Implants

What are Dental Implants

Dental Implants are today the nearest equivalent replacement to the natural tooth, and are a very useful addition in the management of patients who have missing teeth because of disease, developmental anomalies and trauma.

The quality of Dental Implants in India and what is being provided at Dental PARTHA DENTAL is at par with the global standards.

Dental Implants

Dental implants are used to replace teeth loss due to various factors like teeth rots. They are the next best thing to natural teeth. Dental implants are natural-looking replacements for missing teeth and also provide the same function as your natural tooth root .Implants provide a strong foundation for teeth that are made to replace your natural teeth. The adverse effects of missing teeth can be detrimental to your long term oral and medical health. If you are missing a single tooth or teeth, dental implants are the best way to replace them. Dental Implants can be used to replace both single and multiple teeth.

How do Dental Implants Work?

A dental implant is a small "anchor" made of titanium that is inserted into the jawbone to take the place of your missing tooth root. After osseointegration (when the surrounding bone has healed to the implant), a replacement tooth is secured to the top of the implant. This new tooth looks, feels and performs similar to your natural teeth.

What are the benefits?
Choosing dental implants as a treatment option can offer you a number of significant advantages.

• Maintain anatomy. If you have missing teeth, the bone begins to shrink over time. Unhealthy bone loss can make your jaw line recede and change your facial structure. Dental implants can help prevent deterioration of the jawbone so your face retains its natural shape
• Keep your healthy teeth. A better long-term alternative to bridgework, dental implants eliminate the need to grind down healthy teeth when replacing one or more adjacent teeth. Your own natural healthy teeth are not compromised.
• Security. Securely anchored dental implants do not slip or move. This eliminates some of the key problems of dentures, including poor fit, gum irritation and pain from exposed nerves. The result is superior comfort, reliability, and freedom from embarrassment.

What is involved in the implant procedure?
The dental implant process involves several steps that take place over a time period.

The typical process will include:

Pre-treatment consultation: After a careful evaluation of your dental and medical health history, your practitioner will determine if you are a good candidate for dental implants. If you are, you will then have thorough consultations with surgical and prosthetic specialists before your treatment begins.

Initial implant placement: Your practitioner places the dental implant into your jaw while you are under either local or general anesthesia. Over the next several months, bone will heal to the surface of the implant, anchoring it into position. Depending on your particular case, an additional minor procedure creates an opening through which your artificial tooth will emerge.

Implant prosthetic attachment: During this phase, your practitioner painlessly attaches a prosthetic "post" to the implant. An impression will be taken, and soon after, an artificial replacement tooth will be created for a natural restoration.

Proper maintenance: Your dental practitioner will guide you on the proper care and maintenance of your new implants before, during and after the procedure. By following a regular routine of careful oral hygiene and regular checkups, your implants will look, function and feel great for many years to come.
There are three types of implants, and they can be described according to their shape and how they are attached to the jaw. They are:

• Endosteal -"within the bone" implants - these are surgically implanted directly into the jawbone.
• Once the surrounding gum tissue has healed, a second surgery is needed to connect a post to the original implant.
• Finally, an artificial tooth (or teeth) is attached to the post-individually, or grouped on a bridge or denture
• Subperiosteal"on top of the bone" implants or Ramus – frame implants these consist of a metal frame that is fitted onto the jawbone just below the gum tissue.
• As the gums heal, the frame becomes fixed to the jawbone.
• Posts, which are attached to the frame, protrude through the gums.
• As with endosteal implants, artificial teeth are then mounted to the posts.
• This type of implant can be used if the lower jawbone is too thin for a root-form or subperiosteal implant. A Ramus-frame implant is embedded in the jawbone in the back corners of the mouth (near the wisdom teeth) and near the chin Once it is inserted and the tissue heals, a thin metal bar is visible around the top of the gum.Dentures are made that can fit onto this bar. Ramus-frame implants also can stabilize weak jaws and help to prevent them from fracturing.

TRANSOSTEAL "through the bone" implants. These implants are either a metal pin or a U-shaped frame that passes through the jawbone and the gum tissue, into the mouth. Transosseous implants originally were designed to be used in people who had very little bone in their lower jaws and who had no bottom teeth. However, they are rarely used today because placing them requires extensive surgery, general anesthesia and hospitalization. Also, their use is limited to the lower jaw. Placing transosseous implants involves inserting two metal rods from below the chin, through the chin bone, until they are exposed inside the mouth. The rods that can be seen inside the mouth are used to attach a denture.

