Prosthodontist Dental Treatment Implant Dentistry Dental Surgeon

By: Prosthodontist  11-11-2011
Keywords: Teeth, Dental Implants, Implant Dentistry

Implants are an excellent means of replacing teeth. The titanium implant osseointegrates (biologically binds) to the bone, and a full crown goes on top. The result is a natural looking secure means of replacing teeth.

An evaluation with diagnostic records and a CT–Scan which is a 3–dimensional type x–ray that accurately measures the amount of bone remaining to anchor the implants, will determine if you are indeed a candidate for implants.

Success Rate

Statistics indicate that implants may last an excess of 35 years. Once successfully integrated with the surrounding bone, implants have a long-term potential as natural teeth, if properly taken care of.

The current cylinder type of titanium has been used in excess of 30 years. Implants were invented in 1957 in Stockholm, Sweden. They were then tested in the 1960’s and introduced in Europe and the U.S in the 1970’s and early 1980’s. Implants are safe and provide for an excellent option for people with missing teeth.

The success rate of implant dentistry is very high. Implants boast low infection potential, no rejection by the body, ninety-five to ninety-eight percent success rate for the lower jaw, and eighty-six to ninety-two percent success rate for the upper jaw. However, implants must be maintained by the patient with proper oral hygiene and frequent dental exams and cleanings.

Implants have been used to support a lower full arch fixed reconstruction

What are dental implants?

Dental implants are small precision posts that are manufactured from high-grade Titanium. They are used where teeth have been lost. Implants resemble screws or cylinders with a thread that is used to stabilize the implant after placement. The surface of implants is treated in a special way to enable the jawbone to grow onto them. This process is called osseo-integration. After a few months the implants will form an integral part of your body.

Once they have integrated, implants are used to support artificial teeth similar to the roots of your own teeth.

The dental implant consists of three main parts:

  • The first is called a fixture, which is the titanium screw inserted surgically into the jaw.
  • The second, the abutment, forms a link between the fixture and the overlying restorations.
  • Thirdly, there is the restoration, which may be fixed or removal. i.e. the bridge, crown or denture.

When can one use dental implants?

Implants are the most natural way to replace missing teeth. Careful examination and planning must be done prior to any treatment. X–rays will be needed to see if you have good enough quality and quantity of bone in the area. In general most people are suited for implants. The youngest patients receiving implants are in their early teens, the oldest in their nineties. What often happens where there are missing teeth is that the jaw bone begins to shrink. This is common with denture wearers, and the ridge which is important for holding the denture gradually disappears making wearing the denture more and more problematic.

Dental implants restore normal loading to the bone and thereby hinder the further loss of bone. The sooner one decides to have the implants placed, the less the permanent loss of bone will be and the easier it is for the implant to achieve a good result. Implants are ideal if single teeth are missing, restoring the gap without cutting or damaging adjacent healthy teeth.

Dental implants are equally effective for large gaps caused by several missing teeth. Missing molar teeth can also be replaced by implants even though the loss may not be visible, the absence of molar teeth can result in eating difficulties and cheeks, which appear to have "collapsed".

Implants are commonly used in patients with no natural teeth at all. A non–removable bridge is a possibility or a denture can be secured by two or more implants, which serve as supporting pillars. The implants provide firm anchorage, reducing the worries of denture movement, painful chewing and bone loss, and once again preventing cheeks, which appear to have "collapsed".

What are the advantages of dental implants?

Your face is your most prominent visual feature. Therefore the loss of teeth leads to a great deal of emotional distress. There are many causes for the loss of teeth such as accidents, disease or ageing. Many adults are faced with this scenario. Technological advancements in modern medicine have however ensured that missing teeth no longer need to result in a lack of self–confidence or a missing smile. Dental implants offer the ideal solution, having become a viable and aesthetic dental replacement for thousands of people across the world.

