Modern dental implants are titanium roots which can be used to anchor single cemented crowns, bridgework and removable artificial teeth. A number of shades and sizes are available. The classic “Swedish-type” machined titanium screw is a common design. High success rates with the titanium screw are achieved when the root is at least 10 mm in length and preliminary bone enhancement/bone grafting may be required to allow this length. Evolution implant technology has led to microscopically textured implant roots which offer excellent success rates with a much smaller size. Smaller implants can be placed with a better margin of safety.
Often the need for bone enhancement/bone grafting in poor recipient sites can be reduced or even eliminated. New research had demonstrated that the small, textured implants are as safe and reliable as the classic machined screw designs.
Traditional implant technique involves placing the titanium root and then closing the gum over top a dormant period of 12-30 weeks. The implant is uncovered in a 2nd surgery and creation of the artificial teeth starts soon after.
Accelerated implant placement is possible in selected cases. The titanium root place and healing cylinder is attached to allow the gum to form a tight cuff. A 2nd surgery is not required. Often a temporary acrylic crown is attached to allow to the healing cylinder for esthetic purposes. This is a newer technique with limited long-term follow-up. However, scientific reports to date indicated a success rate equivalent to the traditional implant technique.
Bone enhancement bone grafting may be required in situations of low bone density and/or mass. These procedures may be done in conjunction with titanium root placement, or they may need a separate operation. Enhancement is osseous reshaping at the implant site to increase width and/or density. Grafting is the placement of either synthetic hydroxyl-appetite crystals (derived from sea coral) or bone (from a neighboring part of the jaw) to the implant site.
Dental implant treatment is a complex form of bioengineering. Complications are uncommon but may include:
1. Post-surgical bleeding, bruising, swelling and/or infection.
2. Rejection of the titanium root: this can occur even years after the placement.
3. Injury to the adjacent teeth, gums, tongue, cheeks and/or the jaw joint.
4. Sinus contact with the possibility of post-surgical nosebleeds and/or teeth.
5. Material fatigue failure such as fracture of the titanium root, foundation post and/or teeth.
6. Gingival contour irregularities resulting in food trapping.
7. Aesthetic problems arising from gum/bone shrinkage before and/or after implant restoration.
8. Paresthesia/ altered sensation or numbness in the gums, lips, and/r cheeks.
9. Super ordinary reactions: altered taste, radio reception, ect.
A 95% success rate can be expected in a good implants candidate. Individual results may vary. The initially low risk of rejection becomes even lower with time, but in rare cases a rejection can happen years after the surgery.
Factors Which Reduce the Survival Rate of Implant Restorations
1. Decline in health, the onset of new medical problems and/or the use of certain OTC drugs and Rx medications.
2. Tobacco use, including smokeless tobacco and nicotine patches.
3. Poor home maintenance, such as inadequate brushing, flossing & rinsing.
4. Inappropriate profession care, such as probing, scaling, abrasive polishing of the titanium roots.
5. Excessive bite pressure, from hard or sticky foods, as well as daytime clenching and/or nighttime grinding (bruxing).
6. Failure to attend, short-term and/or long-term follow-up appointments with our office.
7. Unauthorized modification, and/or adjustments to the implant restorations and/or the opposing teeth.