Twenty years ago, if someone described how missing teeth could be replaced with implants it might have been called a miracle. Ten years ago, the use of implants to replace missing teeth might have been called astounding. Today, these same implant procedures are called routine.

Advantages of Implants Implant restorations are the closest thing to your own teeth. Implants have one of the highest success rates of any dental restoration. The placement of implants preserve your jaw bone. Proper placement and restoration of your bite will probably increase your chewing efficiency over conventional tooth replacement. Implants last and do not decay. Almost 500,000 implants were placed in 2000. The dental profession has over 30 years experience with implants. Disadvantages of Implants If you are in a hurry, implants are probably not for you. Bone grafts are sometimes needed. Time has to be allowed for healing. Implant therapy may cost more than conventional tooth replacement.

What is an implant and why is it used? An implant is a synthetic metallic root substitute that is placed (implanted) in the jawbone. It can be used to either replace a single missing tooth, provide an abutment (anchor or retainer) to replace several missing teeth, or be used as a retainer to provide added retention to a removable dental appliance - such as a full denture. In fact, if you are missing all of your natural teeth, it is possible to have maxillary (upper) and mandibular (lower) fixed replacements - the replacements do not come out and you cannot remove them yourself, even if you want to!

Two separate events are needed in replacing a missing tooth with an implant. First, there is the surgical phase when the implant is placed, and second the prosthetic phase, where the replacement teeth are constructed and fixed into the proper position.

The implant placement procedure involves making a small incision in the gum area where the implant is to be placed, preparing a site in the underlying bone, inserting the implant into the prepared site, and closing the tissue over the implant with several sutures. This area is left undisturbed for several months - usually 4 - 6 months. More healing time may be required for more involved situations. This is not uncommon. Because the lower jaw is composed of bone that is more dense than the upper jaw, the healing time is usually less when an implant is placed in the mandible. This 4 - 6 month healing process is nothing that you can feel. It relates only to the slow integration of the implant with your jaw. This integration occurs slowly.

After the healing and integration of the implant the implant placement site is exposed - the gum is cleared away from the top of the implant. The dentist will then fasten (by cement or with internal threads) to the implant the appropriate post that will be attached to the crown, bridge, or whatever type of replacement is indicated. The implant is held in place by the bone, the post is fastened to the implant and provides means to attach the crown (or bridge or whatever is the final replacement needed) to the implant.

Do the implants work? They are very successful. Occasionally there is an implant failure but maxillary and mandibular implants are more than 93% successful. Lower implants have a somewhat higher success rate those upper implants. If an implant is not going to be successful, many times this can be determined during or after the surgical phase and before the replacement tooth or teeth are constructed. Implants can fail, but this is not common.

Implants can be used to replace single missing teeth - especially back teeth. It is a more conservative alternative to fixed bridgework (crowns that require drilling of the natural tooth structure). They can be used to replace multiple missing teeth. They can be used in conjunction with remaining natural teeth to provide support for missing teeth. They can be used to obtain better retention for full dentures, or to eliminate removable full dentures entirely. You also have alternatives to implants if you wish to replace a missing tooth or teeth. Fixed bridges (crowns), resin bonded and retained bridges, removable partial dentures, full removable dentures or you can do nothing at all. The implant option may offer the most conservative treatment for a fixed replacement - that is, the least amount of drilling of natural tooth structure.

There are usually several possibilities for replacing missing teeth that will be effective and can easily be discussed with our staff at your next office visit.