Your natural tooth is made up of a root and a crown. The visible
part with which you chew your food is the crown. The root lies underneath
the crown and serves to anchor the tooth through the gum to the
jawbone. When you lose a tooth both the root and crown are lost.
A dental implant is a man-made titanium post that replaces the root.
It is shaped like a screw or a cylinder. Your dental surgeon creates
a socket in your jaw bone into which the implant is fitted. The
jaw bone then fuses with the implant and forms a support onto which
an artificial tooth or prosthesis is built. Titanium was chosen
as the source material for implants because it is most compatible
with the human body, that is, it is rarely rejected.
The
proper positioning of a dental implant within the jawbone
is a carefully planned process which is critical to the success
of the procedure. Clinical evidence has repeatedly shown the
stable healing of soft tissue and bone around the implant
allowing for a predictable long-term result. This X-ray with
its matching clinical picture illustrates how a dental implant
has replaced a patient’s front tooth.
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How does tooth loss occur and how does it affect your life?
You may lose a tooth as the result of an accident, tooth decay,
or infections of the gum and surrounding bone tissue (known as periodontal
disease). Some individuals have teeth that have been missing since
birth. Missing teeth can cause you discomfort when you eat or speak
and lead to muscle pain in your jaws or headaches due to the extra
stress placed on the rest of your teeth. The change in your appearance
may make you feel awkward in social situations.
How can dental implants help?
Implants look, feel and function like natural teeth that are part
of your mouth. They can replace one, several or all of your teeth.
As they substitute for missing tooth roots, they preserve the surrounding
bone by stimulating new bone growth and thus prevent the break down
of bone that would normally occur when teeth are missing or replaced
by bridges, partials or dentures. The structure of you face is maintained
and you can eat and smile confidently. You are also spared the potential
discomfort of poorly-fitting dentures and partials. With the evolution
of state of the art technology and over 30 years of research and
clinical experience, most patients, regardless of age, can benefit
from implant treatment. This provides a stable, attractive, comfortable
and long-lasting result.
Working as team
The implant process is a team approach involving you, your surgeon
(who places the implant) and your restorative dentist (who builds
the replacement teeth). They work together to develop a treatment
plan that best meets your needs. It is important that you take an
active role by making a commitment to:
Keep all your appointments.
Maintain your oral health during the procedure
and thereafter.
Continue to have check ups at least every
6 months.
Promptly get in touch with your dental professional
if problems arise.
Am I a candidate for dental implants?
To determine if dental implants are the right option for you, you
will need to undergo a complete dental evaluation involving a dental
exam, medical history, X-rays, and possibly CT scans.
The examination will reveal important information about the
structure of your mouth including:
How your jaws fit together.
Whether you have enough bone in your jaw.
This is done by measuring the height and width of your jawbones.
Whether your gums are healthy. Any gum disease
that is found must be treated before the implants can be placed.
The condition of any existing dentures or
dental work.
This
diagram illustrates the key anatomic structures that are examined
during an assessment before implant surgery.
Your surgeon will want to know about
your general health, any medical conditions, allergies and previous
dental treatments such as crowns and bridges. You should tell him
about any medication you are taking, especially blood thinners including
aspirin or insulin. He will talk to you about some medications and
certain habits such as smoking that can affect the healing process.
If you have a condition such as diabetes, you may need to have blood
tests to make sure it is in control before the implant is placed.
To ensure the success of your implant procedure, it is very important
that your surgeon learns as much as possible about your medical
and dental history.
Dental X-rays and scans help your surgeon to see of parts
of your mouth and head that are not visible in the examination.
He gets a better view of your teeth and jaws with dental X-rays
and a wider view of the jaw, nerves, teeth and sinuses with panoramic
X-rays. In certain cases the surgeon will ask you to have a CT-scan
and X-ray tomography in order to have a three-dimensional view.
A panoramic X-ray (Roll
over the text links below to animate this X-ray.)
A CT Scan
During the planning stages
in the preparation for dental implant placement, it is very
important, in some cases, for the surgeon to have very detailed
information about the shape and size of the very specific
area into which the implant will be placed. The computerized
tomography scan (CT scan) provides additional details that
cannot be obtained with a regular dental X-ray.
