What is an implant?
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What is a dental implant?
A “dental implant” is the name given to an artificial prosthetic appliance that is fixed in the patient’s jawbone. It is made up of smaller components, which attach to one another to form a tooth-like appliance.
Dental implants are used to replace missing or loose teeth. Various components can be attached to the implant fixture. Dental implants can be used to replace a single missing tooth, several missing teeth or a full arch of missing teeth. Dental implants can also be used to stabilise loose dentures.
Missing front tooth- Treatment options include: (1) removable denture (2) bridge (3) dental implant
A dental implant is inserted and tucked under the gum
A post is attached to the implant fixture, which protrudes from the gum. The crown sits on top of the post.
Final result: implant restored crown. This is a fixed option, just like your own natural tooth. No teeth are damaged because this is an independent option. You look after it by brushing and flossing as you do with your natural teeth.
What components make up a dental implant system?
A dental implant is made up of smaller components, which attach to one another to form a tooth-like appliance:
1. The implant fixture is the screw which is gently inserted under the gum into the jawbone. The patient undergoes a small surgical operation to have this implant placed; it’s a bit like the opposite of a tooth removal. The implant fixture is buried underneath the gum and it cannot be seen. The Implant Surgeon places this fixture. The patient has the option to have this stage carried out whilst being sedated so that they are relaxed.
2. The abutment is the component which is screwed on top of the implant fixture.
3. Various components can now be attached to the abutment:
For a single missing tooth, a crown is constructed to slot over the abutment and is held in place by glue or a mini-screw.
For patients with several missing teeth, a long span fixed bridge can be made which can be held in place by 2 implants. Think of a bridge running over a river with supports at either end.
For patients with no teeth, a denture can be stabilised by positioning it over the implants. Male and female components are used which lock into one another. This denture can either be removable (only removable by force) or permanently fixed into position.
Who will be placing my implants at Herts Dental?
The Implant Surgeon places the implants and the Restorative Dentist works towards constructing the crown, bridge or denture. The Implant Surgeon and Restorative Dentist can be the same person.
What clinical factors determine if a patient can have dental implant treatment?
Patients must have enough jawbone to seat the implant fixture. The implant fixture is a screw and comes in various lengths and diameters. A CT scan (3D x-ray) is usually taken to assess how much jaw bone the patient has in the site in which the implant treatment is proposed. If there isn’t enough jaw bone, then advanced procedures such as sinus elevation and bone grafting can be performed.
Patients should have enough space between their upper and lower teeth so that an adequate size crown, bridge or denture can be fitted. If the patient has lost any restorative space or had extensive tooth wear, then the Restorative Dentist will have carry out treatment to ensure there is enough space.
Patients must have good medical health.
A non-smoker is ideal.
Having medical problems is not a contraindication for dental implant treatment. As long as your medical issues are controlled with medication and your doctor is taking care of you then there shouldn’t be a reason not to have dental implant treatment. We have to be careful with patients on high dose immune suppressants and those patients on Bisphosphonate medication.
Patient must have good dental health.
Patient must have good oral hygiene.
Patients are advised to return for regular check-ups, even after the implant treatment is carried out.
The Implant Surgeon/Restorative Dentist will assess these factors amongst other issues.
How soon after having a tooth removed can a dental implant be placed?
It all depends on the patient’s clinical situation. You have to bear in mind that when a patient has a tooth removed then they are left with a defect in their gum and jawbone. Overtime, this defect is filled with the patient’s own bone and gum.
If the extraction is simple then a period of 4-8 weeks is usually observed before inserting the implant fixture. This is because new jawbone is required to support the implant fixture.
If the patient’s tooth is a challenge to extract or a surgical procedure is required to remove the tooth, vital jawbone may be lost in this way. A period of 2-6 months is usually normal to observe before assessing the site for implant treatment.
Sometimes an implant fixture can be placed the same day a tooth has been extracted. However, the clinical factors must be favourable and your Implant Surgeon/Restorative Dentist will be able to assess this.
It is important that an infected tooth is not left untreated, even if it causing the patient no issues. This is because vital jawbone can be lost due to the bacteria and infection, making implant dentistry a bit of a challenge. If an infected tooth cannot be saved then it is best to have it removed at the earliest opportunity to prevent unnecessary jawbone loss.
How long does the treatment take from start to finish?
Once the implant fixture is surgically placed, a healing period of 3-6 months is observed before the final crown or any other superstructure can be attached on top of the abutment and implant fixture. This healing period varies according to many factors and the site the implant is placed in. If the implant fixture is placed into very strong bone and the healing period is uneventful, then as a general rule we can attach the crown after 3 months. In softer bone, a longer healing period is advised so that the patient’s own jawbone can grow around the implant to make it solid.
A CT Scan is a 3D image of your jawbone. Sometimes we take a CT scan for complex implant cases or when the Implant Surgeon would like further information about the jawbone quantity and quality. Practically speaking, it is only when an implant fixture is actually placed that the Implant Surgeon can determine the quality of the jawbone.
Some parts of the mouth have got hard bone. For example, the bone around your chin area is usually strong. Bone density can only vary in different ethnicities and the general build of the patient (imagine a rugby player vs. a frail person).
In complex cases where the patient does not have enough jawbone, the patient’s natural bone can be utilised to substitute the defect or bone from other sources can be used. Your Implant Surgeon will discuss this with you if this is the case.
What will an implant feel like?
Patients are delighted when they have their missing teeth restored with a fixed appliance. It can help them to smile, eat, get rid of their dentures and increase their confidence levels. An implant tooth is not bulky like a denture and is more comfortable.
If the patient has had a gap for some time, then the implant tooth can feel strange for a little while. Most patients will be able to adapt quickly. The gum may feel tight for a few days until it adjusts to the contours of the new crown.
How do I clean my implant?
Treat it like a normal tooth: be gentle when brushing and use a soft bristle toothbrush. Make sure to angle the brush bristles into the gum to clean the plaque and any food debris. Clean in between the implant and the adjacent tooth by using floss, interdental brushes or super-floss. Use branded toothpaste. It is very important to keep the implant tooth and the surrounding gum clean and free of plaque. Plaque contains harmful bacteria which can cause damage to the gum and bone surrounding the implant if not kept clean.
Can I go on holiday during treatment?
It is probably best to wait a period of a few weeks after the initial surgical procedure until you go abroad. This is because the Implant Surgeon may have to call you back to review the implant site and to remove any stitches. Once you have your final crown, bridge or denture fitted then most patients adapt uneventfully; however the Restorative Dentist may call you back for a review 1-2 weeks later. Your Implant Surgeon will advise you according to the complexity of your procedure.
Alternative implant options