Dental Implants

What is a dental implant?

Your natural tooth is made up of a root and a crown. The visible part with which you chew your food is the crown. The root lies underneath the crown and serves to anchor the tooth through the gum to the jawbone. When you lose a tooth both the root and crown are lost. A dental implant is a man-made titanium post that replaces the root. It is shaped like a screw or a cylinder. Your dental surgeon creates a socket in your jaw bone into which the implant is fitted. The jaw bone then fuses with the implant and forms a support onto which an artificial tooth or prosthesis is built. Titanium was chosen as the source material for implants because it is most compatible with the human body, that is, it is rarely rejected.

 

The proper positioning of a dental implant within the jawbone is a carefully planned process which is critical to the success of the procedure. Clinical evidence has repeatedly shown the stable healing of soft tissue and bone around the implant allowing for a predictable long-term result. This X-ray with its matching clinical picture illustrates how a dental implant has replaced a patient’s front tooth.

 

To learn more about dental implants at our Montreal office please view these in-depth multi-media presentations designed to answer many of your questions.

Dental Implant Presentations

dental implants presentation

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How does tooth loss occur and how does it affect your life?

You may lose a tooth as the result of an accident, tooth decay, or infections of the gum and surrounding bone tissue (known as periodontal disease). Some individuals have teeth that have been missing since birth. Missing teeth can cause you discomfort when you eat or speak and lead to muscle pain in your jaws or headaches due to the extra stress placed on the rest of your teeth. The change in your appearance may make you feel awkward in social situations.

 

How can dental implants help?

Implants look, feel and function like natural teeth that are part of your mouth. They can replace one, several or all of your teeth. As they substitute for missing tooth roots, they preserve the surrounding bone by stimulating new bone growth and thus prevent the break down of bone that would normally occur when teeth are missing or replaced by bridges, partials or dentures. The structure of you face is maintained and you can eat and smile confidently. You are also spared the potential discomfort of poorly-fitting dentures and partials. With the evolution of state of the art technology and over 30 years of research and clinical experience, most patients, regardless of age, can benefit from implant treatment. This provides a stable, attractive, comfortable and long-lasting result.

Working as team

The implant process is a team approach involving you, your surgeon (who places the implant) and your restorative dentist (who builds the replacement teeth). They work together to develop a treatment plan that best meets your needs. It is important that you take an active role by making a commitment to:

  • Keep all your appointments.
  • Maintain your oral health during the procedure and thereafter.
  • Continue to have check ups at least every 6 months.
  • Promptly get in touch with your dental professional if problems arise.

 

Am I a candidate for dental implants?

To determine if dental implants are the right option for you, you will need to undergo a complete dental evaluation involving a dental exam, medical history, X-rays, and possibly CT scans.

 

The examination will reveal important information about the structure of your mouth including:

  • How your jaws fit together.
  • Whether you have enough bone in your jaw. This is done by measuring the height and width of your jawbones.
  • Whether your gums are healthy. Any gum disease that is found must be treated before the implants can be placed.
  • The condition of any existing dentures or dental work.
 

anatomical features for dental implant assessment

 
This diagram illustrates the key anatomic structures that are examined during an assessment before implant surgery.

Your surgeon will want to know about your general health, any medical conditions, allergies and previous dental treatments such as crowns and bridges. You should tell him about any medication you are taking, especially blood thinners including aspirin or insulin. He will talk to you about some medications and certain habits such as smoking that can affect the healing process. If you have a condition such as diabetes, you may need to have blood tests to make sure it is in control before the implant is placed. To ensure the success of your implant procedure, it is very important that your surgeon learns as much as possible about your medical and dental history.

Dental X-rays and scans help your surgeon to see of parts of your mouth and head that are not visible in the examination. He gets a better view of your teeth and jaws with dental X-rays and a wider view of the jaw, nerves, teeth and sinuses with panoramic X-rays. In certain cases the surgeon will ask you to have a CT-scan and X-ray tomography in order to have a three-dimensional view.

 

A panoramic X-ray (Roll over the text links below to animate this X-ray.)

