By: Dr. J. Russell McFarlane DDS
I will try to demystify the process of implants by answering the critical questions that every journalist is expected to address, the 5 Ws – who, what, where, when, why.
Who is a candidate for a dental implant? If you have lost a tooth, then, you may be a good candidate for a dental implant. If you have a healed area, where a tooth has been removed, you may be a good candidate for an implant. Pro Tip during extractions: Patients who undergo ridge preservation bone grafting at the time of the extraction tend to have much more robust bone with which to work. In answering the question of who is a good candidate, we must also address who is not an ideal candidate. The patients at highest risk for implant failure are patients who have a history of periodontal disease. Another factor that plays into how well individuals will heal is their medications. The prescription drugs most likely to cause problems are bisphosphonate drugs, which are often used for bone density, in cases of osteoporosis. These drugs are also being used to reduce recurrence of cancer, and the most significant problems are found with the injection variant of these medicines. Lastly, smokers have decreased healing capacity as it cuts off bloodflow to the peripheral blood vessels.
What is a dental implant? A dental implant acts as a tooth replacement, with a root form and attaches to a crown. A dental implant is a carefully manufactured and sterilized precision root replacement. They range in diameter size from 3.0mm to 5.0mm for the vast majority of dental implants. A small window is made in the tissue, then, the implant is placed into the bone to heal. After 3 months of healing, a crown can be made that connects to the root component. The crown portion of the implant is the part that most people think of when they think of a tooth, (the tooth colored top part that comes out of the gums.)
Where can you place an implant? Any site that has adequate bone can be replaced with an implant. Some of the most common implants are used to replace front teeth (incisors, central and lateral, canines, premolars, and first molars.) If there is no bone in an area, then, a bone graft with a guided tissue regeneration may be required.
When is the right time to get an implant? There are 2 distinct times that an implant can be placed for tooth replacement. 1. Sometimes an implant can be placed immediately at the time of extraction (at the time the tooth is pulled.) It is only possible to complete immediate implant placement when the tooth being extracted is not infected and generally only when the tooth comes out easily in one piece. 2. More commonly, we extract the tooth, and place a bone graft. The bone from the graft material will turn into your bone over the course of a few months. We like to place the implant after the bone has had 4-months to heal.
After the implant is placed, then, we wait for the implant (root form) to integrate with your bone. On scanning electron micrographs, there are images that show your body placing bone directly onto the implant. Titanium is very biologically compatible.
Why should you replace a tooth with an implant? This will help create a healthy and well-supported bite.