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What are implants?
Missing teeth can often be replaced by implants. Implants act like roots of teeth. After they have been fitted and have healed in place, dentures or crowns may be attached to them. When dentures are held in place by implants they do not slip around. If crowns are fitted on implants they act like normal teeth
There are various types of implants, however, the most commonly placed throughout the world are often described as root-form or endosseous implants. These generally have a cylindrical form and may be threaded on the outer surface to assist placement. Other designs such as blades or subperiosteals whilst in use by some practitioners are not the focus of this information. The success and rapid growth in popularity of the root-form implant is largely due to its predictable behaviour when trying to achieve a rigid fixation with the surrounding bone and the maintenance of this state throughout many years of function.
Implants can only be placed if there is enough bone present in the jaw. When teeth are lost, the bone around the teeth gradually disappears. If too much bone has been lost it is sometimes possible to grow bone in its place.
What are the alternatives?
NO remaining teeth the alternatives are:
• Complete dentures
• Implants which secure their dentures in place
• Implants which support crowns and bridges
SOME of their own teeth the alternatives are:
• Crowns and bridges supported by implants and/or teeth
• Partial dentures secured by implants and/or teeth
• Partial dentures supported by teeth
• Bridges supported by teeth
The initial evaluation and additional diagnostic material
General Dental Health
To plan the most suitable treatment certain information is helpful for example photographs, x-rays, models of your teeth and jaws. In some circumstances, a more comprehensive three-dimensional x-ray evaluation using a CT Scan may be requested to give greater detail of the shape of your jaws.
What is a CT scan?
The conventional x-ray views most familiar to patients are only 2-dimensional and subject to varying degrees of distortion and inaccuracy. Where important anatomical structures must be avoided, the information they provide may therefore be inadequate. The CT scan in contrast can provide life-sized 3-dimensional information of all regions of the upper and/or lower jaw from which precise measurements can be taken for pre-operative treatment planning. In some cases the CT scan may also be used to evaluate the results of bone grafting procedures prior to placing implants.
Having a healthy mouth
Implants survive best in a healthy environment. Any tooth decay or gum problems need to be corrected before implants are placed to give them the best chance of success.
Sometimes treatment is needed before you are ready for implants
Gum Health: This may involve the use of special brushing methods, flossing, tooth picks and small “bottle” brushes. Some gum treatment may be necessary.
Removal of Unsavable Teeth: Despite advances in modern dentistry some teeth may have reached a stage when no treatment can save them. It is often best to remove them at an early stage, particularly if you are thinking of having implants so as to prevent further bone loss.
Treatment of existing or potential oral infections
Treat or remove all pre-existing oral infection wherever possible. The success of implant therapy can be seriously affected by infections resulting from failed gum or root canal treatments or untreated gum disease or nerve problems in sites adjacent to implants. Long-standing infections of the soft-tissues beneath dentures can also adversely affect healing at the various surgical stages. Your treatment may be delayed whilst these areas are resolved.
Although gum infections arising in opposite jaws have no clearly proven link with problems around implants, there is at least the theoretical risk of bacterial transmission, therefore for the meantime it would be considered prudent to assume that there is a risk. Your mouth should be treated as a whole and not simply as unrelated regions.
How many implants?
As a general principle, as many implants as possible should be used. This allows the stresses of biting to be spread over the maximum number of implants, thus diminishing the load on each particular one.
Upgrading
Some people find it more convenient to proceed in stages.
It is sometimes possible to have two or three implants placed, use them for a while and some time later, add more implants to improve the treatment plan. This is not an approach which is feasible in all situations and is probably most suited for treatment of the lower jaw where no teeth are present.
An example of this might be the patient with no teeth in the lower jaw who has two or more implants placed in the first instance. By stabilizing their denture using the implants, it can be held more firmly in place. Later on, if they have sufficient bone, more implants can be added and eventually fixed-teeth placed on the implants eliminating the denture altogether. A number of the implant systems available today could support this approach, however the feasibility of upgrading should be confirmed by all parties rather than assumed.
What is it like having implants fitted?
Generally speaking, having implants fitted is not at all painful. For apprehensive patients, sedation can be given making the procedure quite comfortable.
What is it like after having the implants placed?
The after-effects of having implants placed are usually mild and may include slight bruising, dull ache, and swelling, the amount of which will vary dependent upon the number of implants placed and the difficulty of the surgical procedures.
When choosing a date for implant placement avoids significant social engagements and work commitments for at least a week after. This is just to be on the safe side. Taking time off work is not usually necessary.
