Here is a great faq page on dental implants from dental-implants.com
What is a dental implant? A dental implant is nothing more than a metal screw that is placed into the jaw bone. It acts as an anchor for a false tooth or a set of false teeth. The slide to the left shows the replacement of a lateral incisor with a dental implant retained restoration. Roll your cursor over the image to see the implant.
Who is a candidate for dental implants?
Anyone in reasonable health who wants to replace missing teeth. You must have enough bone in the area of the missing teeth to provide for the anchorage of the implants. Some people are missing all their teeth and most of those are excellent candidates for dental implants, but today, we use implants to replace small bridges, removable partial dentures and even missing single teeth.
What is the success rate of dental implants?
This depends very much on where the implants are placed and what they will be called upon to do. The best case scenario is the placement of implants in the front portion of the lower jaw. Here success can be as high as 98-100%. In other areas of the mouth, success rates can drop significantly. According to figures that we have today, the success of implants in the front part of the upper jaw are anywhere from 90-95%. Success rates of implants in the back part of the upper and lower jaw can be in the 85-95% range. The success rate in my practice for the past five years has been 99+% for all implants placed.
What can go wrong with dental implants?
There are really not too many things that can go wrong with dental implants. They can fail to integrate into the bone and come out. They can fracture or break. There can be problems with the connection between the implant and the prosthesis. There can be an infection or an inflammatory condition in the soft tissue and sometimes in the bone as a result of the implant placement. There can be damage to the nerves in the lower jaw and there can be damage to the maxillary sinus or the nasal cavity. All of these complications are rare and usually account for less than 5% of all dental implant treatments. These complications can usually be easily corrected.
Who should you see about dental implants?
The question is really who should you see about getting missing teeth replaced? Before implants, you went to either your general dentist or, if you wanted a specialist, to a prosthodontist. It's the same today. If you want to replace missing teeth, talk to the people who do that job and they will be glad to discuss the use of dental implants in that process. If you decide that dental implants are for you, then your general dentist or prosthodontist can either place the implants for you or refer you to a qualified surgeon, usually either an oral surgeon or a periodontist, for that phase of the treatment.
My suggestion is to stay away from dentists who call themselves "Implantologists" or say that they are specialists in Implantology or "Board Certified" in Implantology.
Is Implantology a Specialty Area of Dentistry?
While there are people and organizations who would like the general public to believe that there is such a thing as a dental specialty of Implant Dentistry, there is NO SUCH THING! There are organizations who give credentials and awards to dentists that make it look like these dentists are highly trained implant specialists, but these credentials are unrecognized by the American Dental Association. In some states, it is considered illegal to advertise these credentials. The specialty areas of dentistry that are most aligned with dental implants are Prosthodontics, Oral and Maxillofacial Surgery and Periodontics. If someone tells you they are a specialist in dental implants or that they are Board Certified in that area of dentistry, RUN!
Why have dental implants become so popular?
As our life span increases, the need for some type of permanent dental replacement system becomes very important to our overall health. Dentures and removable bridges have obvious problems: They are loose and unstable. Implants can provide people with dental replacements that are both functional and esthetic. The demand was always there, we just needed the tools to fulfill that demand.
How long after a dental implant is placed can it be used to anchor my new teeth?
The protocol that was originally developed clearly states that we must wait three months in the lower jaw and six months in the upper jaw before we can begin to construct the new dental prosthesis that will be supported by the implants. In recent years, however, there has been a movement within the profession to sort of speed up this process. Today we believe that it is possible in selected patients to accelerate the healing time. We are even loading implants in very specific situations right away. However, the general protocol that I favor is 3 months in the lower jaw and 4 months in the upper jaw.
Does it hurt to have dental implants placed?
The actual procedure to surgically place a dental implant is done under local anesthesia and is generally not at all painful. When the anesthesia wears off about three or four hours later, you might expect some discomfort. The level of discomfort is quite different from patient to patient, but most patients do not have significant problems. Some patients do have varying degrees of pain or discomfort which may last for several days. Swelling and black & blueing may also develop.
In cases where there is prolonged pain, you should see your dentist right away. Prolonged pain is not a good sign with dental implants and although it does not always mean failure, the cause of the pain should be determined as soon as possible. If an implant is not properly integrating into the adjacent bone or if an infection develops, the implant may have to be removed.
What happens if I have dental implants and they are rejected?
Occasionally dental implants do fail or, as some people say, they are rejected. In many instances, they can be replaced with another implant, usually of a slightly larger size. Failure rates should be about 1-2%. Each year I place 400 to 500 implants and each year 3 or 4 of them fail. I replace those at no additional charge.
Do I have to go without my "teeth" while the implants are bonding to my jaw bone?
Once again, the original protocol called for patients to go without wearing their dentures for at least two weeks after implant placement. Over the years, this has been modified considerably and in most situations, patients leave the office wearing their teeth the day the implants are placed. Every patient and procedure is evaluated separately and there might occasionally be a recommendation that a patient go without their prosthesis for a short period of time. You may also have to be on a soft diet for a period of time after implants are placed.
Bone Graft
Sometimes when a dental implant is placed, it is necessary to build up the bone in the area to insure success. The procedure of building up the bone is known as Bone Grafting. Bone grafting is a very common procedure in dentistry and it is used quite a bit for dental implants and in periodontal procedures around natural teeth. In order to do bone grafting, we need a source of bone to place in the site. The bone that we use can be one of three types. The best bone is bone that is taken from the patient that we are working on. This bone can be taken from other areas of the mouth or collected in our suction apparatus as we drill into the bone to prepare the sites for dental implants. Occasionally this bone is taken from areas outside the mouth, such as the hip. When bone is taken from the hip, it is usually done in the hospital by an orthopedic surgeon and transferred to the dentist doing the implant procedure in the OR.
Another very common source of bone is bone taken from cadavers. This bone is harvested under very strict supervision at several bone banks around the country and it is used in many dental and medical procedures. There has never been a case of a transmitted disease with this type of bone. It is very safe and very useful in our work to help patients. A third type of bone is a synthetic type of bone taken. This has some use in dentistry but it does not seem to be as useful as the first two types of bone.
The cost of dental implants.
In some situations today, we still pay for these services according to the number of implants used. Dentistry, however, has realized that the number of implants used for a given restoration is most important in terms of the success of the restoration, not the overall fee and we have begun to start charging patients according to the complexity of the overall procedure. It is certainly much more cost effective when the same dentist both places and restores a patient's dentition, but this is not always possible. In the future, as dental implants are incorporated into the scope of general practice, implants will be not only much more widespread in their use, but much more cost effective for the patients.
A Bridge or a Dental Implant
Perhaps one of the most frequently asked questions on this site is whether or not to use a fixed ("permanent") bridge or a dental implant to replace one or two missing teeth. Suppose you are missing your lower left first molar. If a fixed bridge were to be used, your dentist would cut down the adjacent teeth (the second molar and the second bicuspid) and fit a three unit fixed bridge over those two teeth. The missing tooth would be called a pontic and it would be effectively replaced by the three unit bridge. If your dentist were to use an implant with a crown on it, he would place an implant in the site of the original first molar. He could do this immediately or at some date after the first molar was removed. There is no time limit here. The implant will take about 3 months to connect with the bone and then at that time, your dentist can construct a single crown on the implant to replace the missing first molar.
The cost of each one of these procedures varies from office to office, but a three unit fixed bridge costs about the same as an implant and a crown. The actual decision to do one over the other rests with you and your dentist. One technique is not inherently better than the other and each depends upon how you present and your dentists skills. All things being equal, I would usually prefer to place the implant and crown over the bridge.
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