Implants | David L. Crawford D.M.D. | Dental Implants | Indiana, PA
David Crawford DMD

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Dental Implants

Dental implants are a permanent and appealing solution to replace missing or extracted teeth. They are better than other alternatives like bridges because no additional teeth need to be altered to place the new tooth.

 

The entire implant process is performed over the course of a few months. The first part of the process is to install the implant itself, where a screw is placed into the jaw bone. An incision is made in the gum so that the implant can be inserted. Multiple implants can be placed at once if necessary. After the implants are placed the gums are sutured.

The implant must be allowed about 3-6 months to heal, and during this time the jaw bone will form around the implant in a process called Osseo integration. During this healing time you can have temporary crowns installed so that you can eat and speak normally and maintain a proper aesthetic appearance for your smile.

 

After the implant has healed it is time to place an abutment on the implant. The abutment serves as the base for your new tooth. Once this is placed an impression of the abutment is taken and is used to create your permanent restoration. Some offices have an onsite lab to create the crown, but others will have to send it to an outside lab. Once the restoration is completed you can return to the office to attach the restoration permanently. Your smile will look just like it used to, and after a short period of getting used to the implant it will feel just like one of your own teeth.

Dental Implant FAQ

What is a dental implant and how successful are they?

A dental implant is a small screw made of titanium that serves as the anchor to replace the root portion of a missing natural tooth. Implants can be placed in the upper or lower jaw. Over time it forms a strong bond with the bone. Dental implants can be used to replace a single tooth or many missing teeth.

 

The technology has been around for more than 40 years. There are patients that have had implants that long. Over all in the US hundreds of thousands of implants have been placed with excellent success rates. However, success rates are much higher with those dentists that specialize and have extensive training in implant dentistry.

Who is a candidate for an implant?

Just about anyone with a missing tooth or several missing teeth may be a candidate for dental implants.  We have specialized training in the most advanced implant procedures and can evaluate you and decide whether dental implants are a viable solution for you.

 

Age can be a factor but more important is your overall general heath. For the most part if you are healthy enough to have a tooth extracted or have a dental bridge placed you probably are healthy enough to have a dental implant. The best way to determine if a dental implant is the correct solution for you is to schedule a consultation with us. After a careful evaluation of your needs and your health condition we can determine if you are a reasonable candidate for a dental implant.

What impact do implants have on my daily life?

For the most part implants function as natural teeth. They look and feel the same. They improve your self-esteem and allow you to smile worry free. Overall implants can improve your quality of life whether it is just cosmetic or truly functional by improving your ability to chew food. While implants may not be the solution for everyone we will review your needs and recommend the best solution possible for your specific dental issues.

How are Dental Implants Placed?

Usually there are two steps. The actual implant is usually performed in the office with local anesthesia. A light sedation can be used if needed.

 

First x-rays are usually done to confirm you have enough bone to sustain the implant. The implants are then placed through surgical techniques into the jaw for several months to allow the implant and the bone to bond. This is called Osseo-integration.

 

The final step involves the careful creation of the "replacement tooth". These are created by experienced dental labs and this "tooth part" will attach to the anchored implant in your jaw. Dental implants are used to replace one or several missing teeth. In some cases they can be used to anchor dentures

Is the dental implant prone to decay or to disease of the gums?

Cavities are not an issue with dental implants because they are made up of metal. There can be some bone loss observed with gum disease. The best way to prevent gum disease is with regular oral hygiene and professional cleanings.

What are the different types of Implants?

1) Endosteal is the most common type and is placed directly in the bone. There are several types including screws or cylinders which are surgically placed into the jawbone. This type of implant is used as an alternative to removable dentures or bridges. Each implant holds one or more prosthetic teeth.

Do I have enough bone for dental implants?

Traditional plain film dental x-rays only show detail in two dimensions. . They do provide information allowing the implant specialist the ability to judge height of bone available for placement of an implant. However there is much more advanced radiologic techniques available that can provide much more information including bone width. This is very important to performing a successful implant.

 

3D Dental CT scans – Advancement in CT (CAT SCAN or Computer Tomography) scanning now allow the jaw bone to be viewed in all three dimensions. Images obtained by CT scanning will normally be able to show all of the information required about your bone. CT scans give much more information about the quantity and quality of your bones as well as the other anatomical structures that must be avoided when placing the implant.

What are the different dental implant procedures?