 
 

A CT Scan

 
CT scan for dental implants CT scan for dental implants
 

During the planning stages in the preparation for dental implant placement, it is very important, in some cases, for the surgeon to have very detailed information about the shape and size of the very specific area into which the implant will be placed. The computerized tomography scan (CT scan) provides additional details that cannot be obtained with a regular dental X-ray.

 

If your surgeon finds that you do not have enough healthy bone or gum tissue in your jaw, a can be done to help build up the necessary tissue and create a solid platform for the implant. A healing period of between 3 and 9 months may be required before the implant can be placed.

You and your surgeon will discuss a treatment plan that will be suitable for you. Your surgeon will explain the steps in the process, including the time frame and costs involved.

How is the dental implant procedure done?

The procedure usually involves one main surgery that may be followed by minor adjustments to the surrounding gum tissue after the implant site has healed.

  • Generally, the surgery will be performed in a dental office.
  • The length of time it will take will vary depending on the number of implants to be placed. Surgery involving a single implant normally takes about an hour.
  • Your surgeon may offer you some medication that will make you feel relaxed or sleepy. The surgeon will then freeze your jaw.
  • The jawbone is exposed through an incision in the gum and a small hole is drilled for the implant.
  • The bone is prepared by drilling a hole in the jawbone that is the right size to receive the implant.
  • Using surgical instruments a space or “socket” is created.
  • The implant is inserted into the socket, by twisting or gently tapping it into place.
  • As required, the incision is closed with sutures.

 

What can I expect after dental implant surgery?

You may rest for short while in the office and then return home. If you have received a medication to make you sleepy you must not drive for 12 to 24 hours afterwards and should bring a responsible adult to take you home. You will be advised and provided an instruction sheet on what to eat and how to care for your mouth after the procedure:

  • Take your antibiotics and pain medication.
  • Hold an ice pack to your face at 30 minute intervals for the first 48 hours to reduce the swelling.
  • Eat soft foods such as yogourt, soup, milk products and jello for the first few days.
  • Try not to put pressure on your jaw.
  • Do not wear your temporary prosthesis until your surgeon advises you to do so.

    Contact your surgeon if you experience:
  • A lot of swelling under the tongue or around the face and neck
  • Continuous bleeding
  • Jaw or mouth pain that does not stop after you take the pain medication you have been given.
  • Fever (greater than 38.5°C)
  • Numbness after the anesthetic has worn off.
    •  

What are the next steps after dental implant surgery?

  • In order for your implant to heal, your jawbone must fuse to the implant. The duration of this healing interval is influenced by factors such as bone density, bone grafting (if performed) and the type of dental implant. The healing period ranges from 6 weeks to 4 months. The healing time will be discussed with you and is usually determined by your surgeon at the time of implant placement.
  • Your surgeon may choose to place healing “caps” or abutments on your implants to help the gum to heal. Once the implants have healed completely, between 6 weeks and 4 months after surgery, the final abutments that will connect the implant to the prothesis will be placed.

What is the “one-step” (immediate implant) approach?

  • In most cases the entire implant procedure can be completed in one surgery. Healing “caps” or abutments are placed on the implant at the same time that the implant is placed.
  • Under the right conditions, your dentist may immediately place a temporary crown on the newly inserted implants. This is referred to as “immediate loading”.
  • Stitches are then used to close the space between the gum and implant.
  • Although this method requires only one surgery and is often preferred by patients, it is not always the best choice and each case must be considered separately.
 

The one-step approach (Roll over these small images to animate.)

 

How are my artificial teeth or “dental prosthesis” made and what options are available to me?

  • After your gums have healed, your restorative dentist will take impressions (molds) of your teeth, jaw and abutments as well as bite registrations that show how your jaws fit together. A model of your mouth will be created from which your prosthesis will be made.
  • This process may take several weeks to months. Once the prosthesis is ready, you will need several fittings to adjust it for a comfortable fit.

