|Also known as 'Endosteal' or 'Endosseous implants': this type of implant involves the insertion of the implant directly into the jawbone. This is the most popular type of implant and comes in two forms: cylinder and screw. The implants can hold a single tooth or several artificial teeth. They are an ideal choice for those patients who have removable dentures or a bridge. The procedure involves the dentist making an incision in your gums in order to expose the jawbone. He or she will insert the implant and close the incision with tiny stitches. You are asked to wait for 3 to 6 months to allow healing or osseointegration to take place. In that time, the implant will have fused with the bone of your jaw. Once done so, you will return for a second procedure in which the incision is opened up to allow access to the implant. Your dentist will then fit a special attachment called an abutment to the end of the implant. This forms a strong, solid unit which is then ready for the replacement teeth. These are considered to be the easiest and most versatile form of implant. The implant itself is constructed of titanium and lends itself well to fusion with living bone. The most suitable candidates for this implant are those with a wide, deep jawbone. If your jawbone is small or thin then don't worry; root form implants are still an option although you will require a bone graft to build up the jawbone area. If your dentist feels that your jawbone is far too narrow and bone grafting is not an option then he or she may recommend a plate form implant. There is another type of endosteal implant called 'endosseous blade implants'. These have been in existence for some time now and take the form of long, flat pieces of metal which are inserted via a channel, into the bone. These metal implants can be bent or manipulated in a variety of ways to fit an individual patient's anatomy. However, they have been reported as having a high failure rate and because of this, are not generally recommended.|
|This takes the form of a narrow metal plate which is inserted into the jawbone. Your dentist will expose the area of your jawbone for treatment before preparing the bone to receive the implant. He or she will make a series of incisions in the gums before inserting the implants. The number of incisions made will depend on the number of implants. The implants are inserted and the incisions closed with tiny stitches. The dentist will advise you to wait for a set period of time to allow osseointegration to take place. However, in some cases you can have restorations directly after the implant procedure. This is known as 'immediate loading'. If your jawbone is not deep or wide enough to support root form or plate form implants, and there is too much bone loss, then consider having a subperiosteal implant.|
This implant takes the form of a lightweight framework which is designed to your anatomical requirements. In other words, the size and shape of your mouth.
This framework is inserted underneath the gum tissue and sits over the jawbone, acting as a series of tooth roots. This enables it to act as an 'anchor' for the subsequent restorations.
The restorations are attached to this implant via a series of posts which protrude through the gum tissue.
This is a custom made implant which is produced in two ways:
Are these an option?Unfortunately, these also have a high failure rate and as a result, are not recommended. There is another form of implant called a 'Trans-Osseous Implant' which involves attaching a plate via a series of screws on top of the jawbone. The implants are inserted into the jawbone and stick out above the gums, ready for the restorations. However, the implants for this procedure are both costly and difficult to produce. As a result of this, this procedure is not usually recommended. The Endosteal or Root Form Implant is the preferred type of implant. To summarise, the main advantages of implants over bridges and dentures are:
What happens if I can't afford dental implants?There are some patients who for financial reasons are unable to afford dental implants. In these cases, the mini implant is a good, affordable option.
The mini implant is as the name says: it is smaller than the normal sized implant and were originally designed as a temporary measure. The idea was that these would be inserted as a temporary implant and then removed at a later date, replaced by the full sized implant.
However, they were found to be a useful type of implant in their own right. They tend to work best as a replacement for small teeth or incisors.
They are placed in the jawbone but because of their limited height do not fuse easily with the jaw bone (osseointegration). But, they do last a long time and tend to be used as a means of stabilising the lower denture, especially in older patients.
If a patient's x-ray shows bone loss then they normally require a bone graft before the implant is inserted. However, they may be reluctant to do so, either for reasons of age or health.
If this is the case then a mini dental implant may be an acceptable choice of implant. It is a solid although smaller form of implant and does not require the patient to undergo a bone graft beforehand.
The mini implant is comprised of a slim titanium rod that has a retaining fixture which can be incorporated into a denture. The head of the implant is shaped like a ball and the retaining attachment contains a rubber 'O-ring' that acts like a socket.
