Dental implants - Click to see examples
What is it?
Dental implants are devices designed to replace one or more missing teeth. Implantology consists of two main procedures: surgical and prosthetic phase.
Clinical indications
Dental implants can be used to replace either front or back teeth in adult patients. However, not all patients can benefit from implants. The quantity (thickness) and quality (density) of the bone have to be assessed by radiography and tomography. If not enough bone exists to support the implant, a bone graft sometimes can be done to correct the deficiency. In addition, the implant cannot be placed where there is a risk of compromising nerves in or adjacent to the jawbones.
Surgical step
Dental implants are placed in the upper or lower jawbone to substitute for the missing root or roots. The implant is typically a cylindrical unit that, once placed, integrates with the surrounding bone. Currently, most implants are made from titanium alloys. The same materials used to make implants in dentistry are used in orthopedics to make artificial joints and for the treatment of bone fractures.
The implant can be placed immediately after the extraction of a compromised tooth or root, in the same socket occupied by the natural root (artificial root). The tooth may be compromised due to dental decay, root fracture or irreversible apical inflammation.
Implants may also be placed in an edentulous area where the teeth have been missed since many years. The operative procedure is not traumatic at all (flapless surgery) because no gingiva incision is required.
The development of implant materials with even better and faster bone-integration capacity might soon enable the dentist to place an implant and a crown or bridge with less waiting time after the implant is placed in the bone. Forty days is the mean time required to complete bone-integration in the lower jaw; conversely, ninety days is the mean time required to complete bone-integration process in the upper jaw.
Prosthetic steps
Dental implants are usually an alternative to fixed bridges or removable partial dentures. When a single tooth is missing and the teeth adjacent to the space are sound, the placement of a single implant-supported crown prevents the need for cutting down the adjacent teeth to place a fixed bridge.
Implant-supported crowns / caps are cemented to artificial abutments which are connected to the dental implant through a screw. In the past, only PFM (porcelain-fused to metal) crowns could be cemented on implant-supported teeth. Lately, both all-ceramic crowns and all-ceramic abutments have been available to restore implant-supported prostheses.
Dr Deliperi prefers using a combination of full-ceramic abutment and crowns. This procedure contribute to join aesthetics with function on both anterior and back teeth; it is sometime difficult to distinguish a well fabricate all-ceramic crown from natural teeth even for the dentist.
In other cases, when all teeth of the arch are missing, full dentures also can be supported on several implants; these are called overdentures.
Overdenture prostheses function as well as natural teeth and maintain jawbone better than removable dentures. This also avoids the periodic relining of removable prostheses. The final aesthetic result may be excellent.
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