Dental implants are changing the way people live. They are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything, knowing that their teeth will remain stable during the chewing process. In addition, implant supported crowns, bridges and/or dentures appear very natural, and restore normal facial contours by appropriately supporting the overlying soft tissues of the lips and cheeks. Also, patients with implant supported dentures are free to go ahead and smile, with the confidence that their replacement teeth will not move.
What Are Dental Implants?
The implants themselves are titanium posts that are surgically placed into the jawbone where teeth are missing. These metal anchors act as tooth root substitutes. In three to six months, the bone bonds with the titanium, creating a strong foundation for artificial teeth. This is known as “osseointegration.” Dental Implants come in several different lengths and widths to accommodate the variation in height and width of the available bone at any prospective implant site. Small posts that protrude through the gum are then attached to the implant. These posts are called “abutments”, and they provide stable anchors for artificial replacement teeth.
Implants also help to preserve facial structure, preventing the bone resorption that occurs after teeth are removed. When teeth are lost due to periodontal disease, this natural phenomoenon can occur quite quickly.
Surgical Protocols: Single Stage vs. Two Stage
In general, the placement of dental implants involves one or two surgical procedures.
If there is adequate bone, and therefore no bone graft is required, implants for the posterior (back) teeth can be placed using a Single Stage Protocol in which a “healing abutment” is connected to the implant on the day it is inserted. This healing abutment is slightly visible at the gum line. In three to six months the healing abutment is simply removed by unscrewing it and replacing it with a permanent abutment, to which the teeth are connected. A second surgery to uncover the implant is not required.
The Two Stage Protocol is indicated when bone grafting is required, or if implants are being used to replace anterior (front) teeth. The implants and the grafted bone (if required) are covered at the first surgery by closing the overlying gum. No healing abutment is attached to the implant at the first surgery. You may wear temporary dentures during this time. A minor second surgery to uncover the implants is done in three to six months. At the second surgery the healing abutments are placed and the patient may then return to their dentist to complete the process, as in the single stage protocol outlined above.
For the first three to six months following implant placement in either protocol, the implants are beneath the surface of the gum and are gradually bonding with the jawbone. If a bone graft was required, it will take six months to consolidate (i.e. become mature, solid bone).
With either of the above protocols, most patients experience minimal disruption in their daily life. Please realize that the above description of implant treatment protocols is intended to be informative, and treatment plans may vary according to the specific needs of individual patients. Your first visit will address whether any modifications to the above treatment plans are indicated.
Dental Implant treatment is a team effort with the oral surgeon and the dentist working together. Dr. Vecchione may do the initial tooth extraction(s), place the implant(s), and do any necessary bone grafting. Your dentist will make the permanent replacement teeth. Your dentist will also make any temporary replacement teeth needed during the healing phase.
What Types Replacement Teeth Are Available?
A single implant is used to replace one missing tooth. Two or more implants can be used to replace any number of missing teeth with fixed bridges. For example, six implants can be used to replace all the teeth in your upper or lower jaw with a one-piece fixed bridge which can only be removed by the dentist.
Two to four implants can be used to effectively stabilize complete dentures, which can be removed by the patient. This is referred to as an over-denture. This is a complete denture which attaches to the implants by means of either ball and socket attachments, or clips which attach to a bar that is connected to the implants.
In general, the number of implants required to replace all the teeth in either jaw depends upon which type of replacement is recommended. Over-dentures usually require fewer implants than a one-piece fixed bridge. An over-denture is removable by the patient, whereas a one-piece fixed bridge is “permanent” and removable only by the dentist.
Why Dental Implants?
A Swedish scientist and Orthopedic Surgeon, Dr. Per-Ingvar Branemark, developed this concept for oral rehabilitation of the great number of edentulous patients in Sweden more than 35 years ago. With his pioneering research, Dr. Branemark opened the door to a lifetime of renewed comfort and self-confidence for millions of individuals facing the frustration and embarrassment of tooth loss. His traditional two stage protocol was time tested, and after undergoing rigorous scientific scrutiny it was offered to the general public only through oral surgeons who were trained in his precise surgical protocol. Dr. Vecchione was trained in the Branemark Osseointegration Technique in 1988, and has been utilizing it for dental implant candidates since that time. Over the last three decades, advances such as the single stage protocol, etc. have taken place, and Dr. Vecchione has incorporated many of them for the benefit of his implant patients.
Once you learn about dental implants, you will realize there is a proven way to improve your ability to chew the foods you like to eat, with confidence. If you wear dentures and they have a tendency to slip during speech, they can be effectively stabilized with implants.
Why Select Dental Implants Over More Traditional Types Of Restorations?
There are several situations where implant supported replacement teeth have advantages over more traditional types of restorations, such as conventional fixed bridges and partial or complete removable dentures:
When a conventional fixed bridge is used to replace missing teeth, the teeth adjacent to the space must be reduced in order to place crowns on them. This usually requires the sacrifice of intact, healthy tooth structure. Those crowns are then connected to the false tooth. Flossing the teeth under those crowns will now require the floss to be “threaded.” Although this is not difficult, it is certainly not convenient or quick to do. There is also the potential for recurrent decay to form on the natural tooth structure under the crowns which are connected to, and support the false tooth.
Conventional removable or complete dentures may be unstable during eating or speaking, compromise your appearance, entrap food underneath them, and be especially inconvenient to remove if a denture adhesive is required to stabilize them. Connecting removable dentures to dental implants will eliminate all of the above.
Are You A Candidate For Implants?
If you are considering implants, your mouth must be examined thoroughly and your medical and dental history reviewed. If your mouth is not ideal for implants in its present condition, an additional procedure such as bone grafting may be recommended. Bone grafting, when necessary, can be done either before or at the same time the implants are placed.
What Type Of Anesthesia Is Used?
The majority of dental implants can be placed in the office with local anesthesia (“Novocaine”), with or without intravenous sedation as an adjunct.
Do Implants Need Special Care?
Once the implants are in place and restored, they will serve you well for many years as long as your oral hygiene is adequate. Although there is no potential for cavity formation, the soft tissue around the implants may become inflamed if debris is allowed to accumulate in the area. This would be similar to periodontal disease affecting natural teeth, and is referred to as peri-implantits. Proper brushing and flossing, and having your implants cleaned professionally every three to six months will eliminate the potential for this to occur.