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Dental
Implant
Maxillary edentulous area
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Fxed-detachable
prosthesis
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Overdenture prosthesis
Mandibular Completely Edentulous
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Fixed denture prosthesis
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Overdenture |
| If
you are self-conscious about missing teeth or wearing dentures,
there’s an alternative that may be right for you.
Dental implants are one option for replacing missing or badly
diseased teeth. A dental implant offers comfort and stability
and by virtue of the artificial tooth it supports, is a restoration
that is the closest thing to a natural tooth.
Dental Implants
is titanium fixture that serves as a replacement for the root
portion of a missing natural tooth. Titanium is used because it
is the most compatible with our human body. The dental implant
is placed in the bone of the upper or lower jaw and functions
as an anchor for the replacement tooth. After the bone has grown
around the implant, implants can hold a crown, bridge or overdenture
just like roots hold natural teeth in place.
Implants provide
additional support where teeth are missing without putting forces
onto remaining natural teeth. They may be used to support the
replacement of a single missing tooth or a complete functional
set for individuals who have lost many or all of their teeth.
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Frequently Asked Questions
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Alternatives to your own bone for grafting
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Stage of dental implant treatment
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| Frequently
Asked Questions |
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What is a dental implant ?
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Can everyone have an implant?
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How many teeth can be supported by implants?
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What are the benefits of dental implants?
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How long does treatment take?
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Are the new teeth joined together?
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How long will implants last?
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Do you have enough bone for dental implants?
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What anatomical structures must be avoided during the placement
of dental
implants?
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If the implant surgery is going to take a long time can you have
a sedation or a
general anesthetic?
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If you do not have enough bone what can be done?
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Where can you get extra bone from?
What is a dental implant?
Dental implant is
a titanium device that replaces the root of the natural tooth. After
an implant is placed into the underlying bone, artificial tooth
is attached to it, enamel function and replicate natural colour
and shape.
Can everyone have an implant?
There are of course
cases where no implantation can be done, for example:
Children during growing age, adults with serious heart problems,
increase tendency for bleeding or bone diseases and patients who
are addicted to certain medication, drugs or alcohol. Diabetics
can receive implants but the blood sugar level has to be adjusted
and monitored during the period of treatment. In this case, a close
cooperation with your dentist is very important.
Like your natural
teeth, good oral hygiene is essential for the longevity of your
implants. Inadequate hygiene will result in failure and subsequent
loss of the implants. In cases where oral hygiene is inadequate,
your dentist can and will reject the treatment for implants.
The above are just
a few of the cases where implantation is not possible. Please consult
your dentist for individual case. But remember, age is not a factor.
How many teeth can be supported by implants?
All the common froms
of tooth replacement, such as bridges or dentures can be replaced
by dental implants. If you missing just one natural tooth, then
one implant is normally all that will be needed to provide a replacement.
Larger spaces created by two, three or more missing teeth do not
necessarily need one implant per tooth, however the exact number
of implants will depend on the quality and volume of bone at each
potential implant site.
In the upper jaw,
bone density is generally poorer than in the lower and if you have
no teeth at all, most treatment providers will want to place a minimum
of 6 implants to support a complete arch of 10 or more replacement
teeth.
In the lower jaw,
the bone towards the front of the mouth is often very strong and
as a direct result, fewer implants may be needed than are required
to treat a whole upper jaw. A simple treatment plan to provide 10
or more teeth in the lower jaw might be possible with as few as
4 implants, although it is still more common to use 5 or 6.
What else can be done with dental implants?
If you have no teeth
in the lower jaw, and are not yet ready for multiple implant placements,
a convention lower denture can be considerably improved with two
implants placed beneath the front section, this is called an overdenture
. The same overdenture concept when used to treat the upper jaw,
will usually require more implants as the bone is generally softer.
Implant-supported overdentures, just like conventional dentures
are still removed for daily cleaning, however, once back in the
mouth, the implants make them much more stable.
Dental implants
have to obey simple engineering principles, in that they must be
placed in strong foundations with enough of them to prevent overloading.
What are the benefits of dental implants?
Improved Appearance
When teeth are lost,
ongoing shrinkage of the jawbone occurs making the face look older.
Dental implants can slow or stop this process. Dental implants look
and feel like your own natural teeth.
Improved Comfort
Dental implants
eliminate the pain and discomfort of removable full or partial dentures.
Since denture sits on top of the jawbone and gums, continuous shrinkage
of the jaw bone alters the fit of the denture resulting in slipping
or rocking of the dentures. Exposed nerves and irritation of the
gum tissue may add to the discomfort
Implant supported
replacement teeth are like natural teeth because they are anchored
securely to your jawbone.