If you are missing any of your natural teeth, implant dentistry can provide you with the teeth that look and feel like your very own. Permanent replacement teeth can be yours without the embarrassment of loose dentures or having to cut into other healthy teeth in your mouth. An attractive cosmetic smile is possible. Implants will enable you to enjoy the simple pleasures of unrestricted eating. With dental implants you have the self–confidence to pursue an active business and social life.

Many people choose implants to preserve their facial bones. Conventional dentures usually lead to accelerated bone loss.

What are the risks involved in dental implants?

What can go wrong with dental implants?

In rare cases one may get non–integration or loss of integration. The implants may not grow into the bone or it may lose the bond to the bone after sometime in the mouth. Another rare complication is the fracture of the implant or component. This occurred with early implants and has largely been overcome by new designs and stronger implants.

As in most other dental treatments, the long–term success of the procedure depends on meticulous planning and completion of every aspect of the treatment. In other words, the right treatment is needed for the right situation. This should be followed by good oral hygiene and regular follow–ups. Dental implants are one of the most successful and most advanced treatments available in dentistry today.

Present day implants are based on scientific evidence and research of over thirty years and has shown a success rate of more than 80% in the upper jaw and more than 90% in the lower jaw. Many dentists now agree that implants are one of the most predictable forms of dental treatment.

Are there alternatives to dental implants?

Yes, there are alternatives to dental implants.

Conventional dentistry has for many years supplied solutions that have worked very well for millions of people around the world. These options were generally used as a first line of treatment. In today’s world however, new possibilities have been developed that can improve the well being of patients. When discussing dental implants, the prosthodontist may consider and advise you to have conventional options because of financial constraints, lack of suitable bone or other factors that may negatively influence the successful use of dental implants.

Dental implant treatments are sophisticated and often demanding on the patient and the clinician. Their many advantages must be carefully weighed against some of the disadvantages in order to obtain the ultimate result for the patient. The prosthodontist and finally the patient will have to decide whether implant treatment suites his or her requirements and whether it is the best solution under the given circumstances.

What steps are involved in having dental implants?

Dental implants involve 4 major steps:

Treatment Planning

The patient’s general health, oral situation, understanding of dentistry, financial resources and specific needs are analysed. Afterwards, the treatment is planned correctly and the results documented accordingly.


The implant is placed in the bone. This may be done in a single stage "procedure" where the top of the implant is still visible after the surgery. Depending on the position of the implant; the primary stability of the implant; and aesthetic considerations, the implant may be immediately loaded. Alternatively, it can be done by a "two stage" approach during which the implant is placed into the jaw and covered with gum tissue to allow healing. In this case it will have to be uncovered at the "second stage" surgery.

Many times a ridge/socket preservation procedure is necessary to prepare the implant site prior to implant placement.


Various clinical alternatives are available to maintain function and aesthetics during treatment. The provisional restorations are generally the blueprint of the final restorations.

Second Stage Procedure

After 3–6 months, the implants will be checked for integration. Then another component will be attached to it, which will support the final prosthesis or artificial teeth. In cases where second stage surgery is required to uncover the implant, it will be done at this stage.

Final Restoration

After the second stage procedures, the prosthodontist will prepare the final restoration. Depending on the implant system, this may take several visits.

How long are implants expected to last?

Research on dental implants began about thirty years ago in Sweden. Vast amounts of data have since become available and thousands of implants have been successfully used worldwide. Dental implantology has reached the stage where it can be integrated into day–to–day dentistry and can be recommended for the right situation with confidence.

Once dental implants have integrated (this should take between 3 to 4 months), they are usually very stable and can last anything up to 25 years. As implant design and knowledge improves, it should be possible to extend the life of an implant supported prosthesis. Recent statistics by major international implant systems show success rates for 10 years survival raging from 85% to the top jaw to over 90% to the lower jaw.

Should an implant become loose, it should be removed. After a period of healing a new implant may be placed in the same position.

How painful is it to have implants placed?

When placing the implant, a small operation will be necessary. It is some times possible to place implants in the dentist’s surgery. The area in the patient’s mouth will be anaesthetized and the preparation and placement performed in the dental surgery. Patients will thus be conscious of the procedure but will seldom experience any pain while it is being performed. In some cases however, a general anesthetic is preferable, and this will require a visit to a day clinic or hospital.

