Chapter 1: Dental implant
Welcome to our complete guide to a dental implant. If you’re interested in a dental implant this is the right place for you. We have created 6 different chapters to guide you through everything you need to know about dental implants. Our dentist, Dr. Cevahir Taşkın, created this chapter by chapter journey for you. Our goal for you is to understand every single detail of the procedure. This will allow you to make a conscious decision and understand the process, types of dental implants, and every single detail. Don’t worry, we kept it simple so everyone can understand, even people who are not in the health sector.
A dental implant (often called a fixture or an endosseous implant) is a surgical implant connecting the jawbone or the skull bone to a dental prosthesis, usually dental crowns, bridges, dentures, or facial prosthesis. A dental implant will replace a tooth root to anchor your prosthesis, like a crown, to your bone in a case of a missing tooth. The dental implant procedure requires different steps and different procedures overtime before the result but offers stable and long-lasting support for your prosthesis.
What is a dental implant?
Dental implants are part of the realm of restorative dentistry and implant dentistry. They’re considered one of the best dental procedures in terms of longevity and effectiveness. A dental implant is a metal post replacing the root part of your missing tooth. It’s considered the perfect option for people wanting artificial teeth functioning exactly like their real ones. A dental implant helps solve problems of tooth loss but also fitting problems some other prosthetics can create. Also, it improves incredibly the aesthetic of your teeth and your quality of life. There are chewing improvements, speech improvements, and overall health improvements to getting crowns. You’ll get the perfect fit, and tight and lasting support. A dental implant has three components: the fixture, the abutment, and the dental prosthetic. Each of them has a precise role in the entire process.
Dental implants made easy: imagine your dental implants being a screw. Yes, that may seem crude and creepy, but it’s the best example we can give. The role of the implant is to screw the outside crown or bridge to your bone, so it will be stable and perfectly long-lasting.
What are the advantages of dental implants?
Dental implant surgery has become a routine surgery, often recommended for patients missing a single tooth or more real teeth. It’s a safe, permanent, and long-lasting solution for your dental care. Dental health is important and if you’re wondering about getting a dental implant, you may wonder what are the benefits of a dental implant. Here they are:
- Solve the problem of a lost tooth
- Helps with the ability to chew food
- Restores the health of bone and gums surrounding the missing tooth
- Improves the overall quality of life
- Helps with the aesthetic appearance of your smile
- It’s a long-lasting solution
- It’s permanent
- Helps keep the jawbone from shrinking because of bone loss
- Helps preserve nearby teeth
- It’s biocompatible
- Mimics perfectly your natural teeth
- Doesn’t require excessive dental care
What are the disadvantages of dental implants?
There are not a lot of disadvantages for an implant. However, it’s important for a patient to understand every single part of a procedure. The good and the bad. So, what are the disadvantages? Here they are:
- It takes over one appointment to get your implants and it may take months for the finished implant. (Check Chapter 3 for the procedure)
- You may need bone augmentation (graft) if you don’t have enough volume and density of bone. It’s nothing in your control and depends on your body. Bone augmentation is becoming less painful and invasive, however, it’s still a surgery requiring healing time.
- Dental implants are an oral surgical procedure and, even if completely safe, there are some risks and side effects involved. If you’re interested in this subject, check Chapter 4.
Who can get a dental implant?
If you’re reading this article, you’re probably considering a dental implant. Well, are you a candidate for a dental implant? Let’s talk about this! You don’t need to have a million requirements to get implants. However, how can you tell if you are a candidate?
You can get a dental implant if you:
- Have at least one missing tooth (both root and teeth)
- Have jawbone has reached full growth
- Don’t smoke (or you’re willing to stop for a few days during the process)
- Have healthy oral tissues
- Don’t want – or can’t – wear removable dentures
- Have adequate bone to have a safe implant procedure
- Will get a bone graft if you don’t have enough naturally
- Are ready to undergo a lengthy process (several months)
- Want to improve your chewing
- Don’t have health conditions affecting bone healing
- Want to improve your life
- Want to improve your aesthetics
We talked about the ideal candidate for an implant. But who can’t get one? Well you can’t get one if you:
- Have uncontrolled and untreated diabetes
- Suffer from blood clotting disorders
- Have cancer or leukemia
- Have a weak immune system or conditions related to your immune system
- Suffer from drug abuse
If you have one of these conditions and you’re unsure you can get implants, get in touch with us. We can tell you if you’re a candidate or suggest you a different solution for your needs.