Improved Speech
With ill fitting
dentures, the teeth slip and side around the mouth. The facial muscles
become tense in an attempt to hold the teeth in place. This often
results in mumbling, slurred speech or clicking noises.
Eat Better
As the jawbone shrinks,
your chewing efficiency is reduced even more, making it difficult
to eat certain foods. Dental implants can restore chewing efficiency
comparable to that of natural teeth
This allow you to
eat your favorite foods with confidence and without pain, enjoy
what everyone is eating and not think twice about it. A full upper
denture covers the palate of the mouth and reduces the ability to
taste foods. With dental implant, you can have the palate removed
from your upper denture so you can taste and enjoy your food.
Convenience
Dental implants
can eliminate the numerous embarrassing inconveniences of removable
partial and full dentures. You will no longer need to cover your
mouth when you laugh or smile, for fear that your teeth will pop
out or fall down.
Protect your remaining natural teeth
Dental implants
are often more appropriate than a bridge for the replacement of
one or more adjacent teeth. With conventional bridgework, the teeth
surrounding missing teeth must be ground down.
Improved self-esteem
Considering all
other benefits, dental implants can improve your self-esteem. You
may feel better about yourself. You can regain nearly all the capabilities
that most people have with natural teeth, giving you renewed confidence,
and allowing you to enjoy life, do what everyone else is doing and
not think twice about it.
How long does treatment take?
For routine cases,
from the implant placement to the time of placing the first teeth,
treatment times can vary between 6 weeks and 6 months. The availability
of better bone can be used to decrease treatment time, whilst more
time and care must be taken with poorer bone, which can therefore
extend treatment times beyond six months.
Are the new teeth joined together?
The bone quality
and the number and position of the implants will largely determine
which option is most suitable for you. When the 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.
How long will implants last?
The success of each
treatment stage will be the main factor determining how the implants
are performing. 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.
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. It could probably be said that implants much like
teeth will last for as long as you can keep clean.
Do you have enough bone for dental
implants?
Dental x-ray
show large amounts of detail, but in only two dimensions. From these
views it is generally possible to judge the height of bone available
for implant placement, however, more advanced imaging techniques
are sometimes needed to determine the equally important bone width,
which can otherwise only be estimated from clinical examination.
Dental CT
scans are now a number of advanced x-ray techniques which
allow your jaw bone to be looked at in all three dimensions. The
most accurate and widely available is known as the CT (computed
tomography) scan. Images obtained by CT scanning will normally be
able to show all of the information required about your bone, including
quantity and quality, but most importantly the presence of anatomical
structures that must be avoided.
What anatomical structures must be avoided during the placement
of dental implants?
Upper jaw
– provided the implants stay within the bone that once supported
your own teeth there are really no important risk areas. If you
have missing upper back teeth then the shape and location of the
maxillary sinus (the region above the roots) can be shown you. The
maxillary sinuses can be seen on most x-ray and are therefore readily
avoided.
Lower jaw-
the most important anatomical structure to be avoided is the “inferior
dental nerve”. This nerve runs from the area behind the wisdom teeth,
passes under the molars and emerges onto the skin of the face in
the region where your premolar teeth are or used to be.
CT
scans are generally the best means for identifying the
location of this nerve and allow implants to be placed with considerable
confidence, however these are rarely available within a normal dental
surgery environment. Whilst CT scans are often invaluable for complex
treatment planning and knowing where important anatomical structures
are located.
If the implant surgery is going to
take a long time can you have a sedation or a
general anesthetic?
Although it is quite
straightforward to provide good pain control during surgery, most
people will be quite anxious for all but the most simple of implant
cases. There is no need to suffer in silence as there are several
very effective means by which you can achieve a relaxed state.
Conscious
sedation- For treatment of greater complexity it may be
suggested that you have a more controlled way of keeping relaxed
and comfortable during the surgical stages. This is known as a “conscious
sedation” and is distinctly different from a general anesthetic,
because you remain alert enough to respond to simple instructions
which may be helpful to the surgeon- however you will remember almost
nothing about the treatment stage. It is particularly beneficial
for procedures taking more than an hour where a hospital admission
is not required- this is probably true for the majority of treatments
related to dental implants. For a routine “conscious sedation” a
carefully controlled amount of sedative is delivered through a vein
in your arm or hand for as long as the treatment takes. It is a
very safe procedure during which your heart rate and oxygen levels
are monitored throughout by an anesthetist.
With conscious sedation,
a normal dental local anesthetics is injected around the proposed
implant sites. Most people do not remember this stage because the
sedation has already taken affect by the time the dental anesthetic
is given.
