Dental Implant Surgery
Teeth serve an important role in our daily lives as it affects our speech, our ability to eat well and the way we look. Its loss through disease or trauma sets in motion the loss of underlying bony support resulting in tooth loss. This in turn affects support for our lips and cheek leading to a more aged appearance. Failure to replace missing teeth often leads to the opposing teeth overgrowing and the adjacent teeth tilting resulting in areas of food trapping which in turn may result in gum disease tooth decay.
What are the different ways of replacing missing teeth
Traditionally, missing teeth were replaced by either removable plastic or metal based dentures, or fixed bridges made of either metal alone, or porcelain fused to a metal base. Developments in dental material science have focused on developing more aesthetic materials with adequate strength, such as all-porcelain and zirconia bridges. While all of these are still very much in use today, implant based methods of replacing missing teeth are increasingly preferred as it provides greater biting ability and a more comfortable and natural feel.
What are dental implants?
Dental implants are sterile titanium screws which are inserted into the jawbone as artificial roots to support and retain replacement teeth. It comprises 3 parts. The first part or “fixture” is placed within the jaw bone to replace the roots of missing teeth. The second part or “abutment” emerges through the gums and is used to carry the 3rd part, which may be a single crown or a bridge depending on how many teeth are missing. If we have lost all our teeth, we can use 4 to 8 implants in each jaw which when connected can support dentures or even a fixed bridge
How do Implants compare with alternative options?
When compared with removable dentures, they provide stronger support, firmer retention and are more stable. The implant supported and retained replacement teeth occupy less space and are more comfortable. They are also able to generate much stronger biting force. When compared with fixed bridges, they can be used even when more teeth are missing as they can provide stronger support over a longer span. They are also preferred when the teeth adjacent to the gap are weak or too small to provide sufficient support. Additionally, they provide an alternative to trimming healthy teeth.
Benefits of Dental Implant
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Are permanent replacement for missing teeth
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Has predictable and good long-term success rate
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Prevents supporting bone from shrinking after tooth loss
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Does not decay as it is made from Titanium
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Able to generate stronger bite forces for better chewing and hence better digestion and nutrition.
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Restores appearance thus creating more confidence and self-esteem Able to provide better support for lips and cheeks for a more youthful look
Types of Dental Implant
Dental Implants have been widely used for more than 40 years since the original scientific research was published. While many different implant systems are now available and are generally of high quality, our clinic prefers using implants from Nobelbiocare, Sweden and Straumann, Switzerland due to the extensive research and long track record. These implants come in different sizes and lengths and are generally at least 3.5 mm in diameter and 8 mm in length which differentiates them from “mini-implants” which should be used only as temporary supports or in very specific cases.
Are you suitable for Implants
Implants can be placed in most patients from age 18-80, even if you have lost your teeth for many years as we are able to regenerate bone in order to place implants as a foundation for your denture or bridge. Patients with health conditions should inform the dentist so that additional precautions can be taken, if required. Conditions which require attention include patients with significant heart disease, unstable high blood pressure, uncontrolled diabetes and patients on therapy for cancer. Surgery can still be performed after clearance from your medical specialist.
What is the surgical procedure like?
After giving some local anaesthetic, a small incision is made through the gums and a point of insertion decided. Drills of a predetermined length and with increasing diameters are then used to gently prepare the site to receive the implant. The implant is then rotated to the desired depth. The top of the implant channel is then covered with a temporary cap and the gums stitched either over or across after cleaning the surgical site and allowed to heal undisturbed for 3-4 months. A higher temporary cap called a healing abutment is often placed to avoid a second surgery to uncover the implant.
Is Implant Surgery Painful?
No, implant surgery is generally a minimally invasive procedure and in most instances the pain is minimal. If more major treatment is required, some post-surgical pain may be present. If you are fearful, we can arrange for you to have a complete pain-free experience either by performing the procedure under intravenous sedation or general anaesthesia within an operating theatre. The mix of drugs given will help you relax, sleep and eliminate pain. You will also usually be given a painkiller to take before the procedure so that you will be comfortable after the surgery.
How long does it take to recover from the Surgery?
After the operation, you may feel uncomfortable but this can be eliminated by taking the prescribed painkillers regularly. Some swelling and bruising is to be expected for a few days after the surgery. You can resume normal activity within a day but should avoid strenuous exercise and swimming. A normal or soft diet is advised and can be commenced after the numbness from the local anaesthesia wears off, usually around 2-3 hours after the procedure to avoid biting your lip or tongue inadvertently.
