Dental Implants

Despite massive improvements in dental care, many people still suffer tooth loss due to a number of reasons—periodontal disease, tooth decay, and injury to name a few. For many years, the treatment options available were dentures and bridges. Fortunately, nowadays, dental implants has been added to the list.

  • The use of dental implants has been traced to around 600 A.D. when they discovered tooth-like pieces like a shell that were hammered into a Mayan woman’s jaw.
  • Dental implants are considered the only dental restoration alternative that preserves the natural bone. It is also designed to help stimulate bone growth.
  • In 1952, P.I. Branemark, a Swedish orthopaedic surgeon discovered that titanium fuses with the bone naturally. In fact, this exceptionally biocompatible metal is very strong and can withstand the pressure of biting and chewing with ease – and that’s a lot more pressure than most people realize, making it a suitable material for dental implants. Indeed, titanium can even hold up nicely against the extreme forces of space travel, when it is used in construction of the space shuttle.
  • Another important discovery is that the National Dental Centre Singapore (NDCS) has developed a second-generation bioresorbable 3D-printed dental plug that aims to improve the experience of patients who require dental implants. Patients can benefit from having one less surgery procedure, and a shorter treatment process.
  • According to the National Dental Centre Singapore (NDCS) there is a steady increase in the number of dental implant patients, with the number of dental implants placed tripling between 2005 and 2010.

An artificial tooth root that is placed into the jaw to hold a bridge or replacement tooth is called a dental implant. Dental implants are also considered artificial tooth roots and are similar in shape to a screw. When dental implants are placed in the jawbone, they bond with the natural bone. They also become a sturdy base for supporting one (or more) artificial teeth called crowns. A connector called an abutment is used and placed on top of the implant to support and hold the crowns in place. Modern dental implants have been successfully used for many decades now. Dental implants are considered the most sturdy device available that can support replacement teeth. They also allow replacement teeth to look, feel, and function naturally.

Dental implants provide numerous benefits including:

  • They behave and act like natural teeth. One of the biggest benefits of dental implants is that they help restore full chewing power. Most patients with dental implants won’t be able to tell the difference between an implant and their natural teeth. Patients can also eat using their dental implants with comfort and ease. They can floss and brush without any issues as well.
  • Dental implants can last a lifetime. While a dental bridge can only last approximately 10 years or so, dental implants can last a lifetime if they are cared for accordingly. Dental implants are made from titanium, making them biocompatible and are integrated into the jawbone. In other words, it is not toxic and will not be rejected by the body’s immune system. All in all, dental implants are truly a powerful replacement for lost teeth.
  • Dental implants can prevent loss of bone. When there is no tooth, the jawbone can deteriorate because of a lack of stimulation. If no dental implant is placed during the first year the tooth is lost, the bone area will lose at least 25 percent of its volume. Bone loss can continue over the years when left unattended. In some cases, dentures can accelerate bone loss when they become loose unlike dental implants. And because dentures can rub against the bony ridge, it can also wear it away gradually, which will not happen with dental implants. Since the dental implant not only replaces the tooth but the root as well, chewing is restored to normal and natural bone growth is stimulated.
  • Dental implants can keep adjacent teeth stable. In some cases, a gap brought about by a missing tooth can cause adjacent teeth to shift toward the gap crookedly. This can pull the teeth out of position and can affect the bite, the ability to chew, and even the appearance which is easily solvable by dental implants. It can also cause interference which can make replacement of tooth like dental implants challenging later. A poor bite can also result in issues with the temporomandibular joint (TMJ) and may lead to headaches and pain.
  • Dental implants can help prevent gum disease. A missing tooth can sometimes trap bacteria and food that can result in gum disease.
  • Dental implants can prevent premature aging and facial sagging. One unwanted effect of bone loss resulting from missing teeth is facial sagging. This occurs when the lower third of the face will collapse, closing the distance between the chin and the tip of the nose gradually. Without dental implants, changes in the appearance can include wrinkles around the mouth, a more pointed chin, and thinning lips. All these changes can make the person look older than their real age, which are preventable by dental implants.
  • Dental implants can help improve overall oral health. Unlike tooth-supported bridges, dental implants won’t require reducing other teeth. Since teeth that are nearby are not altered in order to support the new dental implant, more of the teeth are left intact thereby improving oral health in general. Individual dental implants also make easy access between teeth possible, improving overall oral hygiene.
  • Dental implants can provide convenience. Unlike removable dentures, you won’t have to go through all the hassle and inconvenience of removing dentures with dental implants, as well as the need to use messy dental adhesives just to keep them in place.
  • Endosteal (in the bone). This is the most prevalent type of dental implant used. The various types can include blades, cylinders, and screws being surgically placed into the jawbone. Each dental implant will hold one (or more) prosthetic teeth. This type of dental implant is generally an option for those patients with removable dentures or bridges.
  • Subperiosteal (on the bone). This type of dental implant is placed on top of the jaw. The posts of the metal framework will protrude through the gum to hold the prosthesis. This type of dental implant is considered ideal for patients who have minimal bone height and are unable to wear traditional dentures.
    As mentioned earlier, dental implants are placed in the jawbone surgically so they can act as roots of the missing teeth. Since the titanium dental implants fuses with the jawbone, it won’t make noise, slip, or cause any bone damage. Generally, dental implants can be the best option for patients who have:
  • One or more missing teeth
  • A jawbone that has already reached full growth
  • Adequate bone structure to hold the implants in place
  • Healthy oral tissues
Preparing for a Dental Implant surgery

Since dental implants can require one or more surgical procedures, a thorough assessment is needed, including:

  • Comprehensive dental exam. Dental X-rays and models of the teeth and mouth might be required to determine whether there is sufficient bone for dental implants.
  • Treatment plan. A treatment plan is tailored for each patient since individual factors can affect the success of a dental implant procedure, like the number of teeth to be replaced as well as the jawbone’s condition. The planning process may entail the involvement of a variety of dental specialists including a dentist who’ll work with the structures that will support teeth, a dentist who specializes in conditions of the jaw, mouth, and face, and a dentist who will restore dental implants using bridges, crowns, or dentures.