Most clinicians today prefer to use bone grafts and one of the other endosseous implant methods described earlier instead of the transosseous method because they are equally effective and do not require the level of surgery needed when placing transosseous implants.

Single-Tooth Implants

Single-tooth implants can be used in people who are missing one or more teeth. An implant is surgically placed in an opening that is made by your dentist in the jawbone. After the implant integrates (attaches) to your bone, it acts as a new "root" for the crown that will be replacing your missing tooth. A crown (cap), which is made to look like a natural tooth, is attached to the implant and fills the space left in the mouth by the missing tooth. For this procedure to work, there must be enough bone in the jaw, and the bone has to be strong enough to hold and support the implant. If there is not enough bone, bone may need to be added with a procedure called bone augmentation. In addition, natural teeth and supporting tissues near where the implant will be placed must be in good health.

An implant-restored tooth consists of several parts.

• The implant, which is made of titanium, is placed in the upper or lower jawbone.
• The abutment can be made of titanium, gold or porcelain. It is attached to the implant with a screw. This part connects the implant to the crown.
• The restoration (the part that looks like a tooth) is a crown, usually made of porcelain fused to a metal alloy (PFM), but also could be an all-metal or all-porcelain crown. The crown is attached either to the abutment or directly to the implant. It can be screwed or cemented onto the abutment. If the crown is screwed to the abutment, the screw hole will be covered with restorative material such as tooth-colored filling material (composite).

The Implant Process

The time frame for completing the implant and crown depends on many factors.

• Implant-supported crowns are a naturally better solution.
• Looks, feels and performs similar to your natural tooth
• Does not compromise your adjacent teeth to support a bridge
• Preserves surrounding bone (replaces tooth root)*
• Prevents bone collapse and jaw line recession*
• Oral care same as a natural tooth
• Restores a more secure biting ability than a removable denture
• Restores self-confidence and appearance

The Implant Process

Initial consultation

Before any work is done, you will visit our Implantologist who has had advanced training in the placement and restoration of implants will do a comprehensive examination. During the exam, he or she will review your medical and dental history, take X-rays, and create impressions of your teeth and gums so that models can be made. In some cases, the dentist also may order a computerized tomography (CT) scan of your mouth. This scan will help your dentist determine how much jawbone is available to hold the implants in place, and will show the location of structures such as nerves and sinuses (located above your upper teeth) so they can be avoided during surgery. If the X-rays show that your jaw does not have enough bone to hold an implant, the dentist can discuss options, such as bone grafting and bone distraction, for building up the bone. If you need one of these procedures.

First Visit - implant placement

Once you have enough bone to successfully hold an implant, you will schedule the first surgery, which involves placing the implant or implants in your jaw. Our Implantologist usually does this surgery, and stays in close contact with your prosthodontist or general dentist. Although there are several types of implants, the most popular type is root-form implants designed to serve as the root of the tooth. They are placed in the jawbone in the space created by the missing tooth. We wait till the bone and the implants fuse.

Second Visit and placement of healing collar and/or temporary crown
Once the implants have become fused with the bone, you can schedule the second appointment. Your dentist will confirm whether the implant is ready by taking an X-ray.

Healing after second-stage surgery

A collar, called a healing abutment (collar), is placed on the head of the implant after it is exposed. This encourages the gums to heal correctly. The collar is a round piece of metal that holds the gums away from the head of the implant. The collar will be in place for 10 to 14 days. If you previously had a removable partial denture, your dentist may adjust it so you can use it during this time.

Healing abutments help the gums to heal properly After the stitches and collar are removed, final impressions are made. These impressions will be used to make models that will look exactly like your mouth. A dental technician will use these models to make the temporary and final crowns.

