A dental implant is a titanium metal post that bonds to bone - a replica tooth or teeth are fixed onto the top of this post (see Figure 1). The modern day implant is manufactured by several companies who all claim specific advantages.

Who needs dental implants

People are primarily motivated to have dental implants by a desire to eat more easily and to eat a wide range of foods. It is a strong quality of life issue for many people. People who should consider dental implants include:

  • those with missing teeth
  • those who cannot tolerate dentures
  • those who want a permanent replacement that looks and feels like their own
Dental implant of a single tooth

Figure 1

Dental implant of a single tooth
A: Space where tooth is missing
B: Implant
C: Crown (new tooth) in place

Dental implants are no more painful than any other surgical dental treatment

The process for dental implants takes several months, but the success rate is higher than any other procedure and the risks are minimal. The only risk, as with any surgical procedure, is that of infection.

  1. First, the mouth area is given an X-ray, CT, or MRI scan. The image is used to plan the size and placement of the implant. CT and MRI systems are often restricted by their cost.
  2. Next, the mouth area is frozen with a local anesthesia and the jaw bone exposed by surgically lifting up the gums. A special drill prepares the site that will hold the implant. The actual placement of the implant in bone is a simple procedure using slow-moving, water-cooled drills. The soft tissue (gums) is then placed back. At this time there are 2 important options:
    • Completely cover the implant while it heals and bonds to the bone. This option means a second surgical exposure is necessary in 2 to 6 months (Branemark system).
    • Leave the neck of the implant exposed in the mouth, thus eliminating the need for a second surgical visit (Straumann system).
  3. The implant is left undisturbed for several months, during which time the bone bonds to the metal implant. The technical term for this process is osseointegration. The amount of time needed for healing depends on bone density, blood supply, and possibly variation in implant design. If bonding is not successful it can be repeated until success is achieved.
  4. After 2 to 6 months, the patient goes back to the office for an "impression" visit. Impressions of the jaw, soft tissues, and teeth are taken, as well as how the teeth meet. Patient and dentist also select the colour and shape of the replacement tooth. These records are sent to the dental technician.
  5. One week later the finished tooth is placed permanently in the mouth. Again, the placement can be done in 1 of 2 ways: it can be cemented (glued) onto the implant or it can be screwed onto the implant.

Implants can dramatically increase quality of life

Patient satisfaction is extremely high, whether the implant is a single tooth or a complete denture. Possibly the most dramatic results are seen with patients who cannot wear complete dentures. The universal response is one of increased quality of life. There is no age limit for this procedure. The dentist will determine suitable candidates based on an individual evaluation, but the most important consideration is the amount of bone in the jaw for the implant to adhere to.

Alexander Yule , BDS, MDS