Dental implants are artificial tooth roots. They provide a permanent base for fixed, replacement teeth. The implant itself is usually made of titanium and is surgically placed in the jawbone. Dentists use dental implants to replace missing teeth as an alternative to bridges, crowns or dentures. There are three basic parts to an implant 1) the metal screw like post that acts as the root of the tooth. 2) An abutment (used to attach the crown to the metal post. 3) the crown which is placed over the abutment.
Benefits of dental implants
They provide a strong foundation for fixed (permanent) or removable replacement teeth. Also they are made to match your natural teeth. They are durable and will last many years and could last a lifetime. They can also help with the problem of the jaw bone deteriorating because there will be a “tooth” there to create the force of a natural tooth.
Patients often prefer to get dental implants instead of dentures or bridgework. In some cases, a patient does not have enough of their natural teeth to allow building a denture or bridge, therefore, dental implants may be the only option. The major benefit of implants is having solid support for your new teeth.
Implant procedures
Dentists typically perform dental implants in A series of procedures and as outpatient surgery. Each procedure requires a healing time before the next procedure is done. The entire process for an implant can take many months from start to finish.
Here are the basic procedures:
- Removal of the damaged tooth
- Jawbone preparation (grafting), when needed
- Dental implant placement
- Bone growth and healing
- Abutment placement
- Artificial tooth placement
Preparing for an implant
Because dental implants require one or more surgical procedures there is a lot of preparation that is done in advance of dental implant surgery.
· Comprehensive dental exam.
First you may have dental X-rays and 3D images taken, and have models made of your teeth and jaw. This is important to ensure you have enough bone in place for the implant. Also a 3D image aides the surgeon to precisely place the implant in your jaw.
· Review of your medical history.
Let your doctor know about any medical conditions and any medications you are taking, including prescription and over-the-counter drugs and supplements. If you have certain heart conditions or orthopedic implants, your doctor may prescribe antibiotics before surgery to help prevent infection.
· Treatment plan.
After compiling and assessing all of the above data, your dentist makes a plan taking into account factors such as how many teeth you need replaced and the condition of your jawbone and remaining teeth. The dentist makes each treatment plan according to the patient’s situation.
In some situations the planning process for dental implants may involve one or more specialists In this case your dentist will go over with you what the specialist does and why this is needed.
Is bone grafting necessary?
In some cases a bone graft is necessary. If your jawbone isn't thick enough or is too soft, you may need bone grafting before your dental implant surgery. This is a minor surgical procedure that is normally done in a dental office. The dentist makes an incision in your gum to gain access to the bone beneath it, and then grafting material is added. Most often, the grafting material is processed bone minerals around which your body will actually make new bone cells.
After a bone graft is done, the jaw needs time to heal and for the transplanted bone to grow enough new bone to support the implant. This can take a few to many months. In some cases, you may need only minor bone grafting, which can be done at the same time as the implant surgery. The condition of your jawbone determines how you proceed.
Placing the dental implant
To place the implants, the surgeon first makes an incision (cut) in your gums to expose the bone. They then drill a hole in the bone and place the implant in the hole. The surgeon probably will take an X-ray of the area to make sure the implant is where it should be. The surgeon will then stitch your gum closed over the implant. At this point, you will still have a gap where your tooth is missing. If necessary, a type of partial, temporary denture can be placed for appearance. You can remove this denture for cleaning and while you sleep.
Waiting for bone growth
Once the metal implant post is placed in your jawbone, the jawbone begins to grow and unite with the surface of the dental implant. This process can take several months. It helps provide a solid base for your new artificial tooth.
Placing the abutment
The abutment is the “connecting piece” that joins the implant and the crown together. Once the jawbone and post have fully united, you will be ready to have the abutment placed. This minor surgery is typically done with local anesthesia in an outpatient setting.
To place the abutment:
- Your oral surgeon reopens your gum to expose the dental implant
- The abutment is attached to the dental implant
- The gum tissue is then closed around, but not over, the abutment
In some cases, the abutment is attached to the dental implant metal post when the post is implanted. That means you won't need an extra surgical step. Because the abutment sticks out past the gum line, however, it's visible when you open your mouth. Some people don't like that appearance and prefer to have the abutment placed in a separate procedure.
After the abutment is placed, your gums must heal for about two weeks before the artificial tooth can be attached.
Getting your new crown
Once your gums have healed, the dentist makes impressions of your mouth and remaining teeth. They use these impressions to make the crown that will be placed onto the abutment.
You and your dental specialist can choose artificial teeth that are removable, fixed or a combination of both:
· Removable.
This type is similar to a conventional removable denture and can be a partial or full denture. It contains artificial teeth surrounded by pink plastic gum. It's mounted on a metal frame that's attached to the implant abutment, and it snaps securely into place. It can be easily removed for repair or daily cleaning.
· Fixed.
In a fixed type, an artificial tooth is permanently screwed or cemented onto an individual implant abutment. You can't remove the tooth for cleaning or during sleep. Most of the time, the dentist attaches each crown to its own dental implant. However, because implants are exceptionally strong, several teeth can be replaced by one implant if they're bridged together.
After the procedure
Immediately after the surgery and for a few days you will likely experience some discomfort.You may experience some of the following with any type of dental surgery, such as:
- Swelling of your gums and face
- Bruising of your skin and gums
- Pain at the implant site
- Minor bleeding
In these cases you may need pain medications or antibiotics after dental implant surgery but any pain should be manageable.
After each stage of surgery, we may require you eat soft foods while the surgical site heals. Your surgeon may use stitches that dissolve on their own. If your stitches aren't self-dissolving, your doctor will remove them.
Risks
As with any surgery there may be risks but problems with dental implants are rare and when they do occur they're usually minor and easily treated. However, as there is with any surgery, dental implant surgery poses some health risks. Risks include:
- Infection at the implant site
- Injury or damage to surrounding structures, such as other teeth or blood vessels
- Nerve damage, which can cause pain, numbness or tingling in your natural teeth, gums, lips or chin
- Sinus problems, when dental implants placed in the upper jaw protrude into one of your sinus cavities
When making the decision of whether or not to get implants have your dentists fully discuss the procedure and any risks that may be involved.
Results
Most dental implants are successful. Sometimes, however, the bone fails to fuse sufficiently to the metal implant. For example, smoking can contribute to implant failure and complications. In the case of any failure the surgeon removes the implant and cleans up the bone. Most often a patient can try the procedure again in about three months.
Here are some things you can do to help protect your dental work and preserve your other teeth as well:
- Practice excellent oral hygiene. Just as with your natural teeth, keep implants, artificial teeth and gum tissue clean. Specially designed brushes, such as an interdental brush that slides between teeth, can help clean the nooks and crannies around teeth, gums and metal posts.
- See your dentist regularly. Schedule dental checkups to ensure the health and proper functioning of your implants and follow the advice for professional cleanings.
- Avoid damaging habits. Don't chew hard items, such as ice and hard candy, which can break your crowns — or your natural teeth. Avoid tooth-staining tobacco and caffeine products. Get treatment if you grind your teeth.
If you are missing teeth or need to have teeth removed we invite you to consider getting dental implants here at Dr. Carothers Family & Cosmetic Dentistry in East Portland, Oregon. We’ll be happy to schedule a consultation and answer any questions to help you find out if dental implants are right for you. (503) 257-3033.
Sincerely,
Dr. Dave
Carother’s Family & Cosmetic Dentistry