Dental implant surgery.

What are dental implants?

Dental implants are a popular and effective way to replace missing teeth and are designed to blend in with your other teeth. They are an excellent long-term option for restoring your smile. In fact, the development and use of implants is one of the biggest advances in dentistry in the past 40 years.

Dental implants are made up of titanium and other materials that are compatible with the human body. They are posts that are surgically placed in the upper or lower jaw, where they function as a sturdy anchor for replacement teeth.

Dental implant surgery is a procedure that replaces tooth roots with metal, screwlike posts and replaces damaged or missing teeth with artificial teeth that look and function much like real ones. Dental implant surgery can offer a welcome alternative to dentures or bridgework that doesn’t fit well and can offer an option when a lack of natural teeth roots don’t allow building denture or bridgework tooth replacements.

There are generally three phases to getting an implant:

▪️ First, the dentist surgically places the implant into the jawbone. Your dentist may recommend a diet of soft foods, cold foods and warm soup during the healing process.Next, the bone around the implant heals in a process called osseointegration. What makes an implant so strong is that the bone actually grows around it and holds it in place. Osseointegration means “combines with the bone” and takes time. Some patients might need to wait until the implant is completely integrated, up to several months, before replacement teeth can be attached to the implant. Other patients can have the implants and replacement teeth placed all in one visit.

▪️ Finally, it’s time for the placement of the artificial tooth/teeth. For a single tooth implant, your dentist will customize a new tooth for you, called a dental crown. The crown will be based on size, shape, color and fit, and will be designed to blend in with your other teeth. If you are replacing more than a single tooth, custom-made bridges or dentures will be made to fit your mouth and your implants.

(Note: The replacement teeth usually take some time to make. In the meantime, your dentist may give you a temporary crown, bridge or denture to help you eat and speak normally until the permanent replacement is ready.)

Over time, technology and science have progressed to greatly improve the outcomes of dental implant placement. Today, the success rate for dental implants is close to 98%.

Why would you need a dental implant?

Dental implants can be used to replace a single tooth, several teeth, or all of the teeth. The goal of teeth replacement in dentistry is to restore function as well as esthetics.

When it comes to tooth replacement, generally, there are three options:

1. removable dental appliance (complete denture or partial denture).

2. fixed dental bridge (cemented).

3. dental implant.

4. Have healthy oral tissues.

Dental bridgework was the more common restorative option prior to the relatively recent shift to dental implant treatment. The main disadvantage to bridgework is the dependence on existing natural teeth for support. Implants are supported by bone only and do not affect surrounding natural teeth. Deciding on which option to choose depends on many factors. Specifically for dental implants, these factors include:

1.blocation of missing tooth or teeth.

2. quantity and quality of the jawbone where the dental implant is to be placed.

3. health of the patient.

A dental surgeon examines the area to be considered for the dental implant and makes a clinical assessment of whether the patient is a good candidate for a dental implant.

What are the types of dental implants? Why are they used?

Historically, there have been two different types of dental implants:

1. endosteal and

2. subperiosteal.

Endosteal refers to an implant that is “in the bone,” and subperiosteal refers to an implant that rests on top of the jawbone under the gum tissue.

Subperiosteal implants are no longer in use today because of their poor long-term results in comparison to endosteal dental implants.

While the primary function of dental implants is for teeth replacement, there are areas in which implants can assist in other dental procedures. Due to their stability, dental implants can be used to support a removable denture and provide a more secure and comfortable fit. In addition, for orthodontics procedures, dental mini-implants can act as temporary anchorage devices (TAD) to help move teeth to a desired position. These mini-implants are small and temporarily fixed to bone while assisting in anchorage for teeth movement. They are subsequently removed after their function has been served.

Stages of the dental implant placement process.

Dental implant surgery is usually an outpatient surgery performed in stages, with healing time between procedures. The process of placing a dental implant involves multiple steps, including:

1. Damaged tooth removal.

2. Jawbone preparation (grafting), when needed.

3. Dental implant placement.

4. Bone growth and healing.

5. Abutment placement.

6. Artificial tooth placement.

The entire process can take many months from start to finish. Much of that time is devoted to healing and waiting for the growth of new bone in your jaw. Depending on your situation, the specific procedure done or the materials used, certain steps can sometimes be combined.

When bone grafting is required.

Bone grafting in the jawbone Jawbone graftOpen pop-up dialog boxIf your jawbone isn’t thick enough or is too soft, you may need bone grafting before you can have dental implant surgery. That’s because the powerful chewing action of your mouth exerts great pressure on your bone, and if it can’t support the implant, the surgery likely would fail. A bone graft can create a more solid base for the implant.

There are several bone graft materials that can be used to rebuild a jawbone. Options may include a natural bone graft, such as from another location in your body, or a synthetic bone graft, such as bone-substitute material that can provide support structures for new bone growth. Talk to your doctor about options that will work best for you.

