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Choosing Dental Implants To Replace Missing Teeth



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By : John Markus   

Missing teeth can result from a number of circumstances. For example, one or more teeth may be knocked out during an accident; decay might compromise a tooth to the point that it needs to be extracted; or, advanced gum disease may weaken the alveolar bone (the bone that anchors the teeth), leading to tooth loss. Regardless of the cause, the space left by a missing tooth can appear unsightly. It can also pose oral health issues.

Dental implants offer a comfortable, natural-looking solution. This article will explain how they work, and describe the different types. You'll learn how dentists place them and the factors that influence whether a patient is a good candidate.

Dental Implants Explained

A dental implant is a device (usually made of titanium) that is placed into a patient's jawbone. There are three pieces to a conventional implant: the fixture, an abutment, and a crown. The fixture has a screw-like appearance. It is implanted into the space left by the missing tooth's root, and fuses with the bone that surrounds it.

The abutment is a small piece that is placed over the top of the fixture. While the fixture remains below the gumline, and thus unseen, the abutment lies above the gum's surface. It is typically placed several months following implantation of the fixture.

The crown is a cap that is placed on the abutment. It is usually made of porcelain, metal, or a blend of both. The crown is fabricated in a laboratory to match the color of the patient's other teeth.

Endosteal Versus Subperiosteal Implants

There are two major categories of implants - endosteal and subperiosteal implants. In the case of endosteal implants, these are those that are placed in the patient's jawbone, similar to the natural root of a tooth. These are the most common form of implants used today. The patient's bone must be wide and deep enough to support the fixture. Bone grafts may be necessary.

Subperiosteal implants are used when the patient's bone lacks sufficient width or depth. These devices are placed on top of the gumline, and anchored by a special metal frame. The frame is implanted beneath the surface of the gums.

Procedure For Placing Dental Implants

In most cases, an implant can be placed with a local anesthetic. Once the area has been numbed, the dentist makes a few incisions into the gumline. The gums are peeled back to expose the jawbone. The bone is shaped (if necessary) to improve its smoothness.

Once the dentist has identified the target location of the implant, a hole is made into the bone. A series of drills are used to widen and shape the hole in preparation to receive the implant. The dentist will confirm the width and shape before inserting the fixture.

With the fixture installed, the gums are repositioned over the entry site, and sutured. The sutures are typically removed within a week, assuming the patient heals well.

Four to six months following implantation of the fixture, the abutment and crown are placed. The months leading up to this procedure allow the jawbone and gumline to heal, and allow the fixture to fuse with the bone (a process called osseointegration). The gums are peeled back to expose the top of the fixture, and the abutment is placed on top of it. Then, the crown is placed on top of the abutment.

Who Is A Good Candidate For Dental Implants?

Candidacy for the treatment is based on several criteria, including the patient's overall health, existing medical conditions, and habits that might lower the likelihood of success. For example, patients who have suffered a heart attack in the recent past are typically precluded from having implants installed. Those with type II diabetes may likewise be poor candidates.

With regard to habits, smoking is the biggest concern since it tends to compromise the density and quality of the bone. Teeth grinding is also a concern.

There are other options for replacing missing teeth, including dentures and bridges. But dental implants remain one of the most popular approaches used today.

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