A dental implant is a small screw that is usually made of titanium alloy. It is embedded in the jawbone and connected to dental prostheses, which replace missing teeth. Dental implants are also known as artificial roots and fixtures.
Dental implants are sometimes used to support loose, removable dentures or in combination with orthodontic treatment.
When are dental implants used?
Replacing a single tooth
Dental implants are mainly used to replace a single missing tooth, which, in most cases, is a premolar or a molar tooth. Tooth decay, failed root canal treatment and cracking are some of the reasons that a tooth may be extracted.
Front teeth, or incisors, are lost less frequently than molars. However, a missing incisor reduces a patient’s ability to chew and is also an aesthetic problem. A single missing incisor can be replaced with a dental crown that is built on top of an implant.
Replacing multiple teeth
Besides replacing a single tooth, dental prostheses can be used to replace multiple missing teeth, including all upper or lower teeth.
An implant-supported bridge is often used when three or more neighboring teeth are missing.
When all upper or lower teeth need replacing, 6-8 implants are placed into the jawbone. A framework for the prosthesis is built on top of the implants from a material such as titanium.
Replacement teeth made from ceramic or other materials are then built on top of the framework. Finally, the bridge is connected to the implants with screws.
Dental implants are also used to improve the stability of removable dental prostheses, also known as dentures.
A removable, complete denture can have poor stability, particularly if it is placed in the lower jaw. The jawbone often erodes following tooth extractions, and as a result, dentures may not have enough area to attach to.
Removable dentures can be supported, for example, with mini implants. Mini implants are thinner than traditional implants and cannot withstand intense forces. They can be used to improve denture stability when the patient has removable complete dentures in both the upper and lower jaws.
Four mini implants can be placed in the anterior portion of the patient’s lower jaw to offer support for the lower jaw denture. Small holes are then made in the denture in order to attach it to the implants. This procedure usually improves denture stability.
Removable dentures can also be supported with attachments or bars that are built on top of the implants. Clips are fitted to the denture, and it is then snapped into the attachment or bar.
In addition to dental prostheses, dental implants can be used in orthodontic treatments.
The purpose of orthodontic treatments is to direct jaw growth (in children and adolescents) and to correct improperly positioned teeth (in adults) while considering occlusal and aesthetic factors.
Different appliances, both fixed (bonded directly to the teeth) and removable, are used to help move teeth.
The appliances place a gentle force on the teeth and slowly move them. Sometimes, the neighboring teeth, which assist in moving the crooked teeth, shift to an unwanted position.
A small titanium implant, designed for orthodontic anchoring, can be placed in the palate or next to the tooth to serve as an anchor. Forces can be placed on the implant instead of on the neighboring teeth.
Implants are becoming increasingly popular in orthodontic treatments, particularly in adults, when the patient’s own teeth don’t offer enough support and cannot be moved safely.
Who is a candidate for dental implants?
One of the advantages of dental implants is their convenience. If placed successfully, dental implants look and feel like your own teeth. For most patients, it is the best and most convenient way to replace missing teeth.
There are alternative ways to replace single or multiple missing teeth, such as dental bridges or removable dentures. Sometimes, a missing tooth is not replaced at all.
Since there are alternatives to dental implants, it is important to know their benefits and risks. A risk/benefit ratio has to be carefully evaluated whenever implants are considered.
Dental implants are a suitable option for most adults. However, implants are not recommended for children and adolescents, whose jaws have not stopped growing. This growth slows down after the age of 22.
Dental implants are not used for children and adolescents because their jaw may grow, but the implant will remain in a fixed place. If the jaw around the implant continues to grow, the implant may be left in an unwanted position.
Dental implant treatment includes surgical procedures; the patient’s general health and medications may affect the treatment.
Diseases that weaken the body’s immune system, such as diabetes, affect wound healing and can increase the risk of implant complications. General illnesses are usually not an obstacle to receiving dental implant treatment. However, their effect on the treatment outcome has to be evaluated.
Some medicines, such as cortisone and cytostatic drugs, affect the body’s immune system and increase the risk for implant treatment complications. A commonly used osteoporosis medication (bisphosphonate) can also create additional problems after oral surgical procedures.
Radiotherapy to the head area, for example during cancer treatment, can present challenges for implant ossification. Therefore, patients who have received radiotherapy are given hyperbaric oxygen therapy before implant treatment, and implant placement is often performed in a hospital setting.
Smoking is a significant risk factor for implant failure. Heavy smoking increases the risk for ossification and connective tissue problems. Cutting down or quitting smoking improves treatment outcome.
Dental implants are not suitable for patients with untreated oral infections. Untreated periodontitis, in particular, is a considerable risk factor for treatment failure.
