If you’re missing a tooth or a couple of teeth, dental implants are the best way to replace those teeth. At Midtown Dental Design, we offer traditional dental implants, which are the strongest, longest lasting solution. But replacing multiple teeth with implants can be cost prohibitive, so we also offer two options for implant-supported dentures — All-on-4 dental implants and mini implants.
What is a dental implant?
An implant is a prosthetic replacement for a missing tooth or for a tooth with extensive damage that needs to be extracted. The implant is named for its base, a titanium screw that is placed into the socket from the former natural tooth root. Because the human body accepts titanium, the jawbone grows around the titanium implant and it becomes a part of the jaw. Once this process has finished, a post is attached to the implant, and an artificial tooth atop that. Implants function basically like a natural tooth because they are anchored into the jaw.
Why do I need to replace a missing tooth?
Some people opt to not replace a missing tooth or two, either for cost or just to avoid the hassle. But this can cause problems with your oral health:
- Our teeth stay in place thanks to the pressure placed on them from the adjacent teeth on each side. When a tooth is missing, the teeth on both sides tend to slide over into the gap. This creates problems with your alignment and bite.
- Chewing and biting create a great deal of bite force energy. This energy travels down into the tooth and through the tooth into the jawbone beneath. This stimulates the jawbone to continually regenerate new bone mass, which is key to a healthy, strong jawbone. Without that energy coming down through the tooth, the jawbone in that area begins to deteriorate and resorb.
- Missing teeth can be embarrassing visually, and can also create whistling sounds when pronouncing certain words. And missing molars can create problems with chewing, making the person avoid certain foods, which can create nutritional deficiencies.
Who is a good candidate for dental implants?
The determining factor in a patient’s ability to have a traditional dental implant is his or her jawbone mass. Because the implant needs to screw down into the jawbone, there needs to be sufficient mass to support it. If the person has been missing a tooth or a few teeth for some time, the jawbone under those missing teeth has likely begun to deteriorate and lose mass. In these circumstances, the patient will need some bone grafting to rebuild the jawbone before having a traditional implant placed.
But if the patient is a denture wearer or has a number of missing teeth that could be replaced with a partial denture, the newer options of All-on-4 dental implants and mini implants can be placed even if the person has lost jawbone mass. That’s the advantage of these two options.
What are the advantages of dental implants?
- Unlike a bridge, dental implants behave exactly like your natural teeth. You can chew and eat all foods without worrying that your bridge will break or come loose.
- Unlike bridges, where adjacent “abutment teeth” need to be crowned to anchor the bridge holding the false tooth or teeth, implants stand alone.
- Implants keep adjacent teeth from moving.
- Implants are load-bearing teeth, so you don’t have to avoid chewing or biting with them. Plus, they transfer energy down into the jawbone just as natural teeth do.
- Implants have a 90 to 95% success rate and can last for decades, giving the patient back his or her smile and the ability to eat any foods.
What is the procedure for placing a dental implant?
When you opt to replace a tooth with an implant, Dr. Sadeghi begins the process with a full oral exam, including x-rays and a CT scan to determine your jawbone mass, and in the case of All-on-4 implants, the best location for each implant. This is the process for placing an implant:
- Placement: Dr. Sadeghi opens a tiny hole in the gums and screws the titanium implant down into hole formerly occupied by the tooth root. She may have to drill a small hole into the jawbone to prepare it.
- Osseointegration: The jawbone then needs time to naturally grow around the implant, making it a part of the bone. This takes from three to six months, depending on the patient
- Abutment: When the jawbone has fully grown around the implant, a small metal post, called an abutment, is attached to the implant and the gum tissue is allowed to heal for around six weeks.
- Placing the crown: The final step is to place a custom-made porcelain crown onto the abutment. The crown is made to match the color and shape of the surrounding teeth so, once placed, it fits in naturally.
