Implants & Replacement

Dental Implants
The replacement of missing teeth using dental implants is now a routine, predictable procedure. Implants can be used to replace single teeth or for multiple tooth replacement as well as providing improved support for a denture. Dental implants are usually made from titanium and are unique in forming a natural longstanding union with the jaw bone - a process commonly described as osseointegration.

Who May Be Treated?
Dental implants are increasingly becoming the treatment of choice for tooth replacement in many people. There are very few absolute contra-indications for implant treatment and the majority of patients in good general health can benefit from this technology. Young people who have not finished growing are usually best advised to delay having implants until they have finished growing but there is no upper age limit for treatment.

It is important that implants are placed in a healthy mouth and your implant surgeon will assess your mouth and advise if any other treatment is advisable before embarking upon implant treatment.

Clinical photograph of a replaced incisor tooth one year after placement. Good aesthetics have been achieved because the implant-supported crown emerges through the gum like a tooth.

A dental X-ray to show the implant which is supporting the middle tooth in the far left picture.

Implants provide a means of tooth replacement that is as close to a natural tooth as currently possible and which can last as long as your natural dentition.

Individuals who may particularly benefit from implant treatment include:

• People who have lost their teeth due to trauma, decay, gum disease or failed dental restorations.
• Individuals whose teeth have failed to develop.
• Denture-wearers who have difficulty eating or who find their dentures are easily displaced.

Implants were originally conceived as replacements for teeth that had been missing for some time and were therefore placed into already healed sites. In recent years the immediate replacement of teeth using implants has become possible but is not recommended in all situations.

What Does The Procedure Involve?
Surgical Stage:
Implant surgery is usually performed under local anaesthetic, although sedation or general anaesthesia can be arranged for long or complex procedures or according to patient preference.

Implant placement can be performed as a one stage or two stage procedure. In single stage surgery the implants are placed into the jaw and then either restored temporarily or more usually left to integrate with the jaw for up to three months. During this healing phase a small stud is left protruding through the gum. When using a two-stage approach the implant is buried under the gum to protect the healing process - this is often the case if bone grafting techniques have to be used to enable implant placement. Once the implants have integrated with the bone a simple surgical procedure is required to uncover the implant to bring it back through the gum.

The implants and bridgework are shown on this scanning X-ray of both jaws

To reconstruct the entire dentition multiple implants have been placed. The teeth are replaced using a single cast gold alloy subframe to which porcelain is added.

Restorative Phase:
This phase involves the recording of impressions and relationship between the opposing jaws before making the final prosthesis. This may take several appointments over a number of weeks depending on the complexity of the case. At all restorative stages patient requirements are considered and patients are encouraged to have input into the final result. In cases where there has been significant change to the tooth bearing area advanced grafting techniques and/or restorative procedures can be undertaken to optimise the final result.

Where Can Implants be placed?
In order to place implants, enough bone must be available to accommodate implants of sufficient size and number to support the proposed restoration. This is more difficult in the back part of the jaws due to the air sinuses which lie in the upper jaw and the location of the nerve supplying the lower lip in the Iower jaw. In difficult areas sophisticated scans are required to plan the treatment. Difficult sites can be augmented using bone expansion and grafting techniques.

What Is The Success Rate Of Implants?
The overall success rate of dental implants is very high but will vary between different parts of the jaws and also between different patients and applications. The success rate exceeds 90% over a ten year period in most applications. An initial consultation will usually allow an individual assessment of the likelihood of success in your particular situation.

The success rate is lower in individuals or sites with poor bone quality and in those with a significant smoking history. Patients undergoing treatment are encouraged to quit when embarking on implant treatment.

A scanning X-ray of both jaws in a patient who had all their upper teeth replaced in a single day.

The finished result of the same patient with the permanent bridge in place.

What Maintenance Is Required?

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