Dental implants have been around a very long time. Anthropologists working at the pyramids have discovered crude implants in Egyptian mummies thousands of years old.
But modern implant dentistry was born in Sweden about four decades ago. Since then, researchers have made great strides, resulting in a procedure with an extremely high success rate.
"Implants survive very well. They're successful in the high-90-percentile range," says Dean Morton, B.D.S., M.S., associate professor of oral and maxillofacial surgery and director of implant dentistry at the University of Florida's Center for Implant Dentistry. "There aren't many procedures that you can have done that have as high a rate of success."
How long will dental implants last? "If a person is healthy and has great bone and very good home care, an implant can last a lifetime," says periodontist Sally J. Cram, D.D.S., a consumer adviser for the American Dental Association who practices in Washington, D.C.
The basics of implant surgery haven't changed much in decades, but the materials dentists use have improved markedly. Basically, a metal, ceramic, or combination-type implant is placed in the empty bone space, below the gum line. A post, or abutment, juts out to receive the prosthesis, usually called a crown if it is replacing a single tooth or a bridge if multiple teeth are being replaced in a row. The changes are a result of technological advances with newer methods to match.
"One of the biggest advances is that the surfaces of the implants are manufactured to be rough," says Robert J. Buhite, D.D.S., director of implant dentistry at the University of Buffalo School of Dental Medicine. "These rougher surfaces give the implant greater contact with bone, allowing better healing and faster results."
In fact, if the patient is otherwise healthy and has good bone at the site, implants can be put in and a temporary crown affixed all in one visit. The permanent crown, usually made of porcelain, will be put on in a few months. "Years ago," recalls Dr. Buhite, "we'd have to do the implant and send the patient home to heal for quite a while before [he would] get a crown."
Typically, recovery from modern implant surgery is relatively routine. Some people take an antibiotic before the procedure, and some need ibuprofen or acetaminophen afterward. It's no more traumatic that having a tooth removed and a tooth crowned, notes Dr. Morton.
Modern implants, made of titanium, are chemically treated to enhance their compatibility with living tissue. And computer assisted design (CAD) can be used for better placement and fit with the other teeth.
After you receive implants, you need to take care of them. It's very important to continue to brush and floss and to use a dental water jet, Dr. Cram says.
"You can get periodontal disease at the site of the implant just as you could if it was your natural tooth," she adds. "And you should continue to see your regular dentist for checkups and teeth cleaning even more often, once every two to three months."
Dental implants are more expensive than a comparable bridge and dentures, but implants last far longer. Patients don't suffer bone loss with implants, as they do with bridgework done without implants.
If your dentist suggests dental implants, discuss what your procedure will entail, and how often he or she has done similar procedures. "It's important for the public to evaluate the education and experience of the practitioner," Dr. Morton says.
Most people who are missing a tooth would be good candidates for dental implants, regardless of age. But there are some exceptions. Here are some issues that Dr. Cram advises you and your implant dentist to consider before you give your consent:
Is there enough bone present to which the implant can adhere? In many cases, bone will be grafted to ensure good adherence of the implant.
Do you have diabetes? People with uncontrolled diabetes don't always heal as well from dental implant surgery and other surgeries.
Are you a smoker? Smokers don't always do as well with the procedure. This is probably because of decreased circulation, but other factors can be involved. Some smokers do fine.
Do you have gum disease? This is a red flag. Periodontal disease should be cleared up before implants are seriously considered. Your dentist might need to refer you to a periodontist.
Are you otherwise healthy? Infection in the mouth or elsewhere and systemic disease can make you a poor candidate for the procedure. Once your problem is cleared up, you could receive the go-ahead from your health care provider and your dentist.
Are you on medication? Most medications will not cause a problem, but some will. For instance, blood-thinning drugs prescribed for circulatory problems can cause trouble with the procedure and the ability to heal afterward. Check with your health care provider and your dentist to see if and when dental implants are a good idea.
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