After the operation some patients do experience one or two days of discomfort. Many however hardly use the pain–killers prescribed. The discomfort of the procedure is generally comparable to having a tooth removed. Often this is due to the stitches present. Patients should be able to function normally again one to two days after the operation.

Regular pain–killers and anti–inflammatory drugs will be given with specific post–operative instructions to alleviate any discomfort that may exist.

Which professionals are involved in placing the implants?

Dental implantology involves planning, a surgical phase, and finally the restoration of integrated implant. The complexity of the case as well as the risk of specific complications strongly influences the choice of the professional used to perform the procedure. In an environment, where specialists are available and where patients choose to use their services this may be the first choice.

Different fee structures may also influence the choice of the professional. Planning however, has to be done by all involved. Implant treatment is a technical and complex form of dentistry. Not all dentists wish or are trained to provide implant treatment.

The surgical part (placing the implant) is most often done by a maxillo–facial and oral surgeon or a periodontist. The design and the construction of the artificial teeth is done by the prosthodontist working in conjunction with a dental technician.

What conditions are detrimental for implants?

Implants are sophisticated technical structures designed to be integrated into the human body. Any factor that poses a risk to your oral or general health may also be detrimental to your implant.

General health of the patient has to be acceptable, and diseases like diabetes, osteoporosis and a lowered immune response will have an impact on the implant. Bad oral hygiene, excessive grinding of teeth, and general neglect of the teeth, gums, and oral structures will negatively effect the survival of implants. In such cases, conventional restorative options may offer better long-term solutions as they eliminate unreasonable expectations and costs created by opting for implants.

Excessive smoking has been shown to significantly lower the survival rates of dental implants. New, rough and surfaces on implants have improved these statistics to a certain extent.

Recent studies have shown that certain anomalies within the genetic setup of patient’s leads to an altered immune response. These patients have been shown to have a significantly lower survival rate for dental implants. Tests are becoming available that may determine whether a person falls within this risk group.

What costs are involved in dental implants?

Dental implants fall into the most complex group of dental treatment. The component utilised have to conform to the highest international standards of medical technology, and stringent quality control is applied throughout the manufacture of the implants. A large part of implant technology is manufactured in countries with strong currencies and may be subject to fluctuations in exchange rates. Dental implants are therefore considered the most advanced but expensive treatments by many patients.

An accurate estimate of costs must be obtained from the implant team members. This is often given in the form of a quotation and treatment plan. Each medical aid schemes looks favorably upon implant treatment differently. It is important to ascertain the third party contribution prior to commencement of treatment. Studies have shown that implants are cost effective when compared with alternative treatment plans.

The components chosen will depend on the type of treatment needed. In addition to component costs there will be professional fees and there might be hospitalisation and medical costs. In general, implant treatment is not very much more expensive than the alternatives (bridges or new dentures at recurring short intervals). The major difference lies with long–term success. Your implants can be with you for a larger part of your life.

Which system or make of implant is the most Suitable?

Dental implants have become very popular worldwide. Design and technology has improved constantly and today one may choose between 1500 different implants worldwide. The final choice depends on the professional but the patient should make sure of what is being used in his specific situation.

In this practice, the implant systems used include Branemark, Southern Ti–Tec and ITI. The choice of system is most often dictated by the clinical situation. The most commonly used systems today comprise small titanium cylinders or tapered cylinders of various sizes and shapes. Surfaces are roughened and etched by acids to increase surface area and thus form stronger and faster bonds to the bone.

The second part (abutment) is attached to this cylinder, which then carries the artificial tooth. It is important to use an implant system that is supported by sound research and distributed by a reputable company. It should be widely used, easy to restore and affordable.

Patients should ensure that they get a written copy of the name and specifications of the system used by the implant team on completion of treatment.

Keywords: Dental Implants, Implant Dentistry, Teeth