Implant is an artificial replacement of the root of the tooth structure placed into the bone to support the missing tooth
• Who needs an implant?
Anyone who has lost teeth due to cavities or mobility, needs a fixed replacement.
Sometimes people who have missing teeth since birth or lost them due to an accident also need implants to replace them.
• Can all patients have Dental Implants?
If the systemic health of the patient is good, reasonable amount of bone is available to receive implants then they are a good case for replacements with implants.
• How will one know if bone is available or situations is favourable?
The advent of CBCT provides 3D imaging that allows for precise assessment of bone structure, nerve pathways, and sinus positioning around missing teeth. This enhances diagnosis, improves treatment planning for implants or surgeries, and reduces surgical risks.
• What if there is no bone?
In some cases bone can be regenerated or replaced with bone substitutes. If not, higher level implants like pterygoid and Zygomatic Implants are alternatives.
• What is the success rate of dental implants?
According to the literature, the survival rate of dental implants is typically reported to be between 90-98% over a period of 10 years.
• Do implants get rejected?
In some cases, dental implants may fail due to infection or an inability to fuse with the surrounding bone (osseointegration). While the implant may remain firm, it cannot function properly, leading to failure despite its physical stability.
• How to go about with such situations?
In most cases of implant failure, the implant is removed, the site is thoroughly cleaned, and grafting is done if necessary. The area is allowed to heal for 8 to 12 weeks before re-entering, and the implant typically integrates successfully afterward.
• What should be done if the implant is rejected again after the second attempt?
Implant failure is often site-specific, meaning an implant may fail in one area but succeed in a nearby location. In such cases, we can reposition the implant in a different site. If the surrounding conditions remain unfavorable, alternative tooth replacement options are considered.
• Will there be any complications if implants fail?
If well-planned, the main issue with implant failure is the implant becoming loose or losing some bone, but serious complications are rare and manageable.
• How may implants do we need?
Ideally, each implant is designed to support a single tooth. However, in the posterior area, two implants can support up to three teeth, while in the anterior region, two implants may hold four teeth.
• Can we have numbness after placing implants?
In some cases where there is insufficient bone in the lower jaw and implants are placed near the nerve, temporary numbness may occur. Fortunately, this sensation typically resolves over time.
• What steps should be taken if temporary numbness occurs after placing implants near the nerve in cases of insufficient bone in the lower jaw?
An assessment of the proximity of the implant to the nerve is essential. The best approach is for the patient to wait, as nerve regeneration occurs slowly and may take anywhere from 3 to 18 months.
• Can we place implant immediately after extraction?
If there is no active infection in the tooth or surrounding area and there is adequate bone to support the implant, placement can be done immediately.
• Can we place an immediate tooth along with the implant?
If good stability is achieved beyond the clinically acceptable value of 35 Ncm torque, immediate replacement is possible; however, this will be a cosmetic, not a functional replacement. It is essential to handle the area gently and avoid using it for biting.
• What is the success of immediate implants with teeth?
Successful outcomes depend on careful case selection; however, a well-healed area is often more predictable in terms of preventing implant infection. While patients are instructed not to use the teeth for biting, some may forget this over time, which can lead to loss of stability.
• What to do if immediately placed implant with tooth loses stability?
We remove the implant and tooth, then re-enter the site later for further evaluation. In the meantime, the patient is provided with a temporary replacement.
• Are implants predictable?
In most cases, the implantologist carefully evaluates the area and positions the implant scientifically to ensure optimal orientation. While tissue healing can be unpredictable due to various factors influencing success and failure, good case selection often results in a 97-98% success rate. Even in cases of failure, pinpointing the exact reason can be challenging, so patients are informed of all facts and risks. A second attempt is made, but if it fails again, the site may be abandoned. It’s important for patients to understand the potential for both success and failure, as we are dealing with biological processes.
• What is the average life of implants?
Dental implants typically last around 10 years, though they can last even longer. However, their longevity cannot be predicted, as it depends on individual biological factors and the patient's overall health, which can change over time.
• What is immediate tooth replacement with implant?
1. Implants placed in healed bone, where the tooth is immediately replaced, typically done in anterior cases or full-arch scenarios where splinting is possible. 2. Implants placed in extraction sockets, with a temporary tooth provided right away.
It's crucial that the implant is well anchored in bone; procedures may not be feasible with soft bone or insufficient bone volume.
• What is the predictability of these immediately placed implants?
The predictability of conventional implant placement with three months of healing is approximately 97%. However, when implants are placed in a healed area and loaded immediately, the success rate decreases to around 87%. This indicates a 10% reduction in success when the implant is placed and the tooth is provided on the same day
The predictability of immediate extraction, placement, and tooth replacement decreases further, as the wound is still raw. Bone must grow into the space around the implant, which should not be subjected to heavy forces during healing. Just as an orthopedic cast prevents movement of a fracture, it's crucial to minimize movement between the implant and bone. Patients are typically advised to avoid hard foods during this healing phase, but forgetting this guideline can lead to implant failure.
