Dental Implants

Dental Implants are a predictable method to replace missing teeth. They offer a way to have artificial teeth that look natural and feel secure. An dental implant is a titanium screw that is embedded into the jaw bone. Bone heals very tightly against the implant making the implant fixed to your jaw.  

Implant Crowns

An implant crown is where an implant replaces the root of the tooth, providing a stable platform to support a false tooth. Dental Implant crowns are often a favoured alternative to fixed bridges supported by natural teeth, especially when the teeth adjacent to the missing tooth or teeth have not been filled. When preparing teeth for a conventional tooth-supported bridge, a significant amount of tooth is cut away. In contrast, implant crowns are more conservative, replacing a missing tooth while leaving adjacent teeth unaltered.

A surgical procedure is required to place a dental implant into your jaw bone. This procedure is normally  conducted under local anaesthetic so is not usually painful,  although can be a little uncomfortable but tolerable. Sometimes sedation is offered depending on your needs. When placing dental implants It is crucial that there is sufficient bone volume to support the fixture with predictable results.  Sometimes if there is insufficient bone height remaining, the final appearance of an implant crown may not be perfect. You will be advised on whether an implant is the most suitable option for you and what the expected result should be like. Additional surgical procedures such as bone grafting may be needed if there is insufficient bone to support an implant.

Implant restorations consist of two parts; the titanium implant fixture and the implant crown. According to research, Dental implant fixtures can remain integrated within the jawbone  for well in excess of 25 years and in fact many implants will remain integrated for life. The limiting factor for the survival of implant restorations is usually the implant crown. Maintenance issues that can affect the implant crown include fracture of porcelain or the framework, screw loosening, screw fracture and loss of the filling covering the screw access. 

Most problems affecting implant crowns can be repaired or replaced relatively easily, provided the implant fixture remains integrated in bone. It is difficult to give you an accurate estimate of exactly how long the crown will last, as this is dependent on many factors, some beyond our control. However what we do know is that most material complications  tend to occur early within the first year of service and provided the implant crown is regularly with routine checks, you should get many years of satisfactory service.

Implant Bridgework

Implant bridges are used where no teeth remain or when the number of missing teeth spans too far to be replaced by a conventional, tooth-supported bridge. Implant fixed bridges are often the most reliable long-term method to restore normal appearances and/or function where multiple teeth are missing.  An implant bridge can provide a fixed solution when a partial denture is not satisfactory, or if you cannot manage with conventional dentures. A fixed implant bridge will improve your confidence when eating and speaking if you do not manage well with conventional complete or partial dentures. 

A fixed implant bridge means you can enjoy a more natural experience when eating food compared with conventional dentures which cover your palate. Taste and thermal sensations when eating are not altered with implant bridges, which can occur with conventional dentures that cover your palate.

Implant bridges cost more than partial or complete dentures. 

Implant bridges perform similarly to implant crowns. The limiting factor for the survival of implant bridges tends to be the porcelain, framework (metal substructure) or veneering acrylic that the bridge is made of rather than issues with the fixtures which tend to perform well once they have osseointegrated.

Maintenance issues that occur with implant bridges include fracture of porcelain, acrylic or the framework, screw loosening, screw fracture and loss of the filling covering the screw access. Most problems involving  implant bridges can be repaired or replaced relatively easily, provided the implant remains integrated in bone. Acrylic will wear faster compared with porcelain however acrylic is significantly less expensive and easier to repair. Almost all acrylic veneers on implant bridges need to have some repairs or replacement within 8-10 years.

Implant Overdentures

Implant overdentures make use of implants to  help secure dentures to the jaw bone.  Implant overdentures are often helpful  when there has been severe jaw-bone loss affecting the ability to enjoy a secure denture wearing experience. Typically, the procedure involves placing two or three implants in the lower jaw, and when the implants have integrated with the bone, a denture is then made to fit over the top of the implants.

Small attachments or clips are used to join the implants to the dentures. Implant overdentures can still be removed from your mouth like a normal set of dentures to be cleaned and to give your gums a rest at night. The biggest difference is that they hold much better to your lower jaw compared with a conventional denture, improving quality of life and providing more confidence when eating and speaking.  Implant overdentures are often more cost effective than fixed implant bridges (fixed bridges on four or more implants).

Implant overdentures may require maintenance;  it is fairly typical to require maintenance within the first year of service because it takes time to learn how to use new dentures, and particularly to learn how to reduce the stress placed on the clips that hold the dentures to the implants. Every patients’ experience is different. Common maintenance events include tightening or replacement of attachment clips, relining the overdenture, easing sore spots, denture tooth wear, or fracture of the denture base. Typically you can expect to see some sort of wear and tear on the overdentures within a 5 year life-span. Often teeth  need replacing after 5 to 6 years,  or a reline of the denture base may be necessary. Provided Implant Overdentures are meticulously maintained, it is often possible to get many years of satisfactory service.

While dental implants are highly successful,  there are several factors which can affect how well they last including the amount and quality of bone available to support the implant, the patient’s health, whether or not the patient smokes,  and the quality of ongoing home care. If an implant fails to integrate within your bone, it can be removed under local anaesthetic. Most implant failures occur within the first year. The bone and soft tissue repair rapidly and it is often possible to place another implant in the same site after a few months of healing.  There is also a risk that the margin between the implant and the crown may become exposed over time if the gum receeds.  In general, the best site for implant placement is the front of the lower jaw where they enjoy a 95%  survival rate, whereas  implants placed in the upper jaw or the back of the lower jaw have slightly lower 88-90% survival rates . 

It is worth noting that conventional upper dentures may  begin to feel loose when an implant overdenture is placed in the lower jaw, improving the tightness of the lower denture.  However, overall, implant overdentures are often a significant improvement when compared with conventional dentures.