Dental Implants

What is a dental implant?

A dental implant is a medical device that is placed surgically in the jawbone in order to replace a tooth that is missing. It functions as a support for new teeth. The variety of the implant and the state of the jawbone dictate the manner in which the surgery is performed. Lost teeth can be replaced with dental implants. Since their initial use in the mid 1960’s, they have grown in popularity as a substitute for detachable dentures. Crowns that replace a single lost tooth, bridges that restore several lost teeth, and even dentures for patients who have become edentulous (toothless) can all be supported by dental implants. Titanium, a metal that is known to be compatible with bodily tissues and capable of bonding with nearby bone during healing, is typically used to make implants. Zirconia which is white instead of metallic and possesses bone-bonding properties similar to Titanium has gained popularity and been proven to be just as successful as Titanium implants in recent years. Dental implants are now a safe, practical and natural-looking alternative to lost teeth, according to a plethora of research and clinical experience.

However, implants require maintenance much like natural teeth. Inflammation of the gums and harm to the bones and tissues surrounding implants are examples of peri-implant disorders, which can result in major concerns including implant loss. Therefore, maintaining proper oral hygiene at home and scheduling routine dental exams are crucial.

What are the constituents of a dental implant?

1. Implant fixture: The implant fixture is generally made of Titanium but in some cases Zirconia is used. It functions as a substitute for the tooth root and is shaped like a screw.
2. Abutment: Abutments are also made of Titanium or Zirconia. It serves as a connection and is attached to the implant fixture.
3. Crown: The visible part of the implant is the crown. It is made in such a way that it blends with your natural teeth.

What are the advantages of a dental implant?

1. Solidity and comfort: Dentures can move around in your mouth when performing activities like chewing. On the other hand dental implants are very stable giving you the liberty of enjoying the food you like without any fear.
2. Cost Effectiveness: The upfront cost of a dental implant may be high. But they last very long and require little to no maintenance. This is what makes them cost effective over an extended period of time.
3. Robustness: Titanium and Zirconium are strong metals that provide a very robust structure to dental implants.
4. Long life: Bridges and dentures generally last for a maximum of 5-10 years. But dental implants can last as long as 20 years or even a lifetime. This makes dental implants a better option as compared to dentures or bridges.
5. Natural appearance: Dental implants blend seamlessly with your natural teeth unlike bridges and dentures. This gives you the liberty of performing activities like chewing, smiling and speaking without a feeling of awkwardness.
6. Trouble free oral care: Since dental implants are in no way dependent on adjacent teeth it becomes very easy to clean them while brushing and flossing.

What are the types of dental implants?

1. Endosteal Implants: Endosteal implants are made from Titanium. It is the most widely used implant for replacing teeth. They are placed directly in the jawbone enabling a stable foundation for a dental crown.
2. Subperiosteal Implants: These implants are meant for patients who have low bone volume in their jaws. They can be used to support dentures. They are placed on top of the gum tissue.
3. Zygomatic Implants: These implants are used for patients who don’t have sufficient bone in the upper jaw. Regular implants cannot be utilized in such cases. This implant is placed at an angle to the cheek bone or zygoma bone.

Process of Dental Implant Surgery

1. Anesthesia: An anesthesia is administered to the patient to numb the gums.
2. Creation of an incision: An incision is made in the gums to facilitate the smooth installation of the implant.
3. Preparation of the jaw: A small aperture is created in your jawbone with the help of tailor-made instruments. The size of the hole depends on the size of the implant that needs to be placed.
4. Placement of the implant: The implant is placed in the jawbone. The depth and angle of the implant are very important and are delicately managed to facilitate the best possible result for the positioning of the implant.
5. Closure of the gum tissue: After the implant is safely in place, the gum tissue is stitched back together over the implant location. A healing cap or an abutment may be set on the implant before the closure of the gum.

Depending on the complexity of each case and the number of implants being placed, the complete surgical procedure may take one to several hours. You will be given time to rest and recuperate following the procedure before being permitted to return home. After the treatment, some soreness, swelling and bruising are common, but your dental team will provide information on how to take care of yourself and manage your pain as you heal.

Post-Surgery Care

1. After implant insertion, bleeding is common and can continue for a few hours. Use cool packs to apply light pressure on your chin, jawline and cheeks.
2. Put gauze in the area of your molars and bite down if you have a removable denture. Keep the gauze out if there isn’t any bleeding going on.
3. Position yourself semi-reclined. Unless you feel faint, keep your head above your heart.
4. For a whole day, refrain from spitting, bending down, sucking through a straw and washing.
5. Ten days without smoking or physically demanding activities.
6. If an oral mouthwash is prescribed, it should be used for two weeks.

Risks

Difficulty in integration: One important element in the integration of a dental implant into the bone is primary implant stability, or the stability of the implant immediately after the procedure. Inadequate primary stability may cause the implant to fail in the first several weeks. The dental implant is supported and given secondary stability as the surrounding bone starts to grow back and join with the implant. In the best case, this finally results in biological stability as it gets stronger as the union between the implant and bone grows.

There is a higher chance of osseointegration when the implant is not positioned in the bone enough to offer main stability. In order to lower the likelihood of implant failure by a third, prophylactic antibiotics are typically administered before the implantation process.

Perforation: Some of the surrounding anatomic structures may sustain injuries during the process of placing a dental implant in the jaw. The maxillary sinus, inferior border, lingual plate, labial plate, inferior alveolar canal, or gingiva can all be perforated. For instance, if the implant punctures the maxillary sinus cavity, this may result in future infections and sinus issues.

Loss of Bone: The stability of the implant replacement may be compromised by excessive bone loss near the dental implant, which typically calls for intervention. Black triangles between the teeth, which are unsightly and make it more difficult to keep teeth clean, can also result from bone loss between implants and natural teeth.

Fracture of implant: A major issue that is difficult to resolve is the dental implant abutment screw breaking. Sometimes it can be saved by taking out the screw and replacing the dental implant, but in other situations, the bone that remains might not be strong enough to hold a new implant. The abutment and crown can be replaced to repair an abutment fracture. This is a cosmetic issue that is significantly easier to manage than abutment screw breaking because it has no discernible effect on the fusion of the implant and bone.

Additional dangers and consequences associated with dental implants: When a nerve is injured, the surrounding tissues ( such as teeth, gums, lips or chin) experience pain, numbness or parethesia.

Tissue necrosis: In about 1 in 20 cases, the cells in the tissue flap surrounding the implant may perish.

Gingival recession: The metal abutment holding the prosthetic in place may become visible when the gingiva surrounding the dental implant recedes.

Dehiscence: Bone grafting is necessary for this wound healing failure.