In a recent study, 92% of dental implants were found to have survived the twenty-year mark — an impressive track record for any dental restoration.
Still, implants do fail, although rarely. Of those failures, tobacco smokers experience them twice as often as non-smokers. The incidence of early failure (within the first few months after implantation) is even higher for smokers.
Early implant failure typically happens because the titanium implant and the surrounding bone fail to integrate properly. Titanium has a natural affinity with bone — the surrounding bone will attach and grow to the titanium in the weeks after surgery, forming a strong bond. An infection around the implant site, however, can inhibit this integration and result in a weaker attachment between bone and implant. This weakness increases the chance the implant will be lost once it encounters the normal biting forces in the mouth.
Smokers have a higher risk of this kind of infection because of the way tobacco smoke alters the environment of the mouth. Inhaled smoke burns the mouth’s top skin layers and creates a thick layer of skin called keratosis in its place. Smoke also damages salivary glands so that they don’t produce enough saliva to neutralize the acid from food that’s left in the mouth after eating. This creates an environment conducive to the growth of infection-causing bacteria. At the same time, the nicotine in tobacco can constrict the mouth’s blood vessels inhibiting blood flow. The body’s abilities to heal and fight infection are adversely affected by this reduced blood flow.
The best way for a smoker to reduce this early failure risk is to quit smoking altogether a few weeks before you undergo implant surgery. If you’re unable to quit, then you should stop smoking a week before your implant surgery and continue to abstain from smoking for two weeks after. It’s also important for you to maintain good brushing and flossing habits, and semi-annual dental cleanings and checkups.
Although smoking only slightly raises the chances of implant failure, the habit should be factored into your decision to undergo implant surgery. Quitting smoking, on the other hand, can improve your chances of a successful outcome with your implants — and benefit your life and health as well.
Dental implants are one of the best tooth replacement systems available. But while they can rejuvenate patients’ smiles and potentially provide a lifetime of service, they require thorough planning and preparation before the implant is inserted.
The process begins with the assembling of your treatment team. Implants require the training and expertise of a number of professionals who collaborate during the process: a dental specialist, like an oral surgeon, periodontist or a general dentist trained in implant dentistry, who surgically installs the implant; a dental technician who fashions the permanent life-like crown that will attach to your particular implant; and a restorative dentist who begins and ends the process with you — from initial consultation and planning to the permanent crown attachment. You, the patient, are also part of the team — your input and informed choices are essential to a successful outcome.
Your restorative dentist will take the first steps to develop your treatment plan. It begins with both a dental examination and a general health assessment to determine your fitness for any surgery. The dental examination serves to evaluate the site where the proposed implant or implants will be placed, along with x-rays for assessing the quantity and quality of bone at the site. Next, the dentist will create study models of your mouth to assess bite, and possibly take photographs to guide decisions on the implant crown’s color and appearance. The last step may be the development of surgical guides to ensure accurate placement of the implants by the surgeon.
One of the biggest questions to answer at this stage is whether or not you have sufficient bone mass to support the implant. You may have experienced significant bone loss due to disease or from resorption (the dissolving of bone) because of tooth loss. Insufficient bone mass can be remedied with a bone graft placed within the site that stimulates bone growth, which if successful will provide enough bone to support the implant.
While this preparatory phase before implant placement can be very involved, it’s absolutely necessary for ultimate success. The careful planning and prep work performed by your implant team — and your own participation in the process — will ensure that you’ll be happy with your new implants and your new smile.
If you would like more information on dental implant options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants.”
Dental implants have emerged as the premier replacement option for lost teeth. Their life-like appearance, durability and versatility have made them extremely popular with patients.
Implants aren’t a quick fix, though: in most cases the process takes months to complete. Here’s a chronological overview of what you can expect if you decide on dental implants.
Stage 1: Planning. The process begins at least a few weeks before the actual implantation with an examination to determine what’s best for your individual case. Implant materials and designs are quite numerous, enabling us to precisely match individual tooth types, shapes, lengths and color. We then use x-rays or CT scanning to identify the best locations for the implants — careful planning here increases the chances that implantation will go smoothly and the final outcome will be aesthetically pleasing.
Stage 2: Implantation. Once we’ve finished planning, it’s time to surgically insert the titanium implants into the pre-determined locations in the jawbone identified during Stage 1. While this procedure is relatively minor and routine, the surgeon still operates with precision and care to ensure the best functional and aesthetic outcome.
