A Guide to Dental Implants

Dental implants are a popular choice for patients who have missing teeth, often as a result of an accident or injury. Patients who have to wear dentures or a bridge are also suitable for dental implants.

An implant is a thin, metal rod, often made from titanium which acts an artificial tooth root and forms an attachment for a replacement tooth.

Implants are strong, long lasting and indistinguishable from natural teeth. They look and behave in exactly the same way as ‘real teeth’ and can hold a single tooth or several via an overdenture or bridge.

They do require the same amount of care and attention as natural teeth. This means daily brushing and flossing plus regular checks up with the dentist.

• Can I have an implant?
• How much do dental implants cost?
• How long does dental implant treatment take?

These are just some of the more commonly asked question about dental implants.

What is a dental implant?

A dental implant is an artificial replacement for the root part of a tooth. An implant takes the form of a small metal post which is screw or cylinder shaped and is usually made of titanium.

Titanium is the most popular material used as this works well with living bone and tissue with living bone and tissue, without any risk of rejection or inflammation.

Other materials can be used which include titanium alloy, stainless steel and zirconium.

The implant is inserted into your jawbone and allowed time to fuse with the bone in a process called ‘osseointegration’. Once this has happened, a replacement tooth called a restoration can be fitted to it via a small attachment.

Implants can be placed in either your upper or lower jaw and can hold several teeth in place at once.

An implant is seen as a prosthetic replacement for the problem of missing teeth although it also falls into the cosmetic dentistry category.

There are two types of implant:

• Endosteal (‘Root Form’)
• Subperiosteal

The subperiosteal implant usually takes the form of a metal framework which is placed onto the jawbone just underneath the gums. This framework has small metal posts which protrude through the gums. These enable the attachment of replacement teeth. This type of implant is less commonly used.

The ‘Root Form’ implant is the most popular type of implant and is inserted into the jawbone.

Most patients are suitable for a dental implant although there are exceptions. Mini dental implants are a good choice for those patients who for a variety of reasons are unable to have the conventional type of implant.

What is the dental implant procedure?

The procedure is usually carried out in two stages – known as a ‘two stage placement’ although some clinics are offering a single stage procedure called ‘immediate loading’.

The two stage placement procedure starts with an initial consultation, which includes an x-ray. This enables the dentist to check the positioning of your teeth and the condition of your jaw.

The latter part is important because your jaw needs to have enough bone density to hold an implant in place. Many people find that they have bone loss as a result of missing teeth or the ageing process. If this is not attended to then it can leave you with a sunken cheeked appearance.

If the treatment is to take place on your upper jaw and you have bone loss in that area then you will require a sinus lift.

To learn more about this procedure visit our dental sinus lift section.

First stage

If you have bone loss then you will require a bone graft. This involves taking bone from a donor site and grafting this into the jaw to increase its depth. There are 4 types of bone graft:

• Autogeneous (also known as an Autograft)
• Allograft
• Xenograft
• Alloplastic

Autogenous graft is the preferred form of bone graft. It involves the dentist taking some donor bone (usually from the chin or hip) and grafting this into the jawbone. This will help to build up a thinning jawbone.

Allografts are a type of graft that is very similar to an autogenous graft except that the bone is taken from a human donor via a ‘bone bank’. This bone is checked and sterilised thoroughly before use.

Xenografts use bone taken from an animal source rather than a human donor. The preferred source is bovine (cows) and it is designed to act as a temporary measure until being replaced with your own bone. This type of graft is subject to rigorous testing and sterilisation to ensure that it is compatible with your own bone.

Alloplastic grafts differ from all the others in that a synthetic form of graft is used. It is made of calcium phosphate and looks almost the same as natural bone.

Bone grafting can be done either before or during the implant procedure.

This stage also includes the insertion of the implant. If you are having the Root Form implant then the dentist will make an incision in your gum to expose your jawbone. He or she will then drill a tiny hole in the jawbone, before inserting the implant.

The implant will either be screw or cylinder shaped.

This process is repeated if you are having more than one implant.

Once it is in place the dentist will close the gum with a series of stitches and allow this to heal. The aim is for the implant to fuse with your jawbone in a process called ‘osseo-integration’. This process can take up to 6 months and during that time, the implant will fuse with the bone to form a solid structure.

This is usually successful although failure can happen.

Your dentist may fit a temporary replacement tooth during this time.

Second stage

The second stage involves the dentist re-opening the gum incision, to reveal the implant, before fitting a small attachment, called an abutment into the top of it. This abutment acts as a connection between the implant and a replacement tooth.

The dentist then attaches the replacement tooth to the implant. If you are having several implants then he or she will attach a bridge (several teeth joined together) or an overdenture.

The procedure can take from 30 minutes up to 4 hours depending on the amount of work to be done. If you are having a bone graft at the same time then this will increase the duration.

You will experience some pain and discomfort after the procedure but painkillers will control this.

Depending on the extent of the treatment it can take from a few weeks to several months for everything to completely heal.

This two stage process is also known as ‘delayed loading’.

A dental implant can also be a good replacement for a damaged or broken tooth. If this is the case then the damaged tooth will have to be removed before an implant can be placed.