This holds a denture in place by means of the rubber 'O-ring' which snaps over the ball at the top of the implant. This enables the denture to rest nicely on top of the gum tissue.
These are fast becoming a popular choice of implant for many patients who are uncomfortable with the thought of a full implant or are worried about the cost!
If you do decide to have an implant then you will find that you have a choice of two techniques:
Implants are a very versatile form of treatment and are effective both on their own and as part of an extensive body of work.
There are several forms of implant treatment available, which vary according to whether you have lost a single tooth, several teeth, or all your teeth (also known as edentulous).
A great many implant procedures typically involve a bone graft: this is a commonly performed technique in which the dentist adds extra bone to build up a narrow or thin jawbone.
Why? Your jawbone needs to be deep and wide enough to hold an implant in place. However, many people find that they have a varying degree of bone loss, often as a result of a missing tooth or teeth.
In order to provide a solid foundation for the implant the dentist will carry out a bone graft to restore any bone loss. If the bone loss is in the upper jaw or maxillary then he or she may perform a sinus lift.
Visit the bone graft and sinus graft pages to learn more about these techniques.
Implant treatments can range from a single tooth, such as lateral incisor replacement through to crown and bridge restorations and even major reconstruction work.
These and other procedures are categorised into the following treatment categories:
You may have lost a single tooth as a result of an accident or injury. This can be replaced with an implant and in fact, having a dental implant in between your natural teeth is the most successful dental procedure. Success rates are nearly 100% perfect.
A single tooth implant does not affect your other teeth, looks better and is easy to keep clean. It is kept clean in exactly the same way as your other teeth.
If your jawbone is not deep or strong enough for an implant then a bone graft will be required.
Single tooth implants can be carried out on both front and back teeth. Mini implants can be used although some dentists prefer the normal, full sized ones.
The procedure is as normal: the dentist will make a tiny incision in your gum in order to access your jawbone. He or she will then drill a small hole in this bone before inserting the implant. The implant will look like a small metal rod and is either cylinder or screw shaped.
This is inserted into the jaw. The incision is closed and given time to heal. This is usually a period of 3 to 6 months. During that time the implant will fuse with the jawbone in a process called osseointegration. A temporary tooth or crown will be fitted during that time, purely for cosmetic reasons.
Once this has happened, a second procedure will be carried out. The dentist will open up the original wound before fixing a small attachment or abutment to the implant. This will enable him/her to fasten an artificial tooth or restoration to the abutment.
This is usually done in two stages although there is the option of having this done all in one go, known as 'immediate loading'.
Are there likely to be any problems with this procedure?Single tooth implants are usually straightforward but there is a condition called 'poor soft tissue result'. If the tissues of the gum have not been properly dealt then you can end up with a dark line around your restoration. In some cases, the gum is so thin that the implant itself is visible. From an aesthetic point of view this looks unattractive and unwanted. Not to mention the fact that it can make the patient feel self-conscious and reluctant to smile. The only way of dealing with this is by soft tissue grafting. This means taking thicker gum tissue from the palate of the mouth and grafting this onto the area which holds the implant. There are different types of single tooth implants.
All Ceramic Central IncisorThis is a type of artificial tooth, made of ceramic which is strong and natural looking. It is also biocompatible: by this we mean it works well with the human body, with no risk of rejection or an allergic reaction. They are non-metallic as well which replaces the old PFM or 'porcelain to metal' type restorations. The advantage of this is no risk of ugly, 'metallic' lines on show if the gum recedes, which is often the case. They look and act in much the same way as natural teeth and so need the same amount of looking after! This means cleaning them twice a day and regular check ups at your dentist. This treatment involves several stages from the initial consultation through to the final restorations. It starts with an initial consultation with your dentist in which your reasons for an implant are discussed in a frank and honest manner. X-rays and/or a CT scan are arranged to show the exact position of the intended implant. If your jaw shows sign of bone loss or 'bone resorption' then you will be advised to have a bone graft. This treatment can be undertaken as a two stage process. The first stage can involve implant insertion plus taking an impression of the patient's jaw in order to produce a cast. This cast can be used to build a temporary restoration. The second stage involves the fitting of an abutment followed by the placing of the restoration.