It may take several months for the transplanted bone to grow enough new bone to support a dental implant. In some cases, you may need only minor bone grafting, which can be done at the same time as the implant surgery. The condition of your jawbone determines how you proceed.

Placing the dental implant.

During surgery to place the dental implant, your oral surgeon makes a cut to open your gum and expose the bone. Holes are drilled into the bone where the dental implant metal post will be placed. Since the post will serve as the tooth root, it’s implanted deep into the bone.

At this point, you’ll still have a gap where your tooth is missing. A type of partial, temporary denture can be placed for appearance, if needed. You can remove this denture for cleaning and while you sleep.

Waiting for bone growth.

Once the metal implant post is placed in your jawbone, osseointegration (oss-ee-oh-in-tuh-GRAY-shun) begins. During this process, the jawbone grows into and unites with the surface of the dental implant. This process, which can take several months, helps provide a solid base for your new artificial tooth — just as roots do for your natural teeth.

Placing the abutment.

When osseointegration is complete, you may need additional surgery to place the abutment — the piece where the crown will eventually attach. This minor surgery is typically done with local anesthesia in an outpatient setting.

To place the abutment:

1. Your oral surgeon reopens your gum to expose the dental implant.

2. The abutment is attached to the dental implant.

3. The gum tissue is then closed around, but not over, the abutment.

In some cases, the abutment is attached to the dental implant metal post when the post is implanted. That means you won’t need an extra surgical step. Because the abutment juts past the gumline, however, it’s visible when you open your mouth — and it will be that way until your dentist completes the tooth prosthesis. Some people don’t like that appearance and prefer to have the abutment placed in a separate procedure.

After the abutment is placed, your gums must heal for about two weeks before the artificial tooth can be attached.

After the procedure.

Whether you have dental implant surgery in one stage or multiple stages, you may experience some of the typical discomforts associated with any type of dental surgery, such as:

▪️ Swelling of your gums and face.

▪️ Bruising of your skin and gums.

▪️ Pain at the implant site.

▪️ Minor bleeding.

You may need pain medications or antibiotics after dental implant surgery. If swelling, discomfort or any other problem gets worse in the days after surgery, contact your oral surgeon.

After each stage of surgery, you may need to eat soft foods while the surgical site heals. Typically, your surgeon will use stitches that dissolve on their own. If your stitches aren’t self-dissolving, your doctor removes them.

Benefits of dental implants.

Among the most prominent benefits of dental implants:

▪️ They are long-lasting and strong, as they can last a lifetime, unlike dentures that must be replaced after a while.

▪️ It supports facial features and gives the patient a natural look.

▪️ Provides optimum comfort, as it is customized to fit the mouth precisely, so no clicking noises.

▪️ It also enables the patient to eat foods and speak comfortably.

▪️ It is easy to take care of, as it can be taken care of like natural teeth using a toothbrush, flossing with regular visits to the dentist.

▪️ Adjacent teeth protect from damage and stress because they are incorporated into the jaw bones, unlike bridges that rely on adjacent teeth.

▪️ Oral health improves, because there is no need to change the nearby teeth to support the implant, so many teeth are left intact, and this improves oral health.

Damages of dental implants.

Dental implants have many damages, including:

1. It takes a long time.

Dental implants cannot be performed in one appointment only, as the jaw bone needs to be immersed with the implanted tooth a certain time, and during this time the doctor places a temporary tooth over the area.

The waiting period is harmful to the patient. The process takes 3 to 6 months, and sometimes 9 months.

2. Its need for certain conditions.

Dental implants need a certain size and density of bone, which makes the procedure more difficult, as many patients are considered unsuitable, and patients need additional bone enlargement.

3. Complications.

Dental implantation is a surgical procedure that may be associated with some complications such as infection and inflammation, bleeding, delayed bone healing, jaw fractures, damage to other teeth and nerve injury.

As the complication and risk rate for dental implants is approximately 5-10%.

Factors such as smoking and poor hygiene increase the risk of complications.

4. High patient cost.

One of the most prominent disadvantages of dental implants to the patient is the high cost, as it is considered the most expensive option among other options.

5. The need for replacement repairs.

Although dental implants last for life, they need continuous restorations, especially for those who do not take care of them.It is also expensive.

6. The possibility of bone loss after implantation.

Although dental implants preserve bone mass in the jaw, it is common to lose bone around the implants.

This is considered one of the main disadvantages of dental implants.

This occurs due to normal bone loss over time, and implants may need to be replaced if the patient has lost a lot of bone.

It takes a long time to heal, and the healing process takes 3-18 months.

7. Cause discomfort and pain during the procedure.

Where the patient needs local anesthesia during the operation due to the pain associated with the procedure.

References :

American Dental Association , “Implants”، mouthhealthy

Donna S. Bautista (8-12-2016), “Dental Implants”، medicinenet

Dental implant surgery/

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