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Dental Implant Procedures

Technically, a dental implant is an artificial tooth root that’s placed into your jaw to hold a prosthetic tooth or bridge. However, when most people use the term “dental implants,” they’re talking about the combination of the implant (the artificial tooth root) and the prosthetic tooth. Dental implants may be an option for people who have lost one or more teeth due to periodontal disease, an injury, or some other reason and who prefer not to wear dentures.

Are You a Candidate for Dental Implants?

 

You’re an ideal candidate for a dental implant if:

  • You’re in good general and oral health.

  • You have adequate bone in your jaw to support the implant.

  • You have healthy gum tissues that are free of periodontal disease.

Dental implants are intimately connected with the soft tissues (i.e., gums) and underlying hard tissues (i.e., bone) in the mouth. Since periodontists have had three years of specialized training beyond dental school to make them experts on both soft and hard tissues, they have the ideal combination of experience and knowledge to make sure you get a dental implant solution that looks and feels like your own teeth.

Types of Dental Implant Procedures

Depending on your specific condition and the type of implant chosen, your periodontist will create a treatment plan tailored to meet your needs.

Here are some of the possible treatment plans depending on your situation:

  • Single Tooth Dental Implants – If you’re missing a single tooth, one dental implant can replace it.

  • Multiple Tooth Dental Implants – If you’re missing several teeth, they can be replaced by multiple dental implants.

  • Full Mouth Dental Implants – If you’re missing all of your teeth, they can be replaced by full mouth dental implants.

  • Sinus Augmentation – A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants.

  • Ridge Modification – Deformities in the upper or lower jaw can leave you with and inadequate amount of bone in which to place dental implants. To correct the problem, the gum is lifted away from the ridge to expose the void where bone is missing. The void is then filled with bone or bone substitute to build up the ridge. Ridge modification has been shown to greatly improve the jaw’s appearance and increase the chances of successful implants.

Dental Implant Procedure Follow-Up

Just like natural teeth, dental implants require conscientious at-home oral care and regular dental visits to preserve function and prevent peri-implant disease. In order to keep your implant clean and plaque-free, brushing and flossing are still necessary.

After you’ve received your implant, your periodontist will work closely with you and your general dentist to develop the best care plan for you. Periodic follow-up visits will be scheduled to monitor your implant, teeth and gums to make sure they are healthy.

Single Tooth Implant
Dental Implant

Single Tooth Dental Implants

        If you are missing a single tooth, one dental implant and a crown can replace it. A dental implant replaces both the lost natural tooth and its root.

What are the advantages of a single-tooth dental implant over a bridge?

     

     A dental implant provides several advantages over other tooth replacement options. In addition to looking and functioning like a natural tooth, a dental implant replaces a single tooth without sacrificing the health of neighboring teeth. The other common treatment for the loss of a single tooth, a tooth-supported fixed bridge, requires that adjacent teeth be ground down to support the cemented bridge.

   Because a dental implant will replace your tooth root, the bone is better preserved. With a bridge, some of the bone that previously surrounded the tooth begins to resorb or deteriorate. Dental implants integrate with your jawbone, helping to keep the bone healthy and intact.

  In the long term, a single implant can be more esthetic and easier to maintain than a bridge. Gums can recede around a bridge, leaving a visible defect when the metal base or collar of the bridge becomes exposed. Resorbed bone beneath the bridge can lead to an unattractive smile. And, the cement holding the bridge in place can wash out, allowing bacteria to decay the teeth that anchor the bridge.

 

 

 

 

 

 

How will the implant be placed?

  First, the implant, which looks like a screw or cylinder, is placed into your jaw. Over the next two to six months, the implant and the bone are allowed to bond together to form an anchor for your artificial tooth. During this time, a temporary tooth replacement option can be worn over the implant site.

  Often, a second step of the procedure is necessary to uncover the implant and attach an extension. This temporary healing cap completes the foundation on which your new tooth will be placed. Your gums will be allowed to heal for a couple of weeks following this procedure.

(Note: There are some implant systems (one-stage) that do not require this second step. These systems use an implant which already has the extension piece attached. Your periodontist will advise you on which system is best for you.)

  Finally, a replacement tooth called a crown will be created for you and attached to a small metal post, called an abutment. After a short time, you will experience restored confidence in your smile and your ability to chew and speak. Dental implants are so natural-looking and feeling, you may forget you ever lost a tooth.

Every case is different, and some of these steps can be combined when conditions permit. Your periodontist will work with you to determine the best treatment plan.

Multiple Tooth Implants

Multiple Tooth Dental Implants

If you’re missing several teeth, multiple tooth dental implants can replace them as well as some of their roots.

 

 

 

 

 

 

 

What are the advantages of implant-supported bridges over fixed bridges or removable partial dentures?

 

    Multiple tooth implants provide several advantages over fixed bridges and removable partial dentures. In addition to looking and functioning like natural teeth, multiple tooth dental implants replace teeth without support from adjacent natural teeth. Other common treatments for the loss of several teeth, such as fixed bridges or removable partial dentures, are dependent on support from adjacent teeth.

  Another big advantage is that multiple tooth dental implants don’t require the time-consuming maintenance associated with removable partial dentures, which should be removed and cleaned after eating and soaked overnight. Instead, multiple tooth dental implants need only be cared for with the same daily brushing and flossing routines that are recommended for natural teeth.

  In addition, because multiple tooth dental implants will replace some of your tooth roots, your bone will be better preserved. Dental implants integrate with your jawbone, helping to keep the bone healthy and your natural smile intact. In contrast, with a fixed bridge or removable partial denture:

  • The bone that previously surrounded the tooth root may begin to deteriorate. This can lead to recession of the jawbone and a collapsed, unattractive smile.

  • Gums and bone can recede around a fixed bridge or removable partial denture and leave a visible defect.

  • The cement holding bridges in place can wash out, allowing bacteria to decay teeth that anchor the bridge.

  • Removable partial dentures can move around in the mouth and reduce your ability to eat certain foods.

In short, multiple tooth dental implants are more natural-looking, functional, decay-resistant and comfortable than a fixed bridge or removable partial denture.

 

 

 

 

 

 

 

 

 

 

 

How will the implants be placed?

There are three components to an implant-supported bridge:

  • The implants, which look like screws or cylinders and are placed into your jaw.

  • The prosthetic (artificial) teeth, which look and function like healthy, natural teeth.

  • The abutments that are inserted into the implants and allow the new teeth to connect to the implants.

   The first step of the procedure is usually to use a scalpel to create and peel back two gum flaps to expose the underlying jawbone. (In some cases it may be possible to access the jawbone through a small circular incision rather than by raising tissue flaps.) A hole will then be drilled into the jawbone to make room for the implant, and the implant will be inserted. This process will be repeated for all of the implants. It may be possible for temporary teeth to be worn over the implant sites. If not, a temporary healing cap will be screwed into the top of each implant to seal off the implant’s interior from the surrounding oral environment. The two flaps of gum tissue will then be trimmed, shaped and repositioned back over the jawbone and around the implant’s healing cap. A few sutures will be placed to hold the gum tissue in place; the sutures will be removed in seven to ten days.

  During the following two to six months, the implants and the bone will be allowed to bond together to form anchors for your new teeth. It will then be time to uncover the implants, remove the temporary healing caps (or the temporary teeth) and attach the abutments. Your gums will be allowed to heal for a couple of weeks following this procedure.

Finally, the bridge created to replicate your natural teeth will be attached to the abutments. After a short time, you will experience restored confidence in your smile and your ability to chew and speak normally.

Implant bridge vs. Regular Bridge
Implant Bridge
Full Mouth Dental Implants

Full Mouth Dental Implants

If you’re missing all of your teeth, full mouth dental implants can replace your teeth as well as well as some of their roots.

 

 

 

 

 

 

 

What are the advantages of full mouth dental implants over conventional dentures?

  Full mouth dental implants provide several advantages over other teeth replacement options like conventional dentures. In addition to looking and functioning like natural teeth, full mouth dental implants are designed to be long lasting. They’re also more comfortable and stable than conventional dentures, allowing you to bite and chew more naturally and to eat certain foods that can be difficult to eat with conventional dentures.

  Another big advantage is that full mouth dental implants don’t require the time-consuming maintenance associated with conventional dentures, which should be removed and cleaned after eating and soaked overnight. Instead, dental implants need only be cared for with the same daily brushing and flossing routines that are recommended for natural teeth.

 

  In addition, because full mouth dental implants will replace some of your tooth roots, your bone will be better preserved. With conventional dentures, the bone that previously surrounded the tooth roots will begin to deteriorate. This will lead to recession of the jawbone and a collapsed, unattractive smile. In contrast, dental implants integrate with your jawbone, helping to keep the bone healthy and your natural smile intact.

