Dental implants are considered the latest treatment procedure in dentistry. It is an ideal and a widely acceptable treatment option in replacing extracted or missing teeth. It is both functional and esthetically pleasing. Studies have shown that dental implants have a high success rate. Unlike other procedures, dental implants involve a two part treatment: surgical placement of a nickel titanium post and prosthodontic rehabilitation.
During the initial appointment an interview on social, dental and medical history is done. Clinical examination of the oral hygiene status and assessment of bone and soft tissues must also be completed. Necessary diagnostic tests like radiographs, CT scan and MRI are also done. The pros and cons of the treatment as well as patient’s expectations are discussed early on. And the most important step would be getting a written consent of the patient regarding treatment. Any necessary pre-operative treatment like bone graft and extraction, must be done prior to the actual treatment.
When assessment and patient approval has been completed, it is time to start the actual treatment. Some dental practitioners prefer to have a pair of dentist: a specialist dental implant surgeon and a prosthodontist. The dental surgeon would be in charge of the first half of the treatment which is surgical placement of the implant; while the prosthodontist would be in charge of the final prosthesis.
As already mentioned, the first part of the treatment involves surgical placement of a nickel titanium post within bone. A flap is made to reflect the gums and expose bone. The bone is then drilled according to the length and size of the post. Once the post is in place, the surrounding area is cleaned and the gums are sutured back to normal. The patient and the dentist would then wait for at least 3 months for osseointegration to occur. Osseointegration is the process in which bone adapts and fuses to the post. During this healing time, it is important not to place any unnecessary stress and force directly on the post. Placing stress and force on the post may cause failure of osseointegration. A post that is well adapted and fused to bone would be stable and immobile. Radiographically there would be evidence of bone deposition or gain of bone.
Once the post is stable and fully adapted, it is time for the second part of the treatment, prosthodontic rehabilitation.
The surgically placed post would serve as anchorage to the dental prosthesis. The design and extent of the dental prosthesis would depend on what the patient needs. It could range from a single crown for one missing tooth. It could also be a 3 to 4 unit bridge with two dental posts on both ends. In some cases, dental implants could be used to replace a completely edentulous arch using four posts strategically placed.
Another technique in prosthodontic rehabilitation is immediate loading. It is sometimes known as “surgery for the impatient patient.” Immediate loading is a method in which a fixed final prosthesis is placed immediately after placing the post. It is an “all-in-one” treatment because the post and final prosthesis are placed at the same appointment. It saves operating time, has a fast recovery time, and it is more affordable. However, there is a high chance of failure and incomplete bone healing and fusion, thus it is a highly discouraged procedure.
Once the dental prosthesis has been successfully installed, regular and proper maintenance is needed.
Infection could occur with dental implants and this is called peri-implantitis. This is a condition when bacteria accumulates and destroys tissues around the dental implants. To avoid this, proper oral hygiene which is removal of plaque and calcular deposits must be done. Regular professional cleaning is done every six months, and home care using dental floss, toothbrush and tooth paste are needed.
The procedure may seem stressful and long, but it is worth it because of the numerous benefits…read more