How are dental implants placed?
Most dental implant surgery procedures are performed in the dentist’s office and occasionally in a hospital setting. Local anesthesia is usually adequate for these out-patient procedures but various other forms of patient sedation (such as nitrous oxide, and oral/or intravenous sedation) may also be used. Adjunctive surgical procedures, such as bone augmentation, may be performed as separate procedures or at the same time as implant placement. Each surgical procedure is different depending on the clinical situation as well as the preferences of the patient and dental practitioner/ surgeon.
Why is the surgical procedure a three-step process?
The most widely practiced method of placing dental implants is a “staged surgery” procedure. The first stage consists of surgically burying the implant (which replaces the tooth root) flush with the bone but underneath the gum. This protects the implant from
force while it is healing. At the end of this healing period, the implant needs to be surgically exposed by removing some of the overlying gum.
At this second stage, the surgeon checks the implant for its successful integration and connects some form of post which penetrates through the gum into the mouth. This post is called the abutment. Abutments come in many forms and can be stock-manufactured or custom-molded by your dentist and a laboratory. The gum is allowed to heal around the abutment and form a cuff or collar through which the dentist has access to the implant when preparing the final restorative stage of placing the prosthetic tooth or teeth.
Research has shown that it is often possible to place a suitable abutment at the same time as the implant. This has certain limitations but can eliminate the need for a second surgery to expose the implant. However, the implant still requires adequate healing time for the bone to osseointegrate.
The abutments must also be protected from chewing forces during this period to assure effective bony integration and successful healing. Once the implants have had a chance to heal and have been tested for successful integration, the third step of surgery takes place. This stage consists of fabricating and connecting the prosthetic teeth to the successfully osseointegrated implants.
What is One-Stage Surgery?
This method employs a non-submerged one-piece implant that has a metal collar designed to protrude through the gum while the bone is healing to the implant. After a suitable healing time, an abutment can be connected to the implant, allowing for fabrication of the crown to replace the missing tooth. Alternatively, a one-stage technique can be achieved by immediate connection of a temporary healing abutment to a two-piece implant that protrudes through the gum in much the same way as a one-piece implant. Both single stage and two-stage implants have similar success rates and you should ask your dentist which systems they use and discuss how one- or two-stage procedures might be appropriate for you.
What is the overall success rate for dental implants?
Despite decades of clinical and scientific research, dental implants do not have a 100% success rate. However, the success rates have improved dramatically since the introduction of dental implant surgery and the dental profession can proudly report success rates well above 90% for most implant patients. Similarly, long-term success rates are in the high 90% range and are likewise improving. When a dental implant has not successfully integrated, it may need to be removed, as it cannot easily be “converted” to osseointegrate. Your dentist will give you best advice about this. A replacement implant can be placed but it may require some months of healing time and possibly bone augmentation (repair by means of grafting). Likewise, if a previously placed implant has lost significant amounts of supporting bone, there are currently no treatments that can predictably restore the lost bone after it has been in function in the mouth.
Dental bridges literally bridge the gap created by one or more missing teeth.
A bridge is made up of two or more crowns for the teeth on either side of the gap — these two or more anchoring teeth are called abutment teeth — and a false tooth/teeth in between. These false teeth are called pontics and can be made from gold, alloys, porcelain, or a combination of these materials. Dental bridges are supported by natural teeth
What Are the Benefits of Dental Bridges?
- Restore your smile
- Restore the ability to properly chew and speak
- Maintain the shape of your face
- Distribute the forces in your bite properly by replacing missing teeth
- Prevent remaining teeth from drifting out of position
What Types of Dental Bridges Are Available?
There are three main types of dental bridges:
- Traditional bridges involve creating a crown for the tooth or implant on either side of the missing tooth, with a pontic in between. Traditional bridges are the most common type of bridge and are made of either porcelain fused to metal or ceramics.
- Cantilever bridges are used when there are adjacent teeth on only one side of the missing tooth or teeth. This is not very common any more and is not recommended in the back of the mouth where it can put too much force on other teeth and damage them.
- Maryland bonded bridges (also called a resin-bonded bridge or a Maryland bridge) are made of porcelain, porcelain fused to metal, or plastic teeth and gums supported by a metal or porcelain framework. Metal or porcelain wings on each side of the bridge are bonded to your existing teeth.
What Is the Process for Getting a Dental Bridge?
During the first visit for getting a dental bridge, the abutment teeth are prepared. Preparation involves recontouring these teeth by removing a portion of enamel to allow room for a crown to be placed over them. Next, impressions of the teeth are made, which serve as a model from which the bridge, pontic, and crowns will be made by a dental lab. Your dentist will make a temporary bridge to wear to protect the exposed teeth and gums while the bridge is being made.
During the second visit, your temporary bridge will be removed and the new porcelain or metal bridge will be checked and adjusted, as necessary, to achieve a proper fit. Multiple visits may be required to check the fit of the metal framework and bite. This is dependent on each individual’s case. If the dental bridge is a fixed bridge, your dentist may temporarily cement it in place for a couple of weeks to make sure it is fitting properly. After a couple weeks, the bridge is cemented into place.
With both treatment modalities being actively used to replace teeth,an insight into a comparative analysis:
“DENTAL IMPLANTS V/S DENTAL BRIDGES”