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.
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As long as tooth loss has been a problem for patients, dentists have tried to provide replacement teeth for both functional and esthetic purposes. For small areas where teeth have been lost, "fixed bridges" provided an easy and predictable result (Fig. 1,2).
When the toothless areas became larger or the area was not bounded on both sides by natural teeth, fixed bridges were not feasible and teeth could only be replaced with removable partial dentures. When all of the teeth were lost full dentures were the only answer.
Although these various types of prostheses generally functioned well, patient complaints included the need to cut down adjacent teeth for fixed bridges, unsightly clasps with partial dentures, and slippage and poor retention with both partial and full dentures.
Extensive basic science, animal, and human clinical research has developed a system of dental implants which, when placed in the jaw, can serve as "anchors" for tooth replacement. This surgical procedure known as "osseointegration" may eliminate the need for conventional fixed bridges and removable partial and full dentures. Although most patients are candidates for these highly successful procedures, individual variations in potential implant sites as well as certain systemic medical conditions may preclude implant placement or change the overall success rate. These factors are all evaluated and discussed in an in-depth consultation with Dr. Bunel and your dentist.
The cases which follow are representative of the most common implant procedures which can be performed as an alternative to fixed bridges and removable full and partial dentures.
Single implants can be used to replace individual teeth without the need to use adjacent teeth for support as in fixed bridges (Fig. 4, 5).
Fig. 4
Fig. 5
Freestanding implant supported bridges allow "fixed" restorations to be placed in areas not bounded by natural teeth, where only removable partial dentures were available prior to the era of "osseointegration". In areas of cosmetic concern, no unsightly clasps are needed (Fig. 6, 7).
Fig. 6
Fig. 7
Overdentures are prostheses which utilize clips and bars attached to implants to assist in holding in the dentures. They improve the ability to chew by reducing undesirable movement while still allowing easy cleansability as a result of their removable nature. Overdentures may be indicated in those patients who have insufficient bone height and width to support a fixed implant borne prosthesis, are limited by the number of implants that can be placed, or who lack the manual dexterity to adequately maintain a fixed prosthesis (Fig. 8, 9).
Fig. 8
Fig. 9
Fixed-detachable or "hybrid" prostheses are denture-like replacements, however, they cannot be removed by the patient. Teeth are held in place by screws placed into receptors in the implants and can only be removed by the dentist. This is done periodically for cleanings (Fig. 10, 11).
Fig. 10
Fig. 11
Fixed bridges are similar to bridgework on natural teeth where individual "caps" are made on each of the implants. The caps are usually made of porcelain and are extremely esthetic. A larger number of implants are required for a restoration of this type and meticulous hygiene is needed to maintain the health of the implants and of the gum tissues (Fig. 12, 13).
Fig. 12
Fig. 13
As we progress in this era of osseointegration, patients who were previously not candidates for treatment can now have implants placed with "site development" techniques such as localized bone grafting. The team approach to implant based dental reconstruction includes you, your dentist, and a qualified experienced surgeon. Only after a complete clinical and x-ray examination and detailed consultation can team members develop a treatment plan in an attempt to reach an optimal esthetic and functional result.
