Dental implant

Dental implants are artificial substitutes for the root of a missing natural tooth or teeth. They may be used to support a single crown, a series of crowns, a removable partial denture or a complete denture. when should implants be used ? Imaplants can be used to ;
1. replace a single tooth
2. replace several teeth in the same general area.
3. replace all teeth in the jaw .
REPLACE A SINGLE TOOTH: The most common method for replacing a single tooth is with affixed bridge that is cemented to the teeth on either side of the missing tooth. The most conservative bridge is a resin bonded bridge.(RBB) sometimes call as Maryland bridge. The RBB offers advantage of minimal reduction af adjacent teeth to support the missing tooth .This type of bridge can be used only under certain particular circumstances. A conventional bridge requires that the teeth on either side of the space be reduced in size to make the room for the crown which is then cemented into the prepared teeth. The artificial replacement tooth is attached to these crowns prior to cementation, When properly maintained, the RBB and the conventional bridge can last for many years.
REPLACING SEVERAL TEETH IN THE SAME GENERAL AREA: When two or three adjacent teeth are missing , a bridge may be the treatment of choice depending on the condition of the teeth next to the space and the bone supporting these teeth. The more missing teeth to be replaced the greater the force that is placed on the remaining teeth which support the artificial teeth. In some cases when there are not enough teeth, a conventional bridge is not possible then a removable denture have to be considered to replace the missing teeth. A partial denture spreads the force to the adjacent teeth as well as to the underlying bone and gum tissue. A removable partial denture is less expensive than a conventional bridge but it is more bulky and less stable than a bridge.Also in some cases partial denture might cause deterioration of the normal teeth due to excessive force.
REPLACING ALL THE TEETH IN THE JAW :The conventional method of replacing all the teeth in the jaw is with Complete denture. A complete denture rests on the gums . In upper jaw it also rests on the roof of the mouth. In addition to chewing forces being spread over larger area.
PROCEDURES INVOLVED IN REPLACEMENT OF MISSING TEETH WITH IMPLANTS:
Diagnostic evaluation. In addition to the routine dental examination, an examination of your jawbone and gum will be done which might necessitate special X-rays that will give a better indication of bone quantity and quality
Surgical phase. If after the evaluation, it is detemined that the implants are a suitable treatment alternative , the case will move to surgical phase. During the surgical phase the implants will be placed in the bone and then covered with the gum tissue .The implants will remain covered for a period of three to twelve months as determined by the surgeon. When the healing phase is complete the implants are uncovered and then dentist can begin to fabricate teeth on top of the implants.
Restorative phase.After uncovering the implant is used as the foundation to restore the mouth to a functional state .This can be done in various ways as previously discussed :A single tooth replacement Replacement of several teeth in same general areaReplacement of all the teeth in the jaw.
Maintenance phase.After completion of the restorative pahse patients will be recalled at intervals determined by the implant team. It is mandatory that patients follow the recall schedule as well as all oral hygiene instructionsgiven to them by the implant team . Failure to do so can lead to implant failure.
RISK :
All surgical procedures pose risks. In this case there are risks of damaging or brushing adjacent nerves which are responsible for sensation to the lips, chin, gums any remaining teeth and the tongue. The change in sensation can vary from a tingling feeling or complete numbness. When the nerve is bruised it is rare that the change in sensatiotion becomes permanant. However temporary changes may last from few months to year or longer. When the sinuses are in complete proximity to the surgical site a patient may develop a sinus perforation or an infection. In some cases bones surrounding the implants may shrink away from the implant as the tissue are allowed to heal. This may result in the undesired exposure of a portion of the implant. In some palces the exposed implant would need to be covered by bone and gum with additional sugical procedures. Sometimes but very ocassionally the replacement of an implant may damage an adjacent tooth and then may require root canal treatment . An implant which does not heal well or adhere to the bone may need to be removed either during the healing pahse oe when the restorative phase has begun. Failure of an implant to heal properly may lead to a change in the restorative treatment plan. The implant procedure can be performed under local anesthesia, sedeation or general anesthesia depending on the patients medical history and anxiety levels.