understanding dental implant

8/8/2019 Understanding Dental Implant

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Comfortand

ConfidenceAgain

U N D E R S T A N D I N G

DENTAL IMPLANTSwww.allislam.net


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A NEW SMILE

Its no fun when youre missing teeth. You may not feelcomfortable eating or speaking. You might even avoid smilingin public. Fortunately, dental implants can help. Implants canreplace a single tooth, several teeth, or all the teeth in your

mouth. Best of all, they look and feel like natural teeth.

This booklet is not intended as a substitute for professional dental care.

2003 The StayWell Company, 1100 Grundy Lane, San Bruno, CA 94066-3030.www.krames.com 800-333-3032. All rights reserved. Lithographed in Canada.

When Teeth Are MissingIt can be embarrassing to have spaces in yourmouth where teeth are missing. But youre notalone. Some people lose teeth due to injury,tooth decay, or periodontal disease (infectionof the gums and bone surrounding teeth).

Others may not have had all their teeth growin. Whatever the reason, dental implants canhelp replace missing teeth. And implantsoften feel more natural than dentures andother dental restorations.

Implants Can HelpIf you want a dental restoration that looksand feels as though its really part of your

mouth, dental implants may be right foryou. A dental implant is an artificial toothroot. Your jawbone fuses with the implantto provide a secure platform for a prosthesis(artificial tooth). If you are missing manyteeth, several implants can be used to sup-port a partial or complete denture.

Prosthesis(artificialtooth crown)

Implant

Osseointegration occurs when bonefuses with the implant. This provides asolid base for the prosthesis.

AbutmentGum

Jawbone

Implants can replace teeth lost from injury.

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Working TogetherThroughout the implant process youll work closely with a dentalteam. Part of the team prepares your jaw and surgically places theimplant. Others build and adjust the prosthesis.

Your surgeon may be an oral surgeon, periodontist, or a generaldentist skilled in dental implant procedures.

Your restorative dentist may be a prosthodontist or general dentist.

Understanding Your RoleDepending on your dental needs, total treat-ment time for implants can range anywhere

from several months up to a year or more.Without a strong commitment from you,implants are less likely to be successful.For best results, be prepared to:

Keep all your appointments.

Take good care of your mouth during theimplant process.

Commit to a lifetime of good oral hygiene.

Have dental checkups at least twice a year.

Contact team members if you haveany problems.

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Your Dental

Evaluation....................... 4

Forming aTreatment Plan.............. 6

The RightProsthesis for You.......... 8

Surgery toPlace Implants ............. 10

Placing Abutments...... 12

Making YourProsthesis..................... 13

Good Habits toLast a Lifetime............. 14

Table of Contents

It takes teamwork to make dental implants a success.

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YOUR DENTAL EVALUATION

To learn whether youre a good candidate for dental implants, youwill have a dental evaluation. The evaluation includes a dentalexam, a dental and medical history, and imaging tests. As part ofthe exam, the health and structure of your mouth are studied. This

helps the dental team understand where to place the implants.

Your Dental ExamAn exam supplies important details about the structure of yourmouth. Your bite is studied to see how your jaws and teeth fittogether. The condition of your jaws, gums, head, and neck is alsochecked. This is done to see whether your mouth is ready toaccept implants. During the exam:

The height and width of your jawbones are measured. This is

done to make sure there is enough bone to hold an implant. Your gums are examined for signs of periodontal disease.

Diseased gums need to be treated before implants can be placed.

Your gums are also checked to see if there is enough firm tissueto surround an implant.

The height ofeach jawboneis measured.

The gums arechecked forperiodontal

disease.

The locations ofnerves are noted.

The widths ofthe lower andupper jaw ridges

are measured.

The base of the

maxillary sinusis located.

Upper jaw

Lower jaw

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The Importance of Imaging TestsImaging tests are a key part of the dentalevaluation. They make it possible to viewparts of the mouth and head that cantbe seen during an exam. Imaging testsalso help your surgeon learn more about

the quantity and quality of the bone inyour mouth.

Dental x-rays show teeth and jaws.

Panoramic x-rays provide a wide view ofthe jaws, teeth, nerves, and sinuses. Theycan also help indicate bone problems.

Other imaging tests, such as a CT scanor x-ray tomography, may also be used.

The Importance of Your Dental HistoryThe more your surgeon learns about you, themore successful your implant surgery is likelyto be. Your dental and medical history is animportant part of this learning process. Itincludes questions about your overall healthand any previous dental treatments, such ascrowns and bridges. Youll also discuss yourexpectations. Why do you want implants?What do you hope the results will be? Finally,youll discuss factors that can affect healingafter surgery. These include smoking andthe use of certain medications.

