Loving Dental Implants
What is a dental implant? The first titanium dental implant was born in 1965 when Branemark, a Swedish orthopedic surgeon, discovered that bone would effectively adhere to a titanium screw. He called this process osseointegration. The FDA approved them in 1982 for US use. Most everyone knows of someone who’s had a hip or knee replaced with an artificial implant. But what is a dental implant?
Very simply, an implant is a titanium screw surgically placed into the jawbone. It sounds painful, but since bone has no nerves, it is a remarkably painless procedure. Most patients experience little or no discomfort. Implants are designed to hold a tooth. Before implants came along the remaining teeth were used as anchors for the replacement tooth. So if one tooth was missing, healthy teeth on either side of the empty space were used to bridge the gap. Many folks have a “Bridge “replacing a missing tooth. An implant eliminates the need to involve other healthy teeth. The implant is surgically placed in the missing space, allowed to heal for a few months, and then the artificial tooth is anchored to the osseointegrated implant. We are finding that of all dental procedures, implants have some of the best track records of longevity.
Can implants fail? Even though the success rate of implants is around 95%, problems can arise when placing synthetic material into living tissue. The 5% that are rejected usually do so within the first few weeks. Infection is the main cause. Also bone that has been altered by the use of drugs designed to prevent osteoporosis, smoking, and systemic diseases such as diabetes can negatively influence the longevity of the implant. If infection is the cause, the implant can be unscrewed, the bone allowed to heal, and in a few months a new implant can be placed in the same area.
Jawbones vary in their density. That is, some portions of the jaw are hard like oak and other portions are as soft as pine. If you’ve done any carpentry or bought any furniture, then you know the difference. So there are different types of screws or implants depending on whether the bone is hard or soft. And unlike wood, jawbones have nerves and blood vessels that must be avoided to prevent complications. Unfortunately not everyone’s nerves and blood vessels are in exactly the same place. So the first part of receiving a dental implant is finding out where those vital parts are located. Sometimes a simple x-ray will be enough other times a three dimensional x-ray will be required. This is commonly referred to as a CT scan. Before we build a house, we pay engineers to determine the quality of the soil. How much load can it bear? This analysis determines the design of the foundation supporting the house. The leaning Tower of Pisa is a prime example of poor soil analysis. The implant itself is essentially a foundation. A foundation for what? For the tooth that will be anchored to it.
Another problem with jawbones is sometimes there’s just not enough wood to hold the screw (implant). Folks who have been wearing a denture for a long time, commonly have much smaller jawbones. Remove all of a tooth causes bone to shrink by as much as 60%. This can be prevented by placing a bone graft (synthetic bone) at the time of extraction. Movement of the denture also causes bone to shrink. When there is not enough bone to hold a conventional size implant, then a mini or tiny implant can be placed. These are usually adequate to fasten the denture securely in place. Interestingly, the implant itself will prevent bone shrinkage. Implant manufacturers have developed all sizes and shapes of titanium screws. With dense, high quality bone, some implants can be put to use immediately, eliminating months of healing. Whether you’re replacing one or more teeth, or anchoring a loose denture, with proper analysis and planning almost anyone can benefit from this conservative technology.
Stay well…Dr. Bill Ardito – Sunshine Dentistry AZ