If your surgeon finds that you do not
have enough healthy bone or gum tissue in your jaw, a can be done to help build up the necessary tissue and
create a solid platform for the implant. A healing period of between
3 and 9 months may be required before the implant can be placed.
You and your surgeon will discuss a treatment plan that will be
suitable for you. Your surgeon will explain the steps in the process,
including the time frame and costs involved.
How is the dental implant procedure done?
The procedure usually involves one main surgery that may be followed
by minor adjustments to the surrounding gum tissue after the implant
site has healed.
Generally, the surgery will be performed
in a dental office.
The length of time it will take will vary
depending on the number of implants to be placed. Surgery involving
a single implant normally takes about an hour.
Your surgeon may offer you some medication
that will make you feel relaxed or sleepy. The surgeon will then
freeze your jaw.
The jawbone is exposed through an incision
in the gum and a small hole is drilled for the implant.
The bone is prepared by drilling a hole in
the jawbone that is the right size to receive the implant.
Using surgical instruments a space or “socket”
is created.
The implant is inserted into the socket,
by twisting or gently tapping it into place.
As required, the incision is closed with
sutures.
What can I expect after dental implant surgery?
You may rest for short while in the office and then return home.
If you have received a medication to make you sleepy you must not
drive for 12 to 24 hours afterwards and should bring a responsible
adult to take you home. You will be advised and provided an instruction
sheet on what to eat and how to care for your mouth after the
procedure:
Take your antibiotics and pain medication.
Hold an ice pack to your face at 30 minute
intervals for the first 48 hours to reduce the swelling.
Eat soft foods such as yogourt, soup, milk
products and jello for the first few days.
Try not to put pressure on your jaw.
Do not wear your temporary prosthesis until
your surgeon advises you to do so.
Contact your surgeon if you experience:
A lot of swelling under the tongue or around
the face and neck
Continuous bleeding
Jaw or mouth pain that does not stop after
you take the pain medication you have been given.
Fever (greater than 38.5°C)
Numbness after the anesthetic has worn off.
What are the next steps after dental implant surgery?
In order for your implant to heal, your jawbone
must fuse to the implant. The duration of this healing interval
is influenced by factors such as bone density, bone grafting (if
performed) and the type of dental implant. The healing period
ranges from 6 weeks to 4 months. The healing time will be discussed
with you and is usually determined by your surgeon at the time
of implant placement.
Your surgeon may choose to place healing
“caps” or abutments on your implants to help the gum
to heal. Once the implants have healed completely, between 6 weeks
and 4 months after surgery, the final abutments that will connect
the implant to the prothesis will be placed.
What is the “one-step” (immediate implant) approach?
In most cases the entire implant procedure
can be completed in one surgery. Healing “caps” or
abutments are placed on the implant at the same time that the
implant is placed.
Under the right conditions, your dentist
may immediately place a temporary crown on the newly inserted
implants. This is referred to as “immediate loading”.
Stitches are then used to close the space
between the gum and implant.
Although this method requires only one surgery
and is often preferred by patients, it is not always the best
choice and each case must be considered separately.
The one-step approach (Roll over these small images
to animate.)
How are my artificial teeth or “dental
prosthesis” made and what options are available to me?
After your gums have healed, your restorative
dentist will take impressions (molds) of your teeth, jaw and abutments
as well as bite registrations that show how your jaws fit together.
A model of your mouth will be created from which your prosthesis
will be made.
This process may take several weeks to months.
Once the prosthesis is ready, you will need several fittings to
adjust it for a comfortable fit.
What dental implant options are available to me?
A single
prosthesis to replace one missing tooth.
A partial,
fixed bridge replaces two or more teeth and is supported
by two or three implants.
A
complete denture prosthesis is offered to patients missing
the entire upper or lower set of teeth. The number of implants
that are need to support it depends on whether the prosthesis
is fixed or removable.
