Dental Implants

               DENTAL IMPLANTS

Dental Implants is a great way to replace missing teeth and provide fixed  solution to 

having removable partial or complete denutures. Implants provide excellent support and stability for these dental procedures.



Components of Dental Implants

DENTAL IMPLANTS is an option to replace a missing tooth. 

Types of Implants-

A) According to the Relationship to the bone-

• 1) Endosteal: These dental implants are placed in the jawbone. They are made of titanium and shaped like small screws, and are the most commonly used type of implant.
• 2) Subperiosteal: These dental implants are placed under the gum but on, or above, the jawbone. These implant may be used in patients who do not have enough healthy natural jawbone. 
• 3) Transosteal Implants- These are combination of subperiosteal and endosteal implants. These are especially used in the Anterior part of the mandible. These are inserted through an external incisions below the chin. 

B) According to the Implant-tissue interface-

1) Direct interface implants eg-Hollow basket implants. 

2) Indirect interface implants eg- Blade implants. 

C) According to functional performance of implants-

1) Retentive Implants -eg Magnetic implants. 

2) Supportive Implants-eg- subperiosteal implants. 

D) According to the type of material used-

1) Implants made of metals and alloys-

a) Titanium

b) Cobalt-chromium, molybdenum. 

c) Stainless steel. 

2) Implants made of polymers-

a) Polymethyl methacrylate

b) Polyethylene

C) Polysulfone. 

3) Implants made of ceramics-

a) Aluminum oxide

b) Hydroxyl apatite

c) Tricalcium phosphate. 

4) Implants made of carbon-

a) Vitreous carbon implants

b) low temperature isotropic pyrolitic carbon implants. 

5) According to the shape of the implants-

1) Mucosal inserts

2) Mandibular staples

3) Blade vent implants

4) Hollow basket implants

5) Screw implants. 

 Reasons why people choose to undergo the Implant  procedures-

1) You are missing a tooth or teeth
 tooth decay, sudden impacts, or gum disease. 

2) You have a rotten tooth
Even if your rotten tooth hasn’t as yet fallen out, then you may be a good candidate for a dental implant.first your dentist will remove the rotten teeth and then implant can be placed. 

3) You hate your dentures
If you really just dislike your dentures, then you are likely a good candidate for receiving dental implants. 


4) You don’t want to get a bridge
Dental implants are an obvious alternative and are often the better choice. 

5) You have very crooked teeth
Depending on how severely crooked your teeth are, you might like to choose to have dental implants rather than getting braces. While braces will get your teeth into line the whole process takes a long time to get your teeth straight. Braces also might not be a good solution for those with cavities and/or issues like fractured teeth. Dental implants may be a better solution to your crooked teeth than braces for some people.

INDICATIONS OF DENTAL IMPLANTS-

1) Single missing tooth replacement. 

2) Multiple missing teeth replacements. 

3) Partially edentulous patients with free end edentulous area. 

4) Completely edentulous patients especially in cases with poor foundation. 

5) As a replacement for one edentulous jaw opposing a dentulous jaw. 

6) Patients who refuse to wear  removable prosthesis. 

7) Patients with unrealistic prosthodontics expectations. 

8) Hyperactive gag reflex induced by a removable prosthesis. 

9) Unfavorable number and location of potential natural tooth abutments in the residual dentition. 

CONTRAINDICATIONS  OF DENTAL IMPLANTS-

The following contraindications for dental implants should be considered-

1) Patients with all systemic problems where surgery is contraindicated. 

2) Patients with hypersensitivity to implants components. 

3) Patients who lack maintenance of good oral hygiene and who are smokers. 

4) Patients with debilitating or uncontrolled disease and epileptic patients. 

5) Patients with bone disease in jaws, psychiatric 
disorders, pregnancy. 

CRITERIA FOR SUCCESS OF IMPLANTS-

The following criteria is suggested for the success of the implant-

1) Individual implant should be immobile when  tested  clinically before any stress loading. 

2) No evidence of any peri- implant radiolucency   should be seen on the radiograph. 

3) The mean vertical bone loss should be less than 0.2 mm annually after the first year of service. 

4) There should be no persistent pain, discomfort, infection or violation of anatomical structures like mandibular canal, maxillary sinus and nasal cavity. 

5) Absence of paraesthesia, anaesthesia or involvement of inferior dental nerve, maxillary antrum and nasal passage. 

6) Absence of damage to adjacent teeth. 

PROCEDURE OF IMPLANTS -

 Before Implant surgery dental surgeon will visually examine the site in the mouth where a dental implant is being considered as well as look at dental imaging studies (X-rays, panoramic films, and/or CT scans). During this period the quality and quantity of jawbone is assessed to determine if more bone is needed at the site.

Steps involved in placing a dental implant

• Damaged tooth removal
• Jawbone preparation (grafting), when needed
• Dental implant placement
• Bone growth and healing
• Abutment placement
• Artificial tooth placement. 

1) The  very first step involves a tooth or teeth extraction.  


2) when bone grafting is required-

If your jawbone isn't thick enough or is too soft you may need bone grafting before dental implants surgery. 

3) During surgery to place the dental implant, your oral surgeon makes a cut to open your gum and expose the bone. In the bone holes are made where the dental implant metal post will be placed. 


4)After you’ve had the implant placed in your jawbone, the healing process can take up to five months for the lower jaw and up to seven months for the upper jaw. Once your mouth is healed, you’ll be ready for the next stage.
5) Next comes the abutment, which is the part that screws into the implant and will support the crown. After the placement of abutment ,your dentist will take another impression of the abutment for each replacement tooth. 

The temporary crown  can be used for four to six weeks and your permanent crown will be made during this period. 

6) Crowns, which are the tooth-looking part, can either be screwed into the abutment or cemented in place. 

COMPLICATIONS-

Dental  implant surgery poses some health risks.   Risks include:

• Infection at the implant site
• Surrounding structures, such as other teeth or blood vessels are injured or damaged. 
• pain, numbness or tingling in your natural teeth, gums, lips or chin( nerve damage) 
• when dental implants placed in the upper jaw protrude into one of your sinus cavities it can lead to sinus problems. 

Alternatives to Implants-

1) fixed  partial dentures. 

2) Removable partial dentures. 

3) Root canal therapy.