Dental implants are the most important dentistry advance in our generation. They are a quantum leap forward in comfort and function compared to bridgework or removable teeth. Whereas other restorations can only cover up for missing teeth, dental implants are long-term replacements that actually restore the missing tooth and root structures.
Nearly everyone is a candidate for dental implant treatment, even those who have had chronic dental problems or have been missing teeth for decades. Dental implant procedures involve minimal recuperation and can be painlessly performed while you are asleep. A single implant can replace a single tooth, and two or more implants can replace several missing teeth or even an entire set of teeth.
Dental implants are the best treatment choice in nearly every situation where teeth are missing – no painful dentures, no metal prongs and no grinding down of healthy teeth. They are placed independent of your other teeth, so healthy neighboring teeth remain untouched and unharmed. Acting as replacement roots, the implants renew stimulation of the jawbone to maintain its strength.
With dental implants, your chewing function can return to normal.
You can eat pretty much anything you want in complete comfort, and you can speak clearly. Implants never decay, which makes them an ideal choice if you are cavity prone. Dental implants are the most successful and cost effective treatment for missing teeth, a fact which has been proven by hundreds of scientific studies. Their success rate, at about 98% for most situations, is far superior to other treatments. Their longevity has been proven for over 45 years; they last about as long as natural teeth.
Dental Implant Anatomy
The best way to describe a dental implant is to compare it to a real tooth. The part of a natural tooth you can see is called the crown. Hidden beneath the gums is the root, which anchors the tooth to the jawbone. If a natural tooth is lost, the dental implant functions as a brand new root. Once this root structure is restored, a crown can be made that matches the color and shape of your natural tooth.
A typical dental implant tooth is composed of three separate parts:
The actual implant is a titanium post that is surgically implanted into the jaw. After healing, the implant will completely fuse with the jawbone to form a firm root foundation.
The abutment attaches to the implant, and serves as a connector between the implant and the crown.
The crown, which is custom fabricated by your restorative dentist, is fitted onto the abutment to recreate the natural shape and appearance of your tooth. A single tooth, a segment of several teeth, or even an entire set of new teeth can be made.
Problems Caused by Missing Teeth
f you lose one or more teeth, there are several unfortunate changes that begin immediately.
Atrophy of the Jaw Bone
When your tooth is gone, the jawbone is no longer stimulated by chewing forces, and the jawbone in the area begins to melt away – a process called atrophy. This progressive bone loss weakens the jawbone, and may complicate eventual implant placement.
Missing teeth also allow neighboring and opposing teeth to drift or tip into the empty space. This creates orthodontic, gum, or cosmetic problems that may need to be corrected.
When back teeth are lost, the chewing force that was borne by the sturdy molar teeth is transferred to the more delicate front teeth. They become overloaded and wear down quickly, becoming shorter and shorter until they are lost altogether. The shape of the face also becomes more short and square because the jaws have developed an over-closed posture. This is why it is always best to have missing teeth replaced, even if they are unseen teeth in the back of the mouth.
Accelerated Wearing Down of the Front Teeth
Problems with the Jaw Joint
When back teeth are lost, the missing support also places a heavy burden on the jaw muscles and joint structures. Over time, this can lead to clicking, popping, or grinding noises and can lead to jaw joint pain, locking, or degeneration (arthritis) of the joint.
Other Tooth Replacement Options
Although dental implants are clearly a far superior tooth replacement treatment, you have a few other options: a removable partial denture or full denture or a fixed bridge.
Removable Partial Denture
A partial denture fills in the missing teeth by resting on the gums while being held in place with metal prongs that clip to the neighboring teeth. A partial denture does not replace the missing root structure or prevent further jawbone atrophy. In fact, partial dentures hasten the eventual ruin of adjacent teeth.
Partial dentures compromise chewing function. They can be bulky and distort speech. Cosmetic results are disappointing if the metal prongs are visible. They are the cheapest way to replace teeth, but success can be short lived if more teeth are lost.
If all the teeth in one or both jaws are missing, then full dentures can be made. Full dentures do not replace missing root structures and do not prevent jawbone atrophy. In fact, the pressure from dentures actually accelerates bone atrophy.
Few people are satisfied with the function and comfort of full dentures, and the fit worsens as time goes by. This causes progressively more pinching, clicking, and food entrapment under the denture. Bulky dentures also cause distorted speech and can prevent normal taste sensation.
A fixed bridge can be made by shaving down and placing caps or crowns on the adjacent teeth and suspending one or two false teeth in between. Fixed bridges have significantly higher treatment costs and last an average of 7-15 years before needing to be replaced. Chewing function can be good as long as the adjacent teeth are in good condition.
A fixed bridge was a breathtaking innovation a few decades ago, but the drawbacks are considerable. The jawbone continues to atrophy. Hygiene is difficult, and recurrent decay is a problem that often requires replacement. Most worrisome, healthy adjacent teeth are ground down and overloaded. When a bridge eventually does fail, it usually means more teeth need to be extracted. The longer the bridge spans, the sooner it fails.
Dental Implant Procedures
Implant Planning and Treatment Steps
We want you to obtain a perfect result. Successful implant treatment is a team effort in both the planning and the procedures. You can maximize your chance of success by utilizing the specialty expertise of Dr. Stout to carry out surgical treatments and the experience of your restorative dentist to carry out the prosthetic (tooth crown and denture) work.
At your consultation, after we understand your treatment goals, we examine your teeth and gums, the way your teeth bite together (the occlusion), and the bone in the jaws. Utilizing 3-dimensional CT scans, and photos, and CAD virtual surgical planning, we correspond with your dentist to ensure we plan and coordinate the most appropriate treatment for you.The treatment concept of dental implants is actually very simple. We surgically create a precision socket in the jaw bone into which a titanium root is fitted. Once an implant has been placed, the surrounding bone needs to heal and completely fuse with the implant.
Once healing is complete, single tooth or multiple tooth restorations can complete your treatment.
For many implant locations, it is best to wait for the bone to heal completely from any tooth extractions before proceeding with the implant surgery. But in many sites, it is possible to remove the hopeless teeth and place the implants all in one procedure, a process known as immediate implantation. This can result in quicker treatment time and slightly improved appearance of the gum tissues.
Once the implant is inserted into the bone, the surgical phase of treatment can be completed in one of several ways:
In the traditional two-stage approach, the gums are closed over the top of the implant, and the site is left undisturbed. After the bone has healed, a minor uncovering surgery is performed, and a temporary healing cap is attached. This approach allows the gum tissues to be sculpted or grafted, which may be needed in the esthetic areas of the mouth.
An alternative approach is called the single-stage approach. Instead of closing the tissues over the implant, the healing cap is connected at the same time the implant is placed. This approach avoids one procedure and shortens the treatment time. It is commonly used to replace back teeth.
The actual implant placement surgery is done in our office surgery center with the aid of intravenous sedation anesthesia. It takes about 45 minutes to place a single implant and longer for multiple implants.
We don’t start your procedure until you are comfortably asleep. The implanted root is then surgically installed and tightened into ideal position. Dissolving sutures are used to close the wound.
When you have finished your treatment, you will awaken from the sedation rather quickly (It feels like only 3-4 seconds have elapsed). You will be comfortable since the area will be numb from the local anesthetic. Once you are stable and recuperating well you can return home, where you should keep your activity light for several days.
We will make sure you are comfortable during your recuperation. The discomfort after implant surgery is surprisingly mild, but may require prescription pain medication. It is best to be on a soft diet for several days and avoid chewing in the surgical area. You can advance your diet to normal foods as your comfort permits.