Dental Implants are slowly becoming the preferred procedure in replacing missing teeth, and it is safe to say that when implants are done by a professional and well-experienced dentist, dental implants are one of the safest and best procedures in dentistry.

What is a dental implant?

Dental implants have been used for more than 30 years as one of the strongest options for replacing missing teeth.
Dental implants replace tooth roots, providing a permanent foundation for a replacement tooth that matches your natural teeth. Even if dental implants are scary looking, it stimulates bone growth as it preserves the natural bone structure.

Dental Implants are made of three parts:

1. Screw
2. Abutment/Connector
3. Crown

The dentist first places the screw into the jawbone, and it becomes the base support for your crown. The abutment connects the implant and the crown. Then, the dentist places the crown or custom-made tooth.

The bond of the screw to the natural bone of the jaw gives the stable support for the crown. The crown won’t shift or slide in your mouth when you eat or speak.

However, dental implants are not suitable for everyone. Children and adolescents who are still growing are not ideal candidates because their bone structure is still developing. People who have lost teeth due to trauma, decay, failed root canal treatment, fractured teeth, or congenital dental issues can benefit from dental implants to restore their smile.

Advantages and Risks of Dental Implants

Dental Implants do not only impact the aesthetic look of your teeth, it also affects your oral health completely. Below are the advantages of Dental Implants:

• Overall Health – Dental implants do not rely on other teeth for support, so dentists leave most surrounding teeth intact. This helps improve overall oral health. Implants also help preserve the natural bone structure of the jaw.
• Durability – With proper care, dental implants are very sturdy and lasts a lifetime. It also lasts longer than other treatments like dentures and bridges.
• Better Confidence – There is no doubt that implants improve the look and feel of your teeth, affecting your total confidence and self-esteem. A fixed implant also removes the discomfort of removable dentures.
• Convenience – Since implants are fixed in place, they are easy and convenient to maintain. You no longer need messy adhesives or worry about loose dentures.
• Speech and taste improvement – Eating, tasting and speaking becomes a worry for a removable teeth replacement. Dental implants act as a replacement for your own tooth, allowing you to speak and eat comfortably, without the fear and pain of your teeth slipping or moving. Implants also improve taste and temperature perception.

Like any other treatment, risks are also present in Dental Implants:

• Infection – Similar to other surgeries, infection may occur in dental implants. The mouth acquires a lot of bacteria and if the surgical site becomes infected, it can compromise the treatment duration and outcome. With prescribed antibiotics, appropriate use of mouth rinses and sterile surgical technique, a patient can counter the effects of infection.
• Inferior Dental and Lingual Nerve Damage – Inferior Dental and Lingual Nerves are major nerves in the lower jaw that supply sensation to the lower teeth, lower lip and tongue. Dentists use digital radiographs, CT scans, and iCAT scans to assess and locate nerves. This helps prevent direct nerve trauma during treatment. Nerves may recover from partial or complete numbness caused by such trauma. Tingling, also called paraesthesia, can occur due to inflammation around the surgical site. This usually improves once the inflammation subsides.
• Damages to Adjacent Teeth – Dentists assess nearby teeth and blood vessels using digital radiographs, CT scans, or iCAT scans before implant surgery. This helps review positioning and prevent damage. In some cases, implants may still cause damage to the roots of adjacent teeth.
• Implant Failure – Failure can still occur regardless of the skill, care and experience of the dentist and the patient’s care and attention to the installed implants. There are many factors attributing to the patient’s implant success. If the implant fails, it needs to be removed so the bone and soft tissue can repair itself. Once healed, an implant may be possible again.
• Sinus Involvement – When the sinus floor drops down to the posterior region of the upper jaw, the amount of available bone is reduced, and the sinus can be affected in the implant procedure. If the sinus appears to be too close to the implant location, the situation needs to be improved first before the implant placement.
• Aesthetics and Gum Profile – Some metallic components may become visible due to gum recession which naturally occurs in the ageing process. Oral hygiene can also aid in minimising recession.
• Smoking – Recent studies show that the failure rate may be as high as 38%. No responsibility can be taken if you smoke.