How will the full mouth dental implants be placed?

 

There are three components to full mouth dental implants:

  • The implants, which look like screws or cylinders and are placed into your jaw.

  • The prosthetic (artificial) teeth, which look and function like healthy, natural teeth.

  • The abutments that are inserted into the implants and allow the new teeth to connect to the implants.

The first step of the procedure is usually to use a scalpel to create and peel back two gum flaps to expose the underlying jawbone. (In some cases it may be possible to access the jawbone through a small circular incision rather than by raising tissue flaps.) A hole will then be drilled into the jawbone to make room for the implant, and the implant will be inserted. This process will be repeated for all of the implants. It may be possible for temporary teeth to be worn over the implant sites. If not, a temporary healing cap will be screwed into the top of each implant to seal off the implant’s interior from the surrounding oral environment. The two flaps of gum tissue will then be trimmed, shaped and repositioned back over the jawbone and around the implant’s healing cap. A few sutures will be placed to hold the gum tissue in place; the sutures will be removed in seven to ten days.

During the following two to six months, the implants and the bone will be allowed to bond together to form anchors for your new teeth. It will then be time to uncover the implants, remove the temporary healing caps (or the temporary teeth) and attach the abutments. Your gums will be allowed to heal for a couple of weeks following this procedure.

Finally, full bridges or full dentures created to replicate your natural teeth will be attached to the abutments. After a short time, you will experience restored confidence in your smile and your ability to chew and speak normally.

Full mouth hybrid implants with fixed restoration
All-On-X Implants

What are all-on-x dental implants?

 

  Dental implants are one of the most important discoveries in dental history and the all-on-x procedure took implants to the next level. It is important to understand how dental implants work in order to comprehend all-on-x implants. The dental implant placement procedure consists of replacing the missing or damaged tooth with the implant which is either Titanium or ceramic, and then replacing the missing tooth crown with a crown using an abutment, which connects the crown with the screw. The all-on-x process allows patients to replace multiple missing or damages teeth at the same time. 

 

 

 

 

Procedure

  The all-on-x process uses a dental bridge anchored by 4 implants that can be placed in your top or bottom teeth. The implants are positioned within the jawbone at the same time. All you need is 4 implants to replace multiple missing teeth. Since the implant is made of titanium, it can fuse to the bone; becoming a part of your jawbone. 

 

 

 

 

 

 

 

 

 

Advantages

  Some of the advantages of All-on-x are that it is cost efficient, it replaces all your teeth in one day, it has a natural appearance and can last a very long time, and in most cases, it does not require bone grafting.  In addition, it helps prevent bone loss since it supports the bone, giving it more strength. 

Maintenance

   All-on-x does not affect your speech abilities. Once your new implants are in, you can eat and drink whatever your desire. To maintain your new smile, you need to treat the implants as natural teeth and take care of them the same way you would your old teeth by brushing at least twice a day.  

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Peri-implant diseases

Peri-Implant Diseases​

  Peri-implant diseases are inflammatory conditions affecting the soft and hard gum tissues around dental implants. Similar to a natural tooth, bacteria can build up on the base of the implant, below the gum line. Over time, the bacteria irritate the gum tissue, causing it to become inflamed, damaging the tissue and if not caught early, causing the bone structure below the implant to deteriorate.

  Peri-implant diseases are classified into two categories.

In peri-implant mucositis, gum inflammation is found only around the soft tissues of the dental implant, with no signs of bone loss. Generally peri-implant mucositis is a precursor to peri-implantitis. Evidence suggests that peri-implant mucositis may be successfully treated and is reversible if caught early

In peri-implantitis, gum inflammation is found around the soft tissue and there is deterioration in the bone supporting the dental implant. Peri-implantitis usually requires surgical treatment.

 

 

 

 

 

 

 

 

 

 

 

 

 

Signs of peri-implant diseases are similar to symptoms of gum disease: red or tender gums around the implants, or bleeding when brushing. And just like your natural teeth, implants require regular tooth brushing and flossing and regular check-ups from a dental professional. Other risks factors for developing peri-implant disease include previous periodontal disease diagnosis, poor plaque control, smoking, and diabetes. It is essential to routinely monitor dental implants as part of a comprehensive periodontal evaluation.

The up side to dental implants is they function just like your natural tooth. The down side is, they are capable of becoming diseased just like a natural tooth. With a proper oral health routine, your dental implant can last a lifetime.

Perio-implantitis
Progression of Peri-implantitis
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