Dental Implants

Dental implants

Dental implant is an artificial tooth root replacement and is used in prosthetic dentistry to support restorations that resemble a tooth or group of teeth. When the implant is used to support a crown, the crown is called an implant crown. Dental implant can be used to support a bridge or a denture as well. Dental implant is placed in the jaw bone through a surgical procedure.

Summarized from Contemporary Implant Dentistry second edition by Dr Carl E. Misch “The use of dental implants to provide support for prostheses offers a multitude of advantages compared with the use of removable soft tissue-borne restorations (removable dentures). These advantages are listed as follows:

  1. Maintain bone
  2. Maintain occlusal vertical dimension (facial height)
  3. Improve psychological health
  4. Proper bite
  5. Regained bite sensation
  6. Increased stability
  7. Increased retention
  8. Improved phonetics
  9. Reduced prosthesis size (eliminate the need of covering the palate)
  10. Improved success rate of prostheses
  11. Increased longevity of the prostheses
  12. Improved function of prostheses

A primary reason to consider dental implants to replace missing teeth is the maintenance of alveolar bone (jaw bone). An implant can maintain bone width and height as long as the implant remains healthy.

A lower denture often moves when the mylohyoid and bucccinator muscles contract during speech or chewing. The teeth are often positioned for denture stability rather than where natural teeth usually reside. With dental implants, the teeth can be positioned to enhance esthetics and phonetics without the worry of denture instability.

The maximal biting force of a traditional denture wearer ranges from 5 to 50 pounds. Patients with an implant-supported fixed prosthesis may increase their maximal bite force by 85% within 2 months after the completion of treatment. After 3 years, the average force may reach more than 300%, compared with pretreatment values. As a result an implant prosthesis wearer may demonstrate a force similar to that of a patient with a fixed restoration supported by natural teeth. The trational denture showed a 30% decrease in chewing efficiency but some studies showed that a denture wearer has less than 60% of the function of people with natural teeth. The implant supported denture, on the other hand, loses only 10% of chewing efficiency compared with natural teeth. In addition, rigid, implant-supported fixed bridges may function the same as natural teeth. Beneficial effects such as a decrease in fat, cholesterol, and the carbohydrate food groups have been reported as well as marked improvement in eating enjoyment and social life.

When do Dental Implant Treatment is not recommended?

  1. Heavy tobacco use (smoking and chewing tobacco)
  2. Severe form or uncontrolled diabetic patients
  3. Active gum disease or periodontal disease in other teeth ( at least thorough oral hygiene should be implemented to control the condition before implant is considered)
  4. Heart condition or other systemic illness that prevents patients to undergo dental surgery procedure in general.
  5. Patients taking a kind of medication called bisphosphonates such as Fosamax and Actonel to treat osteoporosis. This group of patients has a higher risk of unhealing jaw bone after dental surgery.

Role of Implant Maintenance

Patient Role

  1. Plaque control of 85% or more.
  2. Use of interdental brushes, hand and motorized such as Proxa-brush, Oral-B Brush, Rota-Dent, Sonic.
  3. Dip brushes in chlorhexidine, 0.12% (Peridex, Perioguard)
  4. Use of dental floss, Super-Floss, Perio-Floss, G-Floss etc before going to bed.

Dental Hygienist Role

  1. Check plaque control effectiveness (85%)
  2. Check for inflammatory changes.
  3. If pathology is present, probe gently with plastic probe.
  4. Scale supragingivally only with Impla-Care, Implant prophyl+, or Steri-Oss Graphite Scaler.
  5. Check for problems such as loose suprastructure, broken screws, sore spots etc.
  6. No need to proble if no pathology is present.

 Dentist Role

  1. Check patient every 3 to 4 months (implant patient is a perio patient)
  2. Check for 85% plaque control effectiveness.
  3. Expose radiographs every 12 to 18 months if no pathology is present, and as needed if pathology Is present.
  4. If suprastructure is retrievable, remove and clean in ultrasonic every 18 to 24 months.