Dental Implants: Procedure, Myths and Realities

Dental Implants: Procedure, Myths and Realities

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Fretting over losing one or more teeth? If so, put your worries aside as dental implants may be the answer for your missing teeth, shares Dr. Pratima Duggal

A smile adds beauty to a face and that gets distorted by the missing teeth. But never mind, a dentist can bring back your beautiful smile.

There are a number of prostheses which can replace a missing tooth and commonly used are as under:

  • Removable Denture
  • Mixed Denture
  • Dental Implants

Though the first two are good and cost effective too, there is shifting of trends towards dental implants these days.  The dental implants have become popular over the last two decades and there is lot of social acceptance due to obvious reasons.

Dental implants are bone retained artificial teeth. The tooth root is replaced by titanium screw.  They emulate natural teeth both in looks as well as in function. There is no need of plates, hooks, and wires. Also, the modification of the adjacent teeth is not required. They function very much like natural teeth. Post operative complication such as swelling, bleeding, and pain are negligible and the surgery is carried out on day care basis.

Characteristics of Dental Implants

There are many varieties and shapes of implants. It is up to the surgeon to decide as to which type of implant is suitable for a particular patient. There is equally large variation in the length of the implant. However, the most common length used is between 8-15 mm. It is an accepted practice to put the longest implant possible.

The diameter of the majority of implants fall in the range of 3.3 to 6 mm, however larger the implant placed, better is the prognosis. Nevertheless, the narrower diameter implants can be used in the available narrow bone space.

The surface characteristics are important for the retention of the implant in the jaw bone (Osseo-integration) and are dependent on the chemical and the physical nature of the surface of the implant. The current trend is towards increased surface roughness carried out by either blasting or by etching. The surface is also increased by deeper threads on the implant. Tighter the initial grip of the implant earlier will be the loading of the implant.

Loading of the Implant

When the implant fixed to the underlying bone, the supra bony structures of the implant are attached. The supra bony components are abutment and the crown. The abutment is the structure which is directly screwed on the implant and receives the crown (functional part of the tooth) on its top.

Contraindications of dental implants

  • Smokers are not suitable candidates since the failure rates are considerably higher. Diabetes is a relative
  • Diabetes is a relative contraindication, however, a patient with controlled diabetes may be considered for implantation.
  • Patients with an atypical facial pain and those suffering from psychological disorders are not suitable for implants.

Procedure

It is a day care surgery which is usually carried out in two stages. In some cases, it can be carried out in one stage as well.

In the first stage of the two stage surgery, the implant is placed and the soft tissue is sutured.

In the second stage after 3-6 months depending upon the case, the implant is uncovered and it is loaded with abutment and crown which allows the patient to chew.

In certain types of implants, the fixation and loading can be done in one stage only.  The other factor determining the one state surgery is the type of available bone. If the bone is sufficient and hard enough then the implant with initial firm grip can be rigidly fixed in the bone.  Such an implant can be loaded simultaneously and the patient can start chewing in early post operative period.

Myths & Realities about Dental Implants

MYTH: It is an intensely painful procedure.

REALITY:  The dental implant placement procedure is no longer painful since it is done by giving local anesthesia.  In addition, contrary to the common belief, the jaw bone where the implant is placed does not have the pain receptors and therefore there is hardly any pain post the surgery.

MYTH: The implant cannot be offered to everybody since there are too many contraindications.

REALITY:  Diabetes is a relative contraindication, however, if it properly controlled, implant surgery can be carried out. Pregnancy is a temporary contraindication. It should be offered with caution to chain smokers and patients with the problem of alcohol abuse since the risk of rejection is very high.

MYTH: The risk of implant rejection is very high.

REALITY:  In fact, it is very low and is seen in about 3% of cases in early post operative period.  The implants are made of the biologically inert (titanium) material providing an effective integration with the bone tissue.  In addition, if the patient maintains good dental hygiene, and is healthy, without any systemic endocrinal disease and metabolic disorder, the acceptance rate is very high.

MYTH: The dental implants do not last long.

REALITY:  The dental implants once accepted are like your natural teeth.  These are quite sturdy and can make the patient even chew nuts.  However, like normal teeth, one has to maintain good dental hygiene, brush and floss daily, which helps these to last a lifetime.  Nevertheless, just like your natural teeth, the dental implants are also susceptible to bone loss, which is part of the normal aging process of the body.

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