Dental Implants

Dental implants are changing the lives of our patients. They have become the preferred method to replace missing and failing natural teeth. Dental implants provide a foundation for replacement teeth that look, feel and function like natural teeth. With a dental implant you will be able to eat virtually anything. Replacing missing teeth with dental implants helps preserve the jawbone and restore youthful facial contours. Patients with dental implants can smile with confidence. Dental implants also have some advantages over natural teeth. They do not decay or need root canal treatment. As such, dental implant replacements can last longer than conventional options like tooth supported bridges.

What Are Dental Implants?

A dental implant is simply an artificial tooth root. The implant is made of a biocompatible material, such as titanium or zirconia, so it is well accepted by the body with no fear of rejection. The implants are placed into the bone where teeth are missing. The bone then bonds to the implant surface creating a strong foundation for the artificial teeth. An abutment is a component that is fastened to the implant and extends through the gum tissue to serve as an attachment for the replacement teeth. Dental implants can be used to replace one missing tooth or an entire set of teeth. To sum it up here are three parts needed to provide you with new teeth – the dental implant, an abutment and the replacement tooth or teeth.

Dental implants have over forty years of research with outstanding long term results. Many studies have found that the success rate for today’s dental implants is as high as 98%. In the hands of a properly trained and skilled oral surgeon, implants are a safe, predictable and often the most preferred alternative to the traditional way teeth were replaced (bridges, dentures).

Dental Implant Surgery

Patients are often pleasantly surprised how easy implant surgery can be. In our office your comfort is always a top priority. On the day of your procedure, Dr. Misch will perform your personalized treatment plan to precisely and accurately place the implants in their optimal positions within your jawbone. If you are having a tooth extracted, the implant may be placed into the socket during the same procedure. Otherwise a small incision is made in the gum tissue to expose the underlying jawbone. The dental implant will then be surgically inserted into the bone. Most of the time the gum is sutured around a healing abutment attached to the implant that extends through the gum tissue. This is referred to as “one stage healing” of the implant.

At times, patients may have softer bone or insufficient volume of bone. In these cases, the implant may need to heal beneath the surface of the gum for additional protection. This is referred to as “submerged healing” and requires a minor surgery to expose the implant after it heals. You may be a candidate for immediate implant teeth. This option allows for the placement of temporary teeth that are immediately secured onto the implant(s) to avoid the need for removable replacements during healing. Dr. Misch will explain how your case is best managed.

After implant surgery, most patients experience minimal disruption in their daily life. In almost all cases you can wear temporary replacement teeth. Most patients can easily return to work the following day.  Postoperative discomfort is usually considered minimal. Although you will have temporary teeth, dental implants need to heal before the final teeth are fabricated. Implant healing can range from six weeks to four months of more depending on conditions such as bone quality and your ability to heal.

Dental Implants Presentation

To provide you with a better understanding of dental implants, we have provided the following multimedia presentation. Many common questions pertaining to dental implants are discussed.

Dental Implants Presentation

Dental Implant Advances

As an educator, Dr. Misch is at the cutting edge of implant advancements and technology. In the past dental implants required long healing periods of several months. Research has developed new implant surfaces that attract bone and shorten healing times to as short as six weeks. Advancements in implant designs can often allow us to secure temporary teeth to the implants the same day. Our office can evaluate your jaw and determine it you are a candidate for immediate teeth. New implant designs also better maintain bone and allow the use of shorter and narrower implants in your existing jawbone to avoid the need for bone grafting.

Our office uses three-dimensional imaging to diagnose your jaws for implant options. Cone beam computed tomography allows us to visualize the jaw three-dimensionally and use computer software to plan your surgery. By performing your virtual surgery we are able to better plan and place your implants in optimum sites for your replacement teeth. In more complex cases Dr. Misch may use guided surgery that uses a computer-generated template to allow placement of implants in almost the exact position he plans on the computer screen. We are currently evaluating the use of navigational surgery to guide implant placement much like laproscopic surgery used in medicine. However, all this new technology does not replace the judgment and experience of a skilled surgical specialist.

How Long Do Implants Last?

Modern dental implants were developed over forty years ago in Sweden. The first patient they treated recently passed away but he enjoyed the use of his implants for the rest of his life. Dental implants have proven to be an excellent method to replace failing and missing teeth with favorable long term results that exceed conventional options such as dentures and bridges. They have the potential to last a lifetime but remember – your own teeth didn’t last forever. Some patients mistakenly think that once they get dental implants they never need to go back to a dentist again. Nothing could be further from the truth! Although dental implants don’t decay or need root canal treatment, gum disease can occur around implants just like natural teeth. You must thoroughly clean your implants daily. We advise the use of a mechanical toothbrush and a dental rinse such as Listerine or Crest ProHealth. You may be given a prescription for a rinse such as chlorhexidine (Peridex). We recommend you maintain a schedule with your dentist for routine check ups and cleanings. You will also need to return for periodic maintenance of your replacement teeth.