If You Have an Ongoing Medical Condition

If you have an ongoing medical condition,such as diabetes, you may have blood tests.This is to make sure your condition is undercontrol before treatment begins. Also, besure to tell your surgeon if you take medica-tions, such as insulin or a blood thinner,including aspirin.

Panoramic x-rays show all the teeth and bonein your mouth.

Tell your surgeon what you hope implantswill do for you.

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FORMING A TREATMENT PLAN

After the evaluation, your surgeon and restorative dentistwill each discuss treatment options with you. Youll also talkabout any dental work or special procedures you may needbefore the implant process can begin.

If You Have Periodontal Disease

Periodontal disease weakens gum tissue.Left untreated, it can also weakenbone and lead to the loss of both naturalteeth and implants. Depending on yourcondition, cleanings, medications, orsurgery may be needed to treat theproblem. Youll also need to practicegood oral hygiene throughout your life.This will help keep periodontal diseasefrom returning. It will also help your

implants last longer.

If You Need a Graft

Graft surgery can build up bone or gumtissue in an area where its lacking. It canalso replace bone and gum tissue that hasbeen lost due to disease or trauma. Onetype of graft surgery is the sinus lift (aprocedure to build up bone at the bottomof the maxillary sinus). This adds height

to the jawbone, ensuring enough bone tohold an implant.

Bone for a graft may be taken from yourjaw, hip, or other sources. Sometimes asynthetic (artificial) graft is used.

A graft to build up gum tissue usuallycomes from your own mouth.

A Solid Foundation for ImplantsHaving a healthy mouth is just as important for implants as itis for natural teeth. If you dont have enough healthy bone orgum tissue in your mouth, you may need a graft before implantscan be placed. Grafting helps build a solid foundation for theimplants. Youll probably have to wait for a graft to heal beforeyou can have implant surgery. If you have periodontal disease,it will also need to be treated prior to placing the implants.

Periodontal disease must be treated beforeimplants can be placed.

Bone from the jaw (gray areas) may begrafted to a site where it is needed.

Site where bonemay be needed(sinus lift)

Site wherebone isneeded

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You Have AlternativesIf dental implants arent right for you now,consider your alternatives. One option maybe a bridge to replace your missing teeth.

If you already have a denture, adjusting itfor a better fit may help. You can also decideto have implants at a later time. Together,you and your surgeon will decide whatsbest for you.

Outlining Your Treatment PlanIf youre a good candidate for implants,the dental team will talk with you abouta treatment plan. Youll also discuss thecosts and time that may be involved.Keep in mind, your commitment duringthe process will be crucial. In many casesit will take at least several months beforenew prosthetic teeth can be attached toimplants. If you need a graft or treatmentfor periodontal disease, the process islikely to take longer.

A bridge may be an alternative toan implant. The supporting teethare shaped to hold the bridge.

The risks and complications of implant surgery may include:

Bleeding

Infection

Failure of the implant (jawbone doesnt fuse to the implant)

Injury to adjacent teeth or sinus

Injury to nearby nerves and muscles

Risks and Complications

Your surgeon will explain any treatments thatmay be needed before implants can be placed.

Bridge

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THE RIGHT PROSTHESIS FOR YOU

A dental prosthesis is secured to one or more implants. It can be madeof one or many artificial teeth. The prosthesis you have will dependon your dental needs. If youre replacing a complete set of teeth, youmay be able to choose between a removable or fixed prosthesis.

A Prosthesis to Fit Your NeedsDepending on how many teeth youremissing, you may have a single, partial,or complete prosthesis. The more teethto be replaced, the more implants youwill need. For most people, a permanentprosthesis wont be made until the jawbonehas fused to the implants. Until then, a

temporary prosthesis may be used. A single prosthesis is used to replace a

missing tooth. One implant is all thatsneeded for support.

A partial prosthesis replaces two ormore teeth. Two or three implants areused for support.

A complete denture prosthesis replacesall the teeth in an upper or lower jaw,or both. (See page 9.) The number of

implants needed depends on whether afixed or removable prosthesis is used.

The restorative dentist will talk with you aboutthe type of prosthesis best suited to your needs.

A single prosthesis is used to replace a tooththat has been lost.

A partial prosthesis is used as an alternativeto a bridge.

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Fixed Prosthesis

With a fixed prosthesis, the new teethare fitted to a frame that is securedto the implants. Five or more implantsare placed along the contour of the jaw.In some cases, a fixed prosthesis offersmore stability for chewing.

Choosing a Removable orFixed Complete Prosthesis

Removable ProsthesisWith a removable prosthesis, the newteeth are joined to the implants by aconnecting device, such as a clip andbar. This allows you to take the prosthesisout for cleaning. For support, this typeoften uses four to six implants per jaw.