A removable
prosthesis is connected to 4-6 implants (upper jaw) or 2
– 4 implants (lower jaw) by a bar or clip. You can take
it out of your mouth for cleaning. Since the bone in the upper
jaw is not as hard as in the lower jaw, a larger number of implants
may be needed.
A fixed prosthesis
is usually supported by 5 or more implants. The teeth are fitted
to a frame that is attached to the implants by screws or clasps.
As this permanent denture does not touch your gums with proper
technique you can clean under it. It can only be removed by
your dentist.
You
and your surgeon will discuss the options in your case and decide
on the best type of prosthesis for you.
Complete
Upper Implant Case(Roll over these small images to make
them larger.)
How do keep my abutments, crowns
and prosthesis clean after implant therapy?
It is equally important to keep your dental prosthesis clean, as
your natural teeth. Good dental hygiene is essential to ensure that
your implants, crowns and prosthesis function well for many years.
Lack of proper care can lead to inflammation of the gums and bone
surrounding the implant with possible loss of the implant, just
as with your natural teeth.
Optimal dental hygiene involves daily brushing of your crowns or
prosthesis after every meal and at bedtime. You need to pay special
attention to cleaning the abutment posts (“caps”), underneath
the prosthesis, and the area around the gums. Flossing at least
once a day between your teeth and around the prosthesis is important,
so that areas that your toothbrush cannot reach are kept clean.
For a single implant-supported crown,
you should brush the top and back as you would your natural teeth,
as well as your gums and abutments. Floss the crown as you do
your natural teeth. You may choose an interdental brush with a
bent handle to clean around your abutments.
For a fixed prosthesis, brush the
tops and back as your natural teeth. The abutments should be flossed
from the front, back and sides.
If you have a removable prosthesis,
you should first remove it and then brush both the inside and
outside surfaces. While your prosthesis is still out of your mouth,
floss the area around the abutments.
Your dental hygienist or assistant will help you find the right
combination of cleaning techniques and instruments for your mouth.
These are some options:
Soft or ultra-soft toothbrushes are
recommended. Among the choices are Butler’s “Right
Kind” (#300) and one of Butler’s Series #465, which
is made in three varieties of bristles.
We recommend extra thick floss to clean your
abutment posts. Some of the choices are cotton ribbon, tufted
floss (Oral B “Super Floss”) or flossing cord (Butler’s
“PostCare”).
Other cleaning instruments that can be helpful
to maintain your dental hygiene include:
Nylon –coated interproximal brushes
for cleaning surfaces between implant posts
End –tuft brushes (tapered Oral-B
#308 and flat Oral-B #307) for cleaning surfaces between implant
posts
Electric toothbrush (Braun Oral-B Plaque
Remover, Braun Oral-B Plaque Remover #D, Sonicare, Rota-Dent)
– These are not to be used for the first week after
implant surgery.
If you have difficulty seeing your abutments clearly, you can use
a lighted magnified make-up mirror. In particular, if you wear bifocals,
you may want to purchase full frame reading glasses that are available
without a prescription at the pharmacy. They can help make the cleaning
process easier for you.
If you have questions or difficulty with maintaining your dental
hygiene after implant therapy, we encourage you to contact our hygienist
and she will be pleased to assist you.
How often do I need to have follow-up check-ups?
It is recommended that you visit your restorative dentist at least
twice a year to clean your abutments and check that your crowns
or prosthesis are fitting properly. You should visit your oral surgeon
at least once a year so that she or he can check that your implants
are stable and your gums and jaws are in good health. With usual
wear over time implants may require some adjustments or repairs
such as replacement of clips, relining or tightening of screws.
How successful are dental implants and how long can they last?
According to documented studies, implants have demonstrated a success
rate of 80-90% in patients who have lost all their teeth and over
90% for those receiving a one or several implants. It is very important
that you maintain good dental hygiene to ensure that your implants
last for many years. There are patients who have maintained their
titanium implants and prostheses for over 30 years and they continue
to function well.
What are my options if I am not a candidate for dental implants?
If dental implants are not the right choice for you, you can replace
a missing tooth with a bridge supported by adjacent crowns. Adjusting
an existing denture may provide a better fit. You may also elect
to have implants at a later time.
