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 038-723460  Contact@DentalSmilePattaya.com |
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Dental
Implant
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Dental implants
serve as artificial roots, firmly anchored into the jawbone,
that support fixed or removable tooth replacements. This
treatment is considered as the nearest thing to natural tooth
function available in dentistry nowadays. Using the same
principles and material used in joint replacement surgery,
dental implants are securely anchored into bone and will attach
to single or multiple replacement teeth. Implants are also used
to anchor full-mouth dentures.
A
dental implant designed to replace a single tooth is composed of
three parts: the titanium implant that fuses with the jawbone;
the abutment, which fits over the portion of the implant that
protrudes from the gum line; and the crown, which is created by
a
prosthodontist or restorative dentist and fitted onto the
abutment for a natural appearance.
Nowadays,
dental implant is considered the best treatment for patients who
are missing permanent teeth. Rather than resting on the gum
line like removable dentures, or using adjacent teeth as anchors
like fixed bridges, dental implants are long-term replacements
that your oral and maxillofacial surgeon surgically places in
the jawbone. Composed of titanium
metal that “fuses” with the jawbone through a process called
“osseointegration,” dental implants never slip or make
embarrassing noises that advertise the fact that
you have “false teeth,” and never decay like teeth anchoring
fixed bridges.
Because dental implants fuse with the jawbone, bone loss is
generally not a problem |
Benefits of dental implants over dental bridges or dentures
Many people who are missing a single tooth choose dental bridge;
but dental bridge may require the cutting down of healthy,
adjacent teeth that may or may not need to be restored in the
future. Then there is the additional cost of possibly having to
replace the bridge once, twice or more over the course of a
lifetime. Similarly, a removable partial denture may contribute
to the loss of adjacent teeth. Studies show that within five to
seven years there is a failure rate of up to 30% in teeth
located next to a fixed bridge or removable partial denture.
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Implants feel more comfortable, secure, and natural than
removable tooth replacements such as a partial denture.
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Implants allow you to eat what you want.
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Implants give you the confidence to freely laugh and smile
with ease.
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Implants will stop the jawbone from shrinking, which in turn
stops premature facial aging.
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When you missing a tooth |
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Replacing a missing tooth: crown on
implant. If you are missing one tooth including the root, the
dental crown is attached to a dental implant. The implant serves
as a foundation for a dental crown. This method does not affect
your other healthy adjacent teeth.
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| When you missing several teeth |
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Bridge on implants uses modern technology. A durable bridge with
natural-looking replacement teeth is securely positioned on
dental implants. Healthy, adjacent teeth are left untouched.
Dental implants are strong, biocompatible fixtures made of
titanium, that act just like natural tooth roots. |
| When you have no tooth left |
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Removable overdentures on an implant bar. For an even more
secure fit, a dental bar is fixed to your jaw bone with two or
more implants, providing stronger support for your removable
dentures. Your new teeth can be removed for cleaning and the
need for denture adhesives is eliminated.
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Who
is a good dental implant candidate?
Not all people are
good candidates to get dental implants. A person
who is most suitable is someone who is in good health, has
healthy gums, and has enough bone in his of her jaw to allow an
implant to be placed in the jawbone. To determine if you are
suitable to get an implant, you will have to be examined by a
dental professional.
Some people are interested in getting implants to
replace teeth that have been missing for a number of years.
Others may need implants to replace teeth that were extracted
recently because of severe decay, periodontal (gum) disease,
infection of injury. In some cases, the teeth can be extracted
and the implant placed at the same time. If you have a severe
infection in a tooth root or your gums, your dentist may wait a
few months after removing the teeth to allow the area to heal.
Before a dental implant is placed, you may need to have the bone
in the area built up to increase the chance of success. This is
a common procedure called bone grafting or augmentation. You may
have the bone graft done and get the implants at the some time,
but your dental specialist may decide to do the bone-graft
procedure first and give the bone time to heal before placing
the implant. If the bone graft is done first, you will need 4 to
12 months to heal before having the implants placed in you
jawbone. However, you can wear your dentures or bridge during
this time, so you won’t be without teeth.
Sinus augmentation
– In the upper jaw above the back teeth, it is possible to
increase the height of bone available by creating new bone in
the sinus. This procedure is called a ‘sinus augmentation’. A
skilled surgeon can deliver very predictable results in this
location and without the general success of this technique many
patients would be unable to have implants in a part of the mouth
where teeth are so commonly missing.
Bone grafting
– There are many ways in which bone can be added to, however one
simple concept is to take a piece of gone from somewhere else
and secure it as an ‘onlay graft’ to a deficient area. The new
piece of bone will slowly join to the underlying region and when
healed and mature, and implant can be placed in a more favorable
position.
Frequently Asked Questions about Dental Implants
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1. How long will a dental implant last? |
Implants are a well-established, tried-and-tested treatment. 90
per cent of modern implants last for at least 15 years.
After more than 20 years of service, the vast majority of dental
implants first placed by oral and maxillofacial surgeons in the
United States continue to still function at peak performance.
