Dental Implants

A dental implant replaces the root of a missing tooth and is made from surgical-grade titanium alloy to exacting specifications. Initially, the implant is placed into the jawbone either immediately after the loss of a tooth, or after an extended period of time. If there is insufficient bone, various bone enhancing procedures can be performed prior to the implant placement (Bone Grafting). Implants are great for replacing missing teeth. It is important that you have enough bone in the area of the missing teeth for the implants to be attached to. Implants are increasingly being used to replace certain types of bridges and removable partial dentures. Dental Implants enable you to eat your favorite foods, increase your chewing ability and improve your appearance and speech.

• Dental Implants - (Multiple sittings)

Dental Implants are indicated as a treatment option for:

o    Replacing a Single Tooth: If you are missing a single tooth, one implant and a crown can replace it. A dental implant replaces both the lost natural tooth and its root.

o    Replacing Several Teeth: If you are missing several teeth, implant-supported bridges can replace them. Dental implants will replace both your lost natural teeth and some of the roots.

o    Replacing All of Your Teeth: If you are missing all of your teeth, an implant-supported full bridge or full denture can replace them. Dental implants will replace both your lost natural teeth and some of the roots.

In short dental implants

§  Replace one or more teeth without affecting adjacent teeth.

§  Support a bridge and eliminate the need for a removable partial denture.

§  Provide support for dentures, making it more secure and comfortable.

Advantages of Dental Implants over Dentures or a Bridge

§  Dental implants look and feel like your own teeth as they integrate into the structure of your bone, they prevent the bone loss and gum recession that often accompany bridgework and dentures. No one will ever know that you have a replacement tooth.

§  Dental implants don't sacrifice the quality of your adjacent teeth like a bridge does because neighboring teeth are not altered to support the implant. More of your own teeth are left untouched, a significant long-term benefit to your oral health.

§  Dental implants will allow you to once again speak and eat with comfort and confidence. There won’t be worries about displaced dentures and messy denture adhesives.

§  The success rate of dental implants is highly predictable. They are considered an excellent option for tooth replacement.

• Bone Grafting - (Multiple sittings)

In order for a dental implant to be successful the patient must have sufficient bone in the jaw to place the implant into.

The bone grafting procedure is very straightforward. Bone grafting will only take place after your dentist has assessed the quality and quantity of the bone in your jaw and found that there is not enough to continue with a dental implant. Next your dentist will discuss the different types of bone grafts with you and decide which will be the most suitable for you.

Once this has been decided the bone graft can be performed. For this the dentist will cut the gum at the site of the bone graft and create flap of skin. When the jaw bone is exposed the dentist will place the bone to be grafted onto the site and cover it with a protective membrane. This membrane is used to protect the bone from any microbiota (germs) found in the mouth and ensure that the area is perfectly clean to encourage the healing process. Finally the flap of gum is replaced and stitched carefully back into place. Healing time for a bone graft can vary from patient to patient but on average it is around 4 months. Patients are also given a course of antibiotics to take in the days following their bone graft. Antibiotic mouthwashes are also prescribed to preserve the health of the gum covering the bone graft.

The success of the bone graft is checked by x-rays to determine the height and width of the new bone. Once this has been confirmed as satisfactory, and the site of the bone graft is totally healed, the next stage of the dental implant process is started.

Types of bone graft

1. Autografts – this is one of the most successful bone grafting techniques. Bone is taken (harvested) from the body of the patient (usually from the hip or the mouth) and this is then grafted onto your jaw bone. As harvested bone comes directly from the body of the patient, autografts tend to be the most successful form of bone graft as the harvested bone is compatible with the jaw bone.

Advantages of Autografts

§  No risk of disease being transferred – as the bone comes from the patient themselves there is no risk of a disease being passed on from a donor.

§  Little or no risk of the bone graft being rejected by the body

§  Using bone harvested form the patient encourages new bone growth

Disadvantages of Autografts

§  Not all dentists will perform this procedure

§  There is a need for two operations, one to harvest the bone and another to perform the graft

§  Patients may be quite sore on the site where the bone was harvested from and this can last for some time

2. Xenografts – these use bone that is harvested from animals, usually cows. This bone is processed to make it sterile and totally biocompatible. Animal bone behaves like filler and eventually a patient’s body will replace this with natural bone.

Advantages of Xenografts

§  Only one procedure is needed as the bone is not being harvested from the patient

§  Natural bone growth is encouraged

Disadvantages of Xenografts

§  Minimal risk of bovine spongiform encephalopathy due to the fact that all organic components of the bone are extracted

§  Many people are put off by the fact that bone from an animal is used for this type of graft

3. Allografts - these grafts are taken from human bone donors in the same way that organs are taken from donors in the event of their death. Bone which is harvested in this way will be put through various tests and sterilisation techniques to ensure that it is safe to be used as a graft. After the donor bone is placed in the jaw bone it will eventually be converted into natural bone and the jaw bone will be rebuilt.

Advantages of Allografts

§  Only one procedure needs to be performed as no bone is being harvested from the patient

§  Natural bone growth is encouraged

Disadvantages of Allografts

§  Risk of immunogenic reactions

§  Disease transfer can’t be totally ruled out

§  Bone from a donor can be slower to integrate into the natural bone

§  Harvesting the bone from a donor can weaken it by up to 50%

§  Some people do not like the idea of using donor bone for this procedure

4. Alloplastic grafts – these grafts are man made from synthetic materials, normally a type of calcium phosphate as this mimics natural bone. Grafts of this kind can be replaced, over time with natural bone as they are resorbed into the body and encourage natural bone growth. Some alloplastic grafts are made from material which cannot be resorbed by the body and instead these will act as a scaffold on top of which natural bone can be built.

Advantages of Alloplastic grafts

§  No risk of disease transfer

§  The dentist can obtain exactly the right amount of synthetic bone to graft successfully

§  Only one procedure is required for the graft

§  Alloplastic grafts are available in various sizes and shapes and this can be further refined for a perfect fit

§  Alloplastic grafts are made out of biodegradable material so it is safe to be used in the body

Disadvantages of Alloplastic grafts

§  Sometimes alloplastic grafts are weakened by the procedure

§  There is a slight risk that the body will reject the graft