Dental Implants

Dental implants are fixtures that are used to support a dental prosthesis. They are implanted into the jaws and integrate with the bone. In other words, dental implants are just like the tooth roots, but artificial, and hold artificial teeth and / or bridges.

The way these implants are made ensures that the natural processes form a bond with the implant and create a bone around it, which secures the tooth. This way the implant can last for decades without any issues.

Dental implants of any kind are usually an option for people who are missing a tooth or more teeth, be it due to disease or injury and would like to have their teeth back again. As stated, the modern implants rely heavily on osseointegration (fusion of the implant with the bone). The degree of success of dental implants varies depending on the person. Generally, the jaws and gingiva should be healthy. There should be no major periodontal and dental problems and the patient should be in good health.

Generally, dental implants are a better choice than dental bridges. The success rate is higher and there is a risk of losing a tooth when the bridge collapses, and it is very high, about 50 %. They also last longer. Dental implants are usually a bit expensive, but it definitely pays off over time, as there are less risks of dental problems further down the line.

There are various bone-building drugs that can be used which increase the success rate of the procedure. These drugs, called bisphosphonates, are often used but the position regarding their side-effects is uncertain. However, the benefits usually exceed the risks, which include higher bone turnover that may lead to bone fractures when undergoing further oral surgery. Patients with osteoporosis and long term steroid use often have a lower success rate with dental implants, for logical reasons, as osseointegration is a prerequisite for success. Patients are also advised not to smoke and observe good dental hygiene.

Humans have been using dental implants, or crude versions of them, for thousands of years. The ancient Chinese used bamboo sticks to replace missing teeth, and the ancient Egyptians did the same using various metals, ivory, seashells and pebbles. As you may imagine, such procedures were likely to have been extremely painful and unpleasant, but it goes to show how precious teeth really are.

Today, there is no need for such crude methods, as modern science has developed some very interesting materials that are used in the production of implants. Most of these implants are based on titanium. 
Titanium is a chemical element that has a unique property of being biocompatible, and as a result can be found in many implants (not only dental), hip replacements and similar. Its biocompatibility means that the host body accepts it without problems, that is, without an immune or inflammatory response. This is in addition to its nontoxicity. Titanium is therefore an excellent choice for the production of dental implants and for this reason has been for the last fifty years.

However, there have been some improvements to the technique. Usually a patient would be asked to wear a temporary cap or live with a hole in one’s mouth while waiting for the implant to integrate with the surrounding bone. With help of today’s techniques, very often a patient can get an implant set together with a crown in a single visit.

There have also been some very interesting reports by Israeli researchers who claim that placing a small electromagnetic device into the healing abutment can help the bone grow up to three times faster, thereby reducing recovery time. It is currently in experimental phase but is expected to be available soon, at reasonable cost. Unfortunately, due to the size of the MED (miniaturized electronic device) it is currently available only for the implants for molar teeth, as the screw would otherwise be too large.

Some of the most promising research that is unfortunately rather early-stage is the usage of nanotechnology in the production of implants. Again, the implants are made using titanium, but the coating is in the form of TiO2 nanotubes. These tubes are non-toxic and encourage bone growth. Research has shown that the bone better adheres to these nanotubes than to the regular titanium dental implants. The researchers from the Michigan Technological University have also loaded them with anti-inflammatory drugs that reduce the likelihood of side effects. They can also be coated in silver, which has great antibacterial properties. 

If you are searching for a more practical solution that is still an improvement over the regular implants, there is an interesting option in the form of zirconia dental implants. The main benefit of these is that they are white. This is important for people with receded or thin gums, as titanium can cause them to look dark and off-color. Zirconia implants are also non-corrosive. The strength of the material is comparable to that of titanium; however, since this is a new technology, there are few studies on its long-term viability.

It is expected that the procedures of placing the implants will be more convenient and faster in the following years. These procedures are becoming less and less invasive. These minimally invasive procedures are generally done with removing as little to no bone grafting. There are solutions such as OsteoConverter that does the process without drilling. It is placed right after a successful tooth extraction and can be done on any tooth in the mouth. It can even be left as an implant or removed for a more suitably sized implant, and the treatment itself is very successful. The procedure is also very quick and more tolerable for the patient.

The future also brings us a more cohesive use of CT, CAD (Computer Aided Design) and CAM (Computer Aided Manufacture) systems in dentistry. Good CT technology imaging can help create anatomically correct implants that are less likely to fail. Couple that with abutments made with the help of CAD systems and you get safer and easier procedures. The model of the drilled tooth is relayed to the computer and the modelling of the implant is done there, to ensure maximum precision, which works for dental crowns as well. This in turn means they are less likely to fail and the patient is likely to be more satisfied with the process, as fewer visits are necessary for the procedure.

One of the more advertised systems for dental restoration in case of loss of many teeth is the famed All-on-4 procedure. In this procedure, four dental implants can support 14 teeth – a whole bottom or upper arch. These implants are strategically placed so that four implants are enough to hold all the teeth in place, instead of placing a single implant for each tooth. These are usually regular but angled titanium implants. The procedure usually begins with a computer scan of the bone areas to determine the suitability and the positions of the implants. The implants are then places, usually ad tan angle of 30 to 45 degrees to support the new teeth. The procedure is usually done under sedation. It is a lot better alternative to dentures as it prevents bone loss in the jaw.

Over the past few years, mini dental implants have profiled themselves as a viable alternative to the traditional ones. The implants are smaller in diameter (about 2 mm compared to 3.5 to 4 mm for traditional implants) but comparable in length and have smaller bone requirements for proper installation. They can generally be placed by the GP in one appointment in about an hour or two and are usually cheaper than the regular implants. The smaller size also means the procedure is markedly less invasive. In the past, they were used only as a temporary solution but are now approved for long term use, and the success rate is purported to be about the same as with traditional implants, but the general consensus still is that they cannot provide the same level of stability as the traditional implants. This is due to forces acting on the tooth. They are the most attractive options for the front teeth, which do not experience high forces and loads. More of them are required for proper denture stabilization, so in this case, traditional titanium implants are still preferred. Of course, the suitability depends on the patient and it is best to ask your local dentist about the treatment options.

Dental medicine is a rapidly developing field and there are advancements happening every day. However, the development is a step by step process, especially in this field when the technology we already have is really good, and is mainly focused on reducing recovery time and increasing comfort for the patient. New treatments are also becoming more cost-effective and help you save time with fewer appointments. As you can see, the process is bound to be more convenient and successful in the near future, so that you can rest assured the implants will serve you well for many years to come.

source: Las Vegas & Henderson Cosmetic Dentist - Dr. George Harouni