dental implants
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About dental implants
Dental implants are artificial tooth roots made of bio-material which is surgically placed in the socket of the lost teeth to carry a tooth replacement. The material is generally pure titanium or titanium alloy, which is completely accepted by the human body.
Once you have had an extraction two visits to the dentist will be required: the first one, to fit the implant will occur after at least six weeks in order to have enough gums to cover the implant. After another six weeks, your surgeon will fix the crown. The waiting time depends on your bone quality such as density and vascularity. The terms 'osseointegrated implants' or 'endosseous implants' are widely used to describe dental implants that can develop and maintain a close union with bone in order to support replacement teeth. The osseointegration period may last up to 6 months for certain areas of the upper jaw.
The dental implant is normally shaped as a screw or cylinder. The aim during installation of any implant is to achieve close contact with the surrounding bone. This creates an initial stability, which over time is steadily enhanced by further growth of bone into microscopic roughnesses on the implant surface.
In order to support replacement teeth, dental implants normally have some form of internal screw thread or post space that allows a variety of components to be fitted. Furthermore, these provide the foundation for support of crowns, bridges or dentures.
It is also important to note that in order to insert and accommodate an implant, a certain bone height and thickness is required. In case these parameters are not achieved, your surgeon will perform a technique that will help create enough bone.
Stages for routine dental implants
- Consultation, diagnosis and treatment planning.
- Implant placement is followed by 6 weeks to 6 months healing period. Often the implants are completely hidden beneath the gum; in the one-stage procedures implants are visible from the time of placement. Stitches are normally removed 7 to 10 days after the implant placement.
- Several visits may be needed over the following few weeks to adjust temporary teeth or dentures and to monitor healing.
- Once the implants have healed, your surgeon will be ready to connect the teeth.
- In some cases the first teeth fitted to your implants are not the final ones, but replicas of the intended design. This stage can be used to assess the implants, control early loading and in areas where aesthetics are more critical, also give the gums time to mature around each implant before final teeth are fitted.
- Final teeth are normally fitted between 3 and 9 months after the implants were first placed.
- Regular examination and hygiene appointments are then all that is required to maintain the health of the mouth, teeth and implants.
Your consultation
During your consultation your surgeon will ask detailed questions concerning your medical history and will perform a complete examination of your mouth and remaining teeth to get an overview of the nature and extent of any current dental problems. He will also discuss with you all aspects of the treatment and it duration.
page topPreparing for surgery
If you are in good general health then dental implants is the ideal solution for you. However, habits such as heavy drinking or smoking can increase the number of problems associated with initial healing and may negatively influence the long-term health of gum and bone surrounding each implant. Remaining teeth might also be compromised making treatment planning less certain. It is imperative to reduce or give up smoking altogether.
page topYour operation
The insertion of implants is carried out under local dental anaesthetic as used for routine dentistry. Your surgeon will prepare the given part of the jaw, and then insert the implant. The suture is removed 7-10 days later.
Depending upon the complexity of your case, the operation might take anything from 30 minutes for a single implant, to several hours for complex bone grafting and multiple implant placements.
For procedures involving oral or conscious sedation you may be asked not to eat or drink for at least four hours prior to the surgery and you will need to arrange for an adult to take you home. You will also be advised not to operate any machinery for at least 24-36 hours afterwards.
For more complex cases, such as bone grafting from the hip to the mouth, or where large numbers of implants are being placed at the same time, general anesthetic will be used and you will need to be hospitalized. However, most patients will not require a general anaesthetic since conscious sedation is very much safer and has fewer post-operative complications.
In order to calm your anxiety, your surgeon will use an effective means to make you relaxed.
Relative analgesia ? a mask will be placed over your nose through which you inhale a mixture of nitrous oxide (laughing gas) and oxygen.
Oral sedation ? you may be given a dose of a short-acting medication that will reduce anxiety and provide a very good effect for uncomplicated surgical stages taking less than an hour.
Conscious sedation - For treatment of greater complexity ?conscious sedation? is the recommended anaesthetic. This is distinctly different from a general anaesthetic, because you remain alert enough to respond to simple instructions which may be helpful to the surgeon - however you will remember almost nothing about the treatment stage.
A carefully controlled amount of sedative is delivered through a vein in your arm or hand for as long as the treatment takes. It is a very safe procedure during which your heart rate and oxygen levels are monitored throughout by an anaesthetist.
A normal dental local anaesthetic is also injected around the proposed implant sites. You may not remember this stage because the sedation has already taken effect by the time the dental anaesthetic is given.
The healing period lasts for about 3 months. During this time bone cells grow into the micro-pores created on the surface of the implant. This process is called osseointegration, and ensures the implants fix in place and become able to support a normal biting load long-term without any damage.
Your surgeon will then fix the tooth replacement onto the implants. First the implants osseointegrated under the gum are uncovered, and then abutment pieces are fitted into them to support or retain the replacement.
The complete implant reconstruction process may take from 2 to 9 months.
page topRecovery
Since the surgery normally involves exposing the bone in the area where the implant is to be placed you can expect some minor swelling and occasionally bruising afterwards.
Your surgeon will prescribe simple painkillers such as Paracetamol for you to take for a few days.
Healing is generally uneventful and any stitches are removed a week to ten days later. You should contact your surgeon if you experience high pain or swelling. Your surgeon may also prescribe a course of antibiotics and will instruct you to rinse your mouth with salt water or an antiseptic mouthwash.
Your surgeon will advise you about mouth hygiene and will ask you to come in for regular check-ups. These are two of the most important criteria for long-run success in dental implantation. If you are wearing implant-based tooth replacement you must regularly attend examinations once a year. Your surgeon will verify the state of the attachment of the bone and of the mucosa around the implant(s) and that of the tooth replacement, and make the necessary corrections, such as removing plaque.
For most implant-supported teeth you will be able to clean around each supporting implant by brushing and flossing in just the same way that you would around natural teeth and tooth-supported bridges. In some areas special floss, interdental toothbrushes and other cleaning aids may be needed to maintain good oral hygiene.
You are expected to spend more time than you may have done in the past if you wish to maintain optimum implant health.
page topRisks and Complications
Implants much like natural teeth will last for as long as you can keep them clean.
Once the implants and surrounding soft tissues are seen to be healthy and the new teeth comfortable and correctly adjusted, it is the quality of your home care and willingness to present for regular maintenance reviews that will have most influence on how long they will last.
When poorly cared for, implants will develop a covering of hard and soft deposits (calculus and plaque) which is very similar to that found on neglected natural teeth. Untreated, these deposits can lead to gum infection, bleeding, soreness and general discomfort, just as they can occur around natural teeth.
Well maintained implants placed into adequate bone can be expected to last for many years and probably for your lifetime.
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