More importantly, the recipients of those early dental implants
are still satisfied they made the right choice. If properly
cared for, dental implants can last a lifetime.
Clincial research shows a lifespan of over 25 years for implant
supported tooth restorations. As with natural teeth, good dental
hygiene and regular checkups are most important to maintain
healthy implants.
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2. What are the success rates for dental implants? |
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Implant success rates throughout the world vary between 90-95%
during the first 5 years. We can proudly say that our
success rate is 98.3%! |
3. Does the implant insertion procedure cause pain? |
Placing the implants requires a small operation. This can be
carried out under local anaesthetic with sedation or with a
general anaesthetic. You will not feel any pain at the time, but
you may feel some discomfort during the week following the
surgery. This is usually due to having stitches in place, and
the normal healing process.
Although each patient reacts differently, most people experience
minimal discomfort, which may or may not be accompanied by
slight swelling that disappears with 2-3 days or so
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4. Will I be able to chew with my implants just like with my natural
teeth? |
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Absolutely! Chewing ability may even be increased due the
replacement of missing or diseased teeth with implants.
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5.
I have some of my own teeth. Can I still have implants?
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Yes. You can have any number of teeth replaced with implants –
from one single tooth to a complete set.
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6.
Can implants always be used to replace missing teeth?
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It depends on the state of the bone in your jaw. Your dentist
will arrange for a number of special tests to assess the amount
of bone still there. If there is not enough, or if it isn’t
healthy enough, it may not be possible to place implants without
grafting bone into the area first.
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7.
How soon can I have the new teeth? |
The implants need to bond (integrate) with the bone after they
have been put in. This takes at least 3 months in the lower jaw
and 6 months in the upper jaw. Sometimes the implants may be
stable enough when they are fitted for the artificial teeth to
be attached much sooner than this.
If you are having one, two or three teeth replaced, you will
have a temporary restoration in the meantime. If you have
complete dentures, then these can be worn throughout the healing
period once they have been modified after the surgery.
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8.
Are the teeth difficult to clean? |
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Cleaning around the teeth attached to the implants is no more
difficult than cleaning natural teeth. However, there may be
areas that give you problems and you’ll be shown methods to
help. If I had gum disease when I had my own teeth, will I get
it with the teeth attached to the implants? Yes, if you don’t
care for them well enough. If you keep them clean, and don’t
smoke, then you should not have any problems.
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9.
Can I take the teeth out if they are fixed to implants?
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Most artificial teeth attached to implants can only be placed
and removed by the dentist. However, if you have complete
dentures fixed to the implants by bars, then you’ll be able to
take them out for cleaning.
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10.
Do the implants show? |
Your dentist will make sure that the implants won’t show during
all normal movements of the mouth and lips. You will need to be
able to see them, so that you can clean them properly.
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11.
What happens if the implant does not bond (integrate) with the
bone?
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| This happens very rarely. If
the implant becomes loose during the healing period or just
after, then it is easily removed and healing takes place in the
normal way. Once the jaw has healed, another implant can be
placed there. Or, the dentist can make a bridge, using the
implanted false teeth that have ‘taken’. |
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Dental Implant Procedures
The time frame for completing the implant and crown depends on
many factors. When the traditional method of placing an implant
is used, the shortest time frame for a complete implant
(including surgeries and placing the permanent crown) is about
three to four months. However, the process can last up to a year
of more, particularly if bone needs to be built up first.
With treatment of implants each case is different; therefore it is hard
to evaluate any case without an oral examination.
In the traditional method, two surgeries are required, with
three to six months between them. During the first surgery, an
incision is made in the gum where the implant will be placed. A
hole is drilled in the bone, the implant is placed into the hole
in the bone, and the incision is stitched closed.
At the end of the healing period, a second surgery takes place.
It involves making a new incision to expose the implant. A
collar, called an abutment, is screwed onto the top of the
implant. The abutment is used to support the crown.
One-stage implant – The implant is placed into a new,
healing or healed extraction site and is visible above the gum
immediately after placement. The advantage of this method is
that a second surgical stage is not necessary to expose the
implant. In this procedure, your dentist can place the implants,
and place a temporary crown or bridge all in one visit. The
implant will not normally be ready to support a tooth for
several weeks of months.
Two-stage implant
– The implant is placed into a new, healing of healed extraction
site and then covered by a layer of gum so that it cannot be
seen – this is the first stage. At the second stage some weeks
of months later, the implant is uncovered and components added
bringing it above the gum ready to begin placing a new tooth.
Same day implants – This technique is most often used to
treat the lower jaw and requires considerable planning before
the actual day of surgery. Several implants are installed and a
few hours later a complete arch of temporary of permanent teeth
can be fixed in place. If temporary teeth are used these will
normally be replaced with a permanent bridge after a suitable
healing interval. Not all patients are suitable for this style
of treatment.
Immediate implant – For this technique a tooth is removed
and an implant placed immediately into the extraction site.