Dental Implants Checklist

The success of dental implants depends on a few factors. Here are some of the requirements for patients who wish to undergo Dental Implants:

1. Adequate bone support – Since the implant fuses with the jawbone, bone quality and density are important. A fully developed jaw structure is also necessary for successful placement.
2. Healthy gums – Having healthy gums is critical to the whole process of placing implants. Patients with gum diseases often experience implant failure.
3. Good overall health –Implants are a surgical procedure, so patients must be in good overall health. Dentists may not recommend implants for patients with severe heart disease, uncontrolled diabetes, immunosuppressant conditions, psychiatric disorders, osteoporosis, or cancer, especially those who have undergone radiation therapy in the head or neck area. Heavy smoking and alcohol use can also lower implant success rates.4. Commitment to oral health – Implants, same with other treatments, need oral hygiene. Brushing, flossing and regular 6 monthly dental visits are vital to the success of the treatment.

Dental Implants Procedure

Dental Implants requires careful treatment planning and execution in a longer period, as compared to other treatments. Depending on a patient’s case, the procedure may undergo for 6 months to 1 year before completion.

1. Treatment Planning

The dentist conducts the treatment planning process through a patient interview and a review of medical history. The process also includes a clinical examination, intra-oral and extra-oral photographs, and impressions to create study models. The dentist uses diagnostic imaging such as digital radiographs, CT scans, or iCAT scans. The process may also include radiographic guide construction and 3D computer modelling of the patient’s jaws.

As the first step in getting Dental Implants, the patient will undergo an initial consultation for the creation of a personalised treatment plan. The dentist assesses whether the patient is suitable for treatment by reviewing overall medical health, psychological conditions, oral and social habits, bone and soft tissue availability, available space, and the relationship of the teeth and jaws. The dentist also considers patient expectations.

A Cone Beam 3D Scan (Cone Beam Computed Tomography) checks whether there is enough bone at the implant site. If the dentist finds the bone too soft or too thin, they may recommend a bone graft to strengthen the area. And if the bone is strong enough, the dentist proceeds with the tooth extraction.

2. Implant Placement

After assessing the bone structure and creating a personalised treatment plan, the dentist places the implant in the target area. The dentist uses local anaesthetic and maintains strict sterile conditions. The dentist places the titanium screw into the jawbone through an incision in the gum. Digital radiographs are taken during the procedure to confirm proper positioning.

3. Abutment Placement

Depending on implant stability, the dentist may place the abutment directly onto the implant. This removes the need for a second-stage surgery. If the abutment is not placed immediately, the dentist covers the implant and places a healing abutment instead. This allows the area to heal before the final restoration. In some cases, the dentist uses a temporary prosthesis to shape the soft tissue before the final restoration. The dentist also takes digital radiographs to confirm proper healing.

After placing the abutment, the dentist provides an information sheet with pre and post-operative instructions. The clinic also schedules a review appointment within 10 to 14 days after surgery to remove stitches and check healing. Osseointegration usually takes about 3 to 6 months to complete.

Subsequently, an accurate impression of the jaw is taken for the creation of the crown. It usually takes 3 weeks to put the final crown or bridge.

4. Crown Fitting

The final stage where the crowns are successfully placed onto the Dental Implants. This will be reviewed after a month and should be checked regularly every 6 months.

View the full timeline here.

­Are dental implants painful? How successful are dental implants?

During the implant placement procedure, a local anaesthetic will be used for pain relief. After this, you may feel some discomfort for a week following the surgery.

Dental Implants are safe and has high success rates depending on each individual. Varying from every circumstance, the success rate in the lower jaw may be as high as 98%, and 90-95% in the upper jaw. Success rates are lower further back in the mouth, as bone quality and quantity are not as good, but generally the chances of a successful outcome are over 90%.

We urge every patient to take care of their implants by going to regular maintenance appointments to avoid implant failure. Aside from regular appointments, factors such as oral hygiene and maintenance regimes, periodontal disease, occlusion and tobacco use affect the success of implants.

Dentists strongly encourage patients who smoke to stop at least 3 months before implant placement, as smoking is a major risk factor for implant failure. Each patient is different, so it is not possible to predict exactly how long a dental implant will last. If patients neglect their oral hygiene, implants can develop similar risks and complications as natural teeth.

MS Dental, your family dentist in Cardiff

MS Dental offers an obligation- free consultation for Dental Implants. To know more about our services and offers, send us a message: