Dental Implants (cont.)

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What are the different types of dental implants? What are the different uses for implants?

Historically, there have been two different types of dental implants: (1) endosteal and (2) subperiosteal. Endosteal refers to an implant that is "in the bone," and subperiosteal refers to an implant that rests on top of the jawbone under the gum tissue. Subperiosteal implants are no longer in use today because of their poor long-term results in comparison to endosteal dental implants.

While the primary function of dental implants is for teeth replacement, there are areas in which implants can assist in other dental procedures. Due to their stability, dental implants can be used to support a removable denture and provide a more secure and comfortable fit. In addition, for orthodontics procedures, dental mini-implants can act as temporary anchorage devices (TADs) to move teeth to a desired position. These mini-implants are small and temporarily fixed to bone to aid in anchorage for teeth movement. They are subsequently removed after their function has been served.

Will I feel pain when getting a dental implant?

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Dental implant surgery is usually performed under local anesthetic and therefore, no pain should be felt during the procedure. After the local anesthetic has worn off, the post-surgery discomfort will vary with each individual case. However, in general, most people will feel discomfort similar to a tooth extraction afterwards. This pain can be managed with over-the-counter pain medications such as ibuprofen (Advil) or acetaminophen (Tylenol).

What is the procedure for getting a dental implant?

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During the planning stage, the dental surgeon will visually examine the site in the mouth where a dental implant is being considered as well as look at dental imaging studies (X-rays and CT scans). Once it has been established that a dental implant can be placed in the desired location, the patient will return for the actual surgery for dental implant placement.

At the implant placement appointment, the patient is usually given local anesthetic to numb the surgical area. With a special drill and tools, the dental implant (titanium post) is placed into the bone. The gum is sutured and the healing phase begins. Healing time depends greatly on the quality of bone present. Healing time is usually anywhere from 2 to 6 months. During this time, osseointegration should be taking place. Care must be taken to avoid placing any force or stress on the dental implant as it heals.

After the required healing period, the dental implant is tested to determine whether osseointegration was successful. Once this has been confirmed, a prosthetic component is connected to the dental implant via a screw. This component is called an "abutment." It will serve to hold the replacement tooth or “crown.” The dentist will take an impression (mold) of this abutment in the mouth and have the implant crown custom-made to fit. The implant crown is either cemented on or secured with a screw to the abutment.

It should be noted that additional procedures may be required prior to the placement of an implant. Bone grafts are commonly performed if the quantity of bone is inadequate. In the situation in which an implant is to be placed in the maxilla (upper jaw) in the posterior region, the available amount of bone may be limited by the presence of the maxillary sinus. "Sinus augmentation" or "sinus lift" is performed to raise the sinus floor and graft more bone into the sinus. This will make more bone available to support a dental implant. "Ridge modification" is performed in locations where there is not enough bone present. "Ridge" is in reference to the jawbone that has no teeth. Bone or bone substitute is used to augment the ridge to achieve adequate bone for dental implant placement.

Medically Reviewed by a Doctor on 2/13/2014

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