Overview of Procedure

A dental implant is an artificial replacement for a natural tooth root. The implants look like screws and are used to hold replacement teeth, also known as dental crowns, in place. The implants are made from titanium or other materials appropriate for the human body. The implant is screwed into the upper or lower jaw, attaching to the bone and surrounding gum tissue, to become a stable base for the tooth restoration.

Dental implants can be used to hold a single tooth, several teeth, a dental bridge or dentures in place. Dental implants and crowns are important because they restore the ability to chew food in those with missing teeth. They also create the natural appearance of teeth in a mouth. The dental implant procedure is followed by the addition of a dental crown-a custom-made artificial replacement tooth which is placed over the dental implant.

Dentists have three types of dental implants to replace missing teeth: an endosseous or endosteal implant is a root-form implant secured vertically into the jawbone; a plate-form implant allows dentists to secure the implant horizontally along the jawbone if the bone is too narrow to hold an endosseous implant. If the jawbone is too weak to hold the dental implant, a sub-periosteal implant can be used and secured on top on the jawbone and held in place with gum tissue that grows around the implant to secure it.

The Right Candidates

Good candidates for dental implants are people with missing or badly decayed teeth and those who have dentures and want more comfort and stability. Furthermore, dental implants are permanent replacements for missing teeth requiring no nightly removal and no dental adhesives.

Tooth restorations using dental implants can be cleaned as natural teeth, with tooth-brushing at home and deep-root scale and polish cleans by dental hygienists. Dental implants help fill out a face which has a sunken appearance because of missing teeth and offers restoration of the closest thing to a natural tooth. If you’ve had a failed root canal, implants offer an alternative base for the attachment of a crown.

Risks and Side Effects

Osseointegration, fusion of the implant with the jawbone, may not occur resulting in dental implant failure. The dental implant can break or become infected. The attached crown can become loose. Smokers have a higher risk of implant failure. Poor oral hygiene habits can lead to severe gum disease surrounding the implant. Bleeding, delayed healing, implant rejection, and alteration in sensitivity can occur.


Surgery

The dental implant procedure is a two or three-part process that takes several months to complete because of the required healing between steps. During the first dental appointment, the dentist surgically attaches the implant to the jaw bone. Because the metal implant itself is hollow to allow for the insertion of an extension, or post, the dentist will insert a protective cover screw into the implant to prevent gum tissue and debris from entering the open space. The gum tissue is then secured over the implant and will remain in place for 3-6 months while the implant fuses with the bone. This process is called “osseointegration.”

In a second appointment, the implant is uncovered and an extension, called a post, is put into place on the implant. Some dental implants already contain the post, so a second appointment is not required because both the implant and post were put into position during the first surgery. The last step of the dental implant procedure is the creation and attachment of the dental crown, or artificial tooth. The dentist will make an impression, or mold, of your implant and surrounding natural teeth. The tooth impression is sent to a dental laboratory where your crown is custom made, usually within two weeks. After the finished crown returns from the lab, it is carefully adjusted and secured to the implant.

The overall procedure will take 3-6 months to complete due to the required healing between stages of the implant surgery. The actual insertion of the implant can take as little as 20 minutes for a single tooth to several hours for an entire set of teeth. The procedure can be performed under general anesthesia (you are asleep) or in some cases, local anesthesia (you are awake).

Recovery

It is normal to feel discomfort and swelling in the mouth and gums for one to two weeks following dental implant surgery. You may have temporary difficulty smiling and chewing. External bruising may be visible around the cheeks and facial areas for 7-10 days, but this is rare. During the early healing stages, it is important to maintain excellent oral hygiene and refrain from any activities that may bump or jar the implants.

Most patients take one week off of work to rest and recover from implant surgery.

The level of pain varies from patient to patient, but it is normal to feel discomfort and swelling in the mouth and gums for one to two weeks following dental implant surgery. Pain medication is usually prescribed and a diet of soft, cold foods or warm soup is recommended.

Results

Studies have shown a 5-year success rate of 95% for lower jaw implants and 90% for upper jaw implants.

The success rates for dental implants in nonsmoking patients are above 90%. Patients who smoke have a significantly lower success rate of around 70%. Therefore, smokers should be prepared to quit for at least 2 months after dental implant surgery to prevent implant failure.