What do we mean by Implant Prosthodontics
Implant dentistry is a 2-step procedure in which the implant is placed at surgery and the replacement tooth connected after bone healing 4-6 months later. The term prosthodontics refers to tooth replacement and can be either a single crown connected directly to the implant, an “implant bridge” to replace 2 or more missing teeth or even an “implant denture” to replace the full set of teeth when mounted on 4 or more implants. The term “implant overdenture” is used when the replacement denture is supported mainly by gums and underlying bone rather than by the implants placed.
How long do I have to wait before getting my permanent teeth?
After the implant is surgically placed in the jawbone and allowed to heal, it usually takes 3 to 4 months for the bone to strengthen around the implant and anchor it firmly. The implant is then uncovered to make a mould for the final restoration. Where possible, this second surgery can be avoided by placing an attachment which passes through the gums at the point of surgery. In some patients the bone is much firmer and it may be possible to load the implants earlier. Conversely patients with porous bone at surgery may require a longer period for the bone to heal.
What is the procedure like?
After the implant has completely healed, a mould is made of the implant by attaching a pin to the top of the implant. This allows the exact position and angulation of the implant to be recorded and transferred to the laboratory for scanning and processing of the final tooth. The relationship between upper and lower teeth is also captured. The final crown is then attached to the implant either directly using a special screw or it can either be cemented on the post which is screwed into position. The replacement teeth are made of porcelain on a base of metal, completely of porcelain or with zirconia.
Will the crown or bridge which is connected to the implant get loose?
No, it rarely happens as the final crown or bridge is usually attached firmly by using a special device to tighten the connecting screw or by utilising a strong cement. If it does dislodge, keep the crown and bring it along with you to the clinic. The dentist will clean the crown and cement it back if possible. If it happens again, there is a need to review the design to check if the forces in the implant are excessive or if the post which joins it needs to be changed. An X-ray is advised to check if the problem has caused any problem to the underlying implant fixture within bone.
How many implants are needed if we have lost all our teeth?
While some patients may choose to replace every missing tooth individually, dental implants are made from titanium, a very strong and lightweight material and 4 to 8 implants in each jaw may be sufficient to carry the load of the removable denture or fixed bridge, even when all your teeth have been lost. Your improved appearance and the ability to once again chew your food well will help you regain confidence and resume an active social life. Even if teeth have been lost for many years, it is still usually possible to rebuild the jawbone to place implants.
Is the final implant bridge or denture comfortable and can we chew better
Yes, the implant bridge or implant denture is more comfortable than wearing a conventional full set of dentures as implants allow better support and thus only a smaller denture base is required. If less than 4 implants are placed, additional support will be needed from the tissues and greater coverage of the gums is required. This will however still be less than if no implants were used. It has also been shown that biting force is many times more with implants than with dentures and that implants are more suitable support for bridges when many teeth have been lost.