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Some of the consequences of tooth loss are: aesthetic compromise, decrease of masticatory efficiency (it is harder to chew), overload of the remaining teeth as they have to compensate for the lost tooth (therefore the remaining teeth could be damaged or lost too), difficulty to talk or to say certain words, loss of lip support (wrinkles), tilting of the neighboring teeth, unstable bite, head and face muscle and joint problems, decrease in size of the bone that held the lost teeth (bone resorption).
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The simplest option is removable partial dentures, which are held in place by hooks and stabilized by a plastic or metallic structure that fits over the palate or under the tongue. The patient can remove them from their mouth and place them back themselves.
The next option is a bridge, which involves trimming the tops of the neighboring teeth so they can be fitted with porcelain crowns that will hold between them the replacement tooth.
The third option consists of dental implants, which involve placing a titanium post that will serve as an artificial root that will support a porcelain crown.
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Dental implants are artificial tooth roots that are placed into the jawbone. They are small cylinders (3.75 mm diameter), most commonly made of titanium. The artificial teeth can be anchored to these new roots zero to four months after their placement, once the implants are fixed strongly to the bone.
Dental implants will improve your smile, speech and chewing function, greatly increasing your confidence. An advantage of dental implants is that there is no need to alter, trim or injure the neighboring teeth to replace the missing tooth.
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They are a type of intraosseous dental implants that fix to the bone by means of the phenomenon of "osseointegration", creating true artificial roots implanted inside the mandible or maxillary bone. They provide a solid base for the restorations built to replace one or several lost teeth.
Osseointegrated implants will allow us to chew, speak and smile with the same confidence as with our natural teeth.
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The main advantages of dental implants are:
a-)With dental implants there is no need to trim (damage) neighboring teeth to replace lost teeth. Bridges have long been a good option for tooth replacement, but they do require trimming the adjacent natural teeth, which over time can lead to failure of these teeth due to overloading or decay.
b-)Dental implants make it easier to maintain good oral hygiene, as they can be brushed and flossed just like natural teeth. Bridges on the other hand require a special technique with a special floss.
c-)Dental implants have a longer life span than bridges or removable dentures. In 10-year studies, it was found that the success rate for implants was 90%; while for bridges and dentures it was 50%. The studies also showed that when a bridge failed the supporting teeth often had to be extracted or required root canal treatment. The few times that implants failed they simply had to be replaced, with no harm to the neighboring teeth.
d-)Dental implants stimulate bone growth in the area surrounding the implant, unlike dentures or bridges which do not prevent the bone loss that occurs over time when teeth are missing.
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The disadvantages of dental implants are:
a-) Dental implants must be placed inside the bone, and this involves a minor surgical procedure. Although it is relatively painless, the fact that it is surgery might make some patients feel anxious.
b-) The amount of time necessary to complete the treatment is longer than with other tooth replacement options. It can normally take between two to six months from implant placement to crown placement. This is also known as osseointegration time, and it varies depending on the area of the mouth where the teeth were lost.
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Through the years many materials have been used for dental implants, but currently the most widely used is titanium.
Apart from being extremely strong, light-weight, corrosion-resistant and very durable, research and experience have shown titanium to have exceptionally high biocompatibility, which is the ability to interact with the body without causing harm. Since it fixes strongly to the bone (osseointegration), these types of implants last for very long periods of time.
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Bone resorption is a process by which specialized cells break down the bone and release its minerals.
The function of the maxillary and mandibular bones is to support the teeth. When we loose one or all of our teeth, because of decay, gum disease, trauma, etc., the bone that supported the lost teeth looses its purpose and the process of bone loss or bone atrophy begins. The aesthetic and functional consequences of bone resorption can be dramatic. Bone loss is greatest during the first months after a tooth is lost, and it can be accelerated by the use of full or partial dentures due to the pressure they exert on the gums and underlying bone.
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Dental implants not only replace teeth that have been lost, restoring function and aesthetics, they also stop bone loss as the bone once again receives the stimulus of mastication. Therefore, it is important to replace missing teeth with implants as soon as possible in order to minimize bone resorption.
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Let us imagine a house. The teeth would be the columns or pillars that support the roof. If some of these columns were to be removed, the rest of them would have to support more of the weight of the structure. These remaining columns would be overloaded, and this could lead to the whole structure collapsing.
The same thing happens in the mouth when teeth are lost. The remaining teeth have to endure all the forces of mastication, suffering an important overload that could injure them and their bone support, and with time they could be lost too.
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The treatment consists of two stages: A surgical phase and a prosthetic phase.
The surgical phase consists of the placement of the artificial roots or implants inside the jawbone. It is performed with local anesthesia and is painless. Sedation and general anesthesia are options for nervous patients. The duration of the intervention is from one to two hours, depending on the number of implants, which will remain covered for two to six months (depending on the area of the mouth where they were placed). In some cases a second very minor surgical procedure is needed afterwards to uncover the tip of the implants, especially in aesthetically important areas.
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The surgical treatment consists of the placement of the artificial roots or implants inside the jawbone. It is performed with local anesthesia, and is painless. Sedation and general anesthesia are options for nervous patients. The duration of the intervention is from one to two hours, depending on the number of implants, that will remain covered for two to six months (depending on the area of the mouth where they were placed). After that time sometimes there is a need of a very small second surgical phase, to uncover the tip of the implants, especially in esthetic related areas.
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