Treatments plan involving dental implants are unique for each individual and accordingly the timing, cost and delivery of care will be customized to suit. Just like a hip replacement, dental implants are made from surgical grad titanium/ titanium alloy, which can develop and maintain a close union with bone in order to support replacement teeth. Dental is essentially a substitute for a natural root and commonly it is screw and cylinder shaped. Dental implants will restore your oral health by supporting natural teeth.

Before	After

There is interchange on a cellular level between the titanium oxide and the bone which in turn allows for the attachment. Once it is placed into the jaw bone it fuses with the bone over a period of 6 months and the bond becomes incredibly strong. This is the process termed Osseointegration. Dental implants offer a smile that looks and feels very natural. Surgically placed below the gums over a period of appointments. Implants offer stability because they fuse to the bone. Candidates for dental implants need to have healthy gums and adequate bone to support the implant. There are several types of dental implants, the most widely accepted and successful is the Osseointegrated Implant.

Before	After

Nearly all implant procedures are performed with local anesthesia in comfortable dental chair. No pain is felt during the number of implants placed , there may be swelling and/or tenderness for a few days following the surgery. Pain medication is usually prescribed which alleviates this discomfort. Patients generally prefer a soft foods diet for the healing period following surgery. Cold foods and tepid soups.

Implant Surgery
There is considerable variation in what can be achieved with implant surgery. The implant surgery plan is tailored for each individual patient. Variations often occur depending on whether an implant is to replace an existing tooth or teeth or whether the tooth/teeth have been missing for many years.

Dental-Implants	Dental-Implants	Dental-Implants

Bone Integration or Osseointegration
Bone integration or osseointegration is a very important concept if you wish to understand the reasons for your dental implant treatment plan. When an implant is placed it is the screw thread which holds it in place. Over 3-6 months the jaw bone grows into the implant surfaces and bonds (or integrates) to it. Bone integration is required before the final restoration can be placed on the tooth.

Immediate Implants
The term 'immediate implant' is used when a tooth is extracted and the implant placed during the same procedure. This can be achieved when the extraction socket has not been damaged by infection or an injury. This technique will assist in the preservation of gum tissues which can otherwise shrink after tooth extraction.

Replacement of a Single Tooth

A lost front or back tooth can be replaced without the need to wear a removable denture.

Dental implants are a total tooth replacement that can look, feel and be used to eat like a real tooth. Once successfully placed a person often finds it hard to distinguish between a normal tooth and their implant tooth. They do however cost considerably more than other forms of tooth replacement, a small amount of surgery is required and treatment times are longer than other replacement options. They are self supporting and so do not damage other teeth.

If looked after well they are now considered to be a lifelong prospect. They also help preserve the bone and gum which would otherwise be lost at an extraction site.

Replacement of Several Teeth (Bridges and Cantilevers)

Mini implants placed in order to facilitate replacement of missing rt. lr. second premolar and first molar

Lower denture stabilization in patients with loose lower dentures Due to poor lower alveolar ridge (gums) height.

Several teeth in a row can be replaced at once with an implant retained bridge or cantilever

A cantilever is when two teeth can be replaced with one implant. This is done sometimes when there is not enough space for two implants such as replacing a central and lateral incisor together.

Three teeth can be replaced with two implants. This is commonly done to replace three back teeth when a person has only front teeth remaining. It is commonly a more effective way to replace multiple teeth.

Dental Implant and Surgical options
Immediately after the placement of the implant , a transitional tooth is inserted into the implant, which not only stabilizes the implant, but also provides the patient with functioning tooth during the 3-4 months healing .

• Functioning transitional teeth after patients first appointment.
• Treatment may be completed in only 3-4 visits.
• Implant placement to final restoration possible in 4 months.
• Patient is never with a fixed tooth.

If you do not have enough bone what can be done?
So far we have covered the building blocks that are part of routine implant placement. This has included the initial examination and diagnosis, special X-rays such as a CT scan, sedation during surgery and what to expect after the implants have been placed. However, for some people, bone loss after the removal or loss of teeth leaves them without enough to secure an implant.

Sinus augmentation
In the upper jaw above the back teeth, it is possible to increase the height of bone available by creating new bone in the sinus. This procedure is called a ‘sinus augmentation’. A skilled surgeon can deliver very predictable results in this location and without the general success of this technique many patients would be unable to have implants in a part of the mouth where teeth are so commonly missing.

Onlay grafting
There are many ways in which bone can be added to, however one simple concept is to take a piece of bone from somewhere else and secure it as an ‘onlay graft’ to a deficient area. The new piece of bone will slowly join to the underlying region and when healed and mature, an implant can be placed in a more favorable position.