An abutment and temporary crown are placed on the implant. The abutment is screwed onto the implant and tightened, using special equipment so that it won't come loose. After the abutment is attached to the implant, the temporary crown is placed on the abutment. In some cases, the temporary crown is attached directly to the implant without an abutment. The abutment then is placed later. In other cases, you may get the abutment and temporary crown immediately after the implants are uncovered during the second surgery, and you won't need a healing collar. The gums will heal around it and will look like the gums around your natural teeth. The temporary crown is made of softer material than the permanent crown. The softer material helps to cushion and protect the implant from the pressure of chewing, and gives the jawbone the opportunity to gradually get stronger.

Placement of permanent crowns

While you are wearing your temporary crown, the permanent crown will be made. The crown can be created from a model of your teeth and gums that includes the implant or the abutment. The crown can be either cemented or screwed to the abutment. Crowns held in place by cement may look better because there is no screw hole in the crown to be seen. However, crowns held in place by a screw are easier for your dentist to remove if he or she needs to reach the implant or the tissue around the implant. Sometimes, an abutment can't be used. In that case, your dentist would attach the crown with a screw.

Caring for Your Implants

You care for your implants the same way you care for your natural teeth.
It is important to brush and floss daily.

You will need to visit your dentist every three months for checkups at first, but eventually you can have checkups every six months.

What Will X-Rays Show?

On an X-ray, you will be able to see the implant in the bone, the connection between the implant and the abutment, and the abutment and the crown.

Your dentist can look at how the implant, abutment and crown fit together and make sure that there are no problems.

Single-tooth implants will work and look like your natural teeth.

Implant Supported Bridge

What Is It?

An implant-supported bridge is similar to a regular dental bridge, but it is supported by implants and not by natural teeth. In most cases, when an implant-supported bridge is used, one implant is placed in the jawbone for each missing tooth. Then the crownsare connected to each other to form one piece.

When Is This Used?

An implant-supported bridge is used when more than one tooth is missing. It also may be used when your dentist is concerned that you might put too much pressure on individual implants that are not connected to each other. For example, clenching or grinding your teeth can put a lot of pressure on individual implants. This can increase the chances that they will loosen from the bone and fail.

An implant-supported bridge reduces the pressure on the individual implants in the bone, and spreads it across the entire bridge. If the implants will be placed next to natural teeth, the natural teeth and surrounding gums must be in good health. If you don't have enough bone to place and support the dental implants, the supporting bone can be built up using bone augmentation or grafting before the actual implant procedure begins.

How Does It Work?

In some cases, your dentist may not want to put an implant in a certain place in your mouth. There may not be enough jawbone to support an implant, or the location may be too close to a nerve or sinus cavity (located above your upper teeth). In that case, your dentist can avoid the area by placing implants on both sides of the space. An implant-supported bridge will be placed on top. An implant-supported bridge also can be made similar to a traditional bridge, with a crown suspended between two implant-supported crowns.
An implant-supported bridge consists of:

• The implant is made of titanium and surgically placed in the jawbone. You may have one implant for each missing tooth. In other cases, your dentist may skip one or more spaces because there's not enough jawbone, or because the space is too close to a nerve or your sinus cavity.
• The abutment, a cylinder made of titanium, gold or porcelain, is screwed onto the implant. In the past, some abutments were attached to the implant using cement. Today all abutments are secured with screws. Abutments can be pre-fabricated or custom-made by the dental lab.
• The restoration (the part that looks like teeth) is a series of crowns connected to form a bridge. They are made of porcelain attached and fused to a substructure of metal.

The Implant Process

The time it takes to complete the implant process depends on many factors. When the traditional method of placing an implant is used, the shortest time frame is about five months in the lower jaw and seven months in the upper jaw. This includes surgeries and the placement of the implant-supported bridge. However, the process can last a year or more, particularly if bone needs to be built up first. More recently, many dentists have been placing an implant and crown in a single visit. Two surgeries usually are needed to place and prepare the implant. During the first surgery, the implant is placed in the jaw and covered with gum tissue. At the end of the healing period the implant is exposed so that the bridge can be placed.

Initial consultation

We will do a comprehensive examination. During the exam, he or she will review your medical and dental histories, take X-rays and create impressions of your teeth and gums so that models can be made. In some cases, a computed tomography (CT) scan of your mouth. This will show where your sinuses and nerves are. The dentist can then make sure that they will not be affected by the implants. If the X-rays and CT show that your jaw does not have enough bone to hold an implant, the dentist can discuss options. These include bone grafting or bone augmentation, for building up the bone. The bone can be taken from your own mouth, chin or hip, or processed cadaver bone or cow bone can be used. If you need one of these procedures, it will take about four months for the bone to be ready for the implant.

