Dental implants are an integral part of prosthetic dentistry - the aspect of dentistry generally done to replace or restore one or more teeth, because of several reasons namely: dental caries, loss of tooth because of trauma, gum disease and the unsuitability of a root canal treatment. Implants are also as much a part of cosmetic dentistry as they are a component of prosthetic dentistry. Implants are intended to take the place of bridges and dentures and are actually a lifetime answer to tooth loss. A dental implant is a synthetic tooth that is surgically combine into the jawbone. It attaches the underlying bone structure to an artificial tooth.

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There are many areas around the implants and the prosthesis that needs special attention to make sure that dental plaque does not accumulate. The home care needed for dental implants is more tedious than for your natural teeth. The critical component of you implant home care is plaque control. Proper maintenance and devices used have proved extremely helpful like soft toothbrush, dental floss, oral irrigation, and mouthwashes containing essential oils. These cleaning aids have individual instruction sheets to assist you in any way it can. Just remember, it is not the tool that counts, but the blend of proper habit, technique and adequate frequency matters.

Once you have decided to go for a dental implant, the next step would be finding a reliable dental implant specialist. A dental implant procedure requires the services of several dentists: an oral surgeon or periodontist who puts the dental implant post in the jawbone, and a restorative dentist, either a general dentist or a prosthodontist, who prepares and places the crown on the dental implant post.

A periodontist specializes in the treatment of diseases and other conditions of the supporting tissues and structures around the teeth, known as periodontium. They work on treatment and management of patients with periodontitis, gum recession and surgical placement of dental implants.

On the other hand, a prosthodontist specializes in the restoration of oral function through the creation of prostheses and restorations such as dentures, crowns and implants. Cosmetic dentistry is included in a prosthodontist’s specialization. An additional three-year specialty training is required for dentists to become prosthodontists.

There are two major types of Dental Implants which are used by dentists today:

1) Endosteal (in the bone)
is the most commonly used implant type and is used as an alternative to bridges or removable dentures, and;

2) Subperiosteal (on the bone) which is used for patients who cannot wear conventional dentures and who
have minimal bone weight.

Dental implants are used to replace a missing tooth and it comprises a titanium implant that is fused with the jawbone, the abutment which is placed over the portion of the implant that projects from the gum line, and the crown which is specially designed by a prosthodontist or restorative dentist in order to naturally fit on the abutment.

When all of the patient’s natural teeth are missing from the lower or upper jaw (complete edentulous), the ball and socket removable overdenture treatment is usually recommended. Although ball and socket overdentures can be used for both the upper and lower jaw, it is more suited for the lower jaw. This treatment might require 2 to 4 implants, depending on the quality and amount of bone present. The implants used have ball-type inserts that are cemented or screwed into them. The inserts are then fitted into an o-shaped recipient site underneath the dentures.

The fixed bridge dental implant treatment are usually built on implants only or combined with natural teeth and implants by providing support needed by the replacement teeth. The crowns are usually built upon the natural teeth and the implants if this is the recommended treatment plan. The crowns are attached to the implants using a screw or implants. Crowns placed on natural teeth are cemented on. The number of implants needed depends on the number of teeth that have to be replaced.

Dental implants may be used for single tooth replacements to replace back teeth or front teeth. Since pleasing bone cosmetics need to be placed at the front of the teeth, the bone quality and quantity at the graft site must be high; otherwise, bone grafting may have to take place. Prior to the use of dental implants, patients would have had to resort to orthodontic therapy to replace missing front teeth. However, the replacement teeth will not look as realistic as the patient would have liked. Replacement crowns from dental implants look more natural and provide patients with beautiful smiles.

The consultation before getting dental implants involve three parts: the oral examination, the x-ray examination, and the case treatment plan. During the oral exam, your dentist will evaluate the health of your gums and remaining teeth. The quality and quantity of the jaw bone where the teeth was previously located will also be examined. The x-ray exam will help determine if there is enough bone, the density of the bone, and if there is enough bone that runs above the nerve of the lower or upper jaw. Finally, the case treatment plan is when your dentist will make a projection regarding what type of treatment can be done with the bone in your jaw, how many implants will be needed, and if there are any special considerations for your case.

The success rate of dental implants is 90%. Failure usually occurs during the second surgery, when the surgeon discovers that the implant is loose and failed to integrate with the jaw bone. The loose implant is removed and another implant can be placed. Implants usually fail due to infection, surgical trauma, titanium allergies, smoking (which decreases blood flow to the healing gums), and lack of healthy bone (if jaw bone is too small for the implant to stay put, bonding will not happen).

Problems may also arise years after getting dental implants. Gums can get infected bacteria, which leads to a disease called perimplantitis. If untreated, this disease can cause bone loss and also loosens the implant. Another problem that can happen is when the denture itself breaks. This usually occurs when your bite is not aligned properly, putting too much force on the implant. The broken denture can be repaired or removed and replaced.