The use of implants has revolutionized modern dentistry and allowed us to offer treatment options to our patients that were only dreamed of a couple of decades ago. The purpose of this brief patient information pamphlet is to acquaint our patients with some basic information on implants, what they can do for a patient, and some of the procedures involved in the course of treatment.

The dental profession has been searching for ways to replace missing natural teeth for many years. These replacements have taken on a myriad of forms with varying degrees of complexity and surgical involvement. However, prior to 1980 implant dentistry was unpredictable and limited in what could be offered to patients. In the 1960’s a Swedish physician, Dr. P. I Branemark, began experiments with a new type of implant.

These implants differed from their predecessors in two major areas: first, they were made from titanium, which had been shown to be tolerated by bone cells very well, and second, they were totally buried in the bone and covered over with gum tissue and left unused for several months. During this period, cells of the bone actually biologically adhered to the surface of the titanium, a process called osseointegration. After this time, a second surgical procedure was performed in which the implant was "uncovered" and used to support some form of artificial teeth.

By the early 1980’s, those implants were approved and made available in the United States. Most of the earlier implant patients were those experiencing difficulties wearing a lower complete denture and unable to function with these "floating teeth". Implants provide a strong, stable foundation on which to attach a lower denture. Many patients have reported a significant improvement in the quality of their lives after having this treatment. As technology improved, it became commonplace to place implants in those patients missing one, or only a few teeth, and fabricating single crowns or fixed bridges on implants.

It is the philosophy of this office that patients are best treated using a team approach. By this we mean that the implants are surgically placed by an oral surgeon or a periodontist, and our office (prosthodontist) fabricates the artificial teeth which the implants support.

Prior to any actual treatment being performed, the prosthodontist, the surgeon, and the patient discuss the case and decide on the number of implants to be placed, their location, and the final implant-supported appliance to be placed. The prosthodontist usually makes a device called a surgical guide stent that aids the surgeon in placing the implant in the correct place and at a proper angle.

After the implants are placed, a period of healing begins, usually three months in the mandible (lower jaw) and six months in the maxilla (upper jaw). During this time the patient is seen regularly by both the surgeon and the prosthodontist to monitor their progress. If a patient is wearing an existing denture, it is relined by the prosthodontist with a temporary soft-lining material. This is beneficial in that it reduces trauma to the implant sites. Similarly, it is highly recommended that existing dentures not be worn for 10 days after the initial surgery. This has proven very effective in aiding the healing process.

After this healing process has been completed, the surgeon uncovers the implant and attaches an abutment, which is used for attaching the artificial teeth. This is called second-stage surgery. After a couple of weeks of healing from this procedure, the prosthodontist can proceed with fabrication of the implant-supported artificial teeth.

1. How long does treatment take?

This depends on several factors, but averages six to nine months. It is faster if the lower jaw is being treated because healing is usually quicker than in the upper jaw. Also, some surgeons prefer not to place an implant at the same appointment that the natural teeth are extracted; therefore, the extraction site must heal before an implant is placed. After the implants are uncovered, several appointments with the prosthodontist are needed in order to fabricate the artificial teeth.

2. How much will it cost?

This depends upon several factors, such as the number of implants placed and the complexity of the restorative dentistry. Patients must understand that there will be separate fees for the surgeon and the prosthodontist. There are also certain x-rays which must be taken and diagnostic procedures performed which will involve additional costs. There is also a separate fee for the surgical guide stent. As regards the restorative treatment, there is often more than one way to restore a patient’s mouth. As a general rule, fixed non-removable appliances are more expensive than removable appliances, regardless of whether or not they are implant supported. Dental insurance generally does not cover implant dentistry.

3. Will the surgeon put me to sleep?

Implants are generally placed in the office of the surgeon under intraveneous sedation. (This is what is usually known as twilight sleep). Putting someone totally asleep (general anesthesia) is a hospital procedure and is usually not needed in implant dentistry.

4. How long do implants last?

An implant placed in the front of the lower jaw has a ninety-nine percent chance of functioning over the life of the patient. This drops to a slightly lower number in the back of the lower jaw, and further drops to about ninety percent in the upper jaw. The prosthetic appliances placed on the implants often need regular servicing and may need to be replaced or repaired at certain intervals. This usually occurs after approximately five years.

5. Are all patients candidates for implants?

Absolutely not! Following are some situations which might reduce the chance of implant success.

Medical conditions: High blood pressure, diabetes, severe heart conditions, and some other conditions may make the patient a poor surgical risk.

Poor oral hygiene: Natural teeth and implants are similar in this important way: they both need to be kept meticulously clean by the patient to enhance their long term survival. In our office, patients are seen at three to six month intervals for implant maintenance. This involves a separate fee for each visit.

Smoking: Studies have shown that the chemicals and heat in cigarettes have a deleterious effect on the implants and the bone and gum tissue supporting them.

6. Am I too old?

Age is usually not a determining factor in deciding whether or not a patient is a candidate for implants. We have successfully treated patients in their eighties who meet the above criteria. The surgeon and the prosthodontist will examine the patient and make a mutual decision as to the patient’s suitability for implants.

7. What are alternative procedures to implant therapy?
1. No treatment, and remain as you are
2. Conventional denture, partial denture, or fixed bridge treatment.
3. For full edentulous situations (no teeth), vestibuloplasty (muscle attachment
   surgery), with mucosal grafting or skin grafting and/or ridge augmentation
   surgery using bone grafting or artificial bone (which is well tolerated).
4. All of these alternatives have the potential for limitations and complications.

8. Where do I start?

If you are interested in implants, we must start with familiarization consultations with both the surgeon and the prosthodontist. If the decision is made to proceed, further diagnostic data will be obtained and treatment started.

 

We hope you have found this information helpful in introducing you to the world of implant dentistry. It is our sincere desire that you make an informed decision about your treatment and that you understand all of its aspects. Our staff is always ready to help you in this process. Please feel free to ask questions at any time. Thousand of implant have been placed with a high level of patient satisfaction. We would like to help you join those many patients whose quality of life has been enhanced by modern IMPLANT DENTISTRY.