General
anesthesia
General anesthetics
require a hospital admission and are mainly, but not exclusively
used for complex cases such as where bone is being grafted from
the hip to the mouth, or where large numbers of implants are being
placed at the same time. Most patients will not require a general
anesthetic since conscious sedation is very much safer and has fewer
post-operative complications.
If
you do not have enough bone what can be done?
So
far we have covered the building blocks that are part of routine
implant placement. This has included the initial examination and
diagnosis, special x-ray such as a CT scan, sedation during surgery
and what to expect after the implants have been placed. However,
for some people, bone loss after the removal or loss of teeth leaves
them without enough to secure an implant.
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 “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.
Onlay grafting-
There are many ways in which bone can be added to, however one simple
concept is to take a piece of bone from somewhere else and secure
it as an “onlay grafting” to a deficient area. The new piece of
bone will slowly join to the underlying region and when healed and
mature, an implant can be placed in a more favourable position.
Where can you get extra bone from?
Bone
can be harvested from a number of sources such as the hip, tibia,
chin and posterior regions of the lower jaw. When you use your own
bone to create new bone in another area of the mouth you will have
to contend with the discomfort created by the donor site as well
as the surgical site. Many people feel this is well worth any additional
discomfort as your own bone is normally considered the “gold standard”.
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| Alternatives
to your own bone for grafting |
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| All
of these materials including your own bone, simply provide a scaffold
into which new bone will grow and consolidate ready to receive
dental implants a few months later. New bone can take anything
from 3 to 12 months before it is ready to receive dental implants.
Do not be in a hurry to move to the next stage. If you need a
large volume of bone it will take longer to mature than a small
amount.
Guided
tissue regeneration- Each surgeon will have his or her preferred
way of creating new bone. Many of them will also use a supplementary
technique called “guided tissue regeneration”. Using this technique
slow moving bone cells are given time to fill a space by placing
a barrier material between them and the fast moving cells of the
soft tissues lining the mouth. When this technique was originally
developed the barrier material had to be removed during a separate
surgical stage a few months later. Whilst these original materials
are still in use, it is now more common to use a “resorbable barrier”
that will disappear naturally a few months after it has done its
work.
Does Bone Grafting affect the length
of treatment?
If
you need bone grafting, it will almost invariably increase the
length of time your treatment will take, however when successfully
applied it will greatly improve the outcome of the implants placed.
When used in the front of the mouth it can also allow for creation
of very much better aesthetics
Bone grafting
requires a considerably higher degree of skill from the operator
and is often more complex to perform than the placement of the
implant itself.
In
certain situations some operators will be recommend combining
the implant placement with bone grafting and the placement of
a barrier membrane all at the same time. This considerably reduces
treatment time and can produce results that are difficult to achieve
any other way. However, many surgeons will still prefer to carry
out bone grafting as a distinct stage, so that the implants are
only placed when the bone grafting has been successful
Whatever method
is chosen to improve the bone quantity the time, effort and expense
is generally well worthwhile.
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. The implant
will not normally be ready to support a tooth for several weeks
or months.
Two-stage
implant- The implant is placed into a new, healing or 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 or 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 od surgery. Several implants are installed and few hours later
a complete arch of temporary or 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.
Not all patients are suitable for this approach.
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| Stage
of dental implant treatment |
[
Top ] |
1. Diagnosis and treatment planning after which it may
be necessary to carry out repairs or treatment to any remaining
teeth.
2. Implant placement is usually followed by a
period of healing lasting from 6 weeks to 6 months. Often the
implants are completely hidden beneath the gum, however one stage
procedures where the implant is visible from the time of placement
are also commonplace. Stitches are normally removed 7 days after
the implant placement.
3. Several visits may be needed over the next
few weeks to adjust temporary teeth or dentures and to monitor
healing.
4. Once the implants have healed uneventfully
for the required time, they are uncovered if necessary and made
ready to connect the teeth. Sometimes the time allowed for implants
to integrate may be increased or decreased to suit the local bone
conditions and the overall quality of healing.
5. In some cases
the first teeth fitted to your implants are not the final ones,
but replicas of the intended design. This stage can be used to
assess the implants, control early loading and in areas where
aesthetics are more critical, also gives the gums time to mature
around each implant before final teeth are fitted.
6. Final teeth are commonly fitted between 3
and 6 months after the implants were first placed. The way that
the teeth fit together is carefully adjusted so that they do not
interfere with each other.
Dental Implants Thailand,The Best Dental Implants Thailand at Promjai Dental
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Cosmetic Dentistry
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