on Prothetic Dental Implants
The purpose of writing
this patient information monograph is to give you as much information
as we can, and to present it as conveniently as possible.
Your own natural teeth
present in your mouth in a healthy, well-maintained condition are the
best natural dental implants which you can possibly have. There is nothing
else which compares with them. It is, therefore, in the best interest
of your health and well-being to do anything you can to keep your teeth
in the best condition for the longest possible time. With good care on
your part, and with good frequent dental check-ups, you will be able to
accomplish this goal.
When a tooth is lost,
it is best to replace the tooth with a non-removable replacement as promptly
as possible. With the replacement of a single tooth, a non-removable bridge
is often very satisfactory. However, in replacing a number of missing
teeth, and at the same time restoring the chewing efficiency, you have
decreased the support which was present when the natural tooth was in
the mouth. The artificial tooth of the bridge does not have a root. In
reality, this is no great concern when dealing with a single tooth replacement.
But assuming that we have lost two or three teeth in a row, or have lost
several teeth spread out intermittently through the entire jaw, it quickly
becomes obvious that a considerable amount of root support has been lost.
Now, it does make a difference. In effect, we have increased the load
on each remaining tooth because there are fewer of them. This can be compared
with losing fence posts in a long fence. The fence is not any shorter,
but there are fewer posts supporting the fence. The fence is not as strong
now as it was earlier. In the case of the fence, it is obvious that the
fence posts need to be added so that the amount of support will be increased,
and similarly these areas in the mouth need to be aided by replacing the
missing root structure by means of dental implants
Does a removable partial
denture replace the missing teeth equally as well? Partial dentures are
either tooth supported or tooth and gum supported. If it is entirely tooth
supported, the space has been replaced or filled in, but the supporting
teeth are no more than they were before. In other words, the load has
been increased on the remaining teeth. In the case of a partial denture
which is both teeth and gum supported, the number of teeth has not increased
(there is still no more root support than there was before), the areas
where teeth are missing have been filled in with gum-supported denture
teeth. This means that the gum tissue and bone under these denture areas
are not relined, then a space develops under the denture. It is not bearing
its fair share of the chewing load, and the remaining teeth will undergo
accelerated bone loss. Also, this partial denture is removable. It is
not permanently fastened in the mouth as a non-removable bridge would
Nature has provided
tooth supporting bone during the years when there are teeth present in
the mouth. When the teeth are lost, the tooth supporting bone is also
lost. Nature takes away from you what you do not use. for example, the
person who is confined to bed for a long period of time loses muscle tone.
The muscles get soft and literally wither away. In the mouth, the bone
under the gums "shrinks", and dentures get loose. Notice in
the mouth of a person who has half of his/her teeth, the bone is present
around the teeth which remain. Where the teeth have been lost, many times
it looks like the back of a "swaybacked" horse. Where implant
prosthetics have been placed and properly maintained, the tendency is
to preserve this bone because the bone is being used somewhat in the same
way it was when the natural teeth were present.
placed onto the Dental Implant
For purposes of comparison
let us assume that the patient with all his/her natural teeth in a healthy,
well-maintained functionally accurate condition can operate with chewing
at 100% efficiency that will decrease with every tooth lost. How much
decrease there will be will depend on whether or not the teeth are replaced
and in what manner.
Ultimately, if s/he
reaches the point where s/he has no teeth at all, s/he may have (with
good fitting dentures on adequate bony ridges) a chewing efficiency of
If the ridges are
not adequate, the percentage decreases. With implants and non-removable
bridge work or supported tooth replacement methods, s/he may get back
as high as 85% compared with what s/he had with his/her natural teeth,
depending on the number of natural teeth present and their condition.
This is an absolute
necessity. We will provide you with a "medical history verification"
form to take to your physician. S/he will provide us with results of recent
examination records including blood tests and urinalysis. S/he will make
indications of drug allergies and/or alternative recommendations. S/he
will want to make sure you are healthy and that there is no reason why
you should not heal very nicely. We also want your medical doctor to be
aware of the treatment we'll be providing you and the medications we may
The dental care you
provide yourself at home must be excellent. You must keep your teeth and
implants cleaner than you may have done before in your life. You must
be able to use dental floss, tooth brush, or other devices we may recommend
to keep plaque off of both your teeth and implants. If this is not done,
there is a very good possibility that these implants will not succeed,
and will have to be removed. By the same token, smoking and excessive
alcohol consumption are a deterrent to excellent dental health as well.
You must have a very
complete examination with x-rays which will include a panoramic x-ray
of your entire mouth. X-Rays are necessary for proper diagnosis and follow-up
after treatment is complete.
