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Removable dentures. These can function reasonably well but are not secure. If they fit round natural teeth they can accelerate the loss of these teeth. They do not maintain the condition of the jaw bone.
Bridges. These are secure and comfortable but involve the shaping of neighbouring teeth to support the missing teeth. They do not maintain the jaw bone. If the supporting teeth develop problems the bridge will be lost.
Implants. These have an excellent success rate. They maintain the health of the surrounding bone. Teeth supported by implants are very secure and comfortable.
About Implants
What is an implant?
An implant is a cylinder made of the metal titanium. It can be imagined as an artificial tooth root. Implants are available in different widths and lengths to enable them to be placed in different positions. There is a thread on the metal surface so that when it is placed there is no movement.
How does an implant work?
The titanium surface has unique properties that encourage new bone to grow onto the implant. This is called osseointegration. Once this has occurred the implant is effectively locked into the jaw bone and is very stable. A precision – made metal cylinder called an abutment can then attached to the implant. Impressions are taken of the abutment enabling crowns, bridges, or dentures to be supported.
If I have implants placed will I have to go without any teeth?
No. You should not have to be without teeth during the treatment. There are ways to replace teeth with temporary bridges or dentures while implants are healing. Sometimes, in favourable situations, implants can support missing teeth immediately.
How are implants placed?
The gum is made numb and carefully raised. A small hole is made in the bone to receive the implant and then the gum is replaced. Healing occurs underneath the gum over a period of time.
Delayed placement.
This is when the implant is placed and left undisturbed for a period of time to allow new bone to grow onto the metal surface. The time period required depends on the stability of the implant and the density of the bone at the time of placement. Bone in the upper jaw tends to be softer than in the lower jaw. The healing time may be from 4 weeks to 6 months.
Immediate placement.
This when a tooth is removed and an implant is placed immediately into the extraction socket. The advantage of this is that treatment is simplified and the gum stays in the right position. Immediate placement is not always possible. There has to be sufficient width and height of bone, and the bone has to remain undamaged during removal of the tooth.
What if there is not enough bone?
When a tooth is lost the bone which was surrounding the tooth root tends to disappear. This may mean that there is not enough bone to enable successful implant placement. Fortunately there are various methods to overcome this problem. (Sub menu leading to next section?)
Guided Bone Regeneration. (G.B.R.) If the defect is small, there are a range of biomaterials that can be placed around an implant, or into an area of bone deficiency. Blood vessels grow into the material and eventually new bone is produced.
Bone Graft. Sometimes a section of bone can be taken from one of the jaws and moved to another area where bone is inadequate. The commonest sites for providing bone are the back of the lower jaw, and the chin area. The piece of bone is held in place with a small screw till it unites with the underlying bone. After 12-16 weeks of healing, an implant can then be placed.
Sinus Floor Elevation. When teeth are lost from the upper back jaw, the sinus cavity can enlarge. This reduces the height of bone available for implant placement. In a sinus elevation procedure, the lining of the sinus is very carefully raised so that new bone can grow underneath it. After about 6 months, implants can then be placed.
Our training
Alan Bell has been placing implants since 1996 and regularly attends courses to keep up to date with new techniques. These have included courses in Berne, Switzerland with some of the world’s leading implantologists. Since January 2006 he has been taking the Diploma in Implant Dentistry from the Royal College of Surgeons, England. The nurses and support staff are trained so that conditions in the surgery are as sterile as possible. This is important to minimise the risk of infection.
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