Same Day Teeth Replacement
Rationale for immediate tooth replacement
Losing a tooth, especially one of our front teeth can be very distressing for most patients. In addition to the effect on appearance and confidence, it affects our speech and on the long-term, the gums and the supporting jawbone will also shrink. A common request from our patients is to get a replacement for their missing tooth immediately, hence the advent of protocols for "same day teeth replacement". This could be done by partially loading the implant on the day of the surgery, or more commonly by using the adjacent teeth as temporary supports.
How long does it take for healing after tooth extraction and implant surgery
Teeth extraction and implant surgery are fairly routine and painless procedures and you will feel back to normal in just a few days. However, it takes around three months after tooth extraction for the bone to reform before placing an implant. In addition, it takes a further three months for the bone to grow around the implant in order to anchor it firmly in the jaw. During this waiting period, removable dentures, or temporary bridges made of plastic are used to prevent direct forces on the implant allowing the implant to heal.
Can this waiting period be shortened
Yes, it is possible to reduce this waiting period as implants can often be placed immediately into extraction sites for patients with missing front teeth. This reduces the waiting times significantly. In general, we are able to place implants to replace our front teeth on the day of extraction as there is usually adequate bone around and beyond the tooth socket to stabilise the implant. For back teeth, it is not always possible as there is usually insufficient bone after removing the tooth. Very often a bone graft will also be needed and is therefore a more technique sensitive procedure.
Immediately Loaded Implants
If the implant lies firmly within bone, it is possible to even allow partial loading immediately after the surgery. In combination, with the latest computer assisted techniques, it is possible to deliver aesthetic looking temporary teeth in selected cases within 3 hours after the surgery. The patients are however advised to avoid chewing on the implant, especially in the initial weeks after the surgery when the original bone anchoring the implant would have been resorbed with the new bone yet to form.
Is immediate loading of implants a new technique
No, the first controlled study of successful immediate loaded implants was published in 1997 after a successful 10 year study. Our lead clinician has been placing immediately loaded implants since early 1999. The success rate of immediate implants are comparable to that of implants placed using conventional protocols but is more technique sensitive as it requires the dentist to determine if the initial stability of the implant is sufficient for immediate loading. Done selectively, it is a useful option for patients with no other remaining teeth to anchor a temporary denture or bridge.
Health Concerns
Allergy
Allergies are reactions triggered by the immune system against food, drugs, pollen, dust, fur, mold, insects and other substances. Common symptoms include runny nose, sneezing, coughing, and eye and skin irritation. The severity and duration of allergic reactions vary. Severe reactions require immediate medical attention.
Anemia
Anemia is a disease that occurs due to the lack of red blood cells needed to deliver enough oxygen to body tissues. The severity of anemia varies, may be temporary or chronic, and may be related to other existing medical conditions. What can be done? Screening for anemia includes tests for iron plate, ferritin, folic acid, and vitamin B12, as well as hemoglobin electrophoresis.
Cancer
Cancer is a disease caused by the uncontrolled division of cells in various parts of the body. It is usually asymptomatic in the early stages of the disease when it is most easily cured. Therefore, it is very important to regularly screen for cancer based on individual risk factors.
Dental
Dental hygiene is an important part of your health, because tooth and gum infections can affect your overall health and quality of life. Prevention begins in childhood, and regular check-ups, tooth cleaning, and daily home care can reduce the risk of tooth decay and gum disease. At Precious Dental, we provide you and your family with a wide range of general and professional dental services as part of our comprehensive approach to health.
Diabetes
Is a condition in which the body cannot produce enough insulin or cannot use normal amounts of insulin properly. Insulin is a hormone that regulates the sugar content in the blood. High blood sugar levels can cause problems in many parts of the body.
Eye Disease
Many eye diseases and problems have no symptoms. Eye screening can detect vision-threatening conditions early. Many of these eye diseases go unnoticed in the early stages, and when it affects your vision, treatment may be too late. Early detection and treatment of these diseases can usually prevent any permanent vision loss.
Liver
Hepatitis is an inflammation of the liver that can cause a range of health problems and can be fatal. There are five main strains of the hepatitis virus, referred to as types A, B, C, D and E. While they all cause liver disease, they differ in important ways including modes of transmission, severity of the illness, geographical distribution and prevention methods.
Osteoporosis
Osteoporosis is a disease associated with weak, low-density or ‘porous’ bones. The disease may lead to bone fractures, resulting in limited mobility and other complications. While it is very prevalent in women above 50, it also affects men of similar age. Adequate Calcium and Vitamin D intake, as well as a healthy diet and physical activity help prevent the disease. As there are no immediate symptoms of weakening bones, adults above 50 years should monitor their bone health.