Using dental implants to support dentures
For people who are missing most or all of their teeth, Dr. Sadeghi offers two solutions to dramatically improve the stability of dentures: All-on-4 implants and mini implants. Mini implants can also be used similar to traditional implants to replace a tooth or two in patients with less jawbone mass.
All-on-4 dental implants
Traditional dentures can slip when a person is talking or when eating. This can be embarrassing and can make a person avoid many different foods. The traditional implants described above can be used to anchor full sets of dentures, but they usually require six to eight implants per arch, and those implants require sufficient bone mass because the implants are placed vertically.
All-on-4 dental implants require just four implants per arch. This is possible thanks to the two back implants on each arch being placed at a 30- to 45-degree angle from the biting plane. By placing these back implants at an angle, the patient can have less jawbone mass and still qualify for these implants. After the back two implants are placed at an angle, the front two implants are placed vertically. This is possible because there is usually less bone loss toward the front of the jaw.
Next, a prosthesis with 10-14 teeth is permanently attached to the four implants on each arch. For these prostheses, the patient can choose between porcelain and composite resin for the artificial teeth. The All-on-4 procedure takes just a single appointment, and Dr. Sadeghi places a temporary set of teeth to the four posts top and bottom. The patient eats a soft diet while the implants become part of the jawbone. After a period of 3-6 months, the implants fully integrate into the jawbone and the temporary artificial teeth are replaced with your permanent teeth. Now the patient can eat whatever he or she wants with confidence.
Mini Dental implants
Another option for supporting dentures is mini implants. These consist of smaller sized implants, usually 2mm versus the 3mm diameter of traditional implants. Like All-on-4 implants, mini implants can be placed in just a couple hours. Each implant is topped by a ball that snaps into a socket on the denture. Mini implants stabilize dentures and can be placed in patients with far less jawbone mass than traditional implants.
Dr. Sadeghi uses a precise, minimally invasive method for drilling a tiny hole and inserting the mini implants into the jawbone. The heads of the implants protrude from the gum tissue. The denture will snap onto these heads and provides a strong, secure foundation. Because the placement is so minimally invasive, the implants are placed and the dentures attached usually in the same appointment.
After receiving your mini implants and the attached dentures, you can eat immediately, but you’ll need to avoid hard or sticky foods for a while to allow the implants to integrate into the jawbone fully. Dr. Sadeghi will give you the period of time for this. Otherwise, you’re good to go. You’ll snap your dentures off for cleaning every night, and you’ll clean the implant posts and your gums. Then the next morning you snap them back in and you’re good to go.
Are dental implants painful?
There is some pain associated with the placement of dental implants into the jawbone, more with traditional implants than with mini implants. The pain is more aching in nature, as the bone does not have nerve cells. There will be some pain as your gums heal, but it is not dramatic and can be handled with pain medication. Mini implants have little or no pain, as the gum incisions are very tiny.
How long will my dental implants last?
Traditional dental implants usually will last the remainder of the patient’s life. This is because each implant is firmly anchored in sufficient bone mass and has basically become a part of the jaw. The porcelain artificial tooth is very durable.
All-on-4 implants can also last for the rest of the patient’s life. What can determine the lifespan is how the lesser amount of jawbone holds up with the implants.
Mini implants, being only about half as large as a traditional implant, usually won’t last as long as traditional implants. This is because the smaller size of each implant doesn’t allow the bite force to be spread as widely. This puts more long-term stress on the jawbone and the implants. Due to their smaller size, mini implants can be thought of as requiring two implants to provide the support of a single conventional implant. Still, for individuals with significant bone degeneration, mini implants may be the only available option.
Do my implants require special maintenance?
Traditional implants do not require anything other than regular brushing and flossing. All-on-4 prostheses usually are also permanent. Mini implants need some specific maintenance. First, the dentures are snapped off and cleaned every night. With the dentures removed, the ball of each implant and the surrounding gums need to be cleaned. Over time, with both All-on-4 and mini implant prostheses, the artificial teeth will likely need to be replaced. This is more likely when resin is chosen for the artificial teeth rather than porcelain.