Treatment Procedures / 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. There are several types of dental implants.

Surgical procedure

Surgical planning prior to commencement of surgery and careful and detailed planning is required to identify 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.

  • Basic procedure In its most basic form, the placement of an implant requires a preparation into the bone using either hand osteotomes or precision drills with highly regulated speed [16] to prevent burning or pressure necrosis of the bone. 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 may vary depending on the experience of the practitioner and difficulty of the individual situation.
  • Surgical Incisions Traditionally, an incision is made over the crest of the site where the implant is to be placed. This is referred to as a 'flap'. Some systems allow for 'flapless' surgery where a piece of mucosa is punched-out from over the implant site. Proponents of 'flapless' surgery believe that it decreases recovery time while its detractors believe it increases complication rates because the edge of the bone cannot be visualized. Because of these visualization problems, flapless surgery is often carried out using a surgical guide, constructed following computerized 3D planning of a pre-operative CT scan.

Considerations

For dental implant procedure to work, there must be enough bone in the jaw, and the bone has to be strong enough to hold and support the implant. If there is not enough bone, more may need to be added with a bone graft procedure discussed earlier. Sometimes, this procedure is called bone augmentation. In addition, natural teeth and supporting tissues near where the implant will be placed must be in good health.

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%.



Immediate Implants

Immediate implants placed in fresh extraction sockets are a proven and predictable treatment modality. Immediate implant placement has helped solve issues with regard to bone quantity, quality at large and aesthetics and also the treatment time, as opposed to delayed implant placement.

Its advantages are evident in that flapless technique and use of implant sizes is more than or equal to root size, allowing lesser absorption and morphological ridge contour preservation. Moreover, this surgical procedure also allows a better final rehabilitation since it facilitates accurate prosthetic fabrication while maintaining the natural tooth angle and emergence profile at the same time. Needless to mention, it provides instant gratification to the patient.

Immediate extraction implant however requires careful case selection and extraction of the tooth. Achieving a good primary stability is the key factor in the success of immediate implants since stability is often achieved with the bone to implant contact in the apical drilled portion of the Osteotomy. In the event of buccal plate fracture during extraction, grafts and GBR techniques maybe used to improve prognosis only if a sufficient amount of primary stability of the implant may be achieved.