Implant Dentistry

A major part of dentistry is dealing with the impact of missing teeth. Whilst fixed bridge work and dentures have been the main stay to fill these spaces, in that have relied on the surrounding teeth or jaws for supports. Implant dentistry has changed all that. Dental Implant are root form fixtures that are placed in the jaw. They can support a tooth in place.

Implants can be used in the following array of situations.

1) Missing single tooth
2) Missing multiple teeth
3) No teeth
The basics are still the same, namely there has to be enough volume and quality of bone available to place an implant. The understanding of implant integration into the jaw bone allows implants to be placed often the same time as a tooth is removed. Also implants come in different designs to accommodate the different anatomy encountered in the mouth. Often what used to a long procedure is now expedited in a matter of months. The imperative today is to have good hard and soft tissue adaptation around the implant.

 Missing Single tooth replacement 

1. Conservative of surrounding teeth
2. Allows return to function on that tooth
3. Easier to maintain than a bridge

 Missing multiple teeth replacement

1.  Overcomes the limitations of bridges flexing over long span of missing teeth
2. Overcomes the disadvantages of removable partial dentures such covering of the palate or restricting the floor of the mouth.
3. Can develop good function on the implant supported bridge.

Replacement for no teeth 

The replacement for people with no teeth or people who wear full dentures, is one of the reasons why implant dentistry became so readily accepted. The complaints from denture wearers include-

1. Sore spots
2. Loose dentures
3. Difficulty eating hard foods
4. Unable to tolerate lower dentures, in particular.
5. Gagging

The implant options for denture wearers are

1. Fixed Implant restorations
2. Implant retained over-dentures

Fixed Implant restorations

These are the ultimate in recreating the functionality and aesthetics for people with missing teeth. They do come with a significant cost, however the benefit they provide is immeasurable. For those patient who have had long periods of missing teeth and denture wear, the impact of this treatment is transformational.

All on 4

 Cost of fixed implant restoration for people with dentures has been a limiting factor. Therefore the concept of All on 4, which means using 4 implants where possible to retain an acrylic or zirconia bridge is an exciting option. This can also be used as a treatment for people who are about to lose all their teeth. The planning of this is in our practice is with an oral surgeon and a prosthodontist.

 Implant retained

 Over dentures

As discussed above, cost is an issue with fixed implant retained bridges. Therefore an implant retained over denture can represent a significant cost saving to the patient. As a result we find in our practice, this is by far the most utilized option. The denture can be stabilized by

1. Mini Implants
2. Conventional Root form implants

  Mini Implants

Mini Implants are an alloy of titanium, vanadium and aluminum. This allows them to be made in small diameters, hence the term mini implants. They were specifically designed to stabilize lower dentures. The procedure is generally a straight-forward one. After a case work up, the implant sites are chosen. The implants are placed and the denture is stabilized on the implants the same day. The existing denture can be used on top. This can be changed into a new denture in a few months if desired. The cost per implant is much lower, hence it is by far a cheaper option. The disadvantage is that the strength is not as great as the conventional implant. The breakage of mini implants is however rare. For a lower jaw 4 mini implants are used. For an upper jaw 6 mini implants are used to stabilize a denture.

 Conventional Root Form Implants

A denture stabilized over the conventional implants is one of the most researched areas of implant dentistry. Hence it is with some confidence that we can state the success rate of this can be high. With at least 2 implants the denture is located onto the implants. Ideally more than 2 implants are used.

 In summary the uses of implants in dentistry is varied according to the situation at hand. They allow a range of missing teeth iterations to be addressed. The cost of placement also can vary based on the number of teeth or jaws involved. On the patient’s part they require an investment of time and cost and then ongoing maintenance. On the dentist’s part they require planning on where to place and how to restore. It also means keeping up with current research.

Dental Implants-Before & After:

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