Anterior Implant CrownThis refers to a type of restoration which is used to replace a loose or missing tooth at the front of the mouth. In the case of a loose tooth the dentist will replace this with a dental implant and allow time for it to fuse before fitting a crown (a type of 'cap).
Front Tooth Replacement (Maxillary Lateral Incisor/s)The maxillary lateral incisor is a tooth located in the bottom jaw, usually around the midline of your face. Its main function is for chewing. However, these can be missing, often due to an injury or as a congenital defect. If this happens then they will need to be replaced and the best means of doing so is via implants. These are inserted in the usual manner.
Front Tooth Replacement (Maxillary Central Incisor/s)These teeth are also situated in the front of your lower jaw and are the most easily seen of all your teeth. If one or more of these are missing, or require removal then implants can be used to replace them. The procedure is carried out in the usual way.
Immediate Single Tooth Replacement (Lateral Incisor Replacement)This treatment is similar to above but, is completed in one session rather than a two stage process; in other words, 'immediate loading'. By that we mean that you undergo the insertion of the implant, followed by the attaching of the abutment and then, the placing of the restoration, all in a single procedure. You need to have healthy teeth and a jawbone with enough depth and width to hold the implants. This instant procedure is becoming more popular but be aware that there is a greater risk of failure than with the normal 'two stage' procedure. If you are having just the one tooth replaced then you will find that your dentist will use a crown as a replacement. This crown can be made of porcelain, ceramic or metal and will blend in well with your other teeth.
This section is aimed at those patients who are missing a few or several teeth. The technical term for this is 'partially edentulous'. If you have lost a few teeth, either as a result of an accident or an injury then you are basically looking at a crown and bridge implant system.
If, however, you are missing quite a few teeth then you could be looking at extensive dental work. This type of treatment will involve implants but will also include bone/sinus grafts and quite possibly some major reconstructive work.
Are you missing just a few teeth?If so then there are several different ways of performing this treatment although they all involve attaching crowns or a bridge onto an implant. These can be cemented or screwed onto the implants. Crowns and bridges are constructed from a variety of materials such as ceramic, porcelain or a combination of metal and porcelain. The traditional crown and bridge system was a short term answer to the problem of missing teeth but required the dentist to file down a couple of healthy teeth to act as 'posts' to support the bridge. Another issue is that of bone loss. The traditional crown and bridge system does not prevent bone loss. Bone loss tends to happen when a tooth or teeth are lost and are not replaced. The jawbone becomes thinner and less dense and results in a sunken cheeked appearance. The only way to prevent this is to combine the crown and bridge system with dental implants. The implants stimulate the bone cells within the jaw and stop any bone loss. This procedure can be performed as part or all of the following:
Implant crown and bridgeMajor maxillary reconstruction Major reconstruction Replacement of a failed blade implant Total dental care Implant crown and bridge This procedure involves several stages which start with the initial diagnosis, x-ray and wax impression of the patient's jaw. Once this has been completed then the next stage is that of the insertion of the implant itself. Once sufficient time has elapsed for osseointegration then the final stage is that of the restorations. The patient will have had temporary restorations during this time, but once the implants have completely fused then they are ready for the final restorations. A bridge is required to span the gap left by the missing teeth along with laboratory constructed crowns.
Are you missing several teeth?If you have lost several or nearly all of your teeth, or have a problem with your jaw joint, then you may require extensive reconstruction work. This can involve a bone graft, sinus lift, several implants and heavy restoration work.
Major Maxillary ReconstructionThis is an extensive procedure, designed to treat problems with teeth in the upper jaw or maxilla. If you have missing maxillary teeth, for whatever the reason then this procedure is an option. This procedure is carried out on those patients who have been diagnosed with a tumour or have a maxilla related injury such temporomandibular disorder. The procedure involves implants, a cast and restorations.