Patients will be asked about any medical conditions or medications they are taking including supplements, over-the-counter drugs, and prescriptions. Those who have orthopaedic implants or certain heart conditions may be prescribed antibiotics prior to surgery to help ward off infection in dental implant wounds.

What To Expect

Typically, dental implant surgery is an outpatient procedure that’s carried out in stages:

  • The damaged tooth is removed.
  • The jawbone is prepared for surgery. This process might involve bone grafting.
  • After the jawbone heals, the oral surgeon then places a dental implant post in the jawbone.
  • There is a healing period that can last several months.
  • The dentist places an extension of the dental implant metal post called an abutment. When the implant is very stable, the implant is placed the same time the procedure is done.
  • Once the soft tissue has healed, the dentist will create a mold of the jawbone and teeth and place the final tooth or teeth later.

The whole process for dental implants might require many months from start to finish. Majority of the time will be devoted to healing and waiting for the new bone in the jaw to grow.

Bone Grafting

If the jawbone is too soft or not thick enough, bone grafting might be required before dental implant surgery is carried out. This is because the powerful chewing action will exert tremendous pressure on the bone. If the jawbone is not strong enough to support the implant, the surgery would be futile. A bone graft is needed so there is a solid base for the implant.

For bone grafting, a piece of bone might removed from another part of the body like the hip or the jaw and transplanted to the jawbone. Another alternative would be to make use of artificial bone. Typically, it can take several months for new bone to grow and support the implant.

In other cases, only minor bone grafting is needed so it can be done at the same time as the implant surgery. In essence, the jawbone’s condition will determine how things will proceed.

Dental Implant Surgery Procedure

During the surgery to place the dental implant, the gum will be cut open to expose the bone. Holes are then drilled into the bone where the dental implant’s metal post will go. Since the post will act as tooth root, it is implanted deep into the bone.

Bone Growth

After the metal implant post is placed in the jawbone, osseointegration will begin. During the process, the jawbone will grow into and unite with the dental implant’s surface. The process, which takes several months, will help provide the new artificial tooth with a solid base—the same way roots do for the natural teeth.

Placing the Abutment

Once the osseointegration has been completed, additional surgery might be needed to place the abutment. The procedure is done in an outpatient setting and is typically performed with a local anaesthesia.

The procedure will involve:

  • The oral surgeon opening the gum to expose the dental implant.
  • Attaching the abutment to the dental implant.
  • Closing the gum tissue around the abutment.
Choosing the Artificial Teeth

After the abutment has been placed, the gums need to heal for a week or two before the artificial tooth is attached. Once the gum heals, more impressions of the mouth and the remaining teeth will be made.

The impressions are used to make the realistic-looking artificial tooth or the crown. The crown won’t be placed until the jawbone is strong enough to be able to support the new tooth.

The patient and the dentist have the option to choose artificial teeth that’s fixed, removable, or a combination of the two.

  • Removable. This kind is similar to the traditional removable denture. It is an artificial white teeth surrounded by a pink plastic gum. It is mounted on the metal frame that is attached to the implant abutment and it snaps it in place. It can be easily removed for daily cleaning or repair.
  • Fixed. This type is permanently cemented or screwed onto the individual implant abutment. It can’t be removed during sleep or for cleaning. Most of the time, each of the crown will be attached to their own dental implant. However, since implants are often very strong, several teeth can be replaced using only one implant given they are bridged together.

Majority of the dental implants performed have been successful. However, to help ensure the dental work (alongside the remaining natural teeth) lasts longer, the following should be observed:

  • Excellent oral hygiene. Just like the natural teeth, implants, gum tissue, and artificial teeth should be kept clean. Specially designed brushes like the interdental brush can slide between the teeth and help ensure the gums, metal posts, and the nooks and crannies are cleaned.
  • Regular dentist visits. To ensure the good health of the teeth and proper functioning of the implants, regular checkups should be scheduled.
  • Avoid damaging oral habits. Avoid chewing hard items that can break the crows (and even your natural teeth). As much as possible, avoid tooth-staining tobacco and other caffeine products.
Frequently Asked Questions about Dental Implants

Dental implant surgery is one of the safest procedures in dentistry and it is the only restoration method that stimulates natural bone beneath the missing tooth.

Every case is unique, and every patient heals differently. Your dentist is the best person to as and he or she can provide an estimate of how much chair time to expect.

Most patients can be fully sedated, partially sedated, or numbed with anaesthetic. Our goal is to maintain at little to no discomfort. Implants can also be placed with the assistance of dental lasers. Lasers offer leading-edge techniques for successful implant placement and patient comfort.

Dental implants can take two to several months to integrate into place. The bone around a new implant needs time to heal so it can secure the implant into place.