How Much Do You Know About Dental Implant?

Posted on Posted in Oral Surgery, Periodontology, Prosthodontics

What Is A Dental Implant?

A Dental Implant is a surgical component that interfaces with the bone of the jaw or skull to support a dental prosthesis such as a dental bridge, crown, denture, facial prosthesis or to act as an orthodontic anchor.

In 1952, Professor Per-Ingvar Branemark accidentally discovered that when pure titanium comes into direct contact with the living bone tissue, the two components literally grow together to form a permanent biological adhesion. Professor Per-Ingvar Branemark called this phenomenon as Osseointegration. This shows that bio-compatible titanium implants could achieve a bone-to-implant contact.

Osseointegration has become the basis for modern dental implantology, in which bio-compatible materials such as titanium form an intimate bond to bone. A dental implant consists of 3 basic parts, namely implant body (fixture), abutment and prosthetics. The implant fixture is first placed into the jaw bone so that it is likely to osseointegrate, then an abutment and dental prosthetic are added. A variable period of healing time is needed for osseointegration to take place before either the dental prosthetic (a crown, bridge or denture) is attached to the implant or an abutment is placed which will hold a dental prosthetic.

Dental Implant – Photo By Andrew55austin (Own work from http://bendimplantdentistry.com/) [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
What Are The Indications Of Dental Implants?

There are various conditions in which dental implant could be considered as one of the treatment options in replacing the missing tooth/teeth. These conditions include:

  1. For a single missing tooth replacement.
  2. Patient desire.
  3. Patients who are unable to wear removable partial denture.
  4. Patients with Maxillo-facial deformities.
  5. Patients with partially edentulous arches where removable partial denture may weaken the remaining teeth.
  6. Patients who are completely edentulous with adequate alveolar bone height.

Implant Retained Bridge – Photo By Coronation Dental Specialty Group[1] (Own work) [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
What Are The Contraindications Of Dental Implants?

Contraindications of dental implants can be further divided into 2 categories, namely general contraindications and local contraindications. These are explained further in the section below.

  • General Indications:
    • Absolute Contraindications (Serious general body conditions which make the surgical procedure inadvisable):
      1. Active cancer.
      2. Bone diseases such as osteomalacia, osteoporosis, brittle bones syndrome, Paget’s disease and etc.
      3. Certain Immunological diseases.
      4. Patients under Immunosuppressant treatments.
      5. Certain mental diseases.
      6. Heart diseases such as previous myocardial infarction, severe cardiac insufficiency and cardiomyopathy.
      7. Jaw bones that are strongly irradiated due to radiotherapy treatment.
      8. Patients under treatments of osteoporosis and cancers.
      9. Children whose jaw bones are still growing (until the age of 17-18 generally)
    • Relative Contraindications:
      1. Uncontrolled Diabetes Mellitus (especially the insulin-dependent type).
      2. Angina Pectoris.
      3. Heavy tobacco smoking habit.
      4. Certain mental illness.
      5. Alcohol abuse.
      6. Pregnancy.
      7. Certain autoimmune disorders.
  • Local Contraindications:
    1. Alveolar bone where the dental implants in intended to be placed shows signs of infections, having inadequate bone structure, or insufficient alveolar bone height or width.
    2. Poor oral hygiene.
    3. Para-functional oral habits such as Bruxism (Teeth Grinding).
    4. Presence of periodontal diseases.
    5. Allergy to certain metals.
    6. Diseases of oral mucosa or alveolar bone.
    7. Essential body structures (such as inferior alveolar nerve and maxillary sinus) have an abnormal position which interfere the placement of dental implants.

Dental Implant – Photo By Coronation Dental Specialty Group (Own work) [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
What Are The Advantages Of Dental Implants?

Nowadays, dental implants are widely used as a treatment option in the replacement of missing tooth/teeth. Various advantages of dental implants have been identified, which include:

  1. Dental implants are easy to clean and maintain as compared to dental bridge.
  2. Dental Implants are very natural appearing.
  3. Dental Implants can be used to retent removable partial dentures or full dentures.
  4. Dental implants last longer than conventional dental bridge.
  5. Dental implants could preserve the alveolar bone of the jaw, thus preventing excessive loss of jaw height.
  6. Unlike conventional dental bridge, placement of dental implants does not require the cutting of the healthy adjacent natural teeth.
  7. Dental implants offer independent support to the dental crowns, bridges or even over dentures.

What Are The Disadvantages Of Dental Implants?

Every treatment option has its pros and cons. Even though there are a lot of advantages for having dental implants as a treatment of choice, dental implants do have their disadvantages. The disadvantages of dental implants include:

  1. Placement of dental implant is considered a minor surgical procedure.
  2. If there is insufficient bone available for the placement of the dental implant, preliminary treatments such as bone grafting might be needed.
  3. Dental implants are costly.
  4. Even though the success rate of a dental implant is up to 98%, the risk of treatment failure is still present.

Dental Implants are poised for explosive growth in the coming decade. Dental Implant is becoming one of the most popular treatment of choice when the replacement of tooth/teeth is required. If you are in doubt, always consult your dentist to determine the most suitable treatment plan for your oral conditions.

Article written by,

Dr. Wong Kee Cheong (Tommy)
Dental Surgeon
BDS (AIMST), MBA (SEGi), YCDP

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