Can elderly patients get implants?
Absolutely yes. To answer this question, we can give you some data. According to a study on 1.256 patients with an average age of 62 years old, the survival rate of implants is 92,9%. This means elderly patients can get an implant if they have the same health and bone structure characteristic every other patient has. Also, it’s a very good option because elderly patients tend to have more tooth loss.
Dental implant at a young age
We feel like these questions need an in-depth explanation. In dental implants, it’s important for the bone to reach full growth. This means theorically you shouldn’t get an implant before 16-18 years of age. It is because it’s difficult to calculate how the bone – and jaw – are going to grow. This is because they don’t grow uniformly. It is multidirectional, in a sagittal, transverse, vertical direction. Also, it follows periods of fast growth to period of slow or no growth. Planning an implant requires a multidisciplinary approach in the treatment plan, and this makes it extremely difficult. You need to calculate the growth of the jaw and this requires x-rays taken months apart – 6 months apart – to create a growth plan. However, this can’t be 100% accurate. The planning process can be started around a year before the planned implant procedure.
We suggest you consider alternatives to implants in your child’s dental health or wait a few more years if they’re close to 16-18 years of age.
Can you get a dental implant years after extraction?
Yes. It does not matter how many months, or year, passed from your tooth extraction. It can be one month or ten years, it’s not important. You can always get a dental implants to solve the situation. As long as you have the criteria to get a dental implantation surgery, time won’t matter.
In theory, there is no definite limit to how many dental implants you can have in your mouth. You can possibly get several implants in one dental visit. But you might have to wait in between the dental implant procedures in order to leave enough time for recovery. You might experience more post-surgical pain and discomfort when you get several implants at once.
How many dental implant can you get?
How many dental implants you can or you should get will depend on you. While your dentist conducts the pre-surgery medical assessments, they will perform several scans. Also during the pre-surgery assessments, your dentist will determine your bone strength and density. Whether you have adequate bone to support the implant or implants is the most important factor which determines how many dental implants you can have. If you have a healthy bone structure on your jaw that can support the implants, you should have no problem getting the number of dental implants you want. If you do not have strong enough bone to support implants on your jaw, your dentist might recommend a treatment called bone grafting. This will help increase bone strength and density for the implant procedure.
You might be wondering how many implants you should get in order to regain the functionality of lost teeth. If you have one missing tooth, you can get one dental implant in its place to replace it. If you have two adjacent teeth missing, you might get one dental implant to cover both. Your dentist can place a two-unit restoration on top of the implant. If you have more missing teeth, you can use the method mentioned above to cover more than one tooth with a single implant.
Every individual’s condition is different and it is best to consult your dentist for the appropriate number of implants for you.
Dental implant parts: the three components
Dental implants are the only procedure in dentistry able to act as a tooth root. To understand how this works is important to understand what the dental implant parts are. They are three: the fixture, the abutment, and the dental prosthetic. The fixture – similar to a screw – is the one that acts as a root. The prosthetic is the fake teeth and the abutment connects the other two parts.
The fixture or implant post is the dental implant part similar to a cylindrical screw implanted in the jawbone or skull bone. This part acts as the artificial tooth root inside the bone. It’s perfectly designed to recreate a root, therefore it’s tapered at the base. The fixture is available in different sizes, adapting perfectly to the part of the jaw. If there is a missing molar, for example, you will need a bigger fixture. Sometimes longer implant posts are necessary when there is not enough bone mass for a normal fixture.
The important factor to keep in mind is biocompatibility. Think about it, the fixture is an external object inserted into your bone. Therefore, this dental implant part is made of titanium, often coated with hydroxyapatite. This is a perfectly biocompatible material while being extremely long-lasting.
The abutment is the connection part sitting between the fixture and the prosthetic part of the dental implant. A part of the abutment screws into the fixture. Imagine a screw into the abutment. The other side of the abutment adheres to the dental prosthetic, may this be a crown, a bridge, etc.
The type of abutment used for dental implants varies according to the type of dental prosthetic. For example: it may have attachments to clip to a denture or just be screw-shaped for a crown.
