Dental Implant Facts - Viewpoints from Expert Doctors

Last updated date: 26-Feb-2022

CloudHospital

13 mins read

We always hear people say the best thing you can wear is your smile. 

That’s true. Everybody’s smile is unique in a way. 

A big part of the beauty of your smile is your teeth. 

When the teeth are beautifully aligned and of uniform colour, it gives an attractive appearance to its owner. 

But if there is a lost tooth or a broken one, it stands out among other healthy teeth. 

Despite the improvement in dental care, millions of people suffer from tooth loss due to tooth decay, periodontal diseases, and injuries. 

For many years, the only available options for lost teeth were either bridges or dentures. But today, with the tremendous development in the field of dentistry, new solutions have emerged. 

Doctors thought, why can’t we find something that can take the place of a lost tooth root? A fake tooth that can replace the lost one. 

This is when the idea of “Dental implants” came to their minds. This is the topic of our video today, dental implants. 

 

So, what are dental implants? 

As we know them today, dental implants were invented in 1952 by the Swedish orthopedic surgeon and research professor “Per-Ingvar Brånemark”. He is touted as the "father of modern dental implantology". 

Today dental implants are considered the replacement for tooth roots. They take the place of a lost tooth root. 

An implant is a titanium metal screw that replaces a tooth root. Implants act as an anchor, a strong foundation, to fix  permanent or removable artificial (fake) teeth such as : 

  • Dental bridge. 
  • Dental crown. 
  • Dentures. 

 

So, who is a good candidate for dental implants? 

Most people with one or more lost teeth are potential candidates for implants. 

Implants are needed when patients lose teeth due to: 

  • Tooth decay or cavities. 
  • Tooth root fracture. 
  • Grinding habit. 
  • Cleft lip. 
  • Facial injury. 
  • Gum disease.  

Dental implants can significantly benefit people who lost a tooth or two.  It can be used to replace a single tooth, several teeth, or all the teeth. 

When it comes to tooth replacement, there are generally three options: 

  • Removable denture appliance (complete or partial denture) 
  • Fixed dental bridge. 
  • Dental implant. 

Dentures are considered the most affordable option, yet they are the least desired due to the inconvenience and embarrassment of a removable appliance in the mouth. Besides, they can affect patients' taste and sensory experience of food. 

As for bridges, they were the more common option before the relatively recent shift to dental implants.  The main setback of the bridges is the dependence on existing natural teeth for fixation and support. On the other hand, implants are supported by bone only and don’t affect other teeth. 

 

And you might ask, what other benefits do implants offer rather than a good appearance? 

Advantages of dental implants include: 

Improved appearance.: Dental implants look and feel like real teeth thanks to osseointegration which is the ability to fuse with the bone permanently. 

  • Improved speech. Poor-fitting dentures usually slip within the mouth and cause patients to mumble or slur during speaking. Because dental implants are fixed in the root, just like normal teeth, patients can speak freely without being worried that the implant might slip within the mouth. 
  • More comfort. Because they act and feel like normal teeth, they become part of the patient, so he or she doesn’t have to worry about the discomfort of removable dentures. 
  • Easier eating. Sliding removable dentures can make chewing very difficult while implants make patients chew with confidence and with no pain at all.
  • Improved self-esteem. Permanent implants give you your smile back and make you confident, boosting your self-esteem and making you feel better about yourself.
  • Better oral health. Unlike bridges, implants don’t require the presence of other and their reduction to fixed. So, teeth are not altered to support the implant and they are left intact, which improves long-term oral health. Individual implants allow easier access between teeth and better oral hygiene. 
  • Durability. Implants are highly durable and last longer than other dental options. With the right care, they will last a lifetime.  
  • Convenience. Unlike removable dentures, implants don’t need messy adhesives to keep them in place. Therefore, they eliminate the embarrassment of removing dentures. 

While the primary function of the implants seems to be replacing lost teeth, there are areas in which implants can help in other dental procedures. For example, because they are very stable, they are used to support a removable denture and provide more security and comfortable fitting. In addition, in orthodontics procedures, mini implants can help move other teeth to the desired position by acting as temporary anchorage devices, then they are removed after the job has been done. 

Some patients might lose all their teeth due to decay or gum diseases, and when I say all their teeth, I mean teeth of the upper and lower arch. There is an available option for them to provide a very stable prosthesis using minimal dental implants. 

 

So, we can say that dental implants are the best option to replace a missing tooth. But are dental implants for everyone? How can the patient decide if implants are right for them? 