Stage 3: Integration. In most cases after implantation, we’ll need to wait for a few weeks before attaching the final crowns. Because bone has an affinity for titanium, it will grow and adhere to the implant during this waiting period, anchoring it securely into the bone that will increase its long-term durability. We attach temporary teeth made of acrylic plastic (along with giving you some precautions on biting and chewing) to help you function normally during the waiting period.
Stage 4: A Transformed Smile! Once integration has been achieved and the gum tissues fully healed, we can then attach the permanent crowns. These crowns are typically made of strong, durable materials that will fit the healed gum tissues more precisely than your temporary crowns. Depending on the type of implant used, the crowns are either cemented or screwed into place onto the implant.
The process of dental implantation involves a lot of time, effort and precision. In the end, though, it’s well worth it — the joy of new teeth that will function well for years and look great too!
If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “New Teeth in One Day.”
Once you receive your dental implants, you can have peace-of-mind in knowing that you have chosen a successful tooth replacement option, with long-term success rates of well over 95%. Your implant will look, feel and function just like the natural teeth that it has replaced.
However, despite the natural appearance, when you visit us for a regular cleaning, you may notice that we are using special instruments to clean around the implant. Cleaning around implants differs from the maintenance of your natural teeth for two reasons:
Cleaning implants is just as important as cleaning natural teeth, because both depend on healthy surrounding tissues for support. Just as bacterial biofilm (plaque) collects on your natural teeth, it can also collect on your implant. That is why it is very important to brush and floss thoroughly on a daily basis at home. Without daily biofilm removal, the gums surrounding your implant can become infected, leading to bone loss and eventually loss of the implant.
Your regular dental cleanings will also play an important role in keeping dental implants infection-free, and we will select the right instruments for a professional cleaning. We will ensure that these instruments will not damage the crown, abutment, or the implant itself. If implants are scratched, they can attract and harbor bacteria. That's why the instruments we use, called scalers and curettes, are most often made of plastics and resins. Natural teeth don't scratch in the same way, and therefore metal instruments need to be used to clean them.
A number of power instruments have nylon or plastic sheaths or tips to minimize implant damage. They clean by using high-frequency vibration, which may be necessary if large quantities of debris have accumulated on your implant. We use these on a low power setting with a lot of water irrigation, and sometimes antibacterial solutions, to clean and flush material.
When it comes to keeping your implants infection-free, keep in mind that the most successful formula will be consistent oral hygiene at home mixed with regular dental cleanings.
If you would like more information about maintaining your dental implants, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Dental Implant Maintenance.”
You may be considering dental implants for a lot of reasons: durability, functionality and imperviousness to decay. But perhaps the winning reason is how they will make you look — their life-like quality can restore a smile marred by missing or disfigured teeth. Achieving that result, though, requires your dental team to determine beforehand the state of your bone and gums, and treat any conditions that would interfere with the final result.
The first area to look at is the amount of bone available to support the implant. An adequate amount is necessary not only to stabilize the implant, but to also ensure proper placement needed to achieve the best “smile” result. Your specialist, then, will take steps to protect available bone during procedures, or even aid in building up the bone structure by inserting grafting materials that encourage new bone growth.
The degree of bone volume in adjacent natural teeth is also important because it can greatly affect the health of the papillae. This is the triangular-shaped gum tissue that occurs between each tooth that gives normal teeth their arched appearance. Insufficient bone in these areas could cause the papillae not to regenerate properly around the implant site, which creates unsightly dark spaces in the gum tissue known as “black hole disease.”
We must next consider the quality and health of your gum tissue. Patients whose gum tissue tends to be thin face difficulties during cosmetic surgical procedures; their thinner tissues are also more prone for objects behind them to be visible, including metal or other crown materials.
Our aim is an implant crown emerging from the surrounding gum tissue just as a natural tooth would. To achieve this requires knowing first what we have to work with regarding your bone and gums, and to address any issues that are problematic. One aid in this process is to affix a temporary “prototype” crown on the implant to wear while the permanent crown is manufactured. This allows you to “test-drive” the new look, and make adjustments in the final product regarding color and materials.
Accounting for all these factors — and then making adjustments along the way — will help ensure the final crown meets your expectations for function and appearance.
If you would like more information on the fabrication of implant crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Matching Teeth & Implants.”