First surgery - implant placement

Once it's determined that you have enough bone to successfully hold an implant, you will schedule the first surgery. This involves placing the implant or implants in your jaw. We will plan the placement of the implants carefully to make sure that their position allows your new bridge to look natural. To help determine where the implants should be placed, we create a model, called a wax-up, of what the bridge will look like when it is completed. To do this, we use a model of your mouth made from impressions taken of your teeth and jaw.

Using the wax-up, your dentist will make a surgical guide. The surgical guide is a clear piece of plastic similar to a mouthguard. It fits over your existing teeth and extends over the area where teeth are missing to show where the implants need to be placed.

After the first surgery, the specialist will wait till the bone and the implants fuse to one another. There are several types of implants. The most popular type is the root-form implant, designed to serve as a tooth root. It is placed in the jawbone in the space created by the missing tooth.

Second surgery

Once the implants have become fused with the bone, you can schedule the second surgery. Your dentist will confirm whether the implants are ready for the second surgery by taking X-rays. This surgery is simpler than the first. A small incision is made in your gums to expose the tops (heads) of the implants. A collar, called a healing cap, is placed on the head of the implant after it is exposed. This guides the gums to heal correctly.

The collar is a round piece of metal that holds the gums away from the head of the implant. The collar will be in place until the temporary bridge is inserted.

The restorative phase

There are many types of implant-supported bridges. They can be held on by cement or with screws. They can be attached directly to the implant or to an abutment. Your dentist will determine which type will work best for you. If a screw-retained bridge will be used, the first step is to remove the healing cap and screw a permanent abutment into the implant. An impression will be made with the abutment in place. The abutment is shaped like a natural tooth that has been cut down to fit inside a crown. At the next visit, the temporary bridge will be placed on the abutments. The temporary bridge will stay in place for four to eight weeks. The temporary bridge is made of softer material than the permanent bridge. The softer material helps to cushion and protect the implant from the pressure of chewing. During the next visit, your dentist will test the fit of the metal framework that supports the porcelain bridge. If the framework doesn't fit correctly, it will have to be adjusted and you will have to return for another try-in. It might take several visits before the fit is right. If the teeth will not be connected, each tooth will be tried. Once the metal framework fits, the rest of the bridge will be completed, and it will be placed in your mouth and secured.

Implant Supported Denture

What Is It?

• An implant-supported denture is a type of overdenture that is supported by and attached to implants
• A regular denture rests on the gums, and is not supported by implants.
• An implant-supported denture is used when a person doesn't have any teeth in the jaw, but has enough bone in the jaw to support implants.
• An implant-supported denture has special attachments that snap onto attachments on the implants.
• Implant-supported dentures usually are made for the lower jaw because regular dentures tend to be less stable there.
• Usually, a regular denture made to fit an upper jaw is quite stable on its own and doesn't need the extra support offered by implants.
• However, you can receive an implant-supported denture in either the upper or lower jaw.
• You should remove an implant-supported denture daily to clean the denture and gum area.
• Just as with regular dentures, you should not sleep with the implant-supported dentures at night.
• Some people prefer to have fixed (permanent) crown and bridgework in their mouths that can't be removed.
• Your dentist will consider your particular needs and preferences when suggesting fixed or removable options.

How Does It Work?

There are two types of implant-supported dentures: bar-retained and ball-retained.
In both cases, the denture will be made of an acrylic base that will look like gums.Porcelain or acrylic teeth that look like natural teeth are attached to the base.

Both types of dentures need at least two implants for support.

Bar-retained dentures - A thin metal bar that follows the curve of your jaw is attached to two to five implants that have been placed in your jawbone. Clips or other types of attachments are fitted to the bar, the denture or both. The denture fits over the bar and is securely clipped into place by the attachments.

Ball-retained dentures (stud-attachment dentures) - Each implant in the jawbone holds a metal attachment that fits into another attachment on the denture. In most cases, the attachments on the implants are ball-shaped ("male" attachments), and they fit into sockets ("female" attachments) on the denture. In some cases, the denture holds the male attachments and the implants hold the female ones.

