Tooth Implant Procedure

The tooth implant procedure provides individuals with the opportunity to replace missing teeth with a structure that closely represents the feel, form and function of the natural tooth it succeeds.

Individuals are fortunate through modern dentistry to have several different options available to them for replacing missing teeth. The tooth implant procedure provides one of the most clinically effective means of tooth replacement offered today.

What are tooth implants?

These small structures are made through precision engineering of surgical grade material. Their purpose is for replacing missing natural teeth. The implant is the structure placed in the jaw bone. A crown is later placed on the implant to resemble the part of the tooth in the oral cavity.

How are they placed in the mouth?

In most cases, these metal structures are placed in an actual dental office. Unless a patient's health is compromised, or the case is very extensive, the office environment will suffice. Of course the surgeon's preference factors in as well. The procedure involved is of a surgical nature.

An incision is placed on the top of the gum tissue in the edentulous(toothless) area allowing access to the underlying bone. A series of various sized drills are used to produce a surgical opening in the jaw bone in which the future implant will be placed.

During the site preparation, the density of the jaw bone is checked to verify an environment conducive to dental implant success. Prior to this procedure, during the case work up, the bone density is viewed on x-rays looking for possible abnormalities. Bone height is measured on x-rays, as well as, in the oral cavity. When coupled with as assessment of the width of the jaw, a comprehensive strategy can be developed for dental implant placement. After the site for tooth replacement is prepared, an implant body is placed into the orifice. The most common replacement parts are screwed in or tapped in with a friction fit. Each may have strategically placed holes in its body to allow the bone of the jaw to grow into the implant, offering better anchoring properties.

After placement of the implant is completed, the gum tissue is sutured back to a natural position. The

tooth implant procedure requires the newly placed implant body to heal in bone for 3-6 months. After the proper healing time period has passed, the surgeon will perform an additional procedure to uncover the implant and place a healing cap on it. The cap will protect the coping while the area is awaiting a permanent prosthesis. Some doctors will place the healing cap at the initial surgery and allow the healing to begin. This method will save the patient from a second surgical procedure.

Once the prerequisite healing period has expired, the surgeon examines the patient and proclaims him/her ready to start the final stage.

This last stage is completed by the restoring dentist. He/she may be a general dentist of prosthodontist(specialist) but is someone with experience in the restoration of tooth implants and replacement of missing teeth. The restoring dentist will remove the healing cap, place an impression post and take an impression of the post, tissue, surrounding teeth and bite. The healing cap is then replaced for approximately 2-3 weeks while a restoration is made for the implant. Generally, the replacement tooth or crown is screwed into the implant or cemented onto a post which is screwed into the tooth implant. The screws are tightened with a torque wrench.

Single implants can be placed to retain crowns or multiple can be placed to anchor bridges and replace multiple teeth in the oral cavity. They also can be used in conjuction with clips and/or bars to hold full and/or partial dentures.

The following sequence of photos shows 1. Implants and bar for retaining a denture. 2. Implants retaining a bridge.

What are some of the risks associated with a tooth implant procedure?

1. Excessive bleeding 2. Infecton 3. Jaw numbness(permanent or temporary) 4. Implant failure With proper medical and dental histories and judicious case selection, these risks are very manageable.

Why should implants be considered for replacing missing teeth?

1.Implants secure the bite and prevent the bite and teeth from shifting. 2. They maximize proper chewing and digestion 3. Implants replace missing teeth without damaging surrounding teeth. 4. Form, function and feel of implants in the oral cavity greatly resembles that of natural teeth. 5. Implants are capable of excellent esthetics.

Who would not be a good candidate for a tooth implant procedure?

1. Medically compromised patients. 2. Patients taking many medications. 3. Patients with bleeding disorders or permanently prescribed medications that increase bleeding. 4. Patients with inadequate jaw bone to support implants. 5. Financially compromised individuals.

Over the last 30 years, dental implant success rate has ranged between 90-97%. That certainly is a percentage range to put your trust in. Advances in dentistry, fluoride and patient dental education have allowed individuals to keep more teeth longer. When they are lost, one would be best served investigating a tooth implant procedure. It is hard to beat their success rate, reliability, esthetics, form, feel and function. Dental implants are here to stay and will only become more prevalent in the future.

Todd S. Resek DMD