A dental implant (also known as an endosseous implant or fixture) is a surgical component that interfaces with the bone of the jaw or skull to support a dental prosthesis. This includes usage in crowns, bridges, dentures, facial prosthesis or to act as an orthodontic anchor. The basis for modern dental implants is a biologic process called osseointegration where materials, such as titanium, form an intimate bond to bone. The implant fixture is first placed, so that it is likely to osseointegrate, then a dental prosthetic is added. A variable amount of healing time is required for osseointegration before either the dental prosthetic (a tooth, bridge or denture) is attached to the implant or an abutment is placed which will hold a dental prosthetic.
Success or failure of implants depends on the health of the person receiving it, drugs which impact the chances of osseointegration and the health of the tissues in the mouth. The amount of stress that will be put on the implant and fixture during normal function is also evaluated. Planning the position and number of implants is key to the long-term health of the prosthetic since biomechanical forces created during chewing can be significant. The position of implants is determined by the position and angle of adjacent teeth, lab simulations or by using computed tomography with CAD/CAM simulations and surgical guides called stents. The prerequisites to long term success of osseointegrated dental implants, are healthy bone and gingiva. Since both can atrophy after tooth extraction pre-prosthetic procedures, such as sinus lifts or gingival grafts, are sometimes required to recreate ideal bone and gingiva.
The final prosthetic can be either fixed, where a person cannot remove the denture or teeth from their mouth or removable, where they can remove the prosthetic. In each case an abutment is attached to the implant fixture. Where the prosthetic is fixed, the crown, bridge or denture is fixed to the abutment with either lag-screws or cement. Where the prosthetic is removable, a corresponding adapter is placed in the prosthetic so that the two pieces can be secured together.
Replacing a Single Tooth
A single tooth can be replaced with an implant and a crown.
Replacing Several Teeth
Several teeth can be replaced with implant-supported bridges.
Replacing All of Your Teeth
All of your teeth can be replaced with an implant-supported full bridge or full denture.
A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants.
Deformities in the upper or lower jaw can leave you with inadequate bone in which to place dental implants. To correct the problem, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or bone substitute to build up the ridge. Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come.
At Corné Smith Dentistry we work with implant specialists; that have extensive experience in Implantology. All implant cases are done with a multidisciplinary approach, ensuring the best possible outcome for the patient.
Different Implant Systems
Several implant systems are available world wide, and we work with only the most predictable and scientifically proven systems. The systems we use are:
Am I a candidate for dental implants?
If you have lost a tooth or several teeth, you are a candidate for implants. The ideal candidate for a dental implant is in good general and oral health. Adequate bone in your jaw is needed to support the implant, and the best candidates have healthy gum tissues that are free of periodontal disease.
Several types of cleaning aids are used to clean dental implants, and your dental hygienist will also provide you with special instructions. The implants need special care, as the metal surface can easily be scratched which allows the surface to harbor harmful bacteria that could cause inflammation of the tissues around the implant.
It is very important to have a professional cleaning done by our oral hygienist at least every 6 months.
Any natural teeth you have must be cleaned thoroughly with a toothbrush with tapered bristles to reach under the gum line. In-between-teeth-cleaning should be accomplished with either interdental brushes or special dental floss.
Soft picks are ideal for implants, as they have soft, rubber tips and will not scratch implants. Metal objects such as pipe cleaners, safety pins, hard brushes, or paper clips may permanently scratch the dental implant, which then allows the implant to harbor bacteria and may cause infection of the tissues surrounding the implant.
If the implant prosthesis is removable, it will also need to be cleaned daily with a soft toothbrush.
Flossing is best accomplished with special floss that is designed for dental implants.
How does the process work?
This procedure is a team effort between you, your dentist and your periodontist. Your periodontist and dentist will consult with you to determine where and how your implant should be placed. Depending on your specific condition and the type of implant chosen, the team will create a treatment plan tailored to meet your needs.
The implant procedure can be summarised in 5 steps:
- Implant placement:
- Crown placement:
Correct diagnosis is a step that cannot be emphasized enough. We will take several x-rays, study models and sometimes a cone beam 3D scan of your jaw to determine the health of the bone and underlying tissues.
The implant is inserted under local anaesthesia, conscious sedation or in theatre. A Temporary restoration may be used in the front of your mouth to ensure a natural looking smile.
After approximately one week, the stitches are removed. The healing phase will last between six weeks and a few months, depending on the medical situation. During this time, diligent oral hygiene is vital.
After the healing is complete and the implant is integrated, an impression is taken for the crown, which is then manufactured by the dental laboratory. In areas where more than one tooth is replaced, a bridge or denture is then manufactured.
Implants require special care afterwards, and regular cleanings from an oral hygienist. Cleaning visits should be scheduled every 6 months, and on these visits the hygienist will give further instructions on cleaning. Also see our section on cleaning implants.
Risks & Complications
The risks and complications related to implant therapy are divided into those that occur during surgery (such as excessive bleeding or nerve injury), those that occur in the first six months (such as infection and failure to osseointegrate) and those that occur long-term (such as peri-implantitis and mechanical failures). In the presence of healthy tissues, a well-integrated implant with appropriate biomechanical loads can have long term success rates of 93 to 98 percent for the fixture and 10 to 15 year lifespans for the prosthetic teeth.