What are dental implants?
Teeth may be lost because of caries, gum disease or trauma. Dental implants are one of the options to replace missing teeth, and they typically have 2 components – bone screws and the prosthesis (crown, bridge, or denture) attached to screws. Other options for replacing missing teeth are removable dentures or fixed dental bridges, depending on the clinical condition.
Dental implant surgery involves placing a titanium screw into the bony ridge of the missing teeth in the jawbone. It would be ideal to have sufficient jawbone to house the titanium screw to provide sufficient stability. If there is insufficient bone available, bone grafting may be required before or during the implant surgery.
The most significant benefit of dental implants is that the inserted titanium screws become osseointegrated (a union with the jawbone) to allow load-bearing of the prosthesis. Osseointegration is a process which occurs over a few months. Hence, dental implant treatment requires at least several months or even longer (if treatment is complex), depending on the treatment required.
Generally, the success rate for dental implants is high, but it may be lowered if you are a smoker, have untreated periodontitis (severe gum disease), or uncontrolled diabetes. Like natural teeth, dental implants need to be maintained with good oral hygiene habits and regular dental maintenance visits with your dentist.
Why should I seek treatment?
Tooth loss can cause both functional and aesthetic issues in an individual.
Dental implants can be used in various situations, such as to replace single missing teeth, multiple missing teeth or even when there is complete tooth loss in a jaw. However, it is essential first to evaluate the patient's general medical condition, jawbone volume and quality, occlusion, and jaw relationships before the placement of implants.
Your surgeon and/or restorative dentist will assess your suitability for dental implant treatment before offering it as an option to replace your missing teeth.
In general, implants may be suitable for patients who meet the following criteria:
- Reached skeletal maturity
- Adequate bone volume or ability to tolerate a bone graft procedure
- Healthy oral tissues and no medication conditions that affect bone healing
- Commitment to the implant treatment process
- Good oral hygiene
- Difficulty in wearing dentures
- Non-smokers (smokers have a higher risk of implant failure)
What does it involve?
Dental implant treatment is carried out by a team of restorative dentist and surgeon working closely together. The implant treatment process generally consists of three phases - treatment planning phase, surgical phase, and restorative phase.
During the treatment planning phase, a clinical exam and X-ray of your jaws are usually performed to evaluate the soft and hard tissues and planning the surgical procedures required. You may require additional grafting procedures before or simultaneously with implant placement surgery. In some cases, soft tissue grafting may be required as well.
The surgery phase involves cutting the gum and drilling the bone to prepare the implant site for insertion of the dental implant into the bone. Depending on the clinical condition, the implant site can be stitched up or have a healing cap exposed. If the gum is stitched up after the implant surgery, a second minor surgery will need to be performed after osseointegration to insert the healing cap. Immediate implant surgery is possible in certain selected cases.
The restorative phase can start once the implant has osseointegrated. During the restorative phase, the restorative dentist will take a mould of the implants and teeth to design and fabricate the prosthesis. A temporary prosthesis may also be used in some patients. The fabricated final prosthesis will then be screwed or cemented onto the implants.
What to expect after dental implant surgery?
A small amount of bleeding and a short period of swelling and pain are expected sequelae after dental implant surgery. Bruising can also occur in some patients. Painkillers and an antibacterial mouthwash will usually be prescribed after the surgery, and you will be advised to stay on a soft diet for about a week. You may also be advised to refrain from wearing any dentures which covers the implant surgery site until the denture has been adjusted.