What You Need to Know About Dental Implants

By Darlene Oakley HERWriter

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In the last 30 years, dental implants have become the standard treatment of care for tooth replacement. Properly integrated implant-based restorations have a life span of up to 20 years or more, compared to a standard bridge, which has an average life span of 10 years.

What are Implants Made of?

Implants used in replacement of teeth are made of titanium. Titanium is a very durable metal that is easily accepted by the body. There have been no known cases of implant-restoration failure due to a patient allergy or adverse reaction to the titanium.

Titanium is not only strong, it also creates a strong bond with the surrounding/existing bone so that it is virtually inseparable from the bone. The process by which the implants "adhere" to the bone is "osseo-integration."

Implants have two parts: the root analog and the abutment. The root analog is the part of the implant that will "osseo-integrate" and provide inter-bony support for the crown or bridge. The root analog will stay below the surface of the gum. The abutment portion screws into the root analog and will protrude through the surface of the gum. When your dental professional feels it's time to "attach" the crown or bridge to the implant, these will screw into the abutment.

The implant root analogs come in a variety of widths and lengths. Molars are often replaced with two narrow or one wide-bodied implant. Other teeth may be replaced with a standard-width implant. Narrow implants may be opted for if there is limited space between two teeth.

Mini-implants are also available in places where there is minimal bone, but they can only be used in special circumstances. For instance, they would not likely be chosen to support a bridge because they would not be able to withstand the bite pressure exerted on the bridge.

How Long Does Implant Treatment Take?

It depends on the individual patient. Some patients have ideal bone and gum (soft tissue) structure to support an implant-based prosthesis. In these cases, the dental professional may opt to skip the three- to six-month healing process usually required between placement of the implant and abutment, and place the implant, abutment and temporary restoration in a single procedure. After a three- to six-month healing process, the final restoration will be placed.

Some patients may require the implants to be placed in a standard two-stage procedure. In this procedure the root analogs are placed first, the area is allowed to heal and osseo-integration takes place for three to six months. During the second stage, the abutment is placed followed by another healing period of three- to six-months before placement of the final prosthesis.

The exact healing time allowed will vary from patient to patient. Some patients will need the full six months, some will need three and some will need six weeks. Your dental professional will keep very close tabs on your progress through this time.

Some patients will require bone or soft tissue (gum) grafting before proceeding or in conjunction with implant placement. If grafting is needed before proceeding with implants, there will often be a period of healing between the bone grafting procedure and implant placement. Bone can be harvested from the back of the mouth (usually the lower jaw) where the wisdom teeth were or from the hip (iliac crest). Iliac crest bone grafting procedure is usually carried out in the hospital, while the intra-oral bone graft can be done in-office.

Soft tissue or bone grafting may be required after the implant and abutment are placed. Whether grafting is necessary will be determined once the gum has had a chance to heal around the implant.

Risks or Complications

As with any procedure, there is always the chance of failure or complications, some which are impossible to predict even if all avenues have been covered, explored and anticipated. It is estimated that 95 percent of implants in the upper jaw and 98 percent of implants placed in the lower jaw succeed. Successful implant treatment requires adequate quality and quantity of bone.

Other factors that can affect successful implant integration include pre-existing or recurring periodontal disease (often responsible for the demise of the tooth in the first place), poor oral hygiene, smoking, para-functional habits like grinding or clenching during the healing process or the patient functioning too soon on the implant-borne prosthesis.

The patient will normally be instructed to quit smoking during this time and to use the temporary prosthesis for appearances only. The patient will probably also be instructed to maintain a soft diet until adequate osseo-integration is confirmed.

Be sure to discuss with your dental practitioner all aspects of your medical condition: any diseases, treatments, medications and symptoms that are under investigation. This will help him/her decide the best treatment options for you.

Many insurance companies don't, as of yet, cover implant placement treatment, although some will offer the equivalent of a conventional bridge that can be used toward the implant placement. Hopefully this will change as time continues to prove that implant replacement of missing teeth is the most reliable way to go for many patients.

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.