If you’ve never been a dental implant patient before, the concept and process can be confusing and foreign as implants are not what most people think of as day-to-day dentistry. However, implants quickly became the gold standard for tooth replacement after being introduced to dentistry in the early 1980s due to how versatile and predictable they are.
Traditionally, if missing a tooth, the dentist would make a bridge. To fabricate a bridge, the neighboring tooth on either side of the space needs to be ground down to allow for a 3-unit bridge (3 crowns fused together that rest on the two teeth).
If the surrounding teeth did not need crowns then this process removes a major portion of healthy tooth unnecessarily. Bridges set those teeth up for difficulties in the future, such as the need for a root canal, the development of cavities in hard-to-fix areas (you can’t floss between the teeth when fused together), and fracture (we’re asking two teeth to do the work of three, and the supporting teeth have been whittled down).
Individual implants mimic a natural tooth better than any other option in dentistry. And unlike bridges, partials, or dentures, the strength of implant biting is often stronger than a natural tooth.
Although bridges have been successfully used in dentistry for hundreds of years, they generally shorten the lifespan of the teeth that support them and often need to be replaced multiple times over the years. Implants, as we know them, were introduced in the early 1980s, which means that our current research is only about 35 years old at this point. Over the last three decades, implants have changed and improved greatly to be very predictable restorations. Because they are attached to a human body nothing can be guaranteed, but we anticipate implants that are well maintained will last many decades, and hopefully for life.
Without stimulation, our bone atrophies and shrinks away. When a tooth is removed, the bone that is used to support that tooth will resorb over time, creating defects or dents, changes in face shape, and collapse of the cheeks and lips to make the patient appear older than they are.
When implants are placed, the forces from chewing are transmitted through the restoration into the bone. These forces stimulate the bone so that it maintains density and volume to support the implant, just as the bone surrounding natural teeth does. Also, our teeth prefer to have partners: if a tooth is removed, the opposing tooth will often grow out of the bone because there is no contact. Teeth will also tip or move forward into areas where teeth are missing which can alter and disrupt proper biting.
The most common image of a dental implant is one supporting a single crown, but they can be used in a variety of indications. Implants placed in multiples are able to support bridges to maximize the number of teeth replaced with a smaller number of implants.
When a patient has lost bone, four or more implants can be placed to support up to a full arch prosthesis that replaces teeth and the bone that is used to support them.
Partial and complete denture patients benefit greatly from implants, as snaps can be placed on top of the implants instead of crowns and bridges. These snaps help the denture fasten in place and provide a major improvement in stability, comfort, chewing forces, and phonetics.
A set of complete dentures can only provide about 25% of the chewing forces that a mouth of healthy teeth can. By adding in just two implants at the lower canine positions, the patient improves to about 60% of their previous chewing ability. With every additional implant, those forces increase, and the dentures can be designed to be smaller and less cumbersome which also improves taste, comfort, and aesthetics.
The top portion of the implant can be changed or updated throughout the patient’s life. If an implant was first placed to replace a single missing tooth, it can be swapped out to help support a bridge if nearby teeth are later extracted. If many or all of a patient’s teeth end up being removed, the crown or bridge can be changed to a snap to help support a partial or complete denture. This ability to modify an implant helps the patient to continue to benefit from the implant as they age and indications change.
Despite all of these safety features, we understand the thought of implant placement can give patients anxiety, which is why we encourage our patients to take advantage of IV sedation. This makes the surgery a comfortable and forgettable experience.
IV sedation is a very safe method of anesthesia, where the medications are short-acting and reversible. You’ll feel like yourself again shortly after the procedure, and in case of an emergency, we can wake you up immediately, which is not the case in many general anesthesia procedures.
Platelet Rich Fibrin (PRF) can be incorporated into just about every oral surgery procedure: wisdom teeth, tooth extractions, implants, bone grafts, and sinus lifts.
Using PRF speeds up how quickly the surgical site heals by stimulating the body to accelerate its normal processes. This causes soft tissue (gums) to close faster and it has Bone Morphogenic Proteins (BMPs) that help create new bone quickly.
Once we’ve developed a personalized treatment plan for you and decided on the positioning of the implants, we use surgical guides on as many procedures as possible to help ensure that every implant is placed exactly how we want it. These guides are made from CT scans and are 3-D printed to have a very high accuracy for safety and predictability every time.
Guides can be used for a variety of procedures, ranging from implant placement to bone reduction to proper positioning of restorative components such as “screw-in” or “hybrid” dentures.
The Atlanta Dental Spa team is always planning for your safety and comfort, which comes in many forms during the implant process. The 3-D planning process using CT scans is critical. You are a three-dimensional being, and any implant surgery should be planned in a 3-D manner to safely avoid important anatomical structures like your sinuses and nerves. Proper planning = Predictability
At the beginning of your dental implant journey you will complete an oral evaluation and consultation. The doctor will use a state-of-the-art Cone Beam CT 3D scan, and evaluate your bone to make sure you are a good candidate for dental implants.
Virtual surgery can be done on a computer to plan exactly what size, position, depth, and angulation your implant should be, which helps determine if you require or would benefit from any bone or gum grafting before or during implant placement.
At this point, we’re able to discuss all of your treatment options and indications as well as answer any and all questions you may have.
May of our patients report they’d been told by other dentists that they are not candidates for dental implants. These days, it’s fairly rare to be a patient who cannot have implants. One limiting factor is the loss of bone that will support the implant, but with advances in technology and understanding, we can now do bone grafting as a routine aspect of tooth replacement.
The answer varies depending on the patient’s individual scenario. We can provide a more qualified answer during the initial consultation. Bone healing takes roughly 3-6 months depending on a number of factors: age, gender, size of the tooth, if infection was present, health history, etc.
From the day an implant is placed to the day a tooth can be attached is usually around 4 months. There are plenty of instances where a tooth or arch full of teeth is attached to implants the very same day the implants are placed. For individual teeth, this is more common in the anterior portion of the mouth where the biting forces are weaker and it is safer for the implant. If a tooth needs to be extracted prior to implant placement, that bone often needs to heal for 3-4 months before it is strong enough to support an implant. In these cases, the full timeline for many patients who need a tooth extracted is 8-10 months. Again, this varies greatly depending on the scenario. CT scans, intraoral exams, and bite assessments allow us to develop a timeline specific to each patient during their consultation.
For any patient who has not had an implant before, pain is usually heavy on their mind. Fear not! It’s truly a daily experience for us to hear how easy the process was or how shocked someone is with the lack of discomfort and swelling.
The bone itself has very little feeling. Gums have feeling, but discomfort in these areas is very easily controlled with mild medication. The same often holds true for implant surgeries, especially when they are CT guided which is the preferred method at Atlanta Dental Spa.
When able to work in a small space, the discomfort is essentially limited to the tiny area of gums around where the new implant is, which is very easy to manage.
With the help of IV sedation to make your visit a stress-free experience, we are able to give medication that helps make the first 48 hours extra easy. The best part is your body produces that medication naturally, so no one is allergic to it and it’s very safe! We strive to make every procedure as comfortable as possible.