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Dental Implants are a rapidly developing area in dentistry and can be an ideal way to replace that missing tooth.
Do you need a Dental Implant?
Due to the very high success rate, dental implants have become a very popular treatment choice. So what exactly is a dental implant? Basically it is a screw made of titanium that is screwed into your jaw bone. The bone then heals around the screw to keep it in place. The top of the screw has a thread into which a crown is inserted and screwed into place. There is far more to placing an implant than you might think, in order for the implant to look as natural as possible.
It takes 3-6 months for the bone to grow around this screw until it has integrated or united with the bone, this is known as Osseointegration. This is a very successful process, but certain medical conditions such as diabetes, periodontal disease and smoking can interfere with the healing. It is important to look at your medical history information to ensure having an implant is the right choice for you.
Dental Implants are a rapidly developing area in dentistry and can be an ideal way to replace that missing tooth. There are many options to replace missing teeth, but an implant is often the best option to replace a single missing tooth.
What are my options to replace my missing tooth?
If you have one or two missing teeth, the options can include:
There are advantages and disadvantages of these options to replace missing teeth:
A Denture is obviously removable and for some a very comfortable choice. For others it can be very annoying. This is the most affordable option.
A Bridge is a fixed choice that cannot be removed from your mouth as it is cemented onto the two teeth either side. The biggest advantage is that a bridge cannot be removed and is very comfortable. The disadvantage is the teeth either side need to be cut to support the bridge. If these teeth have never had any dental treatment and are virgin teeth, then this can be very destructive. People may choose this options if the do not want or cannot have dental surgery for an implant.
A dental Implant is also fixed in the mouth. It can be used as a single implant or in multiples as part of a bridge. The cost of an implant is similar to a bridge but without cutting the neighbouring teeth, so can ultimately be the best choice to replace a missing tooth in these situations.
What types of implants are there and what implants do we use at our Brisbane Dental Practice?
There are three main types of dental implants:
•Single dental implants
•Multiple dental implants
•”All on 4″ implant supported dentures
Single dental implants will use a single surgically placed implant screw supporting a single implant crown. In some patients it is possible to support two crowns off one single implant screw. Eg: you may have an implant screwed in at the position of a large molar and attached to the molar crown is a smaller premolar. This is called a cantileverimplant. It is ideal when there is not too much heavy force on the implant and the extra tooth is smaller and in front of the surgically placed implant.
Multiple dental implants can be ideal when you have a larger span of missing teeth. These implants can be bridged and joined together such that two surgically placed dental implants support three crowns. These can be helpful in avoiding an extra surgically placed implant, thereby saving on cost. But it is also ideal to avoid placing implants too close together. It is critical that implants are no closer together than 3mms or bone will be lost between the implants. The dental implants can be placed with an extra crown between them and spaced out.
“All on 4” is a treatment concept that has taken the dental world by storm. It involves 4 surgically placed dental implants supporting a full denture. It’s popularity stems from its success at stabilising dentures in patients who have struggled with eating due to denture movement. The implants fix the denture to the jaw bone. We do not perform this system here, but refer you to a Brisbane dental clinic that specialises in this treatment. It can be an extremely expensive procedure, but patients have sometimes described it as being so successful it has been life changing.
We surgically place and restore our own implants from Noble Biocare at our Brisbane dental clinic, these dental implants are considered the best implants as they are the most highly researched implant in the world.
Why do I need so many appointments when my friend has her implant in one go?
There are many ways to place implants. The research shows that you are far more likely to have a better success rate with a two stage surgery approach. This is because the osseointegration, where the bone heals around the implant, can be affected by many factors such as bacteria getting in around the implant. By closing the gum over the top of the implant and stitching tightly you are more likely to prevent this happening.
If you do not have enough bone and a bone graft is required, then a two stage surgery is also required to hold the bond graft in place so it heals and forms part of your jaw bone into which the implant is placed.
A single stage surgical dental implant placement is also successful and we certainly do perform them, but only under the right conditions. At a minimum there must be sufficient jaw bone and no pre-existing infection. This ensures the dental implant is more likely to heal without complication.
Why do I need a bone graft for my dental implant and what is it?
A bone graft is always required if there is insufficient jaw bone to support the implant. Without adequate bone thickness, the thin bone can dissolve and the implant not heal properly. A bone graft is often done at the time the implant is placed, but can sometimes be completed prior to implant placement. A bone graft will increase the time it takes to complete your implant, to between 4 and 6 months, allowing time for the bone to grow.
There are many different types of bone grafts in dentistry: An Autologous bone graft uses bone from your own body, such as the back of the jaw or next to the implant sight. An Allograft bone graft uses bone harvested from cadavers. A synthetic bone graft uses most commonly hydroxyapatite combined with other compatible substances. The bone graft we perform is a xenograft using Bio-Oss and Bio-Gide. Bio-Oss comes from a bovine source and is very similar to human bone and in dentistry it is a very successful bone grafting material. Bio-Gide is a collagen membrane that is placed over the top of the bone graft material to keep it in place so it can heal.
The surgical implant procedure:
1. It is critical that a thorough assessment is completed prior to implant placement. This involves photos and X-rays such as a dental cone beam X-ray to measure the thickness of bone. The amount of bone around an implant has to be sufficient for the implant to be successful. Implants also come in various sizes, which needs to be decided prior to surgery.
2. On the day of the appointment we perform first stage surgery: Anaesthetic will be given and the area numbed. A hospital style sterile field is created, as this has been shown to have better success rates. The gum is raised up and the implant screwed into the bone with a series of drills that gradually increase in size. Once the final implant is in place the gum is closed over and stitched back into place.
3. 3 months later we perform second stage surgery: Anaesthetic will be given and the head of the implant is exposed. The implant is tested to make sure it has osseointegrated. A healing abutment is then placed above the gum and the gum is stitched back in place around the healing abutment. After 2 weeks the dental implant is then ready to restore with an implant crown.
4. Impression appointment: When the implant is ready to restore we fit what is called an impression coping and take an impression of the implant. This impression is then poured in stone at the laboratory and used to construct the implant abutment and implant crown. The implant, the abutment and the crown, then all screw together.
This link to a Noble Biocare clip will show you how a dental implant works as opposed to having a bridge fitted.