DENTAL
IMPLANTS
What is a dental implant?
A dental implant is an artificial root of a tooth that is
inserted into the jawbone. A
replacement tooth is built on the implant to simulate the
natural tooth in terms of colour, shape
and position. Dental implants are made of titanium as it has the special
property of forming a firm biological “bond” with the jawbone. The bonding is
known technically as osseo-integration and this is the
basis of dental implant treatment. If this bond is not achieved, then implant
treatment will not work. Fortunately, it works in most cases.
I have a few missing
teeth. Am I suitable for implants?
You are suitable for implants if you are:
1. Medically
healthy. As long as you are able to have an extraction or undergo a minor
operation without any special precaution, it is possible to have dental
implants.
2. The site of the
missing teeth must have sufficient bone, in terms of thickness and height. In
addition, the gums must also be healthy.
3. Vital structures
such as nerves or sinuses must not encroach on the position of the implants.
4. Good oral hygiene
and motivation. As with natural teeth, implant restored teeth must be brushed
and kept clean regularly. If you smoke, it may be advisable to stop smoking.
There is now evidence to suggest that smoking is harmful for the long-term
success of dental implants.
To assess the above conditions, you would normally be required to
have a clinical assessment, together with investigations such as digital X-rays, photographs
and study-models of your teeth. Special investigations such as computerized
tomograms and computer software simulation may be necessary in complicated
cases. In our clinic, state-of-the art cone
beam computerized tomography is used to assess the bone condition and
to plan for surgery. With this 3-dimensional details
of the bone, exact details of the surgery can be planned accurately.
I am wearing full dentures now. Am I suitable for dental
implants?
The same conditions as above apply. However, the surgeon has to
consider the position of your lower jaw in relation to the upper jaw bone.
How many implants can I have?
It depends on the number of missing teeth. Each missing tooth can
be restored with a single implant. However, a minimum number of implants can be
used to replace multiple missing teeth by ‘bridging’ two or more implants
together. The final decision will have to depend on the clinical condition and
cost factor.
What does implant treatment involve?
Dental implants traditionally involve 3 phases:
Phase 1 is involves a surgery to insert the implants into the
jawbone. This can usually be done as outpatient with local anaesthesia
(and sedation). Complicated cases may require hospitalization with the surgery
done under general anaesthesia. After the appropriate
healing of about ten weeks, the implants are connected to the oral cavity to
allow for the gums to heal. This cuff of gums is special in that it is the
interface between the external oral and internal jaw bone.
Phase II is the construction of the replacement teeth. The
replacement teeth are built on abutments that have been tightened onto the
implants. Some replacement teeth are cemented on whilst some are screwed on.
The dental surgeon will decide based the clinical assessment.
Phase III is the regular maintenance of the implant-restored teeth.
X-rays may be required to study the osseointegration.
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Surgical insertion
of implant into jaw bone |
Fixing of an
abutment onto the implant |
The tooth is
built upon the abutment |
In selected cases, where all conditions are ideal, all the three
phases can be shortened to one single stage. This is called “immediate loading”. This is a
result of improvement in the implant design and more scientific evidence of
success. However, a lot of pre-surgical preparation is required before this
“instant” implant treatment. State-of-the-art implant surgery with Nobel Guidetm is available at our clinic. With this, the
replacement teeth / bridge are inserted on the same day as the implants are
placed into the bone.
What are the advantages of dental implants?
With dental implants, the bite force is close to natural teeth, if
not stronger. A denture or ‘false teeth’ only provides up to 25% of the natural
bite force. Also, there is no plastic flange that covers part of the palate or
gums.
If a bridge is used to replace the missing teeth, the drilling of
the adjacent teeth is required to provide the ‘strut’ or ‘support’. Over the
long-term, it may give rise to problems such as decay, gum disease and
loosening of the teeth. With dental implants, drilling of the adjacent teeth
especially good teeth with no filling whatsoever, is
avoided.
One of the main advantages of the dental implants is that the bone
is preserved, instead of resorbing or thinning.
What are the complications?
Straight-forward implant surgery is usually free of complications.
However as in any field of medicine, complications may occur. These include
bleeding, discomfort, swelling, bruising and injury to adjacent anatomical
structures such as nerves and sinuses. An experienced surgeon, who has
undergone an accredited Oral & Maxillofacial Surgery training programme,
can usually anticipate the common complications and strive to avoid them at all
cost. However, the risks in complicated implant surgery are naturally higher.
Complicated cases where advanced surgical procedures are required include bone
grafting, nerve displacement, multiple implants and distraction osteogenesis.
Another complication is poor aesthetics especially with anterior
teeth. The replacement teeth can be redone without any effect on the implant
that has bonded in the bone.
How long can an implant last?
One would like to have implants to last a lifetime. However, as in
any field of medicine, there are multiple factors that may affect the longevity
of the implants. These include the patient’s health, oral hygiene and habits
such as clenching and grinding at night (bruxism).
Additionally, the treatment process must take into consideration careful
planning, choice of implant system, proper implant placement and appropriate
construction of the replacement teeth to maximise the
functional forces of mastication.
Additionally, there is now sufficient scientific evidence to show that
smoking can affect the long-term survival of implants. Experts generally agree
that implants should last at least ten years.
How much does it cost?
Generally in
Disclaimer:
The above FAQs are strictly for
information only. It is NOT intended as treatment advice over the Internet. See
your Oral Surgeon or Dental Surgeon to assess your individual need.