Finally, the artificial tooth is attached.

Implants are not an option for everyone. Because implants require extensive surgery, patients must be in good health, have healthy gums, have adequate bone to support the implant and be committed to meticulous oral hygiene and regular dental visits.

How Do I Know If Implants Are Right For Me?

If you are considering implants, a thorough evaluation by your dentist will help determine if you would be a good candidate. This evaluation includes a clinical examination and a complete dental and medical history to gather information about any dental and medical conditions that you have, such as diabetes, heart problems or any condition that interferes with normal healing. Be sure to tell the dentist about any allergies you have or any prescription or over-the-counter medications that you take. If necessary, the dentist may request a consultation with a physician.

During the dental examination, the dentist will check the condition of your mouth, the supporting bone in your jaws and the way your upper and lower teeth fit together. The dentist may gather additional information by taking X-rays and by making models (casts) of your teeth. This information will help your dentist determine if you are a good candidate for an implant and decide which implant to use and exactly where to place it.

What Is Involved In Placing Implants?

Implants cost significantly more than dentures or bridges and require a considerable investment of time. The implant process involves several steps and may take up to nine months to complete.

First, surgery is performed to place the anchor. Surgery can take up to several hours, and up to six months may be required for the bone to grow around the anchor and firmly hold it in place. Some implants require a second surgery in which a post is attached to connect the anchor to the replacement teeth. With other implants, the anchor and post are already attached and are placed at the same time.

After the gums have had several weeks to heal, the next step is begun. The restorative teeth are made and fitted to the post portion of the anchor. Because several fittings may be required, this step can take one or two months to complete.

Implant surgery can be done either in a dental office or in a hospital, depending upon the type of implant, the patient's health and the dentist's preference. A local or general anesthetic may be used. Usually pain medications and, when necessary, antibiotics are prescribed. Your dentist will give you careful instructions on diet and oral hygiene.

Implants provide artificial teeth that look more natural and feel secure. People who cannot successfully use conventional dentures or people who need an alternative to removable partial dentures may be candidates for implants.

Sometimes using implants can cause "stress" to the bones in the jaw. If bone loss occurs as a result, the implant may loosen. If the implant fails and needs to be replaced with a conventional denture, there may be problems in getting the denture to fit. Other possible complications include improper alignment, persistent discomfort, cosmetic problems, implant breakdown, inadequate healing or damage to adjacent teeth.

Because there is always the possibility of a gum infection, brushing, flossing and regular dental visits are essential to the success of dental implants. Your dentist will give you instructions on proper care and periodically evaluate the healing and attachment of the implant to the jaw. Given proper conditions and scrupulous daily oral hygiene, implants can last for 10 years or longer.

Replacement teeth are made of porcelain, metal or polymer resin, the same materials as those used for conventional bridges and dentures. The anchors and posts are made from a number of synthetic materials. Titanium is a favored metal for many implants since it is very compatible with bone and other tissues. Cobalt alloys are used for some types of dental implants.

A complete or partial denture can be attached to several implants, allowing a secure fit.

There are several types of implants. One factor involved in determining which type to use is whether or not the jawbone is adequate to support the implant. Two types of implants that the American Dental Association (ADA) considers being safe- with careful patient selection-are the endosteal and the subperiosteal. Manufacturers of implants can submit their products to the ADA's Council on Dental Materials, Instruments and Equipment, which evaluates products for safety and effectiveness. Talk with your dentist about the implant you will be receiving.

Endosteal

An endosteal implant is placed directly into the jawbone. Adequate bone is an important requirement for its use. First, an anchor is surgically placed into the jaw. Anchors come in several shapes and are sometimes coated with a material that helps bone adhere to it. This process of attachment, called osteointegration, can take from three to six months. A second surgical procedure may be needed to connect a post to the implant. Finally, artificial teeth are then attached to the post.

Subperiosteal

A subperiosteal implant consists of a metal frame that rests upon the jawbone, under gum tissue, rather than being placed directly into the jawbone. A metal frame is made, using impressions of the surgically exposed jawbone. After the frame has been constructed, the gum tissue is reopened and the frame is fitted onto the jawbone. As the gum tissue heals, the implant becomes fixed to the jaw. Posts, which protrude through the gum, support a denture.

Instead of attaching directly into the jaw, subperiosteal implants are placed on top of the jaw.