Replacing a single tooth-If you are missing a single tooth, one implant and a crown can replace it. A dental implant replaces both the lost natural tooth and its root.

 

Replacing multiple teeth-This can be accomplished by using the implants as supports and adding a bridge between the missing teeth. Not all the roots are replaced in this procedure.

 

Replacing all of your teeth-Similar to an implant supported bridge for multiple teeth a full bridge or denture can be anchored to the implants to replace your lost teeth.

 

Sinus Augmentation-Many people lack appropriate bone growth over the upper back jaw adjacent to the sinuses. This lack of bone growth makes it technically difficult or impossible to do an implant without increasing the bone growth. Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants.

 

Ridge Modification-Some individuals have deformities of the upper or lower jaw causing inadequate bone to place a dental implant. By lifting the gum away to expose the bone defect, the defect can be filled with bone or bone substitute to build up the ridge. Ridge modification can increase your chances for successful implants that can last for years to come.

How long will the implants last?

Once you have completed successful placement of a dental implant, your home care and willingness to present for regular cleanings and maintenance reviews will have the most influence on how long they will last. If you do not care for them they will develop a hard calculus covering and plaque. Untreated, these deposits can lead to gum infection, bleeding, soreness and general discomfort. This is very similar to that can happen with normal teeth. Well maintained implants placed into adequate bone can be expected to last for many years and probably for your However it is not unreasonable to expect that just like other dental procedure such as filling , crowns and bridges you may need periodic malignance requirements.

How does Bone Grafting affect the length of treatment?

As you would expect with this additional therapy requirement there will be a corresponding increase in the amount of time involved in your treatment process. Bone grafting requires a considerably higher degree of skill. We have the experience and training for this procedure. This is a very complex procedure that should only be perfumed by specially trained implant dentists. Sometime the implant placement can be combined with bone grafting and the placement of a barrier membrane all at the same time. This will result in a significant reduction in treatment time. However many times it is better to carry out bone grafting as a distinct stage, so that the implants are only placed when the bone grafting has been successful

Are there contraindications to dental implants?

Nearly everyone is a good candidate for implants. Possible contraindications include poorly controlled diabetes and smoking, bone disease including osteoporosis, gum disease and other medical conditions. It is best to let us evaluate your medical history and your dental needs.

 

There are several absolute contraindications to a dental implant including heart conditions such as valvular disease, a recent heart attack and diminished heart function or enlargement of the heart called cardiomyopathy.

 

You would not want to consider an implant if you have active cancer or certain bone disease such as Pages or oteomalacia .

 

If you are taking any immunosuppressive drugs or have AIDS or have had any radiation therapy to the jaw bones you may not be an implant candidate. Treatment with osteoporosis medications like ACTONEL®, FOSAMAX®, DIDRONEL®, LYTOS®, SKELID® etc. and PARTICULARLY as INJECTIONS: ZOMETA®, AREDIA®

 

Some relative contraindications that must be evaluated on a case by case basis include Diabetes (particularly insulin-dependent),, Angina pectoris (angina),,certain mental diseases,, radiotherapy to the neck or face (depending on the zone, quantity of radiation, localization of the cancerous lesion etc.),certain auto-immunes diseases, drug and alcohol dependency, Pregnancy.

 

Other contraindications include an insufficient quantity of bone, certain diseases of the mucous membranes of the mouth., periodontal diseases (loosening of the teeth); it may be necessary to clean up the gums and stabilize the disease first, severe grinding or clenching of the teeth, a bite issue with an unbalancing between the upper and lower teeth, infections in the neighboring teeth (pockets, cysts, granulomas), major sinusitis., or poor hygiene of the mouth.

 

Of course, this list is not exhaustive and it is entirely up to the practitioner who is examining you and asking questions to establish any contraindications.

What are the possible complications when an implant is inserted?

There is always the risk from the anesthetics: For the most part local anesthesia is used but the risk of an anesthetic is never zero. Some people are unaware of allergies they may to certain anesthetic agents.

 

Rejection of Implant or non-osteo-integration of the implant: The bone rejects the implant and a solid bond to hold the prosthetic tooth does not form.

 

The same material used in hip and knee prostheses is used for implants – titanium. There is a well-documented history of individuals tolerating this material well. Long term rejections or allergic reactions have been extremely rare.

