What are Dental Implants?
After an extraction or tooth loss, an implant commonly replaces the permanent tooth. A dental specialist places a dental implant, also known as an artificial tooth root, into the patient’s jawbone. The implant mirrors the shape of a screw and bonds with the natural bone. It creates a base to support artificial teeth, also known as dental crowns. An abutment also sits between the implant and crown to connect all of the elements together. Abutments connect crowns with dental bridges and partial removable dentures.
Implant Body Regions
The body of a dental implant consists of three pieces that serve different functions:
The crest module holds the prosthetic components of the implant.
The body of an implant screw provides surgical ease and prosthetic loading to the jawbone.
The apex supports the initial placement of the implant into the osteotomy (a removed piece of the jawbone).
Types of Implants
There are two main types of implants:
An endosteal implant (root form implant) consists of alloplastic material that surgically inserts into a patient’s remaining jawbone. In dentistry, alloplastic refers to artificial materials that are substituted for tissue grafts. These implants are typically made of titanium and small screws. Endosteal implants form a single replacement root for a missing tooth, regardless of how many roots the original tooth had. They are the most common type of implant used today.
For patients who do not have enough natural jawbone to support endosteal implants, dentists recommend subperiosteal implants instead. This type of dental implant is placed under the gums (on or above the jawbone). Subperiosteal implants are extremely rare.
Causes of Missing Teeth
Implants have been successfully used by dentists for over 30 years to treat a variety of different oral conditions and diseases.
There are a few primary causes of tooth loss that may lead to implant surgery:
The primary cause of tooth decay is poor nutrition and a lack of proper oral care. Cavities, which are caused by bacteria, require dental treatment to prevent the progression of the decay. Without restorative treatment, the tooth will continue to deteriorate, eventually resulting in tooth loss. Regular dentist visits are recommended to catch early signs of decay. If the decay is too severe, dental implants are used to replace the tooth, especially in elderly people.
Periodontal disease is a serious gum disease. When the gums become vulnerable, debris and bacteria infiltrate the broken seal and cause inflammation and infection. The breakdown of gum attachments eventually causes bone loss around the jaw and affected tooth.
Age & Medications
Many implant patients have healthy teeth, or just minor oral conditions, their entire lives. Although, after 55 years of age, tooth loss is more common. Those who take medications for high cholesterol, heart disease, or high blood pressure, are even more at risk as they age. This is because the long-term use of medication causes dry mouth, which speeds up the tooth decay process.
Another common reason patients get implants is from the loss of tooth structure following a car accident, injury, or fall. When a tooth cannot be restored to its natural shape and function, a dentist places an artificial implant.
All dental implant surgeries are completely customized, which is why they look natural and can last a lifetime. The cost of treatment depends on the number of appointments and procedures.
Some insurance plans cover the expenses of dental implants, while others do not or only cover part of the procedure. For example, the crown attached to the implant may be covered by some dental plans. If the procedure is medically necessary, some medical insurance plans will cover part of the surgery.
Who Places Dental Implants?
Oral and maxillofacial surgeons specialize in the placement of dental implants. They specialize in performing these procedures. Oral surgeons are also qualified to use deeper levels of sedation and understand how to do it safely.
Dental Implant Procedure: Step-By-Step
Endosteal implants are a type of outpatient surgery, meaning patients are able to return home the same day of surgery. The process can take many months to complete, especially during the healing process before artificial tooth placement. The procedure takes multiple steps, depending on the severity and number of implants a patient needs:
Step 1 — Remove the Tooth
If the damaged tooth is still in a patient’s mouth, the dentist will extract the tooth. If the tooth is already missing, this step is not necessary.
Step 2 — Grafting and Jawbone Preparation
Many patients needing implant surgery have thin or soft jawbones. Bone grafting, which improves the quantity of bone, ensures the procedure doesn’t fail. Options include a synthetic bone graft, such as a bone-substitute, or a natural graft, which means bone is taken from another area of the patient’s body. The healing process for this step takes a few months before a dental implant can be placed. Grafts are not always necessary.
Step 3 — Implant Surgery
During the actual procedure, the oral surgeon exposes the bone by cutting the gums with small instruments. An oral surgeon or periodontist drills holes into the bone. Then they position the implant (a post) deep into the bone, which functions as the tooth’s root. If a front tooth is being restored, the dentist fills in the empty space with a temporary removable solution while the implant heals below the gums. If it is a back tooth, a dentist places nothing over it.
Step 4 — Healing and Growth
An oral surgeon will prescribe a sufficient healing time for every patient. During this period, the supporting bone bonds with the implant. This process can take several months and ensures the artificial tooth root is sturdy enough to support an artificial tooth (crown).
Step 5 — Abutment Placement (Crown Preparation)
After the healing stage is complete, a dentist places an abutment on top of the post. It extends the implant above the soft tissue (gums). This step allows for easy placement of the artificial crown.
Step 6 — Crown Placement (Artificial Tooth)
Once the implant integrates into the bone and is strong enough to support chewing, a dentist makes new impressions of the patient’s mouth. Then a dental laboratory creates a custom crown (artificial tooth). The crown sits on top of the abutment (connector) and becomes the only visible part of the implant.
Step 7 — Aftercare
After the implant surgery is complete, regular check-ups are necessary within the first few months. Oral surgeons also recommend keeping up with regular dental exams post-surgery. Pain medications and antibiotics are usually prescribed, depending on the patient. During the healing process, it’s important to only eat soft foods and practice excellent oral care habits. Restricting the intake of alcohol, caffeine, and tobacco is also essential to see the best results.
Common Problems & Conditions
Most implant procedures are successful. Although, in rare cases, implants will fail or heal incorrectly. For example, smoking increases the risk of failure. To reduce the risk, it is crucial to practice good oral health care at home, including proper nutrition, brushing, and flossing.
As with any dental surgery, minor discomfort is normal. Common conditions, that aren’t threatening to the implant, include:
- Gum and face swelling
- Bruises on the skin or gums
- Minor bleeding
- Pain where the implant was placed