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About Dental Implants

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What Are Dental Implants?

Dental implants are artificial tooth roots inserted into the jaw to replace missing teeth.  Today, implants with attached crowns are the preferred method for treating tooth loss because they function the same as natural teeth and help preserve the jaw structure by preventing atrophy from bone loss. Bridgework and dentures address the cosmetic problem of missing teeth but do not prevent bone loss.  Permanent implants maintain proper chewing function and exert appropriate, natural forces on the jawbone to keep it functional and healthy.

Implants are titanium screws a dentist inserts into the jawbone and affixes a prosthetic tooth or crown.  Titanium implants over time fuse naturally with bone, a process known as osseointegration.  Implant surgery can replace one or more teeth provided there is sufficient bone to support the implants.  Would-be implant patients should have the procedure done as soon as possible after losing a tooth to prevent bone loss at the site.

Many implant dentists now use 3D images and implant surgical planning software to construct a vivid map of the patient’s mouth, pinpoint potential problems, and plan the implant procedure in advance.  During the initial visit, a 3D image is taken to enable the dentist to assess bone structure and nerve locations, plan the surgery, and mold replacement teeth before the next visit. 

From beginning to end, the entire process could take three-to-nine months, but with 3D imaging, it’s possible to do single and full-mouth implants in far less time.

Implant dentists are concerned about both oral health and cosmetic outcomes.   Replacing missing teeth helps regain a confident smile as well stay fit and healthy by maintaining good nutritional habits and eating health foods they previously were unable to chew. 

Early History

Archeologists who excavated Mayan burial sites in Central America found skeletal remains in which tooth shaped shells had been placed into empty tooth sockets.  It is also believed that the ancient Egyptians inserted shells to replace missing teeth.

In 1952, a Swedish orthopedic surgeon, P.I. Branemark discovered that titanium naturally fuses with bone in his experiments transplanting the tibia and fibula in rabbits. Though originally interested in applications for knee and hip surgery, which commonly use titanium artificial joints today, Branemark switched his focus to the mouth for easier clinical observation and because widespread tooth loss in the general population offered numerous subjects for study. 

Branemark published several articles about his work with dental implants and eventually commercialized his product in 1981.  Today numerous companies worldwide manufacture and market dental implants in various lengths and shapes.  It is estimated that more than 7 million Branemrk System implants have been placed worldwide.     

Tooth Loss is a Major Health Problem But Dentures and Bridges Aren’t the Answer

An estimated two in three Americans have one or more missing teeth, mainly due the rise in  periodontal disease as the population grows older.  Tooth loss and other oral health problems in older Americans recently prompted AARP to declare the “Over 50 Dental Crisis.”  In 2006, Dental Economics reported that more than 30 million Americas are missing all their teeth in one or both jaws.

The AARP Bulletin warned that dental disease has become a silent epidemic among older Americans.  Older adults with missing teeth often have underlying periodontal disease from which bacteria from chronic gum infection can migrate through the bloodstream to vital organs.  Adults with missing teeth are unable to eat properly and often develop nutritional deficiencies from an inadequate or unhealthy diet.

In addition to the dental and nutritional problems associated with missing teeth, there are social and personal self-esteem concerns as well.  Missing teeth have a negative influence on personal  self confidence and social activities.  Many family and social functions revolve around meals, and these situations can be difficult if not embarrassing for anyone who can’t chew properly.  Also, spaces between missing teeth degenerate and can lead to significant bone loss that cause atrophy in the jawbone.

Some older adults with missing teeth rely on bridgework or dentures to preserve their dental function.  Bridges require grinding down healthy teeth to function as abutments to anchor the side of the bridge without the crown.  Over time, worn-out bridgework can be harmful for preserving dental function and preventing bone loss in the jaw.  Bridges generally fail after 5-10 years as patients have difficulty flossing them.  Therefore, root surfaces below and around bridgework become highly susceptible to decay and are not reparable.  As a result, teeth supporting the old bridge often are lost, requiring insertion of longer bridges that further compromise dentition.  For most patients, implants are a much better treatment alternative because they preserve the bone of the jaw, do not decay, and function just like natural teeth.

Removable dentures often are ill fitting and usually too loose.  In some cases, they don’t allow their wearers to eat and even talk properly. Many feel stigmatized, avoid social functions and feel inhibited from leading an active, healthy lifestyle.  Scientific evidence supports that for patients who are edentulous in the lower jaw, implant supported fixed prostheses are superior to removable dentures.

Innovations in Dental Implant Surgery

3D Imaging and Treatment Mapping

Advanced, highly precise computer-guided dental implant surgery has made implant procedures faster, highly predicable and long-lasting with a success rate of 97 percent.  3D imaging is changing the practice of dentistry. With state-of-the art digital imaging, dentists can analyze the anatomy of the patient’s jaw without surgery, which saves time and money and shortens implant recovery time. It’s like having the patient’s jaw on the computer screen and helps make implants the most predictable procedure in dentistry today. 

Life-like 3D images enable the dentist to assess bone density and locate nerves, blood vessels and sinuses before surgery, thereby eliminating uncertainty about which spots in the jawbone are the right sites for implant placement.  The precision of the CT scan and implant surgical planning software give the dentist a vivid map of the patient’s mouth to pinpoint potential problems and plan the entire implant procedure in advance. 

Also, the superb clarity of the image allows precise insertion of the implant through the gum tissue rather than under it.  This promotes faster healing because gum tissue is preserved.  For some, the entire procedure may take no more than an hour for a single implant. 

Bone Augmentation

Implant dentists have become proficient at restoring or regenerating bone in tooth sockets that would not be able to support implant placements without augmentation.  Sufficient bone mass is critical for implant surgery success.  Digital imaging allows implant dentists to measure exact bone deficiency.  Once the deficiency is determined from the image, the dentist can decide how much bone material will be needed for a successful implant. 

The weight of several clinical studies has steered many implant dentists away from synthetic bone grafting material.  Dental school research has generated strong evidence that using bone additives and growth factors achieve the best outcomes compared to synthetic bone, donor bone or harvesting outside the jaw.

Bone augmentation studies have provided solid evidence offering clinicians greater confidence for successful outcomes in bone-fortification procedures, which significantly impact the long-term success of dental implant treatment. 

Mini Implants

Mini Dental Implants are very narrow, about the size of a toothpick, and are used primarily to stabilize a lower denture.  In most cases, four mini implants are inserted in the front of the jaw using mild anesthesia.  The patient's denture is then carefully adjusted by the dentist to allow it to snap onto the mini implants. If successful, the mini implants will firmly secure the lower denture and prevent slippage.  Typically patients can eat lightly about an hour after the procedure.  Also,  with some practice, patients can remove and replace the denture for cleaning. 

Focus on Evidence-based Dentistry

Today, implant dentists apply the principles of evidence-based dentistry in their practices.  As implant dentistry grows in popularity, greater numbers of general dentists will add the specialty to their clinical services.  Their success will depend on receiving high-quality training, such as the AAID credentialing program.  Training focused on rigorous science from researchers and clinicians who have published widely enables new implant practitioners to adopt techniques and procedures that have been validated over time.

Evidence-based research also holds great promise for developing streamlined protocols that will make implants affordable for greater numbers of prospective patients.  To do this, implant dentists are adopting stricter controls and performance standards, especially when evaluating new products and technologies, to generate robust data in clinical studies to help find ways to further standardize dental implant protocols.