Major reconstructionThe same rules apply as above. The patient can be looking at the insertion of several implants, bone augmentation (possible) and/or sinus lift, and temporary restorations before the placement of the final restorations. It can involve either the upper or lower jaw, or both.
So, what does it involve?It involves bone grafting and/or sinus lifting, dental implants and plenty of restorative work in general. If you require this type of procedure then please be aware that it can be both expensive and time consuming. In some cases it can take up to two years to complete! It also requires a high degree of skill and expertise on the part of the dentist. A major reconstruction can take many different forms. It can involve a bone graft, a sinus lift or a condylar replacement. A condlyar replacement is a procedure in which the dentist will insert a synthetic alternative to the mandibular condyle. The latter is a procedure in which the dentist inserts stabilisation plates into the lower jaw. These plates are made of titanium and are designed to help the action of the mandibular condyles. A mandibular condyle is the technical name for the joint in the lower jaw which controls the opening and closing movement. Think of it as a type of 'hinge' which will allow a smooth opening and closing action. These can be damaged as a result of an accident or injury and will require a replacement. This is a complex procedure which requires a dentist with a great deal of experience and competence.
Replacement of Failing Blade ImplantA blade implant or plate form implant is a type of endosteal implant (implanted into the bone) which is less commonly used than the root form implant. It consists of a flat piece of metal (blade) with two prongs on one side of this metal. It is inserted into the jaw in such a way to support a bridge or crowns. These along with other types of implants enjoy a high degree of success, usually around the 95% mark. But, failure can happen in a tiny minority of cases. This is usually due to a failure to fuse or 'osseointegrate' with the bone, inflammation (peri-implantitis) or fracture. Sometimes, implants can move around or shift out of position. Whatever the reason an implant which is said to have 'failed', needs to be removed and replaced with a new one. In this scenario, the failing blade implant will be removed and replaced by root form implants as part of a two stage process. The first stage will involve the removal of the defective implant and the second stage will be the placement of the new teeth or restorations.
Total Dental CareThis is the 'full works' in regard to dental treatment. It involves implants, crown and bridge restorations and porcelain veneers (also known as laminates). This comprehensive treatment will involve a sinus lift plus a cast for the crown and bridge restorations. The veneers (laminates) are wafer thin shells, comprised of porcelain or ceramic, which are fitted over the front of the teeth in order to improve their appearance. If your teeth are stained or damaged then consider this as an option.
Bilateral Sinus LiftA bilateral sinus lift is surgery undertaken to build up the bone of the upper jaw. If the upper jawbone is too thin then implants cannot be inserted because there is not enough bone to hold them in place. A further complication is the fact that above this upper jaw is an air space or sinus which is unable to hold any type of implant. The answer is to increase the width and depth of the upper jaw so that it will hold an implant firmly in place. There are several types of sinus lift procedures and one of these is the bilateral lift. Bilateral in this case means two surgical procedures: the first is the actual sinus lift and the second is the insertion of dental implants. Once the implants are in place and have fused then new teeth or restorations can be fitted.
Complete Fixed ReconstructionThis is carried out in order to replace badly worn teeth. It can involve the creation of a removable partial denture,for both the upper and lower jaw. This denture is made from a cast which is made from an impression of the patient's mouth. False teeth (restorations) are then fixed to this denture and this acts in much the same way as natural teeth. However, a full reconstruction can involve work undertaken on both the maxillary (upper jaw) and mandibular (lower jaw) arches. A partial denture can then be used although patients may prefer fixed dental implants. What this means is the insertion of the implants in the usual way followed by the placing of the restorations.
Condylar ReplacementAs mentioned before: the condylar mandibles are those parts of your jaw which act as a hinge, to enable your jaws to open and close. In effect, this is your 'jaw joint'. However, they can be damaged as a result of an accident or injury, for example a fracture and so will require treatment. If they are severely damaged then your ability to open and close your jaws will be affected. This can cause all sorts of problems, for example, chewing food. This can show itself in a wide range of symptoms such as pain and discomfort, headaches and difficulty with biting and chewing. Another reason for this surgery is that of 'temporomandibular disorder': this is a medical condition in which the patient experiences headaches, pain and jaw locking. This can be caused by a variety of factors, one of these being stress and nervous tension. Treatments for this include tightening, or releasing the muscles around the jaw, a dental splint or surgery, condylar replacement. Surgery is considered a last resort method. Condylar replacement can involve the insertion of specially constructed components into the jaw, followed by implants and restorations. As you can imagine this is a complex form of treatment and not one to be entered into lightly.