A complete denture prosthesis is used as analternative to a traditional complete denture.

Types of Complete ProsthesesThere are two types of complete dentureprostheses: removable and fixed. Both canbe used to replace a complete set of teeth.Removable means youll be able to take itout of your mouth. Fixed means it can onlybe taken out by a dentist. You and yourrestorative dentist can discuss which typeis best for you.

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SURGERY TO PLACE IMPLANTS

Surgery is used to place implants in your jawbone. Ultimately,successful dental implants depend on the jawbone fusing to theimplant (a process called osseointegration). You can help thisprocess along by keeping your gums and teeth especially clean

over the next few months.

Your Surgical Experience

Upon arriving, you may be asked to rinse your mouth with anantiseptic. You may also be given medication to help you relaxor to make you sleepy. Right before surgery, the jaw is numbed.Then the jawbone is prepared so the implants can be placed. Ifyoure awake, you may hear sounds or feel vibrations. But youshouldnt feel any pain. The length of the surgery depends onhow many implants are placed.

Preparing for SurgeryMost implant surgeries are performed in adental office. To prepare for surgery, followyour surgeons instructions. Also:

Tell your surgeon if youre taking anymedications or herbal remedies.

Wear comfortable clothes to the office.

Take antibiotics if prescribed.

If you will be sedated or asleep (undergeneral anesthesia) during the surgery,arrange for an adult to give you a ridehome. Also, dont eat or drink for severalhours before surgery.

Making the IncisionA small opening is made in

the gum to expose the jawbone.This allows the surgeon toprepare the bone.

Preparing the BoneA precise hole is slowly and

gently drilled into the jawbone.The size of the hole dependson the size of the implant.

Incision Hole in bone Implant Abutment

Placing the ImplantThe implant is twisted or gently

tapped into position. Then theincision is closed with stitches.In some cases, abutments areplaced at the same time asimplants.

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Taking Care of Your Mouth

Much of the healing process depends onkeeping your teeth and gums clean. If youdont take care of your mouth, you may getan infection. This could cause implants to

fail. For best results: Use a soft toothbrush to clean your teeth

and gums after every meal.

Clean the areas near your incisions. Butdo not brush the incisions themselves.

Use an antiseptic rinse if prescribed.

Follow-up Care

It often takes a few months for jawboneto firmly attach to implants. During thattime, youll have several follow-up visitswith your surgeon. This is to see how wellyour jaw is healing. If you wear a denture,you may also visit your restorative dentist.He or she may put a new lining in yourdenture for greater comfort.

When to Call Your Surgeon

Call your surgeon if you have any ofthe following:

A large amount of swelling under thetongue, or around the face and neck

Bleeding that wont stop

Pain in the jaws, mouth, or sinuses thatisnt relieved by prescribed medication

A fever

Numbness that does not go away afterthe anesthesia wears off

Eat soft foods as your mouth heals.

Help the healing process. Keep your teeth

and gums clean.

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After SurgeryWhen your surgery is over, you may rest awhile. But you can go home as soon as youfeel able. Be aware that a certain amount of

swelling and minor bleeding is normal. Tospeed your recovery, be sure to follow yoursurgeons instructions. You may be told to:

Drink only clear liquids for the restof the day.

Take pain medications and antibiotics.

Avoid putting pressure on your jaw.

Eat soft foods for the first few days asyour mouth begins to heal.

Avoid wearing your temporary prosthesisor denture for a certain amount of time.

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PLACING ABUTMENTS

Abutments are connecting pieces that join the prosthesis to theimplants. They also help gum tissue heal around the implant site.In certain cases, abutments may be placed at the same time asimplants. More often, though, surgery to place abutments is done

after the jawbone has fused to the implants. This second surgeryusually takes less time than the first.

After Abutments are PlacedIt usually takes 4 to 6 weeks for gumsto heal around the abutments. Duringthat time, follow your surgeons adviceabout what kinds of food to eat. You willalso be given instructions for cleaningaround the abutments. Proper cleaningprevents infection and promotes healing.

Healing cuff(abutment)

Healing Abutments and Final AbutmentsDepending on your dental needs, two kinds of abutmentsmay be used. Healing abutments (also called healing cuffs)help gum tissue heal around the implant site. Once the gumhas healed, final abutments are placed so the prosthesiscan be joined with the implant.

Placing Healing CuffsIn many cases, a healing cuff(also called a healing abutment)is temporarily secured to theimplant.

Exposing the ImplantIf you have a second surgeryto place abutments, a smallincision is first made in thegum tissue.

Placing Final AbutmentsWhen gums have healed,the final abutment is placed.The top of the abutment sticksout just above the gum line.