Deciding on which option is the right for you depends on many factors, especially for dental implants, including: 

  • The location of the lost tooth or teeth. 
  • The health of the patient. 
  • Quantity and quality of the jawbone where the dental implants will be implanted. 
  • Patient preference. 
  • Cost. 

The dental surgeon will examine the area where the implants will be placed and conduct a clinical assessment of this area to decide whether the patient is a good candidate or not. 

Of course, there are great advantages when choosing dental implants for teeth replacement over other options. Implants are very stable because they are integrated into the bones. So, the final result feels like one’s natural teeth. 

 

But dental implants are not all the same. Historically, there are two different types of implants: 

  • Endosteal. It refers to the implant that is “In the bone”.
  • Subperiosteal. It refers to the implant that rests on the top of the jawbone under the gum tissue. 

However, subperiosteal implants are no longer used because of the poor results they give in comparison with endosteal implants. 

 

So, what happens before, during and after dental implant surgery? 

How dental implant surgery is performed depends on the type of the implant and the condition of the jawbone. 

During the consultation and planning stage, your surgeon will examine your mouth cavity and visually examine the site where the implant is planned to be placed. Your surgeon will also look at dental imaging studies such as X-rays panoramic films and\or CT scan. 

At this stage, the quality and quantity of the jawbone are assessed to determine if more bone is needed at this site or not. If it is all good and it has been determined that the desired location of the implant is fit, the patient can go home and return again for the surgery. 

During all the surgical procedure appointments, the patient is given local anesthesia to numb the surgical areas as well as any other sedatives to comfort the patient’s stress and anxiety. 

The first stage of the procedure always involves tooth extraction, I mean, what if the desired location of the dental implant still has a decayed tooth? So, in order to prepare the place of the implant for the procedure, the damaged tooth should be extracted. 

It is also common to use an alveolar bone graft, additional bone, to provide a stable bone base for the implant. Then it will be allowed to heal for two to six months. 

If the site of the implant has no tooth or bone loss, it will require another type of bone graft called “onlay bone graft” which is placed on the existing jawbone. This technique usually requires six or more months to heal. 

In other cases when enough bone is present, the damaged tooth can be extracted followed by the placement of the implant at the same setting. It is called an “immediate implant procedure”. 

 

And just like any other surgery, a dental implant procedure can pose some health risks. Risks are rare though, and when they happen, they are minor and can be treated easily. 

Risks include: 

  • Injury or damage to the surrounding structures such as other teeth or blood vessels. 
  • Infection at the implant site. 
  • Sinus problems if the implants placed on the upper jaw protrude into one of the sinuses cavities. 
  • Nerve damage can cause pain, numbing, tingling in your natural teeth, gums or lips. 

 

So, are dental implants painful? 

People who underwent dental implant procedures say that very little discomfort is experienced. They say that dental implants involve less pain than a tooth extraction. 

 

Our role today is to answer most of your questions regarding Dental Implant. Today we have Dr. Hyun Ki Roh, who is a leading doctor at S-PLANT Dental Hospital in Seoul. He is going to discuss with us about Dental Implant from an experienced medical point of view.

Interview:

Dr. Hyun Ki Roh

What is a dental implant?

Dental implants replace damaged teeth with a titanium root and once the foundation has been stabilized, installing a crown that will act as a normal tooth.

What would happen if the patient does not do anything after removing their teeth?

Because the teeth are located in their respective places, if one is missing or lost, the overall shape and structure of the dental arch changes and dislocates. Thus, for the stability and safety of the overall teeth structure, it is best to replace the lost tooth or teeth.

How is the dental implant procedure done?

First, we surgically implant the fixture on the bone structure. Then after waiting two to three months when the implant fixture and the bone bonds we attach the prosthetic crown. In cases where the bone structure is lacking, it may take more time in order to supplement with bone grafts.

What are the steps in dental implantation?

If we look at the big picture, we have the surgical portion and the making of the prosthetics. In cases where bone mass is lacking, we may take additional time in order to supplement the missing bone structure with grafting.

Is it possible for the patient to get implants on the same day after teeth extraction?

There are cases, typically women in their forties and fifties, who need to remove all their teeth. If that happens, they need to wear dentures, but most women feel traumatic to even imagine that situation. In such situations, we try our best to implant the fixture same day in order to satisfy the needs of the patient.

What is a surgical implant guide?

