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What is a dental implant?
By The Academy of Osseointegration
A dental implant is a prosthetic replacement for a missing tooth. Natural teeth consist of the crown and the root. The crown is
the visible section that is covered with white enamel. Supporting the crown is the tooth root which extends into the jawbone.
The root is part of the tooth that is effectively replaced by an implant.
There are commonly three parts to what is described as an implant – the implant device itself (which is inserted directly into
the bone); the abutment (the piece that connects the implant device to the third part); the overlaying crown.
Today’s implants are predominantly made of titanium, a metal that is bio-compatible and offers strength and durability as well
as a unique property of fusing directly to bone – the process known as osseointegration. Other materials, such as zirconium,
might be used to make implants in the future. But for now, these materials have not been perfected for general use.
What is osseointegration?
By The Academy of Osseointegration
Dental implants work by a process known as osseointegration, which occurs when bone cells attach themselves directly to the
titanium surface, essentially locking the implant into the jaw bone. This process was first discovered by a Swedish researcher,
Per-Ingver Branemark, in the 1960’s. Placing dental implants into the jaw bones by controlled surgical procedures allow them
to “osseointegrate”.
Osseointegrated implants can then be used to support prosthetic tooth replacements of various designs and functionality,
replace anything from a single missing tooth to a full arch (all teeth in the upper and lower jaw). These replacement teeth are
usually made to match the natural enamel color of each patient which offers a completely natural appearance and a whole
new smile.
Why it's done
By Mayo Clinic Staff
Dental implants are surgically placed in your jawbone, where they serve as the roots of missing teeth. Because the titanium in
the implants fuses with your jawbone, the implants won't slip, make noise or cause bone damage the way fixed bridgework or
dentures might. And the materials can't decay like your own teeth that support regular bridgework can.
In general, dental implants may be right for you if you:
•Have one or more missing teeth
•Have a jawbone that's reached full growth
•Have adequate bone to secure the implants or are able to have a bone graft
•Have healthy oral tissues
•Don't have health conditions that will affect bone healing
•Are unable or unwilling to wear dentures
•Want to improve your speech
•Are willing to commit several months to the process
Risks
By Mayo Clinic Staff
Like any surgery, dental implant surgery poses some health risks. Problems are rare, though, and when they do occur they're
usually minor and easily treated.
Risks include:
•Infection at the implant site
•Injury or damage to surrounding structures, such as other teeth or blood vessels
•Nerve damage, which can cause pain, numbness or tingling in your natural teeth, gums, lips or chin
•Sinus problems, when dental implants placed in the upper jaw protrude into one of your sinus cavities
How you prepare
By Mayo Clinic Staff
Because dental implants require one or more surgical procedures, you must have a thorough evaluation to prepare for the
process, including a:
•Comprehensive dental exam. You may have dental X-rays taken and models made of your teeth and mouth.
•Treatment plan. Tailored to your situation, this plan takes into account factors such as how many teeth you need replaced
and the condition of your jawbone. The planning process may involve a variety of dental specialists, including a doctor who
specializes in conditions of the mouth, jaw and face (oral and maxillofacial surgeon) and a dentist who works with the
structures that support teeth (periodontist).
Tell your doctor about any medical conditions and any medications you take, including prescription and over-the-counter drugs
and supplements. If you have certain heart conditions or orthopedic implants, your doctor may prescribe antibiotics before
surgery to help prevent infection.
To control pain, anesthesia options during surgery include local anesthesia, sedation or general anesthesia. Talk to your dental
specialist about which option is best for you. Your dental care team will instruct you about eating and drinking before surgery,
depending on what type of anesthesia you have. If you're having general anesthesia, plan to have someone take you home
after surgery and expect to rest for the remainder of the day.
What you can expect
By Mayo Clinic Staff
Dental implant surgery is usually an outpatient surgery performed in stages:
•Your damaged tooth is removed.
•Your jawbone is prepared for surgery, a process that may involve bone grafting.
•After your jawbone heals, your oral surgeon places the dental implant metal post in your jawbone.
•You go through a healing period that may last several months.
•Your oral surgeon places the abutment — an extension of the implant metal post — followed by your new artificial tooth
(crown).
