Dental Implant FAQs

What you should know about dental implants

What is a dental implant?

A dental implant (fixture) is a cylinder made of pure titanium or titanium alloy that is fitted precisely into a hole drilled into the jaw bone where a tooth used to be.

After a period of time, the bone heals and attaches to the implant locking it into the jaw in a process called osseointegration. Once this has occurred the implant can be used as an anchor to hold a crown, bridge or be used to help hold a denture in position (over denture).

Determining if you are a candidate

The key factors in determining weather or not you are a candidate for dental implants are first, the quality and amount of bone available to place the implant into. This information is determined by analyzing x-rays, study models or CT-Scans.

The next factor is weather there are any reasons that you should not undergo minor dental surgical procedures and weather there are any systemic problems or medications that you take that would exclude you as a candidate

Age does not play a factor in your ability to have dental implants so long as your general health is good and you don’t have any of the other risk factors mentioned.

Smoking can reduce the success of implant integration. Smoking impairs healing and has other negative effects that are well known. We suggest that you consider quitting.

Certain medications can exclude you as a candidate. These include drugs that suppress your immune system such long term use of steroid medications and some medications used to treat HIV.

Recently there has been a debate on risks of dental surgery on patients who have been taking osteoporosis medications called bisphosphonates such as Fosamax. These medications increase the risk of jaw infections in patients who have received them intravenously as chemotherapy to treat some forms of cancer. It has not been determined if they pose any significantly increased risk in patients who have taken them orally. If you take bisphosphonates, we may need to modify your medications for a period prior to placing implants which would be done in coordination with your physician.

The implant procedure

The vast majority of dental implant procedures are done in the office with local anesthetic. Additional sedatives are available to you if you prefer.

An incision is made in the gum where the implant is to go. The gum is gently pulled back to expose the underlying jaw bone. A series of progressively sized drills are used to precisely create a hole that is exactly the correct size for the implant being used. The implant is then threaded into the site and the gum tissue is closed.

On very rare occasions when placing an implant we determine that the amount or quality of bone present is not adequate for implant success. In those cases we may abandon the implant placement and do a bone grafting procedure instead, returning to place an implant at a later date.

Bone grafting

If we determine that there is not sufficient bone available into which we can place an implant, we might elect to do grafting to build up the quantity of bone available. This is done either as a separate procedure or at the time of implant placement depending on the individual situation.

Any additional fees that might be related to bone grafting will be discussed with you if this seems likely.

The post-operative course

The extent of post operative symptoms are variable from person to person and are related to the number of implants placed, their location or if any additional procedures such as extractions or grafting were done at the same time. Usually any discomfort is mild, lasts only for a day or two and is easily controlled with standard pain medications.

It is not unusual to experience some swelling after surgery. This is normal in the sequence of healing. Swelling is typically minor. It usually peaks 48 hours after a procedure and then dissipates. Some patients might experience discoloration or busing on the cheek or chin. This is not serious and dissipates in a few days.

Surgical risks

Implant placement procedures carry similar risks to any other oral surgery procedures. These risks are generally minimal they include the possibility of infection, bleeding or swelling. In extremely rare cases patients can experience a change of sensation or numbness in the region of the lip or gums. This is usually transient but it can be permanent.

What if an implant fails

Dental implants enjoy a very high success rate. We expect that 92% of the implants we place to integrate successfully. This leaves about 8% that will fail to integrate.

The most common implant failure is the fixture not integrating to the bone during the healing period. This can be caused by inadequate bone quality, early infection, or poor circulation in the region or other factors.

If an implant fails to osseointegrate, we will reexamine the area in order to determine why it failed and decide if it is possible to replace the implant. Should the implant fail a second time, we will either choose an alternative site or elect to treat the problem with conventional dentistry (fixed bridge, removable partial or denture, etc.).

If we elect to replace the implant, you will be charged only for the cost of the actual hardware used and not for the procedure.

Other issues

Esthetics:

We are able to create excellent esthetic outcomes with dental implants and we make every attempt to assure that you will be pleased with the natural look that can be achieved.

However there are some cases where existing defects or unpredictable healing of the bone or gingival tissues gives us a less than perfect result at the gum line. In those cases we may need to do secondary plastic surgical procedures or use other methods such as the use of gum colored porcelains to achieve natural esthetics.

Every attempt will be made prior to your implant procedure to determine if there are any cosmetic issues that need to be addressed.

Longevity:

Dental implants enjoy exceptional long service. Since their introduction in the late 1970’s, studies have demonstrated long term success greater than 90% for over 20 years and still counting. This is better than the average longevity of teeth that have root canal therapy followed by posts and crowns.

The factor that contributes most to implant success is regular dental care. Maintaining healthy gum tissues and an infection free oral environment with a good bite help ensure a lifetime of dental health and long service for your implants.

Some medications, radiation therapy or other systemic disorders can affect dental implants. Should you develop any of these risk factors you should consult us.

Aftercare

Regular professional hygiene maintenance is crucial for implant longevity. Dental implants are not teeth but they are still susceptible to periodontal disease just like natural teeth.

In addition, regular professional hygiene visits provide us with the opportunity to monitor your implants and allow us to determine if there are any problems. As with most things early intervention gives us the best opportunity to address any issues that might occur.