Dental implants are artificial tooth roots that are firmly anchored in the jawbone. They provide support for the dental prosthesis (crowns, bridges, and dentures) to replace a missing tooth or teeth. With few exceptions, dental implants are suitable for almost all patients. They are made of titanium or zirconia that are compatible with the human body. After the placement of dental implants in the jawbone, they fuse with the surrounding bone tissue. This process is known as osseointegration which involves a direct connection between dental implants and living bone tissues. In most patients, osseointegration occurs without complications.
Structure of Dental Implants
The Implant Body
The implant body performs the same function as the original tooth roots. The dentist or oral surgeon inserts the implant body in the jawbone (below the gumline). Then, it fuses with the surrounding bone tissue (osseointegration). The implant body is made of titanium or zirconia.
The abutment is the neck part. It connects the implant body with the dental prosthesis (crown, bridges, and dentures). The dentist attaches the abutment to the implant body after the healing period (4 to 6 months).
The Dental Prosthesis
The dental prosthesis can be fixed (crowns or bridges) or removable (dentures). The selection of the dental prosthesis depends on the number of missing teeth, the quality of bone, patient’s desire and other factors.
Dental Implants Material
Dental implants are made of titanium or zirconia. Both materials are compatible with the human body, FDA approved and considered safe. Titanium implants are widely used because they have some advantages over zirconia implants such as ease of placement and resist fracture in places with high chewing load. However, zirconia implants have very similar color to natural teeth and can be used in places with aesthetic problems.
Advantages of Dental Implants
The big advantage of dental implants over the conventional prosthesis is the replacement of missing tooth or teeth without the need to prepare the adjacent teeth for support. Also, they have a very long shelf life, resistant to high chewing force, can be cleaned easily, and can be used in the case of loss of several teeth or all teeth.
Disadvantages of Dental Implants
Dental implants surgery involves certain risks that may arise during the procedure (including injuries to adjacent teeth, nerve damage, and bleeding) and after the procedure (including prolonged bleeding, delayed healing, and the failure of osseointegration.
Also, dental implants require daily oral hygiene and regular visits to the dental office for prophylactic examinations. If the daily oral hygiene is not sufficient, this can lead to a destructive inflammatory process affecting the gum and bone that surrounds the dental implants (peri-implantitis), leading to the failure of dental implants. Compared to bridges and dentures, dental implants are expensive.
For Whom are Dental Implants suitable?
With few exceptions, dental implants are suitable for almost all patients. Anyone healthy enough to undergo an oral surgery and have a healthy bone and gum can be considered for dental implants. Diabetes mellitus and smoking are generally considered to be risk factors, but this won’t prevent the implantation. Each case needs to be evaluated on an individual basis.
Contraindications of Dental Implants
Typical contraindications of dental implants include:
- Children and adolescents.
- During pregnancy.
- Metabolic disorders (eg: poorly controlled diabetes mellitus).
- Diseases of the kidney, liver, and bone.
- Heavy smoking.
- Alcohol, and drug abuse.
- Nerves are too close to the implant.
- An insufficient bone thickness and the maxillary sinus is too close.
- Acute infectious diseases.
- Immunological diseases.
- A recent radiotherapy.
- Active cancer.
- Osteoporosis (bone loss).
Dental Implants Procedure
First, the dentist will ask about your previous or existing medical conditions. Then, he/she will examine your oral cavity and ask for x-ray and cone beam computed tomography (cone beam CT) to plan the exact position of dental implants. Also, the dentist will treat existing dental problems such as gum disease.
Dental Implants Procedure
In most cases, the dentist performs the dental implants procedure under local anesthesia. After the injection of a local anesthetic, the dentist makes an incision in the gum and drills in the jawbone. Then, he/she inserts the titanium or ceramic implants into the bone and closes the gum over the dental implants with few stitches.
A sufficient bone thickness is important for the success of the implantation. If there is not enough bone thickness, the dentist or oral surgeon will perform a procedure known as bone augmentation or bone graft to rebuild the bone and support dental implants.
During the healing period, the dental implants fuse with the surrounding bone tissues (osseointegration). The healing period depends on the quality of bone. In the upper jaw, it takes 3 to 6 months. In the lower jaw, it takes 2 to 4 months.
Once the healing process is complete, the dentist will attach the abutment to the implant body. The, he/she will take an impression and send it to the dental lab for the production of the dental prosthesis (crowns, bridges, and dentures).
What are The Risks of Dental Implants?
Despite the risks involved, dental implants are the best choice to replace a missing tooth or teeth and have many advantages compared to the conventional prosthesis. Patients interested in dental implants should be aware of the risks:
- Allergy-related to titanium implants.
- Nerve injury.
- Injury to blood vessels.
- Injury to adjacent teeth.
- Delayed healing after the procedure.
- Loss of dental implants.