Dental implants have been around for years, and with very good reason: They are the most successful way for teeth replacement by far. Their success rates are well over 95%, and their lifespan extends beyond 15 years on average. If you are missing a tooth or a group of teeth, then implants are probably the right choice for you, but how are they placed? Is the surgery painful? Can everybody get implants straight away? Let’s cover some basic things first.
How are dental implants placed?
Dental implants are usually placed on 2 stages:
• The surgical stage:
Where a screw-like structure is placed inside the bone and is left to heal for a period of time (usually between 3 and 6 months).
• The prosthetic stage:
Where the overlying crown will be placed after the bone healing period.
Are dental implants procedures usually so straightforward?
If you seek replacement as soon as your tooth is lost, then chances are the procedure will be smooth and easy. Just a simple half-hour procedure to place the screw in the bone, followed by a few stitches, with very minimal post-operative pain or swelling.
Waiting, however, has a lot of detrimental effects, mainly:
• Sequential loss of bone structure:
When a body organ isn’t used, it starts to weaken and fade away. The jaw bones’ main job is to hold the teeth in place, and so when the tooth is lost, that function is also lost. Over time, the bone starts to degrade both in height and in width.
• Recession of the gums:
The gums are held firmly in position by both the bones and the teeth, so when those two are lost, the gums usually follow them.
• Enlargement of the sinus space:
The maxillary sinus (a space of air that helps in breathing) is located just above the roots of the upper back teeth. With age – and teeth loss – that space starts to enlarge and creep into the surrounding bone. The end result is a very large sinus and very little bone in the area.
What happens in these cases?
That’s where bone and soft tissue improvement surgeries come in. The bone has to be in perfect condition before attempting to place a dental implant since the success of the implants mainly depends on the success of the bone’s healing process. The area has to be conditioned to receive the implant to ensure its success. If the bone condition is not optimal, we risk placing too much stress on the implant during the healing, which could eventually lead to the failure of that implant. The failure may not be immediate, and your implant could stay in your mouth for a while, but the projected 15 years or more of service is cut short.
These improvement surgeries include:
• Bone grafting:
This basically means adding to the existing bone, improving its quantity (both in height and width) as well as quality. The bone can be autogenous (meaning it comes from your own body) or synthetic.
• Sinus lifting:
A supplemental bone improvement surgery. Sinus lifting is the same as bone augmentation, but with an added touch: The sinus lining is “lifted” upwards and held in place by the bone graft. In the end, what we get is more bone height for implant placement.
• Soft tissue grafting:
The bone is not the only factor for the success of dental implants. The gums overlying the bone must also be healthy, strong, and of adequate amount. If the gums have receded significantly while you were without teeth, then they need to be improved by grafting just like the bone.
That all sounds scary and complicated, is it worth it?
It really isn’t. Both procedures are simpler than you think. In fact, in most cases they are done simultaneously with the implant placement, so you will only undergo one – very minor – surgery. However, in cases of severe bone loss or severe sinus enlargement, the surgeon will opt for a 2 stage surgery, one where the graft is placed and one for the implants about 4 to 6 months later. It will only add a few months to the treatment plan, but will certainly improve the longevity and success of your implant.
All in all, it is far better to choose a bone improvement surgery than another form of tooth replacement. Not to take anything away from dentures or bridges, but none come even close to the comfort, success, and lifespan of dental implants.