Before and after pictures: dental implant treatments
Case 1: Missing front tooth
Dentist: Masamitsu Amemori
Case 2: Replacing missing tooth after dental trauma
Dentist: Masamitsu Amemori
Case 3: Replacing multiple missing teeth
Dentist: Masamitsu Amemori
Case 4: Removable prosthesis and dental implants
Dentist: Masamitsu Amemori
What is the dental implant procedure?
Planning the treatment
Planning is an important part of the treatment. It is intended to review the condition of the teeth and bite, define the treatment objectives and plan how these objectives will be met.
First, the patient’s mouth is examined in order to review the performance of the jaw joint and masticatory muscle and to check the bite, oral mucosa, teeth and gums.
Oral diseases such as caries, gingivitis and tooth or tooth root infections are treated, and damaged teeth are removed before implant treatment is started.
Dentists may also pay attention to the patient’s oral hygiene, including brushing and flossing, and give additional instructions.
A beautiful and functional dental prosthesis, which looks and feels natural, is the starting point for treatment planning. Implants have to be placed in the right spot and in the correct position in order for the treatment to be successful.
During the initial examination, the dentist takes X-rays and makes plaster models of the patient’s teeth. X-rays are needed to examine the structure of the jawbone and to determine how much bone is available to support an implant.
Plaster models are used both to examine teeth positions and occlusions and to plan optimal implant shapes and positions.
In addition to plaster models and X-rays, computer programs can be used to plan the treatment. Cone beam computer tomography provides a 3D model of the patient’s jaws, which allows for different implant lengths and sites to be tested.
Placing an implant
First, a local anesthetic is injected in the site where the implant will be placed. Incisions are then made into the mucosa to expose the bone.
A small hole is drilled in the jawbone. The depth of the hole ranging from 5 to 15 mm (0.2 to 0.6 in) depends on the length of the implant. The implant is screwed into the hole, and the incision is stitched closed.
Depending on the procedure, the implant is left to fuse with the bone for between 2 and 9 months. A temporary denture can be placed to replace a missing tooth.
Making a dental prosthesis
Once the implant has become fused with the bone, the actual prosthesis can be made. First, models of the implants are created, and a dental technician uses them to prepare the prosthesis.
Depending on the prosthesis, different work phases can be tested to ensure that the shape of the prosthesis is correct and that it sits accurately on the implant.
Dental implant prognosis is usually very good. Around 85-95% of implants still work faultlessly 10 years after they are placed.
The most common problems are cracks in the replacement tooth and infection in the surrounding gum or bone.
Implant doesn’t ossify
When the implant is placed in the jawbone, it becomes fused with the bone. Sometimes, problems may occur during the ossification process, causing the implant to not fuse to the bone in the desired way.
Possible ossification problems occur in the first few months after the treatment. Therefore, the dentist who performed the implant procedure ensures that the implant becomes fused with the bone during the first months following the treatment.
Osteoporosis, diabetes and smoking can cause ossification problems. Certain medicines, such as cytostatic drugs and cortisone, can also increase the risk of ossification problems.
Peri-mucositis is a gum disease in which the microbes in the mouth cause the gum around the implant to become infected. This is equivalent to a gum infection around natural teeth.
Peri-implantitis is a condition in which the gum infection around the implant spreads to the bone. The bone that supports the implant thus deteriorates, and if the condition is left untreated, it can lead to implant loss. Peri-implantitis is equivalent to periodontitis in natural teeth.
Patients suffering from diabetes and heavy smokers are at higher risk for connective tissue diseases. Poor oral hygiene may also lead to peri-mucositis and peri-implantitis.
Like natural teeth, dental prostheses sometimes crack and break.
Cracks are quite common in replacement teeth. Small cracks can be repaired with a filling or grinding. More extensive damage may require removing the prosthesis and repairing it in a dental laboratory.
Although rare, dental implants sometimes break or fracture. If the implant is not designed or fabricated correctly or too much force is placed on it, it may break.
If the implant is severely damaged and cannot be repaired, it has to be extracted.
How much does dental implant cost?
Replacing a single missing tooth with dental implant costs 1799 euros. If more than one missing teeth are replaced, the cost is about 1000–1700 euros per replaced tooth.
We provide 5 year full guarantee for dental implant treatments.
Free dental consultation
We realize that most people feel anxious about a visit to the dentist, so we do our best to make you feel comfortable, in a relaxed informal atmosphere.
From the smallest filling to solving complex dental problems, you will always find a sympathetic ear. We start by getting to know you and helping you overcome any worries you may have about dental care. Our aim is to discover your own particular dental needs and help you keep all your teeth, all your life.
The consultation visit lasts about 15 to 30 minutes, during which you will receive answers to your questions as well as a preliminary treatment plan and a cost estimate.