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Dental Implants
An implant is an extension of a tooth root or the replacement of a tooth. Implants are often a much-welcome alternative to fixed bridges, removable partial dentures, or full dentures.
Implants are made by inserting a post into the upper or lower dental ridges. This post supports the tooth crown or dentures. Because it is not necessary to use adjacent teeth for attachment, implants can be quite practical and comfortable.
There are three types of implants: subperiostoeal, endosseous, and osseointegrated. As they are all labor-intensive, time-consuming, and costly, you may want to obtain a second opinion before signing up for this surgery. All implants must be performed by an oral surgeon or periodontist, or by a general dentist with proper training, credentials, and experience in implant surgery.
Osseointegrated Implants
Developed in the 1960s, osseointegrated implants are the most stable because they allow bone tissue to grow around them. Osseointegrated implants are made of titanium; studies indicate that the body's tissues may better tolerate titanium than the chrome-cobalt metal that comprises other implants. Because the bone thickens and grows attached to these implants, they become stronger with time and cause little or no bone re-absorption. Unlike other implants, they feel and function like natural teeth.
Osseointegrated implant surgery is a multi-step process. First, an incision is made through your gums where the implant will be inserted. Using sterile water as coolant, the dentist drills holes into the bone. Next, the cylinder anchor is inserted and screwed in place. A temporary cap is fitted over the opening above the anchor, and the gum tissue is sutured back in place.
To promote healthy healing and to ensure that no contamination or infection takes place, the area is left alone for six to twelve months, and for a few months a soft-foods diet is necessary. Your dentist will prescribe antibiotics for the first week or two, and you may take Tylenol or other medications for pain management. Stitches will be removed within approximately two weeks.
The second phase of this process starts with a local anesthetic injection, followed by an incision over the implant area. The temporary cap is removed and abutment cylinders are placed within the implant. These abutments extend over the gums; they can receive the bridge or dentures in about two weeks. After the abutments are installed, the gums are again sutured.
Once the area is fully healed, your dentist will make impressions using techniques similar to those used to make standard bridges or dentures. Using these impressions, a laboratory will create the dentures or crown, which your dentist will attach to the implant. The dentures or crown will remain in place until your dentist removes them for periodic cleanings.
Subperiosteal Implants
Your dentist will begin this procedure by surgically opening the gum and periosteum (tissue directly under the gums and over the bone) at the area of the missing tooth or teeth. An impression or mold is taken of the area and the gums are sutured back. Then a metal implant is built, most often of chrome-cobalt metal and containing attachments for teeth. The area is surgically opened again, and the implant is either fastened to or placed on top of the bone. The gums are sutured once more and, with time, tissue grows around the implant, keeping it in place. Crowns or permanent dentures are then fastened to the attachments on the implant.
While infection is a potential risk with subperiosteal implants, other negatives include the fact that they loosen over time and must be replaced in the upper jaw after five years. In the lower jaw, these implants last up to ten years. Of course, replacing these implants requires a surgical procedure.
Endosseous Implants
Endosseous implants require that holes are drilled in the bone, into which wedge-shaped blades or cylinder-shaped screws are inserted. The chrome-cobalt metal blades and screws contain attachments for permanent dentures or crowns. Drawbacks to this implant can be daunting: while infection is always a risk, if it runs deep enough, the implant, bone, and surrounding gums may need to be removed. Should this occur, it would be impossible for a new implant or a fixed or removable prosthesis to be inserted. Another risk is of the bone overheating and growing weak from friction during drilling. Thus, the bone may not provide adequate stability for the implant, causing it to loosen over time.
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