Dental implants are used in dentistry to replace one or more missing teeth that may be lost to trauma or periodontal disease.

dental implantThey consist of a titanium post, or cylinder that is permanently anchored into the upper or lower jaw bone, and are used to support dental restorations such as crowns or certain types of bridges and dentures. Titanium is the best material for posts drilled directly into the bone because the bioactive properties of the metal trick the body into accepting it as a natural part of the body, whereby it bonds to the metal permanently. This process is called osseointegration, and is the reason this implant procedure results in a realistic replacement, resembling the look, feel, and strength of a natural tooth.

Implant Technology Continues to Evolve

Although the concept of dental implants has existed for over a thousand years, dental implant procedures have evolved greatly in the last thirty years to become a highly successful permanent solution to temporary or removable dental appliances, often lasting for the life of the patient. Proper oral hygiene, the skill of the surgeon or dental professional, and quality and quantity of bone available are all factors that contribute to the actual lifespan of the implant. In the sixties, it was discovered that placing titanium cylinders into the jaw bone and leaving them undisturbed for at least three months resulted in the cylinders permanently bonding to the bone. Once completely healed, this bond has a greater strength than that of natural teeth. This theory was tested on dogs, and once properly healed, the animal was suspended by the implant, proving that the strength of the bond was substantial.

Prior to undergoing the process of implant surgery, the condition of the underlying jawbone must be assessed, showing that there is sufficient bone material to place the implant and to ensure proper placement. Without enough healthy jaw bone available there is a risk the implant could penetrate through it into soft tissue, causing pain or rejection. Since bone requires a healthy blood supply to accept natural teeth, once the teeth have been missing for a long time, the blood supply is often diminished or completely absent. Inadequate blood supply causes the post to fail to adhere to the bone, and rejection results. However, after initial rejection, new blood vessels often develop at the site, allowing for a second successful attempt. A lack of sufficient jaw bone material to place an implant post will require a bone graft procedure, also called bone augmentation, prior to implantation to discourage rejection, and it is important that a CT scan or radiograph be taken before considering dental implants.

There are some other important considerations to be given, such as the future function of the dental restoration. The forces that will be placed on the implant may be greater than the biomechanic tolerance of the jaw bone or materials used, and abnormal clenching, bruxism (grinding), or chewing can threaten failure. Some other causes of failure include smoking, diabetes, medications such as those used to treat arthritis and most chemotherapy drugs used for treating cancer, and shifting of the post before bonding to the bone is complete. The most common cause of failure is from smoking. Oxygen is essential to the bonding of the implant, and nicotine reduces the flow of oxygen to the bones, preventing this process and resulting in removal. Individuals with uncontrolled diabetes have great difficulty healing due to poor peripheral blood circulation, and are therefore poor candidates for implantation. Both arthritis and chemotherapy patients use medications containing bisphosphonate. This may put them at a higher risk of developing osteonecrosis, which is a delayed healing syndrome, making undergoing the procedure too risky. Even a patient with no contraindications for implant procedures may experience failure if the titanium post shifts or moves before the bonding process is complete, which takes about three months. Prior to that time, the body will recognize the piece as foreign and will reject it.

As with any other surgical procedure, post-surgical care is critical to the success of the procedure. Aside from healing, the implant must be cared for the same way natural teeth would be. Regular brushing, flossing, remaining healthy, and visiting a dental professional at lease twice a year for regular cleanings and evaluations will all contribute to dental implants lasting for a lifetime.

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