The entire process can take many months from start to finish — three to nine months and sometimes longer. Much of that
time is devoted to healing and waiting for the growth of new bone in your jaw.
When bone grafting is required
By Mayo Clinic Staff
If your jawbone isn't thick enough or is too soft, you may need bone grafting before you can have dental implant surgery.
That's because the powerful chewing action of your mouth exerts great pressure on your bone, and if it can't support the
implant, the surgery likely would fail. A bone graft can create a more solid base for the implant.
With bone grafting, a piece of bone is removed from another part of your jaw or your body — your hip, for example — and
transplanted to your jawbone. It may take up to nine months for the transplanted bone to grow enough new bone to support a
dental implant. In some cases, you may need only minor bone grafting, which can be done at the same time as the implant
surgery. The condition of your jawbone determines how you proceed.
Placing the dental implant
By Mayo Clinic Staff
During surgery to place the dental implant, your oral surgeon makes a cut to open your gum and expose the bone. Holes are
drilled into the bone where the dental implant metal post will be placed. Since the post will serve as the tooth root, it's
implanted deep into the bone.
At this point, you'll still have a gap where your tooth is missing. Usually, a type of partial, temporary denture can be placed for
appearance. You can remove this denture for cleaning and while you sleep.
Waiting for bone growth
By Mayo Clinic Staff
Once the metal implant post is placed in your jawbone, osseointegration (oss-ee-oh-in-tuh-GRAY-shun) begins. During this
process, the jawbone grows into and unites with the surface of the dental implant. This process, which can take up to six
months, helps provide a solid base for your new artificial tooth — just as roots do for your natural teeth.
Placing the abutment
By Mayo Clinic Staff
When osseointegration is complete, you may need additional surgery to place the abutment — the piece where the crown will
eventually attach. This minor surgery is typically done with local anesthesia in an outpatient setting.
To place the abutment:
•Your oral surgeon reopens your gum to expose the dental implant
•The abutment is attached to the dental implant
•The gum tissue is then closed around, but not over, the abutment
In many cases, the abutment is attached to the dental implant metal post when the post is implanted. That means you won't
need an extra surgical step. Because the abutment juts past the gum line, however, it's visible when you open your mouth —
and it will be that way until your dentist completes the tooth prosthesis. Some people don't like that appearance and prefer to
have the abutment placed in a separate procedure.
Choosing your new artificial teeth
By Mayo Clinic Staff
After the abutment is placed, your gums must heal for one or two weeks before the artificial tooth can be attached. Once your
gums heal, you'll have more impressions made of your mouth and remaining teeth. These impressions are used to make the
crown — your realistic-looking artificial tooth. The crown can't be placed until your jawbone is strong enough to support use of
the new tooth.
You and your dental specialist can choose from two main types of artificial teeth:
•A removable implant prosthesis. This type is similar to a conventional removable denture. It contains artificial white teeth
surrounded by pink plastic gum. It's mounted on a metal frame that's attached to the implant abutment, and it snaps securely
into place. It can be easily removed for repair or daily cleaning. It's often a good choice when several teeth in the lower jaw are
replaced, mainly because it's more affordable than multiple individual dental implants and yet more secure than a traditional
denture.
•A fixed implant prosthesis. In this type, an artificial tooth is permanently screwed or cemented onto an individual implant
abutment. You can't remove the tooth for cleaning or during sleep. If affordability isn't a concern, you can opt to replace
several missing teeth this way. Each crown is attached to its own dental implant.
After surgery
By Mayo Clinic Staff
Whether you have dental implant surgery in one stage or multiple stages, you may experience some of the typical discomforts
associated with any type of dental surgery, such as:
•Swelling of your gums and face
•Bruising of your skin and gums
•Pain at the implant site
•Minor bleeding
If swelling, discomfort or any other problem gets worse in the days after surgery, contact your oral surgeon. You may need
pain medications or antibiotics.
After each stage of surgery, you may need to eat soft foods while the surgical site heals — as long as 10 to 14 days. Typically,
your surgeon will use stitches that dissolve on their own. If your stitches aren't self-dissolving, your doctor removes them in
about 10 days.