Finalabutment

Incision

After abutments are placed, callyour surgeon if you have any ofthe following:

Bleeding that wont stop

Pain in the jaws, mouth, or sinuses

that isnt relieved by prescribedmedication

A fever

An abutment that feels loose

When to Call Your Surgeon

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MAKING YOUR PROSTHESIS

Fitting Your ProsthesisOnce the prosthesis is ready, youllhave several fittings to see how it feelsin your mouth. With a fixed prosthesis,this process may take a little longer.After any needed adjustments are made,the prosthesis is attached to the abut-ments. You may be told not to eat hard

or crunchy foods for a few weeks afterthe prosthesis is attached.

The Prosthesis in PlaceThe crown may be screwed orcemented to the abutment. Insome cases, the crown andabutment are a single unit.

When your gums have healed around the abutments, yourrestorative dentist will begin making your permanent prosthesis.Several office visits may be needed to make a precise modelof your mouth. Then it may take a few weeks, or even months,

to build your prosthesis.

A Custom FitTo custom-fit the prosthesis, your restora-tive dentist will make impressions (molds)of your jaws, teeth, and abutments. Biteregistrations are also made to see how yourteeth fit together. These molds are used to

create a model of your mouth. Your newprosthesis is then made from this model.

When to Call Your Restorative Dentist

Call your restorative dentist if youhave any of these problems:

Pain in the jaws

A bite that feels wrong

A prosthesis that feels loose,

chips, or breaks Implants or abutments that

feel loose

Prosthesis

A mold of your teeth takes just a few minutesto make.

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GOOD HABITS TO LAST A LIFETIME

To ensure that your implants last, take good care of your mouth.This means brushing and flossing every day, and having regularcheckups with your dental team. If you dont keep your mouthin good shape, your implants can fail.

Flossing DailyFlossing is important because

it cleans areas a toothbrushcant reach. Floss betweenyour teeth and around yourprosthesis at least once a day.For best results, you shouldalso floss up and down alongthe abutments.

Brushing After MealsBrush your teeth, prosthesis,and abutments after everymeal and at bedtime. Youshould also brush the gum-line and the gum aroundyour abutments. Be sure tocall your restorative dentist

if you have trouble cleaningyour prosthesis or abutments.

Fixed ProsthesisRemovable Prosthesis

Try Special Cleaning Aids

Foam-coated floss and aninterdental brush can helpclean abutments.

An electric toothbrush canmake it easier to clean yourprosthesis and abutments.

A prescription rinse helpsrid your mouth of bacteria.

Brush the top and backof a fixed prosthesis as ifyou were brushing naturalteeth. Brush your gums andabutments, too.

With a fixed prosthesis, flossthe abutments from the front,sides, and back.

After removing the prosthesis,floss around the abutments.

Remove the prosthesis andbrush it inside and out. Alsobrush your gums and abut-ments while the prosthesisis out of your mouth.

Rx

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Make and Keep AppointmentsCommit yourself to a lifetime of gooddental care. See members of your dentalteam as often as directed. Regular care isimportant for the health of your implants.During appointments:

Your abutments are cleaned, and anyneeded adjustments or repairs are madeto the prosthesis.

Your implants and the health of yourjaws and gums are checked. You willalso have x-rays to evaluate the bone

around the implant. Your teeth are cleaned to maintain

good oral health.

To Keep Feeling SecureWith your prosthesis in place, youll be able to speak and smilewith confidence. To make your implants and prosthesis last,follow these tips:

Avoid chewing on hard objects like ice or popcorn kernels. Control health problems such as diabetes.

Stop smoking.

Contact your dental team if you notice any problems withyour implants or prosthesis.

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A WINNING SMILE

It takes time and effort to make dental implants successful.So commit yourself to the care of your mouth. Brush andfloss, and see your dental team for checkups. That way, youcan keep smiling with comfort and confidence.

Consultants:Carl M. Block, DDS, FASO, Periodontics/Implant DentistryRichard A. Smith, DDS, Oral and Maxillofacial Surgery

With contributions by:

Kevin McLaughlin, DMD, Oral and Maxillofacial SurgeryGregory E. Oxford, DDS, MS, PhD, PeriodonticsDavid Richards, DDS, PhD, PeriodonticsStephen F. Rosenstiel, BDS, MSD, Prosthodontics

Resources American Dental Association

312-440-2593www.ada.org

American Association of Oraland Maxillofacial Surgeons888-467-5268www.aaoms.org

American Academyof Periodontology800-356-7736www.perio.org

American Academy ofImplant Dentistry877-335-2243www.aaid-implant.org

American College ofProsthodontists

www.prosthodontics.org

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