What dental implant options are available to me?

 
dental implants

A single prosthesis to replace one missing tooth.

 
dental implants

A partial, fixed bridge replaces two or more teeth and is supported by two or three implants.

 
dental implants A complete denture prosthesis is offered to patients missing the entire upper or lower set of teeth. The number of implants that are need to support it depends on whether the prosthesis is fixed or removable.
 
dental implants A removable prosthesis is connected to 4-6 implants (upper jaw) or 2 – 4 implants (lower jaw) by a bar or clip. You can take it out of your mouth for cleaning. Since the bone in the upper jaw is not as hard as in the lower jaw, a larger number of implants may be needed.
 
dental implants A fixed prosthesis is usually supported by 5 or more implants. The teeth are fitted to a frame that is attached to the implants by screws or clasps. As this permanent denture does not touch your gums with proper technique you can clean under it. It can only be removed by your dentist.
 
You and your surgeon will discuss the options in your case and decide on the best type of prosthesis for you.
 

Complete Upper Implant Case (Roll over these small images to make them larger.)

 
 

How do keep my abutments, crowns and prosthesis clean after implant therapy?

It is equally important to keep your dental prosthesis clean, as your natural teeth. Good dental hygiene is essential to ensure that your implants, crowns and prosthesis function well for many years. Lack of proper care can lead to inflammation of the gums and bone surrounding the implant with possible loss of the implant, just as with your natural teeth.

Optimal dental hygiene involves daily brushing of your crowns or prosthesis after every meal and at bedtime. You need to pay special attention to cleaning the abutment posts (“caps”), underneath the prosthesis, and the area around the gums. Flossing at least once a day between your teeth and around the prosthesis is important, so that areas that your toothbrush cannot reach are kept clean.

  • For a single implant-supported crown, you should brush the top and back as you would your natural teeth, as well as your gums and abutments. Floss the crown as you do your natural teeth. You may choose an interdental brush with a bent handle to clean around your abutments.
  • For a fixed prosthesis, brush the tops and back as your natural teeth. The abutments should be flossed from the front, back and sides.
  • If you have a removable prosthesis, you should first remove it and then brush both the inside and outside surfaces. While your prosthesis is still out of your mouth, floss the area around the abutments.

Your dental hygienist or assistant will help you find the right combination of cleaning techniques and instruments for your mouth. These are some options:

  • Soft or ultra-soft toothbrushes are recommended. Among the choices are Butler’s “Right Kind” (#300) and one of Butler’s Series #465, which is made in three varieties of bristles.
  • We recommend extra thick floss to clean your abutment posts. Some of the choices are cotton ribbon, tufted floss (Oral B “Super Floss”) or flossing cord (Butler’s “PostCare”).
  • Other cleaning instruments that can be helpful to maintain your dental hygiene include:
    • Nylon –coated interproximal brushes for cleaning surfaces between implant posts
    • End –tuft brushes (tapered Oral-B #308 and flat Oral-B #307) for cleaning surfaces between implant posts
    • Electric toothbrush (Braun Oral-B Plaque Remover, Braun Oral-B Plaque Remover #D, Sonicare, Rota-Dent) – These are not to be used for the first week after implant surgery.

If you have difficulty seeing your abutments clearly, you can use a lighted magnified make-up mirror. In particular, if you wear bifocals, you may want to purchase full frame reading glasses that are available without a prescription at the pharmacy. They can help make the cleaning process easier for you.

If you have questions or difficulty with maintaining your dental hygiene after implant therapy, we encourage you to contact our hygienist and she will be pleased to assist you.

 

How often do I need to have follow-up check-ups?

It is recommended that you visit your restorative dentist at least twice a year to clean your abutments and check that your crowns or prosthesis are fitting properly. You should visit your oral surgeon at least once a year so that she or he can check that your implants are stable and your gums and jaws are in good health. With usual wear over time implants may require some adjustments or repairs such as replacement of clips, relining or tightening of screws.

 

How successful are dental implants and how long can they last?

According to documented studies, implants have demonstrated a success rate of 80-90% in patients who have lost all their teeth and over 90% for those receiving a one or several implants. It is very important that you maintain good dental hygiene to ensure that your implants last for many years. There are patients who have maintained their titanium implants and prostheses for over 30 years and they continue to function well.

 

What are my options if I am not a candidate for dental implants?

If dental implants are not the right choice for you, you can replace a missing tooth with a bridge supported by adjacent crowns. Adjusting an existing denture may provide a better fit. You may also elect to have implants at a later time.

 
 
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