The Implant Process

• The implants usually are placed in the jawbone at the front of your mouth because there tends to be more bone in the front of the jaw than in the back.
• This usually is true even if teeth have been missing for some time.
• Once you lose teeth, you begin to lose bone in the area.
• Also, the front jaw doesn't have many nerves or other structures that could interfere with the placement of implants.
• Two surgeries usually are needed. The first one places the implants in the jawbone under your gums.
• The second surgery exposes the tops of the implants.
• A one-stage procedure is now used sometimes.
• In this procedure, your dentist can place the implants and the supporting bar in one step.
• The success rate of this procedure is high.

Initial consultation

During the exam, the dentist will review your medical and dental histories, take X-rays and create impressions of your teeth and gums so that models can be made. In some cases, the dentist may order a computed tomography (CT) scan of your mouth. This shows where your sinuses (located above your upper teeth) and nerves are. It allows the dentist to make sure they will not be affected by the implant placement. A CT scan also may be done to see how much bone is available and to determine the best locations for the implants. If you are not already wearing a complete denture to replace your missing teeth, your dentist will make you one. You will use this temporary denture until the implant-supported denture is placed. By making this temporary denture, your dentist is able to determine the best position for the teeth in the final denture. 

 

The temporary denture also can be used as a backup if something happens to the final implant-supported denture. The temporary denture can also be used as the final denture to reduce overall costs. Attachments will need to be added so it can fit securely to the implants. Once the temporary denture is finished, the surgeon will use a copy of it as a guide to help place the implants in the proper positions. 

Holes will be drilled in the copy of the denture so that the surgeon can see where the implants should be placed.

First surgery

The first surgery involves placing the implants in the jawbone. During the first surgery, an incision is made in the gum where the implant will be placed. A hole is drilled in the bone, the implant is placed into the hole, and the incision is stitched closed. After this surgery, you should avoid putting pressure on the implants. The temporary denture can be made so that direct pressure is placed on other areas, not on the implants. It may also be given a soft reline (new lining next to your gums) to help to reduce the pressure on your gums. After the first surgery, the dentist will wait till the bone and the implants integrate (attach and fuse).

Second visit

Once the implants have become fused with the bone, the second visit can be scheduled. Your dentist will confirm whether the implant is ready by taking an X-ray. A healing cap (collar) is placed on the head of each implant after it is exposed. This guides the gum tissue to heal correctly. The collar is a round piece of metal that holds the gums away from the head of the implant. After about two weeks, the healing caps will be replaced with regular abutments. Your gums should now be healed enough for your dentist to make an impression of your gum tissue and abutments. The impression is used to make a working model of your abutments and jaw. This model is used to make the denture framework and teeth.

Denture Try-In and Insertion

At this point, the metal bar is placed on the abutments. You will have the first try-in of your new denture framework to see if it fits properly. Once the metal bar and the denture framework have been fitted together properly, the teeth are temporarily placed on the framework in wax. The whole denture is then tried in your mouth. If everything works well, the teeth are secured in the denture framework permanently. The bar or ball attachments also will be secured. You will have to return to your dentist for another visit to have the completed denture inserted. When the denture is inserted, the denture is clipped onto the bar or snapped onto the ball attachments. At this point, your temporary denture will be given a new reline. This will allow it to be used as a backup denture in case you lose or break your new overdenture. If you are using the "temporary" denture as a permanent denture, the bar or ball attachments are placed in that denture.

Caring for Your Implant-Supported Denture
You will need to remove the denture at at night and for cleaning. You also should carefully clean around the attachments.

What Will X-Rays Show?
An X-ray will show the implants in the jaw and any attachments to them x-rays help the dentist to see that the implants, abutments and attachments are in the right places.

What Can You Expect From Your Implant-Supported Denture?
Your implant-supported denture will be more stable than a regular denture. You will find it easier to speak and you won't have to worry about the denture becoming loose or falling out of your mouth.

You generally will be able to eat foods you could not eat before. If you have an implant-supported denture in your upper jaw, it can be made to cover less of your palate (roof of your mouth) than a regular denture.
That's because the implants are holding it in place instead of the suction created between the full denture and your palate.


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