tooth replacement

Let’s face it; no one likes to have a tooth missing, especially when it involves a front tooth. However, a missing back tooth is not fun either, since it can affect chewing. This article will help you learn about what your options are for replacing one or more missing teeth, specially the option of dental implants. Simply put, a dental implant is an artificial tooth root surgically placed into your jawbone. A cap (crown) is then placed over this implanted root to make it look and function as a real tooth.

History of Dental Implants

Dr. Leonard Linkow placed his first dental implant in 1952, but it wasn’t until 1966 when published studies by Italian medical doctor Stefano Melchiade Tramonte confirmed the use of titanium for dental implants. Over the years, following clinical studies and human volunteers, dental implants have today become commonplace and offered by most dental practitioners.

Types of Dental Implants

Dental implants are usually made of titanium. There are two types of dental implants:

  • Endosteal—This is the most common type of implant, and it is placed in the bone. The implant can be made of screws, cylinders or blades, and is usually placed in the mouth to hold a bridge or removable dentures.
  • Subperiosteal—For those who can’t wear conventional dentures due to little bone height, these types are placed on top of the jaw. Protruding through the gums, the metal framework’s posts help hold the prosthesis in place.

Will it Work for You?

Your dentist will evaluate your mouth for several factors to determine if you are a good candidate for dental implants. First of all, good general and oral health is very important. Good oral health means there is adequate bone in your jaw to support the implant and healthy gum tissue free of periodontal disease.

Who Do You See to Get the Dental Implant?

Initially your general dentist can determine if you are a good candidate. Although many seminars are now offered to certify general dentists to place dental implants, you may want to seek a specialist for final placement. There are three types of specialists that are trained to place implants:

  • Periodontist—A periodontist is a dental specialist who focuses on prevention, diagnosis, and treatment of periodontal disease, and in placement of dental implants. They require three years of residency and training following basic dental school education.
  • Prosthodontist—This specialty requires three years of residency and training following basic dental school education. Their focus is optimum function and appearanceof your mouth. They become board certified to treat complicated cases involving crowns, bridges, dentures, dental implants, jaw joint problems, injuries involving trauma, or reconstruction of the mouth due to cancer or other conditions.
  • Oral surgeon—Patients with problem wisdom teeth, facial pain, misaligned jaws, and facial injuries can seek services of an oral surgeon. They focus on treatment of facial injuries, placement of dental implants, care for patients with oral cancer, tumors and cysts of the jaw and perform facial cosmetic surgery.

What a Dental Implant Placement Involves

Placement of a dental implant is usually an outpatient surgical procedure involving several steps:

  • Damaged tooth is removed, if not already missing.
  • A two-dimensional x-ray and a CT scan are obtained. A specialized 3D CAD/CAMcomputer program may be used to plan the placement of the dental implant.
  • If needed, bone grafting is performed followed by a period of time for healing. A bone graft may be needed if your own jawbone is not thick enough to provide a solid base for the implant. Usually a piece of bone is removed from another part of your jaw or body (for example, your hip) and placed to your jawbone. This is called autograft. Bone may also be obtained from cadavers (allograft), bovine bone or coral (xenograft), or artificially produced bonelike substances. It may take up to nine months for this to blend with the rest of your jawbone, and be ready to accept the dental implant.
  • stent or surgical template may be used to help facilitate the placement of the dental implant. This is an acrylic post that fits over the bone surface with pre-drilled holes to show the position and angle of the implants to be placed.
  • A dental implant metal post is placed surgically into your jawbone. This procedure consists of cutting into your gum to expose the bone. A pre-measured hole is then drilled deep into the bone where the dental implant post will be placed.
  • A period of three months or more is needed for the bone to heal around the implant. This is called osseointegration, which means the jawbone unites with the surface of the dental implant. Once osseointegration is complete, the dental implant is ready for placement of the crown over it.
  • The crown (cap) is then placed over the implant to resemble natural tooth or teeth, if several implants were placed. Usually, when the implant post was placed, another piece, called an abutment was attached to it. This abutment is visible when you open your mouth. A mold is taken of the area and an artificial crown is fabricated and placed on the abutment. Some people do not like the abutment being visible during the healing time, especially when it involves a front tooth. If the abutment was not added when the post was placed in your jawbone, it must be surgically added to the post after healing. This is called a two-stage surgery.
  • If you have several missing teeth, a removable implant prosthesis is made for you. The removable prosthesis is mounted on a metal frame that is attached to the implant abutment. It snaps securely in place, but can be removed for daily cleaning.

Risks of a Dental Implant

Dental implants, whether for one missing tooth or many, can involve discomfort and have some risks:

  • Swelling of your face
  • Bruising of your face
  • Pain at the surgical site
  • Minor bleeding
  • Infection at implant site
  • Nerve damage
  • Sinus problems involving upper teeth that are in close proximity to your maxillary sinus

Author: Flora Stay, DDS
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