Crown and Bridge ReconstructionThis is another complex procedure in which treatment is required on the teeth in both the upper and lower jaw. This can involve the dentist having to make a special wax model of your current teeth in order to decide where to insert the dental implants. He or she will also take an x-ray of your mouth which is used to help with the positioning of the implants. It is vitally important that the implants are inserted correctly. One these have fused with the bone the dentist will then make a cast, from an 'impression' (wax or clay model) of your mouth which is used for the construction of your new false teeth. The process involves a series of stages which start with the initial diagnosis through to the insertion of the implants, and the placing of the new restorations. With the restorations; some patients prefer to have 'fixed' restorations whereas others prefer the 'removable' type.
What are these?Fixed restorations are artificial teeth which are fixed in place by the dentist. They look and operate in exactly the same way as your normal teeth. A good way of thinking of these is as a permanent denture. Note: these can only be removed by your dentist. Removable restorations are teeth which you can take out. This means easy access to cleaning and caring for them in general. However, some people don't want the hassle of this and prefer the fixed sort.
Grafting for Implant PlacementThere are patients who require a bone graft because their jawbone lacks sufficient depth to hold the implants in place. This means taking bone from one area of the body or a 'donor site' before grafting it into the jawbone. This is done to increase the width and depth of the bone. This bone is taken from either the chin or the hip. The dentist will build up the ridge of the jawbone before inserting the implant. There are 4 types of grafts available although the autogenous or allograft is the most popular choice of graft. The graft is held in place by tacks and a barrier membrane. Once the graft has taken place the site is ready for the implants. These are inserted in the normal manner.
Implant ReconstructionThis sounds like a major form of treatment and in many cases it can be as it can involve dental implants in both the upper and lower jaw, a sinus lift and the restorations. The dentist will use x-rays to help diagnose the problem as well as a template to aid with the placing of the implants. The implants will be inserted in the usual two stage process which can also include a sinus lift. Once the implants have fused to the jawbone, in a process called 'osseo-integration', they are ready for the placing of the restorations (artificial teeth). The restorations look and behave in exactly the same way as natural teeth.
Maxillofacial ReconstructionThis complex procedure is carried out when there is problem with both sets of teeth, and the palate. Note: the upper jawbone is referred to as the maxilla and the lower jawbone as the mandibular. There are a few stages to this treatment.
X-raysThis complex form of treatment starts with diagnostic x-rays in order to see the extent of the damage. You may then be asked to wear a temporary denture for a short period of time. This serves two purposes: the first is for aesthetic reasons in that you don't want unsightly gaps in your mouth. The second is so you have time to get used to having artificial teeth.
ImplantsAfter a period of time you will then undergo dental implants. The usual method of treatment is for them to be inserted in a 'two stage' process: the first stage is where the implant is inserted into the jawbone, and the second is where the artificial teeth or restorations are fastened to the implants via the abutment. As several implants will be required the dentist will use a special type of device called a 'Hader Bar System'. This is a thin metal bar which clips onto the implants to hold them in place. Three or four implants can be held by a single Hader bar. A Lower Hader Bar is used in the lower jaw and an Upper Hader Bar in the upper jaw. If the dentist feels that your jawbone is too thin to support implants then he or she will recommend that you have a bone graft. There are four types of these grafts and they all involve the grafting of new bone into the jaw to increase its depth. This procedure is carried out before the insertion of the implants.
RestorationsOnce the implants have been inserted and allowed time to fuse with the jawbone, the next stage is the placement of the new teeth. An overdenture is likely to be put in place. This is a type of denture, with artificial teeth, which fits over the implants.
