What are Dental Implants?

What are Dental Implants? 

Dental implant is a synthetic tooth which retained by titanium root that is surgically placed (under local anaesthesia) in to the jaw bone.

Why increase need of dental implants?

1. Aging population living longer
2. Tooth loss related to age
3. Fixed denture failure
4. Unwanted outcomes of tooth extractions
5. Poor performances of removable dentures
6. Bad effects of removable dentures
7. Psychological aspects
8. Advantages of dental implants

   

      How success is the dental implant treatments?

 Success rate depends on

o   Operator skills

o   Quality and quantity of bone available

o   Patients oral hygiene

o   Quality of the implant and equipment

If all goes fine it has a success rate around 95%

Can I get an implant to fill a gap between teeth?

Yes, if you have

    

•       Enough jaw bone remaining in jaws (there are some instances where bone grafts can be done)
•       Bone that have enough strength to hold the implant for its function
•       Good health in natural teeth near where the implant will be placed
•       Good general health condition to undergo surgical procedure.

 You can’t get a implant done if you,

                For lower jaw implant, insufficient jaw bone above the mandibular canal (inferior alveolar canal) or mental foramen.

     

                                 Systemic diseases such as

·         Uncontrolled type II diabetes

·         Pituitary & Adrenal Insufficiency

·         Hypothyroidism

·         granulomatous diseases ( Tuberculosis and Sarcoidosis)

·         cardiovascular diseases (angina, marked aortic insufficiency,  Aortic Aneurysms)

·         bone diseases (Paget’s Disease, Fibrous Dysplasia)

·         uncontrolled haematological disorders (anaemia’s ,haemophilias)

•        Patients who take intravenous bisphosphonatas (can cause osteonecrosis)
•       Patients who have a habit of tooth clenching or grinding
•    Regular smoking is a definite contraindication

What the dental implants do?

1.       Replace one or more extracted or missing teeth

2.       Implant supported dentures

3.       Supporting component for bridges 

Tips on Dental Implants

Have you ever think about getting an dental implant done or have your clinician suggested you one ?

For most cases, first and second opinions top the list of things to do before surgery. When your dentist recommends implants (or you ask for them), you'll want a full explanation and a discussion and a second opinion. Most of the questions are may not be relevant for a placement of mini implants which we will discuss later.

Here are some key questions to ask

·        What other solutions are available?

·        What are the possible complications?

·        Does my dental insurance cover the procedure?

·        What are the cost differences among available solutions?

·        What are the functional differences?

·        What happens if nothing is done?

·        Am I a candidate for teeth in an hour?

·        How can I be sure that implants are really needed?

·        What's the basis for your diagnosis?

·        Who do you recommend to do the surgery, and why?

·        How much experience have you had with the recommended implanttologist?

·        Do you know if the implantologist has a clean malpractice history?

·        Can you recommend more than one surgeon and let me decide?

·        Do I have enough jawbones to achieve a crown to root ratio of 1:1 or better?

·        What are the trade-offs if the ratio can't be achieved? (A short implant life with risk of a cracked jaw is one tradeoff!)

·        What kind of life cycle can I expect for the types of implants recommended for me?

·        Are implant placement angles a problem in my case? How will you assure correct angulation?

·        Does the standard of care for my case require a 3D X-ray?

·        Can/will you refer me to a CBCT lab or clinic? What are the choices and trade-offs among different systems offered by these centres?

How are implants placed in the jaw-An animation

How are implants placed in the jaw......... An animation

Common complications of Dental implants

Implant questions
The common complications of Dental implants

Common complications of dental implants

You should remember that Most of the below mentioned complications could be overcome by selecting an experienced surgeon, proper treatment procedures and selecting good types of implants

Well organized, thorough treatment plans lead to successful implant treatment and patient satisfaction, which are the ultimate long-term goals.

Patient health condition is an important factor for the success of the implant. Studies have shown (Moy PK, Medina D, Aghaloo TL, et al. Dental implant failure rates and associated risk factors. Int J oral Maxillofac Implants.2005;20:569-577.)

1.    Increasing age (60–79 y/o) has a strong association on risk with implant failure

2.    Smoking

3.    Diabetes

4.    Head and neck radiation

5.       Postmenopausal oestrogen therapy (hormonal drugs taken due to diseases after stopping of menstruation cycle )

Improper Implant Location causes several complications perforation of the lingual concavity, constriction of the lingual space or damage of the lingual artery. To place implants based on available bone often results in poor aesthetic outcomes as well as long-term problems in cleaning the implant and jaw bone loss.

Possible surgical complications (which are possible for any other surgery) areto postoperative infection, bleeding, swelling, facial discoloration, transient pain, paresthesia, neuralgia, fracture,

Joint pain, muscle spasm, tooth looseness and sensitivity, recession, speech change, difficulty in opening mouth, and swallowing of foreign objects.

Anatomy-related complications

1.       Nerve Injury leading to transient or permanent numbness involved in inferior alveolar, mental, incisive or lingual nerves.

2.       Excessive bleeding related Life-threatening events associated with dental implants are rare.

3.       Cortical Plate Perforation

4.       Sinus Membrane Complications- In the upper posterior, the proximity of the sinuses can create a problem for dental implants if there is minimal residual crestal bone (less than5mm) for stability. Ardekian et al found maxillary sinus membrane perforations were more common in areas with minimal amount (≤5 mm) of residual alveolar bone but this did not affect the overall implant success rate.

5.       Devitalization of Adjacent Teeth implant pathosis caused by dormant endodontic problems of adjacent teeth that flare up after implant surgery.

Mechanical Complications

1.       surgical trauma during osteotomy preparation with the drill

2.       Lack of Primary Stability

3.       Mandibular Fracture

4.       Ingestion and Aspiration

Other

1.       Study done by the Dental Implant Clinical Research Group found that inexperienced surgeons (≤50 implants) were twice as likely to have implant failures compared with more experienced surgeons.some of other complications are due to not following post-operative instructions by the patients