Imagine the abutment as the connection part of the dental implant in between the internal part and the external part of the implant.
The dental prosthetic
If the fixture was the “inside” part, and the abutment is the “connecting” part of a dental implant, the dental prosthetic is the visible part. It’s usually a crown, a denture, or a bridge. The crowns are preferred when just one tooth is missing. The bridge is for one, two, or more adjacent teeth that are missing. A denture is advised when you need an entire arch. Usually, crowns and bridges are cemented in. While a denture is snapped in place. The prosthetic type you pick will determine the number of implant fixtures needed. Crowns usually need one, bridge two and more, while dentures from four to six.
What is a dental implant made of?
A dental implant is made of different materials as different parts are involved. While the fixture – the part going into the bone – and the abutment – the connecting part – is mostly titanium. The dental prosthetic may have different materials, usually zirconia, porcelain, porcelain-fused-to-metal, etc. The material used for the prosthetic varies according to type and preferences.
What does a dental implant look like?
The only part that’s visible to the dental implants is the prosthetic part. This will look exactly like natural teeth. The shape and size will be custom made for you, keeping in mind the surrounding teeth and the space available.
What does a dental implant feel like?
Important questions. What does it feel like? An implant replacing a tooth will feel exactly like a tooth. You won’t feel the implant itself in your gum and bone. Your prosthetic will also feel like it’s naturally part of your mouth. However, during the procedure and during the healing process you may feel some discomfort. Do not worry, this is normal and just a temporary discomfort.
Can dental implants be whitened?
No, they can’t be whitened. The whitening process only works on the natural teeth enamel. Implants, especially porcelain ones are stain-resistant prostheses. But they can’t be whitened as your natural teeth. It’s better to get your teeth whitened before getting implants. So you can easily avoid any color mismatch.
But once you get your implants, you probably won’t need to get them whitened. However, it’s better to take care of dental implants well. After all, they accompany you for decades. It won’t be good to be exposed to staining substances for a long time.
History of dental implants
You may think dental implants are a new discovery and technology. However, that’s not true. We thought it can be both informative and interesting to add a section about the history of dental implants. We will start from 2500 BC – yes, you read right! – and go to modern days.
Have fun learning something new!
Dental Implants during 2500 BC–800 AD
The ancient Egyptian in 2500 BC talked in their manuscripts and texts about toothaches and the use of ligature gold wire to stabilize teeth. Etruscans, around 500 BC, used gold soldered rings to restore the oral health and used oxen bones as dental prosthetics. Roughly around 600AD Mayas had the first evidence of dental implants. They used shells to replace mandibular teeth. When radiographs were taken during the 70s of Mayas, you could see bone formation around the implants made of shells and bones. Later, stone implants were used by Honduran population around 800 AD.
In 1931, Dr. Wilson Popenoe and his wife, Dorothy Popenoe, found a skull in Honduras belonging to a young woman. The skull had 3 teeth missing from the lower arch and they were replaced by shells mimicking the shape of a tooth. There was bone growth and calculus, highlighting the functionality of these implant.
Dental Implants in the 18th Century to 20th Century
During the 18th century, the main problem with implants was the biocompatibility. Most of the implants were rejected by the body. Even a blend of gold and alloy was unsuccessful. Even a porcelain-platinum implant was unsuccessful. If there’s no osseointegration–the “fusing” of implant and the bone as one–there can’t be a successful implant. This needs the “acceptance” from the body of the implanted part.
During the 1900s, doctor tried again with different materials. Dr. E.J. Greenfield tried 24-karat gold. Then, two brothers, Drs. Alvin and Moses Strock, tried Vitallium after this was used for hip implants. These implants were more long-lasting, and it is considered the first really successful dental implant in history.
Modern day implants
In 1952, Dr. Per-Ingvar Brånemar, an orthopedic surgeon and a research professor, he implanted a titanium into a rabbit’s femur. Later, when trying to remove it, he noticed this was not possible, as it was fused into the bone. This made him discover how biocompatible titanium is with bones. He then theorized how titanium could be used in implants and in dental implants. Therefore, in 1965, he successfully used titanium to replace a missing tooth discovering the modern day titanium implants. Since then, titanium implants are used in dentistry.
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