Reconstruction with Sinus LiftThis treatment is carried out to resolve the problem of missing teeth. If you have missing teeth in your lower jaw then your dentist will advise you to have dental implants. He or she will also recommend a bone graft if your jawbone is too thin to hold the implants. This procedure is easier to perform on the lower jaw than the upper jaw.
Why is this?The main reason is that the upper jaw tends to be thinner than the lower jaw plus there is the problem of the sinuses. The sinuses are 'air spaces' in your head and in this case, are situated above your upper jaw. If your upper jawbone is too thin then an implant cannot be inserted as there is not enough bone to hold it. In fact, it will be inserted into thin air! So, the dentist will have to build up the sinus area above your upper jaw. This means a procedure called a 'sinus graft'. Once this has been done the next step is the insertion of the implants. Your jawbone has extra depth and width as a result of the sinus lift which means that these implants will stay fixed in place. Once this has taken place then the implants are given time to heal and fuse with the jawbone. Then, your dentist will fix a small component or 'abutment' on the end of the implant which allows him/her to fix the restorations onto the implants.
Edentulous is a dental term, used to describe a state in which a patient has no teeth at all. This may sound strange but there are a great many people who do not have any teeth, either as a result of an accident or illness.
If you are in this position then dentures are often the only solution. This means having to use a messy 'glue' to fix their dentures in place which can be awkward and off-putting.
Dentures are a tried and tested answer to the problem of missing teeth but they are not without their problems which include the tendency to become loose, soreness and irritation.
These problems will resolve themselves over time as you become used to wearing dentures but there are some patients who never come to terms with denture wear. For that group of patients, dental implants are the answer.
There are several treatment options available to the patient:
Crown and bridge restoration
Mini implant overdenture
Crown and bridge restoration
This involves the use of restorations or crowns (artificial teeth) and a special bridge (a temporary denture). The crowns are attached to this bridge and are a permanent fixture unlike the usual removable restorations.
Fixed restorations (teeth) are more realistic looking than the removable type of restoration but are also more expensive.
And, they are more difficult to clean and generally, care for.
A crown and bridge restoration can be carried out as part of a major reconstruction or as a means of converting from a removable restoration to a fixed restoration.
This is an extensive process which includes initial diagnostics, the taking of an impression of your jaw, for purposes of casting, and the insertion of the implants. The second stage includes the fitting of the abutments and the final replacement teeth (crowns and bridge).
The advantages?They are more realistic looking and feel like real teeth rather than the removal type.
Any disadvantages?They are more difficult to clean and are expensive as well. They tend to be more expensive than the removable type.
What is the procedure?It still involves the insertion of dental implants in the usual manner. Once these have been inserted, abutments are placed over them, ready for the attachment of the restorations. The denture itself will be created via a special cast. Your dentist will take an impression of your mouth by fitting a special 'tray' over your teeth. This tray is filled with a soft material which the patient bites into in order to leave an imprint.
Dental castsThis tray is left to set and is then filled with a casting material. A good way of thinking about this is like this: The mould is formed from clay and left to harden. Once it has done so, the plaster material can be poured into it and left to set. As soon as it has done so, the mould can be chipped away to leave a plaster cast 'impression'. It is very much the same procedure with dental casts. They can be formed out of wax and allowed to harden. Once they have done so, the dental technician will pour in a casting material. Dental casts can be made from ceramics, resins or metals such as gold or silver. Basically, a cast is an artificial model of your teeth. This cast is used as a guide when creating the dental restorations. Plus wax models can be created from this cast for the purposes of crowns, bridges and partial dentures. A crown is a device which looks identical to a real tooth and is fixed in place. It behaves in exactly the same way as a natural tooth. A bridge is a device which can hold a crown or crowns together by means of a thin metal bar. This is often called a partial denture.
These are as the name says: they are a type of restoration which is fixed in place by a series of screws. It is a permanent fixture and can only be removed by your dentist.
These tend to appeal to those patients who find dentures to be awkward or plain unattractive.
Fixed restorations are harder to keep clean than removable ones.
This restoration takes the form of a metal framework, dentures (teeth) and an acrylic resin.