgical Procedure
For most patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. For the first three to six months following surgery, the implants are beneath the surface of the gums gradually bonding with the jawbone. You should be able to wear temporary dentures and eat a soft diet during this time. At the same time, your dentist is forming new replacement teeth.
After the implant has bonded to the jawbone, the second phase begins. Dr. Farbod will uncover the implants, recountour the tissues surrounding the implant, and attach small posts that protrude though the gums and act as anchors for the artificial crowns. After your General Dentist places the artificial teeth, these posts will not be visible. The entire procedure usually takes six to eight months. Most patients experience minimal disruption in their daily life.