Implants are used for many purposes in dentistry, ranging from replacing single or groups of teeth, to retaining loose dentures, to even replacing all of the teeth in an arch with a fixed prosthesis. They were introduced in the mid-1960’s, and have developed a very good track-record of long-term success, ranging from 85-99%, depending on application and area in the mouth. Prosthodontists developed the early protocols for their use, and remain the specialists of implant dentistry today.
The implant itself is often considered the replacement of the root of the tooth lost, and is placed into the bone in a simple surgical procedure, usually with the use of just a local anesthetic. The bone is allowed to heal around the implant for a period of time ranging from eight weeks to six months (according to the specific situation), then the final restoration can be made for it. During this time a patient may continue to wear a temporary prosthesis if desired.
Implant dentistry has been a very large component or our practice and we actively keep abreast of, utilize, and teach the most current of implant procedures. Because of this, we are very knowledgeable and experienced in procedures that many dentists in western New York do not perform routinely, including immediate implant placement (placing an implant the same day a tooth is extracted), immediate provisionalizatiion (placing a fixed temporary restoration on an implant the day it is placed), and CT-guided implant procedures (using computer and CAD-CAM technology to fabricate a very accurate surgical guide for more complex procedures requiring very precise planning and placement). We routinely treat patients missing front teeth, which is often esthetically demanding, and patients who require very precise planning for more complex implant-borne restorations, such as when replacing all missing teeth with implants.
BEFORE: This patient has fractured his tooth and the prognosis to retain and restore it is poor.
AFTER: An implant is placed to replace the tooth and adjacent crowns are remade for a better appearance.
Implant Procedures
Patients who think they are candidates for implants should consult with a prosthodontist first to see if this is the best prosthetic option for them. Our protocol is to plan the proper placement of the implant, then make a surgical guide that communicates the proper positioning during surgery. At times we perform the implant surgery in our office; or when more appropriate, we partner with local oral surgeons and periodontists to execute the surgical phase of the plan. In this way the end result achieved is one of most predictable esthetics, comfort, and long-term success.
Replacing the single tooth or a few teeth: The dental implant is today’s gold standard for the replacement of a single missing tooth, whether lost to decay, trauma, or congenitally missing. This is because the adjacent teeth do not have to be restored to replace the missing tooth, as is often true with other treatments. In this case the implant is truly analogous to the root of the missing tooth. Treatment can be complicated when performed in the esthetically challenging front of the mouth, or when orthodontics is required to create space for a missing tooth. In these situations, we plan treatment carefully, working closely with surgeons and orthodontists to best assure a successful result.
Implants to retain an overdenture: For patients who have difficulty wearing a well-made lower denture, the addition of two implants in the front of the lower jaw to stabilize it can make a world of difference. Attachments are hidden within the denture that fit over abutment components attached to the implants. This greatly reduces movement of the denture and makes wearing it a more comfortable experience.
BEFORE
This patient has no lower teeth but had two implants placed to retain her lower denture.
AFTER
When the denture is in place, the implants and attachments are hidden.
Implants to replace all teeth in an arch: With the placement of just four implants in the lower jaw, or six to eight in the upper jaw, a fixed prosthesis can be made to replace all missing teeth. This treatment option is the most like having one’s own teeth back, as it replaces the missing teeth, bone and soft tissue with a prosthesis that cannot be removed by the patient. This treatment modality requires extremely careful planning, often with the use of a CT scan and computer surgical planning software, for a successful esthetic and functional result.