Dental Implant Information
What are dental implants
Dental implants are substitute tooth roots that are placed into the jawbone by Dr. Miski, a specialist of the gums and supporting bones. Dental implants provide a strong foundation for replacement teeth that look, feel, and function like natural teeth. There are many treatment options for dental implants, from replacement of a single tooth or a failing bridge to restore a natural smile, to providing a stable foundation to attach partial and full dentures. Implant treatment allows people who have lost teeth to regain the ability to eat virtually anything and to smile with ease and confidence in the knowledge that their appearance is natural once again.
Dental implants are a great way to replace missing teeth or provide a more stable solution than having removable partial or complete dentures. Implants provide excellent support and stability for these dental appliances. A November 2009 article in the Health section of the New York Times touts the benefits of dental implants versus a bridge.
When dental implants are placed, a strong bond occurs between the bone and the implant. Once this bond has matured, the implant can serve the same functions as natural tooth roots: a strong foundation for biting and chewing, and as stimulation for the bone, thereby preserving it and preventing the bone loss that would normally occur with tooth loss.
Reasons for dental implants:
- Multiple studies have found that dental implants have the highest rate of long-term success of any dental restorative procedure. They are often the least expensive long-term treatment option for tooth replacement.
- They replace one or more missing teeth without grinding down the adjacent natural teeth
- They look, feel, and function like a natural tooth
- They do not decay (develop cavities)
- They are more hygienic (easier to clean) than a tooth supported bridge
- They restore a patient’s confident smile and self-esteem.
- They improve or restore chewing, speech, and digestion.
- They restore or enhance facial tissues by preserving the jawbone.
- They support a bridge or denture, making them more secure and comfortable.
What steps are involved in dental implant treatment?
Examination and planning
The first step is an examination and consultation to determine whether or not you are a candidate for implant treatment. A review of your medical history will indicate whether there are any medical conditions that might influence planned implant therapy. During the examination process, Dr. Miski will evaluate the area(s) of your mouth where teeth are missing, including the amount of bone available to support the placement of implants. X-rays assist Dr. Miski with evaluating the bone and other critical anatomy under the gums. He will work in conjunction with your dentist to determine the type of replacement teeth that will best meet your needs. They will work together to determine the number of implants necessary, as well as whether additional procedures may be needed to obtain the desired functional and esthetic result.
If you have lost a significant amount of bone, additional x-rays, such as 3-D cone beam imaging, may also be recommended to get a more accurate view of the quality and quantity of bone. In these cases, Dr. Miski will evaluate the need for ridge augmentation procedures to grow new bone.
Routine implant placement
Once the appropriate treatment plan has been determined, Dr. Miski places the implant(s) in the bone using a gentle surgical technique. Depending on your needs and desires, the procedure can be performed under local anesthetic, an oral sedation utilizing sleeping pills, or an IV (conscious) sedation. For most patients, there is minimal, if any, discomfort in the days following the procedure. When sedation is not utilized, most patients are able to resume their routine daily activities as soon as the appointment is completed. Postoperative discomfort is easily managed with over-the-counter or prescription strength non-narcotic medications.
For the implants to bond properly to bone, they must remain undisturbed for a period of several weeks to several months. At this time, greater than 90% of the routine implant placements in our office are ready to begin the final restoration process with the patient’s restoring dentist in 6 to 8 weeks. During the healing period, the bone will remodel around the implants and attach directly to them. In most cases Dr. Miski will attach a small cap to the implant that is flush with the gum tissue. This cap stays in place while the bone is bonding the implant(s). Because this cap extends through the gum tissue, unlike years ago, there is usually no need for a second surgery to expose the implant.
If needed, Dr. Miski or your dentist will create a temporary replacement tooth for you to wear during the bone remodeling period. In some cases, a provisional crown (temporary replacement crown) can be placed immediately on the implant. The important thing is that you will not have to go without your teeth.
Implant site preparations
In many cases, patients are referred to Dr. Miski at the time a tooth has been identified as hopeless, nonrestorable, or when predictable treatment options no longer exist. In those cases that a dental implant is the chosen tooth replacement, Dr. Miski is asked to remove the tooth and prepare the bone for the placement of a dental implant in the future. This process is referred to as a ridge preservation bone graft and can be performed to prevent the loss of bone that occurs after a tooth is extracted or to rebuild bone that is lost due to infection associated with the tooth. The process of preserving the jawbone anatomy is significantly more predictable and more comfortable than rebuilding the jawbone once it is lost. Maintaining proper jawbone anatomy ensures that dental implants are placed into appropriate positions for long-term success.
In areas where teeth have been missing for many years, there may not be adequate bone available to ensure that the implants are stabilized. Fortunately, techniques have been developed that allow Dr. Miski to rebuild the missing bone and provide the necessary support for facial structures and implants. These bone augmentation procedures include ridge augmentation bone grafts as well as sinus elevation bone grafts . Dental implant placement preserves this bone so that it will not melt away again.
In certain situations Dr. Miski may recommend a special type of implant procedure where the implant is placed immediately following the surgical removal of a tooth. This allows the number of surgeries involved with the implant treatment to be minimized and speeds the implant tooth replacement process. To place an implant into an extraction socket, Dr. Miski has to be able to place the implant tightly into the jawbone. This tight fit minimizes any microscopic movement that might occur as the implant and jawbone are both healing. Because the teeth in the front of the mouth often have one root that is closer in size to dental implants, the ability to place immediate implants is more common the closer the teeth are to the front of the mouth.
Immediate implants with immediate provisional restorations
The loss of a tooth is a traumatic event. The psychological trauma is greatly multiplied when the tooth is part of a patient’s smile. Dr. Miski understands the emotional stress caused by the loss of a tooth. For that reason, he and his staff make it a priority to ensure patients understand their options regarding tooth replacement following extractions. Tooth replacements, usually removable, can always be prefabricated by a patient’s dentist or Dr. Miski. In highly specific cases, Dr. Miski and his staff can place a temporary crown on an implant placed on the day of the tooth extraction. The crown is meant to be a cosmetic tooth replacement during the initial healing of the extraction socket and while the bone bonds to the implant. Psychologically, the impact of having an immediate tooth replacement greatly reduces the emotional trauma of losing the tooth.
After the implant has bonded to the bone, a connection post (abutment) will be placed so that your dentist can fabricate your new replacement tooth. There are different types of abutments, including abutments prefabricated by the implant company or customized abutments fabricated for your particular anatomy. Customized abutments are more commonly utilized for the anterior cases where esthetic considerations are important. Your dentist and Dr. Miski will recommend the appropriate abutment for your situation.
In most cases, once the abutments are attached, impressions are taken of your teeth, implants, and abutments, so that your replacement teeth can be fabricated from an exact replica of your mouth. In some cases, impressions will be taken of the implant so that the laboratory can select or fabricate an appropriate abutment. In these cases the final abutment and final tooth replacement are inserted on the same day.
Fabrication of replacement teeth
In the final phase of treatment, your dentist creates and fits the replacement teeth to the abutments. Your new teeth are designed after careful assessment of both your functional and cosmetic requirements. During the fabrication process, the models made from the impressions of your mouth are sent to the dental laboratory technician who will fabricate your new replacement teeth. You, your dentist, and the laboratory technicians will work together during the fabrication process to ensure the replacement teeth are the proper size, shape, color, and fit.
Implant maintenance care is very similar to the care necessary for your natural teeth. Good oral hygiene, eating habits, and regular dental visits will aid in the life of your new implant.