WHEN SHOULD YOU CONSIDER DENTAL IMPLANTS?

Article Updated 1 August 2021

While restoring missing teeth in the mouth, patients can opt from several options. For multiple missing teeth or complete loss of teeth, fixed or removable partial dentures (bridges or dentures) are recommended. However, these restorations have several limitations, which have been overcome by dental implants. Dental implants were introduced in the mid-1960s. Today, the use of dental implants is considered the most effective and reliable method of replacing missing teeth. In this article, we discuss the dental implant treatment, its benefits, and the process of implant placement.

What are dental implants?

Dental implants are screw-shaped metal posts which are embedded into the bone where teeth are missing, just like the roots of natural teeth. Once these implants have fused with the surrounding bone (after 3-6 months), artificial teeth are attached. Implants support crowns (single caps placed over teeth) when replacing a single lost tooth, bridges (two or more crowns anchored together) when restoring multiple missing teeth, and dentures when treating complete loss of teeth. This results in the restoration of the chewing function, appearance, speech, and smile, helping patients regain self-esteem and improve their quality of life. Dental implants are made of titanium, a material that is highly biocompatible with body tissues.

Who should choose dental implants?

Below are the conditions when implant therapy is recommended:

• Individuals with single or multiple missing teeth, or complete loss of teeth in the upper, lower, or both arches of the jaw.
• Individuals who are not satisfied with removable dentures and are looking for fixed dentures.
• Individuals with traumatic and congenital defects in the mouth and jaw.

Why should you prefer dental implants?

Dental implants are one of the preferred options for restoring missing teeth. Here are some advantages of using dental implants over other treatment options:

• Preservation of tooth structure: Before the advent of implant therapy, fixed partial dentures (bridges) were considered the standard means of replacing multiple teeth. This required dentists to trim adjacent tooth structures (one in front and one behind the location of the missing teeth) so that crowns on the adjacent teeth could anchor the crown being placed to replace the missing teeth. This had adverse effects, as reducing a significant portion of healthy tooth structure can lead to sensitivity and decay at the site. On the other hand, a dental implant is placed into the bone at the site of the missing teeth without affecting the adjacent tooth structures. With this approach, the structural integrity of the adjacent teeth is preserved and the missing teeth are replaced with implants that replicate natural teeth function.
• Preservation of the jawbone: Teeth and teeth-bearing bone have a cordial relationship. The presence of teeth in the bone sends regular stimulation that helps maintain the shape and density of the bone. A lack of stimulation due to the absence of teeth can lead to a loss in shape, size, and density of the bone. Replacing missing teeth with full or partial dentures can accelerate bone loss by transferring excessive masticatory stress directly to the underlying bone. This can lead to a gradual loss of soft tissue, which adversely affects aesthetics. On the other hand, screw-shaped dental implants replicate the root of the natural teeth and provide regular stimulation to the bone. In this way, they prevent the loss of bone and the surrounding soft tissue.
• Additional support to teeth: Before the advent of implants, individuals with complete tooth loss only had the option of dentures. The use of complete dentures limits the patients’ chewing ability. This affects the nutritional status and health of the patients and makes them weak due to malnutrition. The use of implant-supported dentures in such individuals gives them the experience of fixed teeth and improves their chewing efficiency. They also improve the condition of soft tissues and enhance aesthetics.
• Higher survival rate: Research suggests that the survival rate of implants is more than 97% when assessed over more than 10 years. The survival rate of fixed partial dentures is lower than implants.

How are implants inserted?

Individuals who choose implant therapy undergo a thorough clinical and radiographic examination before surgery, combined with a basic blood test to assess any existing health conditions. On the day of surgery, local anesthesia is injected into the desired site in the oral cavity. Calibrated drills are used to drill the bone to match the implant size. The implant is then inserted into the bone with the help of a device called the torque wrench. The implant is sunk into the bone for 3 to 6 months until it osseointegrates (fuses) with the surrounding bone. Once it has fused with the bone, a crown is attached to the implant using anchoring screws.

How much does a dental implant procedure cost?

A dental implant procedure costs 1,500 USD to 6,000 USD in the US for a single tooth replacement. In India, a single tooth implant procedure costs 440 USD to 820 USD.

Who should avoid dental implant procedures?

There are no absolute contraindications to dental implant therapy. However, patients with certain medical conditions such as uncontrolled diabetes, bleeding disorders, cognitive problems, weakened immune system, malignancies or risk of developing endocarditis (heart infection), osteoradionecrosis (bone death due to radiation therapy), myocardial risk (heart attack) should avoid dental implant placement. The presence of these conditions affects postoperative care and increases the risk of implant failure (infection or loosening of implant).

Heavy smokers and those with poor oral hygiene are also at risk of implant failure, so the patients must be motivated to stop smoking and maintain good oral hygiene before an implant is placed. The placement of dental implants should be avoided in children and adolescents until jaw growth is complete.

Patients should consider implants after thoroughly understanding the procedure and its benefits, and weighing against its relatively-high cost.

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