Implants

Dental Implants are the modern method for replacing missing teeth. Using this method, new teeth are anchored to the jaw bone and these function like natural teeth. One can eat, laugh, talk without worrying. People earlier dissatisfied with removable denture have found an appropiate answer in implants. Prof. Brane Mark in early 1950's discovered that titanium (which is a high strength, light weight and corrosive material) could integrate with bone tissue. First implant was done in 1965 after lot of research and development. Even though modern dentistry stresses prevention and maintenance therapy, millions of Indians are toothless (edentulous) in one or both jaws; many of them cannot wear dentures for physical or psychological reasons. Fortunately, dental implants now offer an alternative, a ray of hope for toothless people.

INDICATIONS A single missing tooth. Distal free end cases. Fully edentulous jaws. Retaining a removable prosthesis. Full arch reconstruction. In Maxillofacial prosthesis. In Orthodontics In immediate replacement of teeth.

CONTRA INDICATIONS ABSOLUTE AlDS Recent myocardial infarction Uncontrolled diabetes Radiation therapy Severe alcoholism and drug addiction Debilitating or uncontrolled disease Haematopoetic disorders RELATIVE Prolonged corticosteroid therapy Refractive diabetes Blood dyscrasias Chronic alcohalism, smoking and drug dependency Chronic renal disease Malignancies and Chemotherapy Severe endocrine and bone metabolic disease

ADVANTAGES Implants have several advantages over conventional prosthodontic procedures: Maintaining the facial profile. Providing fixed prosthesis where only removable prosthesis were possible. Maintaining width and height of alveolar bone. Conserves tooth structure (as no grinding of adjoining teeth has to be done). Eliminate pain. Restore function and aesthetics. It Improves Phonetics Masticatory performance Retention and stablility of removable prosthesis Patient comfort and acceptance

DISADVANTAGES Needs specialised training to avoid risk of failure. High cost of treatment. Prolonged treatment of time.

PROCEDURE SELECTION OF THE IMPLANT CANDIDATE A thorough Dental and Medical evaluation is done before starting implant procedure. Thorough dental history. Dental Evaluation Hard and Soft tissues are evaluated. Jaw relations, movements and functional habits are checked. Radiographic examination is done. CT Scan, OPG X-rays and dental imaging is done. Study casts are prepared. Photographs are taken for pre and post treatment documentation. Medical evaluation This should include a detailed medical history of the patient and should cover the cardiovascular system, respiratory system, gastrointestinal system, urinary system, endocrine system, diseases of the blood, skin & mucous membrane and malignant diseases. FIRST STAGE SURGERY This stage involves placement of the fixtures [Implant] in bone. The steps for first stage surgery are as follows: Surgical excision of gingiva is done. A hole drilled in the bone. The screw is placed in the hole. The soft tissues are sutured which are removed after 5-7 days. Any provisional prosthesis is modified, adjusted and relined with a soft tissue conditioning material. SECOND STAGE SURGERY It is usually performed 3-4 months later for mandibular fixtures and 5-6 months later for maxillary fixtures. In this the implant is exposed, the screw cover is removed and the abutment is placed. PROSTHETIC STAGE The final restorative procedure is undertaken one or two weeks following second stage surgery. In this accurate silicon impressions are taken, a model is prepared and then final prosthesis is prepared on this model and later cemented on the implants. These new teeth remain in the mouth and can stay secure for years and years.

IMPLANTS - FREQUENTLY ASKED QUESTIONS What is a dental implant? A dental implant is nothing more than a metal screw that is placed into the jaw bone. It acts as an anchor for a false tooth or a set of false teeth. Who is a candidate for dental implants? Anyone in reasonable health who wants to replace missing teeth. You must have enough bone in the area of the missing teeth to provide for the anchorage of the implants. Some people have all their teeth missing and most of them are excellent candidates for dental implants, but today, we use implants to replace small bridges, removable partial dentures and even missing single teeth. What is the success rate of dental implants? This depends very much on where the implants are placed and what they will be called upon to do. The best case scenario is the placement of implants in the front portion of the lower jaw. Here success can be as high as 98-100%. In other areas of the mouth, success rates can drop significantly. According to figures that we have today, the success of implants in the front part of the upper jaw are anywhere from 90-95%. Success rates of implants in the back part of the upper and lower jaw can be in the 85-90% range. Why have dental implants become so popular? As our lifespan increases, the need for some type of permanent dental replacement system becomes very important to our overall health. Dentures and removable bridges have obvious problems: They are loose and unstable. Implants can provide people with dental replacements that are both functional and esthetic. The demand was always there, we just needed the tools to fulfill that demand. How long after a dental implant is placed can it be used to anchor my new teeth? Normally we must wait three months in the lower jaw and six months in the upper jaw before we can begin to construct the new dental prosthesis that will be supported by the implants. In recent years, however, implants in specific situations are placed straight away. Does it hurt to have dental implants placed? The actual procedure to surgically place a dental implant is done under local anesthesia and is generally not at all painful. When the anesthesia wears off about three or four hours later, you might expect some discomfort. The level of discomfort is quite different from patient to patient, but most patients do not have significant problems. Some patients do have varying degrees of pain or discomfort which may last for several days. Swelling and black & blueing may also develop. What happens if I have dental implants and they are rejected? Occasionally dental implants do fail or, as some people say, they are rejected. In many instances, they can be replaced with another implant, usually of a slightly larger size. Do I have to go without my teeth& while the implants are bonding to my jaw bone? In most situations, patients leave the office wearing their teeth the day the implants are placed. Every patient and procedure is evaluated separately and there might occasionally be a recommendation that a patient go without their prosthesis for a short period of time. The cost of dental implants? In some situations today, we still pay for these services according to the number of implants used. Dentistry, however, has realized that the number of implants used for a given restoration is most important in terms of the success of the restoration, not the overall fee and we have begun to start charging patients according to the complexity of the overall procedure. It is certainly much more cost effective when the same dentist both places and restores a patient’s dentition, but this is not always possible. In the future, as dental implants are incorporated into the scope of general practice, implants will be not only much more widespread in their use, but much more cost effective for the patients.