About Dental Implants

What are dental implants?

Dental implants are essentially replacements for the natural roots of teeth. They can be used singly to replace one tooth or multiply to replace several or all missing teeth. Dental research in the 1950s discovered that titanium possessed the ability to develop a close union with human bone. Further research has produced a reliable form of implantology that allows crowns and bridges to be attached in areas devoid of natural teeth. Dentures can also be supported where before they were loose.

What can you gain from Dental Implants?

Firstly we need to determine why we want to replace a tooth or teeth. Missing teeth can impact negatively on our speech, chewing and appearance. One or more of these can affect our confidence. Dental implants can improve your quality of life.

We can replace a single missing tooth with a crown, a series of missing teeth with a bridge or a full arch of teeth with fixed bridges or a removable denture. Dental implants provide us with a very flexible treatment option.

How long will the implants last?

During the initial period after placement success depends upon good bone healing around the implant. Once the implants and surrounding soft tissues are seen to be healthy and the new teeth comfortable and correctly adjusted, it is the quality of your home care and willingness to present for regular maintenance reviews that will have most influence on how long they will last. Another significant factor is smoking.

When poorly cared for, implants will develop a covering of hard and soft deposits (calculus and plaque) which is very similar to that found on neglected natural teeth. Untreated, these deposits can lead to gum infection, bleeding, soreness and general discomfort, just as can occur around natural teeth.

Well maintained implants placed into adequate bone can be expected to last for many years. However, just as you would expect conventional crowns, bridges and fillings to need occasional repairs or replacements during their lifetime, your implant-supported teeth may also have similar maintenance requirements over theirs.

Prevention of bone loss

Whenever a tooth is lost or extracted a considerable amount of the bone that once surrounded the remaining root portion may disappear. This loss can be particularly rapid during the first few months and is described as ‘bone resorption’. Although the rate and amount of bone resorption is highly variable between individuals, it will always occur to some extent, unless specific care is taken to reduce its effects. Sometimes, the simplest measure to minimise bone loss after an extraction is to place the implant immediately or within the first few weeks.

What can you do if an implant does not work?

If an implant does not achieve or cannot maintain a rigid fixation with the surrounding bone it will eventually become loose and no longer be able to support replacement teeth. In most cases another implant can be placed immediately after removal of the implant or after a short period of healing. It is important to find out the cause of why the implant has failed prior to trying to replace it again.

How do I look after the implants?

It is reasonable to expect some of the daily hygiene procedures to be a little more complex than around your original teeth and to spend a little more time than you may have done in the past if you wish to maintain optimum implant health.

For the first few months the implants are in function your dentist may ask that you are seen more frequently, however once they are satisfied your treatment is performing as planned, ongoing care will be similar to any patient with natural teeth.

Implant systems

The fees for implant treatment reflect the surgery costs, laboratory costs and the implant systems we use. The implant manufacturer we use develops comprehensive systems which include the implants, surgical instruments, restorative components and computer assisted design for placement and restoration of implants.

There are many implant systems on the market with a very large range of costs. The Astra Tech system we use in the practice is manufactured by Dentsply.

Their website contains information for patients about dental implants www.dentsplyimplants.co.uk. Alternatively view an outline of the procedures involved on our Dental Implant Treatment page.

These are higher cost systems but we feel that this extra cost brings benefits to patients:

• Global manufacturers at the cutting edge of research
• Strong presence in the United Kingdom with full support of their products
• Long term support supplying components for implants manufactured many years ago
• Extensive experience of manufacturer of implants for a large number of years
• Fully developed CAD CAM systems to assist with all aspects of treatment

CAD CAM systems

CAD CAM is Computer Assisted Design and Computer Assisted Manufacturer. In terms of dental implants in some cases we take a CT scan to assess the bone quantity and position. From this guides can be made to precisely position the implants. The systems are also used to manufacturer restorative components before or after the placement of implants. It is in these areas that Dentsply excels.

Single tooth replacement

Single missing teeth occur in all areas of the mouth and can be restored by the placement of a dental implant and crown.
Alternatives for a single missing tooth

1. Accept the space For back teeth appearance may not be an issue but loss of a tooth can cause other teeth to tilt or drift into the space.
2. Tooth-supported fixed bridge A traditional bridge involves grinding down adjacent teeth to support the bridge. It is a stable solution with good aesthetics and function that is fairly easy to install. However, this alternative has two main disadvantages: continuous bone resorption in the edentulous area, and sacrificing healthy teeth on behalf of the bridge.
3. Removable partial denture Many patients find that they prefer a fixed restoration when they have a single tooth missing as it feels part of yourself.
4. Resin-bonded bridge This alternative has some clear advantages: it is quickly installed, functions well. Moreover, natural healthy teeth aren't too adversely affected. But they can come off during function

Multiple tooth replacement

It is not necessary to have one implant for each missing tooth. For example if three teeth are missing two implants can be placed and three teeth attached as a bridge.

Alternatives for several missing teeth

The alternative would often be removable partial denture. Many patients find they would prefer a fixed solution.
In some cases where there are teeth either side of the missing ones bridgework is an option. However the longer span of this would increase the chances of problems.

Are the new teeth joined together?

When multiple implants are placed, they are routinely joined together in the same way that a bridge supported by natural teeth would be designed.

If enough implants are available, it is often easier and just as effective to make several smaller sections of bridgework each supporting a few teeth. The overall effect in the mouth is the same and if you ever need to repair one of the small sections, this can be very much easier to do.

Again the bone quality and the number and position of the implants will largely determine which option is most suitable for you. When implant-supported teeth are linked together, they are mechanically stronger than the individual parts and can better resist the forces of normal function which will try and undo the screw components, posts and/or cements that secure the underlying structure to each of the implants. For most implant-supported teeth you will be able to clean around each supporting implant by brushing and flossing in just the same way that you would around natural teeth and tooth-supported bridges. In some areas special floss, interdental toothbrushes and other cleaning aids may be needed to maintain good oral hygiene. Cleaning is not at all difficult, provided that you do not have impaired use of your hands.

Replacing all missing teeth

Where all the teeth are missing implants can be used in two ways. The first is to retain a fixed bridge. The second is to secure a removable overdenture. The best solution will depend upon the amount of remaining bone, patient preference and cost. Overdentures can be used in situations where there is less bone. It is also a lower cost solution.

Fixed bridge

For a fixed bridge between four and six implants are required. The bridge is permanently secured in place.

Overdentures

An implant retained overdenture is a removable denture which is secured by dental implants. The implants and denture have attachments that lock together. The dentures are removed for cleaning and at night. For the lower jaw two implants are required and for the upper jaw four implants are required.