Depending upon the local bone and soft tissue conditions, the
implant surgery may be a one- or two-stage procedure. Not all
patients are suitable for this approach.
Immediate implant and early loading – This is distinctly
different from an immediate implant placement. It is effectively
a one-stage technique where the implant is placed into a new,
healing or healed extraction site and is fitted with a new tooth
at the same appointment. This first tooth will normally be kept
out of direct contact with opposing teeth for a healing period
of more than 3 months, after which it is finally restored. This
technique tends to be more common in regions of the mouth where
optimum aesthetics are important. Again, not all patients are
suitable for this approach.
Replacing a missing tooth: crown on implant. If you are missing
one tooth including the root, the dental crown is attached to a
dental implant. The implant serves as a foundation for a
Over the past 30 years, research has validated the success of osseointegrated implants as a viable alternative to fixed or removable prosthetic restorations. Periodontists are extensively trained in surgical procedures to treat and maintain patients with edentulous and partially edentulous arches. They also have a primary role in treatment planning and maintenance therapy. Thus, periodontists routinely integrate endosseous implants into periodontal therapy. This paper was prepared by the Research, Science and Therapy Committee of the American Academy of Periodontology and is intended to inform the dental profession regarding
the utility of endosseous dental implants in the treatment of full and partial edentulism
Several kinds of dental implant systems are available. These are classified according to their shape and relation to the bony housing. They include subperiosteal, transosteal, and endosseous implants. The most frequently used implants are endosseous implants. Endosseous implant systems include a range of sizes, shapes, coatings, and prosthetic components. 14 Implant length and width can be chosen
to fit the available bone and prosthetic components can be selected in a size and angle to accommodate the final restoration. Implant shape is usually a screw-type or cylindrical press-fit design. The selection of implant shape involves the exercise of professional judgement–taking into account such factors as available bone quality and the dimensions of the edentulous ridge.
A threaded implant may provide additional immedi-ate fixation compared to cylindrical implants. In this regard, a screw-type implant has more surface for
bonding than a parallel walled press-fit implant. The implant surface further affects the long-term fixation and stabilization of the implant.17 A porous coating on an implant can achieve more bone contact per implant length than an implant with a machined titanium surface.18 Other surface modifications of implants include a roughened surface (i.e., grit-blasted,19,20 or grit-blasted and acid-etched10), microgrooved or plasma-sprayed titanium,21 and plasma-sprayed hydroxyapatite coatings.
PATIENT SELECTION
It is essential that a candidate for implants be evaluated for potential contraindications to their placement. At present, there are no reports of absolutemedical contraindications for placement of implants, but relative contraindications do exist. Adverse effects on implant survival have been attributed to uncontrolled diabetes, alcoholism, heavy smoking,
post-irradiated jaws, and poor oral hygiene. However, individuals with a strong susceptibility to
periodontitis can be treated successfully with implants.
Age is not an important factor that affects implant survival. However, age may be of considerable importance in treatment planning. When implants are placed in an adolescent, it has been recommended that they be monitored closely and restored with a prosthesis designed for adaptation to a developing jaw. Furthermore, it has been suggested that implants placed after age 15 in girls and 18 in boys are more likely to have a better prognosis than implants placed in younger children. As with other periodontal or prosthetic procedures, prospective patients should be emotionally stable, cooperative, and willing to keep the appointments required for completion of treatment and maintenance. Every candidate for an implant should be made to understand that not all implants are successful; and, that if an implant fails, an alternative treatment without implants may be the only viable option.
SUMMARY AND FUTURE RESEARCH
 Endosseous dental implants have revolutionized the fields of implants and periodontics. During the last decade, a great deal of information has been generated concerning the effectiveness and predictability of endosseous implants. Implant placement is a viable option in the treatment of partial and full edentulism and has become an integral facet of periodontal therapy. The available implants are remarkably successful. However, there is no one ideal implant system. The following areas need further study: edentulous sites with inadequate bone for endosseous implants, splinting of implants to natural teeth, long-term effects of microbial and occlusal stresses, the prevention and treatment of peri-implant infection and disease, effects of implants on alveolar ridge maintenance, and routine maintenance protocols. Research on implant design for narrow ridges and atrophic jaws is ongoing, and the clinical efficacy of localized ridge augmentation and sinus floor grafts is being investigated. An area of research with future clinical significance is the use of growth factors and osteoinductive substances which may be applied locally or incorporated into the implant’s surface. These factors may increase bone quality and quantity and enhance the osseointegration of implants at recent
extraction sites and in areas of inadequate bone.
Equally important are research efforts to determine the predictive ability of biomechanical markers to identify peri-implant bone loss prior to its clinical detectability. Implant surface characteristics also are being evaluated for their effects on bone to implant contact and their ability to decrease the healing period. The placement of implants into the maxillary anterior sextant, which has unique esthetic requirements, has prompted a critical review of existing surgical procedures and implant prosthetic components for the partially edentulous patients. Ongoing and future research efforts should provide further advancements in these area
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