As we age, the likelihood of tooth decay and loss increases. Thanks to the research by Prof. Per-Ingvar Branemark dental implants were discovered as an effective replacement for tooth loss. His early pioneering research allowed the establishment of a protocol for placing titanium made implants inside the jaw bone. He also showed that the jawbone then regrows around the titanium insert to keep it intact (1). Once this piece of metal is in place, then your dentist can assemble a dental crown, denture or a dental bridge on the top of this component.
Eligibility and Risk Factors
During your initial appointment with your dentist, he/she thoroughly examine your mouth and checks the bone characteristics of the area where the dental implant is fixed. In the absence of any underlying problems, your dentist will then discuss the necessary steps that are required to receive the implant.
People with common risk factors listed below should discuss the suitability of this technique with their dentist:
- People with systemic diseases such as diabetes, liver disease or hypertension
- Pregnant individuals
You should also let your dentist know if you take any form of medications as there may be complications involved.
Initial Discussion and Examination
During your initial consultation, your dentist examines the condition as well as the position of the tooth and its soft tissue. Your bone density will also be measured using an X-ray machine to determine if you require bone graft (the grafting is a method which involves the extraction of bones from the jaw and its attachment to the site where the dental implant is held. This will provide additional support to keep the implants secured).
An X-ray will also allow your dentist to locate the position of your nerves to determine the most appropriate location for the dental implant. After obtaining the relevant details, your dentist will then discuss the range of options with you including the risks, cost, and the type of materials for the operation. After the agreement is made you will need to sign a consent and decided on a suitable date for the operation to take place.
Before your operation day, your dentist will provide you with a set of information regarding the procedure including the type of anaesthetic and the recovery period. Dental implantation often needs local anaesthetics where the patient is conscious. Under special circumstances, where there is a requirement for bone extraction from other regions of the body excluding the jawbone, the patient receives general anaesthesia. These factors determine the length of the operation.
Post-Operative Recovery and Abutment Setup
You can leave the dental clinic immediately after your surgery, and you should expect several months post-operation for full recovery and healing of the bone. You may experience pain, swelling and minor bleeding during the first-week post-operation. It is advisable that you eat healthy soft food to enhance the speed of your recovery.
Once the bone is fully regrown around the implant, a metal constituent known as an abutment, which connects the implants to the dental crown, is fixed on top of the implant via a second operation. This procedure also has its own recovery time of one to two weeks. At the last step, your dentist captures an accurate 3D image of your teeth called the dental impression. The design and creation of the false tooth are based on the dental impression. After receiving the dental crown, your dentist will permanently mount it on the dental implant.
Care and Maintenance of Dental Implants
Dental implants are safe, but they are not carefree. Similar to your teeth they need thorough daily cleaning. This will help reduce the possibility of disease development and increase the durability of the implant.
Choosing a skilful and experienced dentist is critical when it comes to the use of a dental implant. Early diagnosis of side-effects related to implant surgery can prevent the occurrence of long-term chronic problems. The complications can arise from poor bone healing which destabilises the implant. Research has shown that low-level laser therapy can help with bone growth and healing (2); however, this technique is only available at specialised centres.
Infection around the dental implant is very common. The damage that arises as a result of loose fitting of the implants and poor dental hygiene (which often help to the build-up of dental plaque) can be some of the primary causes of dental infection (3). Therefore, regular post-surgery appointments with your dentist can help you check the intactness of your implant and the condition of your gum.
Damage to the jawbone can also occur due to the mechanical pressure exerted to it by the implant (4). Careful consideration of your dentist to choose the correct area of the jawbone and select the right type of abutment should help avoid this problem (5).
Dental Implant Cost
The cost of the implant depends on various factors including the condition of the jawbone, number of dental implants, and the type of dental implant. The relative price for an individual tooth is between £800 to £1500. You will need an X-ray scan, and If your dentist decides that you require bone grafting, then this value can increase the cost from £1500 to £2500. Also, dental implants made from more precious metals such as zirconium will double the minimum price from £800 to £1600. The full mouth dental implants can cost around £15000 to £25000. Having said that, there are always alternative options that can be chosen to substitute the dental implant.
One of the main alternatives to the dental implant is the dental bridge. Where there is a missing tooth, the neighbouring teeth are carved to a specific size and shape. The dentist then cements the dental crown on the top of these adjacent teeth. Dental bridges can also be fixed on top of dental implants. Cleaning the dental bridge is their main disadvantage in comparison to dental implants. However, they are less expensive. If many teeth are missing, then the dental denture can be a low-cost substitute for dental implants. Their main disadvantages in comparison to the implants can be their constant displacement from the fixed position as well as hygiene issues that results in inflammation and ulceration (6).
- Brånemark PI, Adell R, Breine U, Hansson BO, Lindström J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg [Internet]. 1969;3(2):81–100. Available from: http://www.ncbi.nlm.nih.gov/pubmed/4924041
- Zaky AA, El Shenawy HMM, Harhsh TAH, Shalash M, Awad NMI. Can Low Level Laser Therapy Benefit Bone Regeneration in Localized Maxillary Cystic Defects? – A Prospective Randomized Control Trial. Open access Maced J Med Sci [Internet]. 2016 Dec 15;4(4):720–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28028422
- Vidyasagar L, Apse P. Biological Response to Dental Implant Loading / Overloading. Implant Overloading: Empiricism or Science ? Stomatol Balt Dent Maxillofac J. 2003;5:83–9.
- Sakka S, Coulthard P. Implant failure: etiology and complications. Med Oral Patol Oral Cir Bucal [Internet]. 2011 Jan 1;16(1):e42-4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20526267
- El-Anwar MI, El-Taftazany EA, Hamed HA, ElHay MAA. Influence of Number of Implants and Attachment Type on Stress Distribution in Mandibular Implant-Retained Overdentures: Finite Element Analysis. Open access Maced J Med Sci [Internet]. 2017 Apr 15;5(2):244–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28507636
- Bilhan H, Erdogan O, Ergin S, Celik M, Ates G, Geckili O. Complication rates and patient satisfaction with removable dentures. J Adv Prosthodont [Internet]. 2012 May;4(2):109–15. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22737317