Dental Implants
A dental implant is an artificial tooth root replacement and is used in prosthetic dentistry to support restorations that resemble a tooth or group of teeth.
Composition of Implants
A typical implant consists of a titanium screw (resembling a tooth root) with a roughened or smooth surface. The majority of dental implants made out of commercially pure titanium.
Training
Implant surgery may be performed as an outpatient under general anesthesia, oral conscious sedation, nitrous oxide sedation, intravenous sedation or under local anesthesia by trained and certified clinicians including general dentists, oral surgeons, prosthodontists, and periodontists.
Surgical procedure
Surgical planning
Prior to commencement of surgery, careful and detailed planning is required to indentify vital structures such as the inferior alveolar nerve or the sinus and to properly orientate the implants for the most predictable outcome. Two dimensional radiographs, such as orthopantomographs or periapicals are taken prior to the surgery. In some instances, a CT scan will also be obtained and specialized 3D CAD/CAM computer programs used to plan case.
Whether CT-guided or manual, a ‘stent’ may sometimes be required to facilitate the placement of implants. A surgical stent is an acrylic wafer that fits over either the teeth, the bone surface or the mucosa (when all the teeth are missing) with pre-drilled holes to show the position and angle of the implants to be placed.
Basic procedure
In its most basic form the placement of an osseointegrated implant requires a preparation into the bone using either hand osteotomes or precision drills. After a variable amount of time to allow the bone to grow onto the surface of the implant (osseointegration) a tooth or teeth can be placed on the implant. The amount of time required to place an implant will vary depending on the experience of the practitioner and difficulty of the individual situation.
Healing time
The amount of time required for an implant to become osseointegrated varies. Consequently the amount of time that practitioners allow the implant to heal before placing a restoration on it varies widely. In general, practitioners allow 2–6 months for healing.
Success rates
Dental implant success is related to operator skill, quality and quantity of the bone available at the site, and also to the patient’s oral hygiene. The general consensus of opinion is that implants carry a success rate of around 95%.