 

Sometimes the bone cells have not colonized the surface of the implant. Therefore the implant does not bond with the bone and had to be removed. For that reason we generally wait 2 to 6 months before finally making the prosthesis on the implant. This happens in less than 5% of the cases.

 

There are occasionally post-op infections. There are quite rare. This can happen around the area of the implant or in the soft tissues of the jaw or in the sinuses themselves.

 

Uncontrolled bleeding or hemorrhages can occur but these are usually easy to control and are usually not serious.

 

Nerve involvement - In the lower jaw (mandible) lays the nerve serving the lip and the chin which runs inside the bone (in the region of the premolars and the molars). For this reason a scan is also requested in order to locate it accurately, and sometimes, if the depth of bone is insufficient, you will be refused an implant in this area. Very rarely the nerve can be touched, while the implant is being or afterwards by a compressive hematoma or edema. This results in a reduction in the sensitivity of the lip and chin (not paralysis).

 

These disorders are generally reversible upon appropriate treatment. On a rare occasion there can also be a lesion of the lingual nerve which gives anesthesia of the tip of the tongue.

 

Very late complications include late failure of the hardware. This can come from improper dental hygiene, bone loss or other mechanical factors including rare fractures of the bone. However these are usually prevented with routine checkups.

Why go with a dental implant vs. crown?

In certain case there may not be enough of the tooth remaining or the decay is too deep to do a crown. A crown is a cheaper alternative but requires more maintenance and will not last as long as in implant. Replacing a missing tooth with an implant provides superior function, stability and esthetics.

 

Implants have a much improved appearance: Your jaw bone can shrink when you lose the entire tooth. This can cause your face to look older. Dental implants can stop this process. Without an implant a traditional denture or bridge cannot, stop the bone loss.

 

There is very little disruption to your normal teeth. For a bridge or crown you must have the remaining tooth or for a bridge the two teeth anchoring the bridge ground down to support the crown or bridge. Dental implants eliminate the need to modify healthy teeth.

 

Implants are a more permanent solution: This is a solid replacement with no loose parts. It is stable and comfortable and no adjustment is needed after placement. It is stronger and keeps its color longer.

How do I keep the implant clean?

Dental implants cannot get cavities because they are made up of metal. However, they are prone to bone loss observed with gum disease. The best way to prevent gum disease is good oral hygiene and regular professional cleanings.

 

A single implant supported crown would be maintained like any other tooth with flossing and brushing. Implant supported denture can be taken out and washed under running water with a denture brush and the implants cleaned as individual teeth.

 

 

How much discomfort should I expect to be in during and after the placement of the dental implant?

Most of the time there is very little discomfort. The entire procedure is completed under local anesthesia. Post-operatively common anti-inflammatory agents are sufficient to control any discomfort.

 

If there is any discomfort it is usually relieved with over the counter medication like Tylenol or Advil for about a couple days following the procedure.

 

Bone grafts and other more invasive procedures may require more time and medication. The procedure is usually done under local anesthesia and should make the placement procedure pain-free.

 

Depending on the complexity and number of implants being placed, the procedure can take between 1 hour to 3-4 hours.

Can I be allergic to Titanium?

Allergies to titanium are very rare but tend to occur with other metal allergies. About 4 percent of all patients tested will have a positive reaction. Contact an allergist for testing if you have had a reaction to other metals. Studies have shown that titanium alloy contains traces of nickel as a result of the production process. This may lead to a reaction to nickel that is falsely attributed to titanium.

 

How much do implants cost?

There are a number of factors that determine cost. This will be different from patient to patient. Cost is usually determined by the number of teeth being replaced as well as the number of implants required to support the teeth needing replaced. As well some individuals require additional procedures such as bone grafting, ridge modification of the gums or sinus augmentation.

 

We cannot quote fees without first assessing your needs. After a thorough diagnostic examination, we will devise a treatment plan that is right for you

 

What is a dental implant and how sucessful are they?

A dental implant is a small screw made of titanium that serves as the anchor to replace the root portion of a missing natural tooth. Implants can be placed in the upper or lower jaw. Over time it forms a strong bond with the bone. Dental implants can be used to replace a single tooth or many missing teeth.

 

The technology has been around for over 40 years. There are patients that have had implants that long. Over all in the US hundreds of thousands of implants have been placed with excellent success rates. However, success rates are much higher with those dentists that specialize and have extensive training in implant dentistry.

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