Where can you get extra bone from?
Bone can be harvested from a number of sources such as the hip, tibia, chin and posterior regions of the lower jaw. When you use your own bone to create new bone in another area of the mouth you will have to contend with the discomfort created by the donor site as well as the surgical site. Many people feel this is well worth any additional discomfort as your own bone is normally considered the ‘gold standard’.

Alternatives to your own bone for grafting
For those who would prefer an easier, but slightly slower solution, there are other sources of bone specially prepared to make them safe for use in humans. All of these materials including your own bone, simply provide a scaffold into which new bone will grow and consolidate ready to receive dental implants a few months later.

New bone can take anything from 3 to 12 months before it is ready to receive dental implants. Do not be in a hurry to move to the next stage. If you need a large volume of bone it will take longer to mature than a small amount.

Guided tissue regeneration
Each surgeon will have his or her preferred way of creating new bone. Many of them will also use a supplementary technique called ‘guided tissue regeneration’. Using this technique slow moving bone cells are given time to fill a space by placing a barrier material between them and the fast moving cells of the soft tissues lining the mouth. When this technique was originally developed the barrier material had to be removed during a separate surgical stage a few months later. Whilst these original materials are still in use, it is now more common to use a ‘restorable barrier’ that will disappear naturally a few months after it has done its work.

Does Bone Grafting affect the length of treatment?
If you need bone grafting, it will almost invariably increase the length of time your treatment will take, however when successfully applied it will greatly improve the outcome of the implant(s) placed. When used in the front of the mouth it can also allow for creation of very much better aesthetics.

Bone grafting requires a considerably higher degree of skill from the operator and is often more complex to perform than the placement of the implant itself.

In certain situations some operators will recommend combining the implant placement with bone grafting and the placement of a barrier membrane all at the same time. This considerably reduces treatment time and can produce results that are difficult to achieve any other way. However, many surgeons will still prefer to carry out bone grafting as a distinct stage, so that the implants are only placed when the bone grafting has been successful.

Whatever method is chosen to improve the bone quantity the time, effort and expense is generally well worthwhile.

Before	After

One-stage implant
The implant is placed into a new, healing or healed extraction site and is visible above the gum immediately after placement. The advantage of this method is that a second surgical stage is not necessary to expose the implant. The implant will not normally be ready to support a tooth for several weeks or months.

Two-stage implant
The implant is placed into a new, healing or healed extraction site and then covered by a layer of gum so that it cannot be seen - this is the first stage. At the second stage some weeks or months later, the implant is uncovered and components added bringing it above the gum ready to begin placing a new tooth.

Same day implants
This technique is most often used to treat the lower jaw and requires considerable planning before the actual day of surgery. Several implants are installed and a few hours later a complete arch of temporary or permanent teeth can be fixed in place. If temporary teeth are used these will normally be replaced with a permanent bridge after a suitable healing interval. Not all patients are suitable for this style of treatment.

Immediate implant
For this technique a tooth is removed and an implant placed immediately into the extraction site. Depending upon the local bone and soft tissue conditions, the implant surgery may be a one- or two-stage procedure. Not all patients are suitable for this approach.

Immediate implant and early loading
This is distinctly different from an immediate implant placement. It is effectively a one-stage technique where the implant is placed into a new, healing or healed extraction site and is fitted with a new tooth at the same appointment. This first tooth will normally be kept out of direct contact with opposing teeth for a healing period of more than 3 months, after which it is finally restored. This technique tends to be more common in regions of the mouth where optimum aesthetics are important. Again, not all patients are suitable for this approach.

Benefits of Dental Implants:

Eesthetic:
Implants help to stop bone loss, when a tooth is lost some of the bone in the area may disappear. This is known as bone resumption. The bone loss can be rapid but can vary between individuals. Placing an implant helps minimize the bone loss by stimulating the surrounding bone which then becomes stronger and more dense.

Tooth saving :
Dental implants do not sacrifice the quality of the adjacent teeth, like a bridge does because neighboring teeth are not altered to support the implant. Most of your own teeth are left untouched a significant long-term benefit to your oral teeth.

Confidence:
Dental implants will allow you to once again speak and eat with comfort and confidence. They are secure and offer freedom from the irksome clicks and wobbles of dentures. They allow you to say goodbye to worries about misplaced dentures and messy pastes and glues.

Reliable:
The success rates of dental implants is highly predictable. They are considered an excellent option for the tooth replacement.  

Before	After

Benefits of Dental Implants

• When a tooth is lost some of the bone in the area may disappear. Implants help in minimizing the bone loss by stimulating the surrounding bone which then becomes stronger and denser.
• Dental implants do not affect the quality of the adjacent teeth because they are not altered to support the implant
• Dental implants allow you to once again speak and eat with comfort and confidence.  There would no longer be any trouble related to misplaced dentures, messy pastes and glues and the irksome clicks and wobbles of dentures.
• An excellent option for tooth replacement, dental implants have a very high rate of success