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Overview

Dental implants are replacements for missing tooth roots and thus serve as a foundation for replacement teeth which look, feel and function like natural teeth. They have created a revolution in dentistry because of the expanded treatment possibilities they provide.  Millions of people all over the world enjoy normal function and an attractive smile thanks to the availability of dental implants. Usually, when you lose a tooth it is best for your oral health to have it replaced. Missing teeth can affect your "bite" as well as your ability to speak and chew. Their loss can increase the burden on your remaining teeth and can cause muscle pain in your jaws as well as headaches. And of course, missing teeth are only cute in my 2nd graders smile; for most adults, a missing tooth in ones smile is an embarrassing problem that needs to be corrected.

History
In 1952, Prof. Per-Ingvar Branemark of Sweden conducted an experiment where he utilized a titanium implant chamber to study blood flow in rabbit bone. At the conclusion of the experiment, when it became time to remove the titanium chambers from the bone, he discovered that the bone had bonded so completely to the implant that the chamber could not be removed. Branemark called the discovery "osseointegration," and was able to foresee the possibilities for human use. Osseointegration was first utilized in dentistry for fixation of teeth and now also is used for cranial and maxillofacial reconstruction as well. With his pioneering research, Dr. Branemark opened the door to a lifetime of renewed comfort and self-confidence for the millions of individuals facing the frustration and embarrassment of tooth loss.

What is a Dental Implant?
The best way to describe a dental implant is to compare it to a real tooth, which consists of a crown and a root. The crown is the visible part of the tooth that we show when we smile, chew with when we eat, and clean when we brush.  Beneath the crown is the root, which anchors the tooth through the gum tissue to the jawbone. When a tooth is lost, both the root and the crown are missing.

Dental implants are prosthetic tooth roots made of specially treated titanium, the same biomaterial used for artificial hip and knee joints (see history above).  This titanium root is inserted into the jaw bone to take the place of the root of your missing tooth or to act as an anchor for retention of a loose denture. Once healing has occurred (healing time usually 6 to 12 weeks), your general/restorative dentist secures a crown to the top of the implant.  Recall that the crown is the top part of a tooth that is seen above the gum level.  In some cases a temporary crown can be placed almost immediately (see immediate provisionalization). The new tooth looks and performs like the original tooth.  If many or all teeth are missing, dental implants may be used to either improve anchorage and reduce denture movement or even to support a non-removable bridge! (see Teeth-In-An-Hour).

How Can a Missing Tooth Be Replaced?
A tooth or teeth can be replaced by some type of removable denture (temporary or longer lasting), a fixed partial denture (Bridge), or by dental implant supported crowns or bridges.

A temporary removable denture (aka, flipper) These are relatively fragile and designed to last for only a few months. Flippers are usually only worn by patients on a temporary basis for esthetic purposes while they are waiting for more definitive and permanent treatment.

A cast partial denture is also a removable tooth replacement. It is precision cast in metal for increased strength and is designed to last longer. Wire clasps are commonly used to hold it in place. These wire clasps are frequently visible when smiling and over time will prove detrimental to the remaining supporting teeth by which they are retained.

Full dentures (aka, plates) are an option for patients who have lost all their teeth in one or both jaws. The success and fit of a full denture depends upon the patients jaw shape and size, their oral habits, and their adaptability.  Having so much of the inside of ones mouth covered by the dentures (including entire roof of mouth) will significantly affect the ability to taste and to perceive hot or cold food.  Some people adapt well to their dentures, while other patients are not able to adapt at all.

A fixed/cemented Bridge is created by first reducing the teeth (a dental drill is used to take away tooth structure) on either side of the missing tooth space; these are called the abutment teeth.  A series of artificial crowns are then made that are cast together in a laboratory and then cemented onto the abutment teeth. Bridges have some significant disadvantages.  Though some may last throughout life, the average lifespan of a bridge is about 7 to 10 years; they are usually lost due to marginal decay (often painless) that occurs where the abutment crown(s) metal joins to the root.  Cleaning beneath a bridge is time consuming and often challenging, which accounts for the marginal decay that often eventually occurs.  Finally the reduction of the abutment teeth is not a risk-free procedure, as the pulp may be overheated, leading to the need for endodontic (root canal) treatment. Endodontically-treated teeth are more brittle and prone to fracture, which may further contribute to the early demise of a fixed bridge.

Dental implants can be used to provide support for the replacement of one, several, or all teeth. After years of research and clinical trials, this option is not only offered with confidence but in most cases is the ideal means of structural support for tooth replacement. While the implant surgery would be accomplished in our office, the implant-supported teeth are created by your restorative/general dentist. The teeth may be cemented, screw-retained, or removable (denture) and may be made attractive, stable, and comfortable for almost any patient.