We used to open up the gums a lot and perform the implant surgery while looking at the bone structure, but in doing so there is limit as to how closely we match the intended plan according the to the CT scan results. We made a surgical guide, which tells us exactly where the implant fixture goes while inserting the implant fixtures without opening the gum tissue. This process results in much less blood loss, less pain and less inflammation after surgery.

Is it possible to have an implant when the patients have systematic diseases such as diabetes and high blood pressure?

For high blood pressure patients, it is fine as long as the patient does not get nervous. With diabetes patients, as long as they are under control, it is no problem. We try to accommodate the patient’s unique situation. As long as the diabetes patient has the disease under control, it is not a big issue in performing the procedure.

Is there any age limit for this procedure?

Age is irrelevant. We even have many patients in their 80’s and 90’s. These days, just because they are in their eighties, does not mean they give up everything and simply wait until the day they go to heaven. These days, they want to keep up with their lifestyle and maintain their best. Age is not an issue.

How should patients take care of their implantation?

When the implant is done on the front teeth, we try to make a temporary prosthetic, but the patient has to watch out and avoid hard to chew foods.

How long does the dental implant last?

The implant fixture itself can last 20 to 30 years or even more. The prosthetic crown can last ten years or so, then it can be replaced. So, the fixture is semi-permanent. We work with that goal in mind.

Do implant teeth get cavities or infected as teeth does?

Unlike natural teeth, the difference is that cavities do not occur. But as the case is with natural teeth, the gums and surrounding tissues can get infected, form pus and get inflamed. So, infections can occur.

Is there any follow-up care needed after the procedure?

The most important part is for the patient to take good care of the implant. If the patient visits for checkups every six months, usually there are no issues. Maintenance is key.

Is it painful?

No. Not painful. The implant process can be less painful than tooth extraction. Long ago, implants were done with the gums being wide open which led to so many experiencing inflammation of the face and the eyes. Nowadays, we can perform the procedure with much less discomfort and way less risk of inflammation for the patient.

What type of anesthesia is used for the surgery?

Normally, local anesthesia is used routinely. For patients who are nervous and worry a lot, we use sedation like those used on colonoscopy. In cases where we have to implant large number of teeth, such as ten to twenty and the patient is very afraid, we can employ full body anesthesia where the patient essentially passes out while maintaining his or her own breathing capability. We can take three to four hours to perform the procedure and wake the patient up afterwards, we can remove all the bad teeth, implant the fixture and temporary prosthetic teeth on the same day.

Can you give us any recommendations on choosing the perfect dental hospital for an implantation?

It is important to select a hospital that has a well-maintained system that can plan step by step from planning the surgery, performing the surgery, making the prosthetics, and providing after care. Some hospitals are not well organized, doctors only do their own specialties, and the overall process is disjointed and disorganized. It is important to select a hospital that can see through the entire process from a long-term point of view.

How long does a dental implantation procedure take and how many times do the patients need to come back to do checkups?

It is a good question. Even I don’t particularly enjoy having the patient visit me too frequently. Fewer times, as much as possible, we also have many patients visiting us from abroad. We try to limit the visit to five times. The first week, the patient may visit about two times. Three to four months later, two more times. The total number of visits to the hospital would be about five, give or take. For foreign visitors, we can do it in about three months. One week at the start and then a second three to four months later. That is our protocol in general.

 

Conclusion

Dental implants are defined by replacing damaged teeth with a titanium root and once the foundation has been stabilized, installing a crown that will act as a normal tooth. Because the teeth are located in their respective places, if one is missing or lost, the overall shape and structure of the dental arch changes and dislocates. Thus, for the stability and safety of the overall teeth structure, it is best to replace the lost tooth or teeth. First, we surgically implant the fixture on the bone structure. Then after waiting two to three months when the implant fixture and the bone bonds, then we attach the prosthetic crown. In cases where the bone structure is lacking, it may take more time in order to supplement with bone grafts.

Age is irrelevant when considering getting implants. We even have many patients in their 80’s and 90’s. These days, just because they are in their eighties, does not mean they give up everything and simply wait until the day they go to heaven. These days, they want to keep up with their lifestyle and maintain their best. Age is not an issue.

The implant fixture itself can last 20 to 30 years or even more. The prosthetic crown can last ten years or so, then it can be replaced. So, the fixture is semi-permanent. The most important part is for the patient to take good care of the implant. If the patient visits for checkups every six months, usually there are no issues. Maintenance is key.

It is important to select a hospital that has a well-maintained system that can plan step by step from planning the surgery, performing the surgery, making the prosthetics, and providing after care.

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