Dental Implant Surgery
Modern dental implants are titanium screws which are surgically placed into the jawbone. They are designed to fuse with the bone, and allow for the connection of various components, ranging from crowns and bridges, to dentures.
For the traditional approach to implant surgery, an incision is made in the gums, the implant is inserted into the jaw bone, and the gums are closed back over. The implant is then allowed to heal within the bone for a period of 2-6 months.
Once the implant is fully fused to the bone, the implant is uncovered and a "healing abutment" is connected, which is a metal base that keeps the gums from growing back over the implant. At this point, the implant is ready for prosthetic therapy.
There are modifications to this process, where a dental implant can be placed at the time that a tooth is removed, or a crown can be placed at the time that the implant is placed within the jaw. These are all very case specific and must be properly planned.
The traditional delayed approach is the default treatment if these more immediate techniques are not possible, so I tell all of my patients to be prepared for a long period of healing when they are considering dental implants.
Single Implant Crowns
A dental implant can be used to support a single crown in the case of a single missing tooth, for both front teeth and back teeth.
There are various ways to make the crown, but I prefer to have a crown that screws down directly to the implant because it is easy to remove the crown if we need to in the future. The other option is to screw a base (abutment) on to the implant, and then to cement the crown to the base, but this option is much less retrievable.
Implant crowns are made of the same materials that crowns for natural teeth are made from, so the results can be very aesthetically pleasing.
Dental Implant Bridges
For people who are missing multiple teeth, dental implants can be used to support bridges.
These bridges can be made in metal and porcelain, or entirely of porcelain. Just like for single implant crowns, there is the option to screw the bridge directly to the implants, which is what I prefer.
For people who are missing all of their teeth, in addition to metal/porcelain and full porcelain bridges, there is also a third option, called a "hybrid implant denture". This design uses a metal frame to support acrylic teeth, like those on a denture, but it is screwed directly to the implants and is therefore not removable, similar to bridge. This explains the name; it is a cross between a denture and a bridge.
Working with implant supported bridges is not similar to working with bridges on natural teeth or working with dentures. It is imperative that treatments which require the placement of multiple implants be properly planned and implemented, or things can turn out quite unfavourably.
At our office we use CT Scans and digital impressions to plan all of our dental implant cases, and utilize surgical guides that have been computer milled.
For people who are unhappy with their dentures, the placement of dental implants can improve the function and retention of their loose and unstable dentures. The implants can be used to support components that allow the denture to snap in and out of place.
It is still a removable denture, but it stays in place better.
A quick side note......there is a group of health professionals called "Denturists". Historically, denturists have been making dentures for people who have no teeth, or partial dentures that do not require the modification of tooth structures. They have, however, started working with dental implant dentures. The current BC Health Profession Act does not allow Denturists to manipulate the implant components, because they are not licensed as Dentists.
If you have had a implant denture fabricated by a Denturist, be sure to follow up with the Dentist who placed the implants on a yearly basis to ensure that all the connections are stable.
"Teeth in a day" and "All-on-Four®"
These terms have become very popular in the BC dental market. You may have even heard about it on the radio!
It refers to the removal of all of someone's teeth in one jaw, the immediate placement of 4 to 6 dental implants, and the immediate connection of a temporary bridge, all in the same appointment. The final bridge is completed after a couple of months.
This is a treatment that can work very well, but it is really only applicable in a few specific scenarios (very few people need all of their teeth taken out nowadays!), so not everyone is a candidate for this procedure.
The default standard of care is the traditional, delayed approach to allow the implants to heal. Patients who come in looking for "teeth in a day" have to be understanding that it may not be an option for them and that the delayed approach will result in a better outcome.
Providing someone with "teeth in a day", or using the "all on four®" technique, is a very advanced dental procedure that must be thoroughly planned, and performed by someone with extensive experience in implant dentistry.
It is not your everyday dental treatment.
We do offer "teeth in a day" and "All-on-Four®" at our office, sometimes in coordination with an oral surgeon or periodontist.