The dental implant is artificial tooth root replacement (made of Titanium), which is surgically placed in jaw bone. It allows the dentist to replace missing teeth or bridge without any visible difference. Conventional treatments such as complete or partial dentures has limitations for many people, and can cause eating difficulties, problems related to esthetics, retention and stability of prosthesis. Because of these issues, patients often suffer decreased self-confidence and develop psychological problems. In order to overcome the problems associated with conventional prosthesis, implants came into existence.
Dental implants are an ideal option for people in good general and oral health who have lost a tooth or teeth due to periodontal disease, an injury, or some other reason. Under proper conditions and proper patient maintenance, implants can last a lifetime. At Dental Excellence, we provide tailor-made treatment options where implants can be used to replace a single tooth (with one implant and a crown), multiple teeth (with implant-supported bridges or multiple implants and crowns) or all teeth (with implant-supported bridges or implant-supported dentures).
Dental Implants can be categorized based on many different things – by size, by material used, by type of connection on of the head of the implant and by the stages of the treatment, the last one being the most common. Teeth replacement using dental implants has proven to be a successful and predictable treatment procedure; different placement and loading protocols have evolved from the first protocols in order to achieve quicker and easier surgical treatment times. Based on the stages of the treatment,
Dental Implants are divided into:
- Two Stage Dental Implants, and
- One Stage Dental Implants
Two Stage Dental Implants
This is the traditional implant process with the first step being a surgery in which we install the implants within jaw bone and is left for three to six months so that it can heal and integrate with the jawbone. With this approach, the implant(s) are placed into the jawbone and the gum tissues cover them. Thus, the implants are not exposed to the oral cavity, but rather stay buried below the gums and left to heal completely out of function. This is normally done in areas where there is poorer bone quality or quantity, no immediate need for a cosmetic solution and when more of a margin of safety is required. There may also be other systemic health considerations that favor a two-stage approach to implant surgery. After placement of an implant in the lower jaw it can take upto three months to heal while those in the upper jaw may need about six months. Once healed, a second surgery is performed to attach healing abutment or an abutment for securing the crown in place. During 3-6 months healing period, the patient may be given a temporary prosthesis until it is time to put in the permanent crown. It is generally safer and wiser not to subject an implant to biting forces until it is fully healed and integrated with the supporting bone. Though this treatment-sequence maybe slightly more time-consuming but it still remains the most tried and tested implant treatment protocol in our experience at Dental Excellence.
One Stage Dental Implants
In the single stage implant a healing abutment is placed at the time of surgery. A healing abutment is a connector that attaches to the implant and protrudes through the gum tissues allowing the gums to be shaped in preparation for the implant-supported crown. After initial healing of 3-6 months allowing implant to fuse with bone, a permanent crown is then placed on the implant restoring the immediate appearance of a healthy, normal tooth. One-stage implant systems are generally used when the bone quality is good and provides good initial implant stability. They are also used when cosmetics is not a concern, such as the back areas of the mouth.
The treatment procedure and steps for immediate loaded implants are the same as that for conventional implants, the main difference being that the temporary crown or bridge is loaded onto the implants after its surgical placement. An initial evaluation and x-ray is taken to determine implant site and bone condition. Then the implant site is prepared, the implant is placed and temporary crowns or bridges are cemented. Subsequently, permanent crown or bridge is placed. Immediate loaded implants do not apply to all cases and is dependent on the individual’s bone quality and condition. Following placement of the implants in the jaw, the bone may be sore and the surrounding gums tender and swollen. Patients are, however, able to go about their normal daily activities a day after surgery avoiding any rigorous physical exercises or activities.
Sometimes, it is possible to place implants on the same day as teeth are extracted but usually, it takes three to six months of healing before you are ready for implant placement. Immediate implants are placed between 0 and 7 days after tooth extraction. Implant placement is considered as delayed when it occurred between 6 weeks and 6 months after extraction. The potential advantages of Immediate placement of a dental implant in an extraction socket includes a shorter treatment time, reduces the number of surgical interventions, an ideal three dimensional implant positioning, the presumptive preservation of alveolar bone at the side of the tooth extraction and soft tissue aesthetics.
In summary, Depending on your individual situation and medical status, our implant team will determine which approach is best for you. However, rest assured, research shows that success rates of dental implants are not significantly different between approaches. For further questions regarding one- versus two-stage implant surgery, please visit us at Dental Excellence, Mohali or contact Dr Sachin Goyal by emailing us at firstname.lastname@example.org
Do you have dentures that are not stable in the mouth? Or have you given up on dentures just because you have had them made a few times, but, they never seem to fit well? Implant supported dentures could solve such problems. Sometimes, the jaw bones have shrunk so much that conventional dentures won’t work well any more. In such cases, our implantologist, Dr Sachin Goyal at Dental Excellence may opt to place a few implants in the jaw and take their support to stabilize the dentures we subsequently fabricate. Such implant supported dentures are generally planned for the lower jaw. The dentures generally have slots that snap onto attachments on the implants. The commonly used implants for supporting dentures come either with ball or bar attachment. These dentures work like overdentures and offer excellent stability over conventional dentures.
The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. If you’ve lost bone in that area due to reasons such as periodontal disease or tooth loss, you may be left without enough bone to place implants.
The clinicians at Dental Excellence perform sinus augmentation which can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants. Several techniques can be used to raise the sinus and allow for new bone to form. Depending on your individual needs, the bone usually will be allowed to develop for about four to 12 months before implants can be placed. After the implants are placed, an additional healing period is required. In some cases, the implant can be placed at the same time the sinus is augmented. Such augmentation can be carried out either by Direct Sinus Lift or Indirect Sinus Lift procedure.
Sinus augmentation has been shown to greatly increase your chances for successful implants that can last for years to come.
Now a days Zygomatic implants are used for complete rehabilitation of upper jaw where there is complete loss of bone may be because of bone loss, late treatment. With zygomatic implants there won’t be any need for sinus lifts and additional bone grafting. Further indications for zygomatic implants include failed conventional implant placement, failed sinus augmentation or grafting procedures, rehabilitation after tumor and trauma resections.
In the atrophic posterior maxilla, in general one zygomatic implant is placed on each side of the maxilla, in combination with 2-4 conventional implants in the anterior region. They can be placed single or two, one on either side or two on either side (Quad Zygoma). Zygomatic implants nowadays are usually immediately loaded with a fixed bridge.