A dental implant is an artificial tooth. This artificial tooth includes the complete root and is used in a variety of replacement procedures. This type of dentistry is known as prosthetic dentistry. Just as a prosthetic arm or leg can replace an amputation a tooth can be replaced using a dental implant. While there are several types the most widely used and the most successful is called the Osseous integrated implant. This type of implant was based on the discovery that titanium could be successfully incorporated into bone and causes a connection to grow between the titanium and the bone. This formed both a structural and functional connection between the living bone and the implant. This can also be done using a bridge or denture to support the implant.
A titanium screw, with a roughened surface is the typical implant. The surface is first treated either by plasma spraying, etching or sandblasting to increase the potential of the implant to integrate with the surrounding bone. At sites without teeth in the jaw a pilot hole is bored into the recipient bone, taking care to avoid vital structures. This hole is then made progressively wider. Extreme care is taken not to damage the site by overheating. A cooling saline spray keeps the temperature of the bone to approximately 117 degrees Fahrenheit. The implant screw is screwed into place at a precise torque so as not to overload the surrounding bone. Once the implant is placed on the bone a cover screw is placed and the site is allowed to heal for a few months. This allows for full integration to occur.
After a few months the implant is uncovered. A temporary crown is placed on the implant. The encourages the gum to grow in the right direction and shape. This should result in the approximation of a natural tooth’s gums and allow a pleasant final aesthetic. Once this has occurred then a permanent crown replaces the temporary one.
The decisions to use dental implants usually occurs after every other restorative procedure has been tried. This decision is usually made as a last resort for the patient. Patients who use this procedure have faced nearly catastrophic problems that have become unsolvable. Usually dentist work with peridontist in determining patients who will benefit the most from this type of procedure. There are certain considerations that have to be determined before proceeding to use dental implants. There must be enough bone in the jaw and it must be strong enough to hold and support implants. This is crucial in determining whether implants will work. If there is not enough bone a procedure know as bone augmentation can be done to a certain degree. In addition the health of the surrounding teeth and supporting tissues where the implant will be placed should be examined and determined to be healthy before implants are used. Also the force being placed on the implant will have to be determined to see if the procedure can be successful for the patient.
The success of dental implants does vary. This overall success is directly related to the dental skill of the doctor placing the implant, quality and quantity of the bone available at the site, and also to the patient’s oral hygiene. Various studies have found the 5 year success rate of implants to be between 75-95%. Patients who smoke experience significantly poorer success rates.
Failure of dental implants is usually due to failure of the implant to integrate with the bone correctly. It is also imperative that the patient follows diligent oral hygiene in treatment of all implants. Also those patients with uncontrolled type II diabetes may find the procedure carries a significantly lower successful rate as well.
While there are over 100 dental implant companies in the United States the scope of this procedure is not beyond a general dentist. Many dentist work in conjunction with oral or maxillofacial surgeons or sometimes periodontist in the actual implant procedure. The typical cost of dental implants is approximately $4000 dollars with full arch implants starting around $12,000 per arch and approaching $50,000 per arch depending on the complexity.