About Dental Implants

Why is it important to replace missing teeth?

Missing teeth can compromise not only your appearance but more importantly your ability to chew.  Overloading of remaining teeth is common and dysfunction of jaw muscles can also be a result.  Dental implants can represent the most permanent, functional, and esthetic form of tooth replacement.

Is a dental implant my best solution?

Several treatment options are available for replacement of individual and multiple teeth. A removable partial denture can be made either of plastic (“a flipper”) which is inexpensive but fragile and temporary or it can be made of a cast metal material.  The cast partial denture is removable and is held in place with wire clips, which attach to the neighboring teeth.

A fixed bridge is attached to the neighboring teeth after the necessary teeth that have been chosen to support the bridge are reduced to allow a crown to fit over each support tooth. Another type of bridge (bonded or Maryland bridge) can be cemented onto the back of the neighboring teeth.  The bonding in this case usually needs to be redone periodically.

For patients who have lost all their teeth, complete dentures represent the traditional option of tooth replacement.  These dentures sit against the gum and bone of the upper and lower jaw but their success varies from patient to patient.  Pressure from the denture resorbs the jaw.  Atrophy of the jaw and gum tissue continues progressively unless the denture is supported by dental implants.

Dental implants represent an option that may supercede all of the above treatment modalities for tooth replacement.  Implants can be used to replace a single tooth or multiple teeth and they can also be used to support a partial or complete denture that firmly snaps onto the dental implant.

What is a modern dental implant?

Most dental implants consist of two components.  The fixture is essentially a root replacement.  The titanium fixture is anchored into the bone and after a variable amount of time, depending on the situation, the secondary component is screwed into the threaded fixture.  This component, called the abutment, protrudes through the gum and is used to anchor either a single tooth, a fixed bridge, or a full or partial denture.  The amount of time from the appointment for placement of the dental implant until the appointment when the crown or denture is attached varies from case to case.  In some cases, implants can be restored immediately with the final crown or denture.  If necessary, a two stage procedure will allow the bone to further anchor itself to the implant for a period of up to there to six months.

What does the dental implant procedure involve?

The first step involves appropriate diagnosis with your dentist and Dr. Hogan to evaluate the area or areas of missing teeth and to study the jaw bone structure.  Dental x-rays and/or a panoramic x-ray may be taken to aid in this determination.  CT scan occasionally may be helpful also.

If you are a good candidate for implant replacement, the implant procedure is undertaken at our office and consists of a small incision in the gum tissue with creation of a socket in the bone into which the implant is placed.  This can be done with local anesthesia or it may be done with sedation and local anesthesia.  General anesthesia is also available but usually not necessary for these typically minor procedures.  Once the implant is inserted into the socket, a small cover or healing abutment is placed into the implant.  Generally, after the necessary time for anchorage of the implant, which may vary from immediately to several months later, the healing abutment is removed and the implant is checked for stability.  No anesthesia is usually necessary for these steps.

In nearly all cases, at no time will you be without teeth as temporary replacement teeth can be worn before, during, and after the implant procedure.  There is no need in the esthetic area of your mouth to go without teeth at any time.  Antibiotics are usually taken during the implant process to prevent problems with infection.  In many cases, if a tooth requires removal, we can place an implant into the site at the same visit when the tooth is removed.

In some instances, additional bone support needs to be gained at the time of implant placement or even prior to implant placement.  This usually only occurs in cases where an examination and x-rays determine that there has been some atrophy of the part of the jaw that anchors the implants.

How many implants do I need?

The general standard of care is to replace each tooth that is missing with a single implant.  However, in cases where patients are missing all their teeth, an upper or lower set of dentures may be anchored to two implants in the lower jaw and usually four implants in the upper jaw.  The advantage of implant anchorage is that the process of chewing against an implant physiologically loads the implant and surrounding bone and stimulates continued bone health and presence in the area of the implant just as a healthy tooth does.  Upon loss of a tooth we see atrophy of the jaw in the area of tooth loss.  This can be prevented or reversed with dental implants.  In the case of a full denture, dental implant anchors can also prevent significant atrophy of the jaw bone in addition to providing great functional improvement with respect to chewing.  This also can prevent the cosmetic changes that occur with bone atrophy such as collapses of the lower face vertically, loss of lip support, and peri-oral wrinkles

What can go wrong with dental implants?

The success rate of the dental implant procedure is quite high. 98-99% of the implants placed anchor and will continue to be a solid support for many years.  Most patients who have the procedure done do not require prescription pain medication although it is provided if necessary.  Antibiotics may be prescribed to prevent infection and allow for a smooth recovery.  In most cases, patients who have implants placed return to work either the same day or the next day.

Anatomically in the lower jaw there is a nerve that provides sensation to the lower lip and chin.  If there has been a great deal of bone atrophy, it is possible that this nerve can be irritated during the procedure creating a tingling or numbness or lack of sensation in the lip, chin, or tongue.  This usually resolves with time although it can be permanent.  If in the rare instance that the implant falls to heal, another implant can be placed.   

Coordination of care between your oral surgeon and general dentist.

Once the implant has been ascertained to be thoroughly anchored to the bone, the restorative phase of treatment begins with your dentist.  This phase involves taking impressions of your mouth so that depending on your case, an implant crown, bridge, or denture can be fabricated through your dentists’ office.  Your dentist will see you for several visits to complete the detailed prosthetic care, which usually requires no anesthetic.

Oral hygiene.

Although titanium does not decay, tarnish, or corrode, proper oral hygiene is important including brushing, flossing, and routine dental hygiene visits.  With proper maintenance and home care, dental implants have represented the most stable and long lasting form of dental treatment to date.  Should you have questions, your dentist and Dr. Hogan can diagnose and prescribe the proper implant and restorative care to return your mouth to a state of health and esthetic balance.

Mini implants.

Mini dental implants are narrower one-piece titanium implants for use in limited bone available sites of the jaw.  They can be used to anchor removable dentures (overdentures) or in some cases they can be used to replace individual narrow teeth. Please speak to us if you have further questions.