Cost of Dental Implants

You simply can’t learn everything you need to know about a dentist, their office and your specific treatment needs over the phone.  Many patients call to ask, “How much do implants cost?”.  This question can’t be answered over the phone because each patient’s case is different and the cost of an implant is only one part of the total fee. In addition, our office does not have a set fee for a dental implant. There is a fee range that is determined by the type of implant, possible need for bone grafting and the complexity of the case. Although cost is important in making your decision on treatment it should not be the primary factor in choosing an office. Today dental implants have extremely high success rates when placed by experienced surgeons and can last a lifetime.  It is a great investment in one of your finest assets – your smile.

After Dr. Misch has performed a thorough evaluation you will get a written treatment plan that includes fees.  More complex plans may require seeing other dental specialists or the need to obtain additional diagnostic information (such as photographs and study casts).  The plan will include an estimated length of your treatment.  Dr. Misch will also provide written plans for other options to treat your case.  Medical insurance does not typically cover dental implants and associated procedures such as jaw bone grafting.  Some dental insurance companies may cover a portion of your implant treatment but there is usually a yearly limit on benefits.  A preauthorization can be obtained from your dental insurance company to see what treatment is covered by your plan.

What are Zirconia Implants?

More recently an alternative was introduced to titanium implants. Zirconium is a hard metal that is resistant to corrosion. Zirconium ceramic or zirconia is obtained through a process that produces a white material that can be formed into dental implants. Just like titanium this ceramic is biocompatible and well accepted by the body. One potential advantage of zirconia implants for esthetic tooth replacement is that they are white in color compared to gray titanium. However, zirconia abutments can be placed onto titanium implants to improve the cosmetic result.

Patients that do research about dental implants on the internet may become confused about titanium dental implants. Some companies and dentists are trying to scare the public to promote the use of their zirconia implants. They claim that a small percentage of patients may have an allergic reaction to titanium. They incorrectly relate titanium to other metals, such as nickel, that have been found to produce allergic responses especially in some women. There have been some reports of hypersentitivity to titanium. The bulk of these studies originate from orthopedics implants due to metal wear particles following knee and hip replacements. However, dental implants do not have moving parts that wear like joint replacements so this does not occur. The significance of titanium as a cause of allergic reactions in patients with dental implants remains unproven.

Titanium is a biocompatible material with superior mechanical properties that has been used in medicine and dentistry for many years. Titanium dental implants were originally developed in Sweden over forty years ago. The long term success of titanium dental implants is well documented in scientific publications. Titanium dental implants have high success rates and used by almost all implant surgeons.

Although zirconia dental implants have shown good success rates, they can have some disadvantages. One of the concerns about the ceramic material is a risk of fracture. To lower this risk, most zirconia implant designs are one solid piece and that can complicate their use. If the implant is not stable in the bone during healing it can loosen and fail to heal. The dentist can have difficulty making a crown on the implant if it needs to be placed on an angle. Your dentist needs to use dental cement to insert the replacement teeth that can make retrieval more difficult. There is also still one issue that is unclear about ceramic implants. Zirconia “ages” due to water absorption, and slowly loses strength over a period of years. How strong will the implant be in ten years? We don’t know. Most of all, zirconia implants do not have the long term studies that match the longevity and success of titanium implants. Dr. Misch will advise you if zirconia implants should be considered in your case.

What Are Mini-Implants?

Mini-implants are small diameter titanium pins that are placed into the jawbone to support replacement teeth. As they are so narrow, they are often placed into the bone directly through the gum. They are mostly used to help retain dentures but some general dentists also use them to support crowns and bridges. One supposed advantage of mini-implants is that they are easier to place than regular implants. As such dentists with less surgical training often see this as a way to offer the service without referring a patient to a surgical specialist. They are also less costly so some patients see this as a way to save money on treatment.

Mini-implants have several limitations and disadvantages. Compared to the vast number of studies that support the long term success of regular dental implants these do not have much scientific data to substantiate their regular use. They have high failure rates when used in softer bone, such as upper denture support. The implants are so narrow that they can wear or fracture over time from chewing forces. Mini-implants can be useful if applied to the right type of case. Our office often uses them as “provisional” implants to support temporary fixed teeth during treatment. This can avoid the need to wear a removable temporary tooth replacement during healing. The temporary mini-implants are easily removed after the regular implants have healed. They can also be useful in cases where there is very limited space between two front teeth in the upper or lower jaw. Dr. Misch can evaluate your condition to see if mini-implants are a viable option, but for most experienced surgeons their use is quite limited. They are less expensive but if they fail it is money wasted.

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