The teeth or denture
which are in the arch opposite to the implanted area compose a very important
consideration in the success of the implant. The load on the implant is
not actually in use. There must not be any grinding (brusism) against
the implant. Also, care must be taken not to overload the implant by chewing
ice or hard objects which could damage even your natural teeth. The patient
should not engage in fights or do anything else which could be damaging
to the implant or the underlying bone.
of Nerve Sensation
There are cases reported
in the dental literature in which there is temporary loss of nerve sensation
following certain surgical procedures. This does happen sometimes, but
is usually temporary. Unfortunately, there have been such occurrences
following removal of deeply impacted wisdom teeth. It is possible that
such a thing could happen with the placement of implants in the bone.
It is usually temporary, and is a loss of nerve sensation only, and does
not cause a drooping or sagging of the face.
All Prothetic Dental Implants Successful?
No. There are many
variables to be considered in placing implant prosthetics. First, the
patient must be healthy. There must be adequate healing powers present
in the patient. If the patient is an uncontrolled diabetic, for example,
the chances for healing are not too good and could be quite a problem.
If such a condition develops at a later date after the implant has been
done, this will certainly complicate the future of the implant. Secondly,
proper diagnosis must be made, and the proper implant must be selected
for the patient and, of course, inserted properly. Thirdly, it must be
treated properly by the patient and the dentist. If either person becomes
forgetful, there could be a problem. Fourthly, if the patient is a heavy
smoker or an excessive alcoholic beverage user, that certainly doesn't
help, and the success of the implant will be affected.
Implants Last A Lifetime?
It is doubtful. Very
few things do last a lifetime. There are some implants which have been
in the mouth for as long as thirty years. this is not the average. The
average has been in less than that time. In the final analysis, whether
they last a lifetime depends on how long you live. Every natural tooth
in the mouth of everyone of us now living will have one of two possible
fates. It will either last until we die, or it will be removed at some
time. The same thing applies to prothetic dental implants.
Age A Deterrent?
No. Health is a deterrent.
Many people 70 and 80 years of age are better surgical risks than someone
years younger who has everything physically wrong with him/her. Older
people are more likely to need implants because they have lost more teeth,
and have lost more ridge.
As long as you live
and breathe and are important to someone, you owe it to yourself and family
and friends to take the best care of yourself that you possibly can. Incidentally,
what is good age for a heart or kidney transplant or a coronary by-pass?
If you need such an operation to stay alive or improve the quality of
your life, would you refuse because of age?
By The Body?
Implants are made
of biologically compatible materials which have undergone extensive testing
over a period of several years in research laboratories using animals.
Since these materials are largely metal--titanium, vitallium, etc. - and
have never been living tissue, there is no likelihood of causing an antigen-antibody
response which could cause rejection similar to that which sometimes occurs
with heart and kidney transplants.
If you have decided
that you want to be considered as an implant prosthetics candidate, and
you feel that psychologically there will be no emotional problem for you
to have prosthetic dental implants, then you can be encouraged from the
fact that there are many people in this country and throughout the whole
world who have hip transplants, pins placed into their hips, kidney and
heart transplants, and cornea transplants with excellent results. If you
do not feel that you have adequate emotional stability to undergo similar
treatment, then I would advise you against having an implant.
There is no way that
we can guarantee anything which goes into the mouth, and which is under
the control of the patient. The physician does not tell you that the transplanted
heart, the kidney transplant, or the coronary by-pass will keep you alive
for any specified period of time. We can only tell you that we will endeavor
to place the implant properly, will give you the information you need
to care for your implant at home, and will be available for periodic check-up
appointments to evaluate your continued dental health. We will do everything
we can to make the implant succeed, but you will have to make the same
commitment. If you do not hold up your end of the bargain, the implant
will most likely fail. Also, you must return to our office at regular
intervals, according to our recommendation for examination and service.
If you do not do this, you could get into difficulty without your knowing
it. This could result in a loss of the implant. Under such circumstances,
the fault would be yours. Due to the complex nature of oral implantology,
it is important that all post-operative examinations and/or treatment
be held by this office. Referrals will be made only to those doctors with
experience and training in implant dentistry.
Are dental implants
inserted for cosmetic purposes? Absolutely not. The primary objective
of dental implants is to give additional support to the replacement teeth.
Dental implantology is not a total substitute for face lift plastic surgery.
Some cosmetic enhancement is possible, however, and those expectations
should be fully discussed prior to treatment.
If you have any questions
on implant prosthetics or dental implants which have not been fully answered
by this monograph, please feel free to ask them prior to beginning treatment.
We will do our best to inform you.