Kidney Disease
Like most organs in the body, the health of your kidneys can be affected by poor diet, lifestyle choices and inherited genes. Apart from uncontrollable factors such as family history, controllable risk factors include smoking, obesity, excessive intake of painkillers and poorly controlled blood pressure and/or diabetes. If you have any of these risk factors, it is important to speak with your doctor to learn how you can better manage your kidney health, such as controlling sugar levels, monitoring blood pressure and not smoking
Bone, Joint & Autoimmune Markers
In autoimmune disorders, inflammation and the immune response may result in connective tissue damage, not only in and around joints but also in other tissues, including vital organs, such as the kidneys and organs in the gastrointestinal tract. The sac that surrounds the heart (pericardium), the membrane that covers the lungs (pleura), and even the brain can be affected. The type and severity of symptoms depend on which organs are affected.
Age Determination (Children)
A bone age study helps doctors estimate the maturity of a child's skeletal system. It's usually done by taking a single X-ray of the left wrist, hand, and fingers. It is a safe and painless procedure that uses a small amount of radiation
Stress & Aging
Normal aging is associated with multi endocrine changes, including those associated with changes in the structure and function of the adrenal gland. The various morphological changes of the adrenal gland that occur during aging are associated with alterations in hormonal output, such as a gradual sustained, increase in glucocorticoid secretion and decline in adrenal androgen levels.
Stress is a constant factor in modern life. The stress response in healthy organisms is aimed at maintaining the balance of biological functions, or homeostasis, when faced with physiological or psychological challenges, that may be real or even perceived
Pre-conception
Male: A blood test that you can have to help determine your likelihood as a couple of having a child with a genetic disorder that can negatively impact their health.
Female: A blood test that you can have before you become pregnant, to help determine your likelihood as a couple of having a child with a genetic disorder that can negatively impact their health.
Sexual Health
Most STDs affect both men and women, but in many cases the health problems they cause can be more severe for women. If a pregnant woman has an STD, it can cause serious health problems for the baby. Antibiotics can treat STDs caused by bacteria, yeast, or parasites.
Venereal Disease Research Laboratory (VDRL) The venereal disease research laboratory (VDRL) test is designed to assess whether you have syphilis, a sexually transmitted infection (STI). Syphilis is caused by the bacterium Treponema pallidum. The bacterium infects by penetrating into the lining of the mouth or genital area. The VDRL test doesn’t look for the bacteria that cause syphilis. Instead, it checks for the antibodies your body makes in response to antigens produced by cells damaged by the bacteria. Antibodies are a type of protein produced by your immune system to fight off invaders like bacteria or toxins. Testing for these antibodies can let your doctors know whether you have syphilis.
Sleep Apnea
Sleep studies help doctors diagnose sleep disorders such as sleep apnea, periodic limb movement disorder, narcolepsy, restless legs syndrome, insomnia, and nighttime behaviors like sleepwalking and REM sleep behavior disorder. Often these disorders cannot be identified with a normal office visit—your doctor needs to gather more conclusive evidence while you're asleep.
Sports Injury
Sports and physical activity are very important for your overall wellbeing, but may sometimes lead to injuries. Imaging allows your doctor to see if there are any fractures or damage to underlying tissues so that the injury can be properly treated. In addition, a cardiovascular screen is appropriate for those who want to engage in vigorous physical activity.
What can be done? MRIs can be used to screen for the likelihood of stroke. Carotid Ultrasound may also be a useful test to image the arteries supplying the brain.
Stroke
Stroke is a medical condition that occurs when the blood supply to the brain is cut off. Signs include weakness, loss of balance, numbness, blurry vision, slurred speech and difficulty in swallowing. You can reduce the risk of stroke by adopting a well-balanced diet, exercising, and refraining from smoking and alcohol.
Hypertension
Your high blood pressure should be assessed by your doctor at least once a year, though more frequent consultations may be recommended in some cases. Mildly-elevated blood pressure may normalise when you lose weight, exercise more and reduce your salt intake.
Digestive Disorders
The digestive system is an intricate and extensive part of the body. It ranges all the way from the mouth to the rectum. The digestive system helps your body absorb essential nutrients and is responsible for getting rid of waste. Digestion problems can mean more than unwanted symptoms. Minor problems that are left untreated can lead to more serious, chronic illnesses.
Urogenital Disorders
Urogenital disorders are problems that affect the urinary and genital tracts (reproductive organs). Before birth, development of the urinary tract and genital tract are closely linked. The parts of the urinary tract are located near or run through parts of the genital tract.
ENT Disease
Ear, nose and throat infections are very common. The symptoms are usually relatively mild, but infections can sometimes cause problems that need to be treated by an ENT specialist. What can cause an infection in your ears, nose or throat, and when should you visit an ENT clinic for advice?
Aches & Pains
Body aches are just what they sound like — your entire body hurts. Every joint and muscle feels tense with a dull ache that doesn’t improve. If you can’t pinpoint a reason for your body aches, you may need to contact your doctor.