DENTAL IMPLANTS: Surgery, Advantages & Risks

Natural teeth and dental implants may look the same, feel the same, and even function in a similar way, but they are very different. The most important differences are in the way they attach to the surrounding bone, their response to dental disease, their maintenance, and repair. This story shares views of dentists on dental implants by Neha Wagle

Dental implants are artificial replacements for natural teeth. Among the available options for tooth replacements they can be considered as the highest among the lot in terms of both advancement and patient satisfaction.

Dr Ganesh R. Bhandari, BDS, MDS (Prosthodontist and Implantologist), Dr Bhandari’s Dental Clinic and Implant Centre shares, “Dental implants consist of two main parts: Implant fixture and Prosthesis (dental crown/cap). The beauty of dental implants lies in the fact that they get fused with the bone upon healing which enables us to use them as ‘anchors’ for a superstructure such as a crown. Also majority of dental implants are made of biocompatible Titanium alloy which is readily acceptable by the body with no side effects. Dental implants have the highest life expectancy as compared with other forms of tooth replacements due to this very fact.”

There are different types of dental implants:
a. Endosteal (in the bone): This is the most frequently used type of implant. The various types include cylinders or blades, screws, surgically placed into the jawbone. Each implant holds one or more prosthetic teeth. This implant is usually used as an option for patients with bridges or removable dentures.
b. Subperiosteal (on the bone): In this procedure the implant are placed on top of the jaw with the metal framework’s posts protruding through the gum to hold the prosthesis. These types of implants are used for patients who have minimal bone height or are unable to wear conventional dentures.

Dr Mukesh P. Wankhede, MDS, Dental Surgeon, Tata Cancer Hospital says, “Once the implant has bonded to the jawbone, a small connector post – called an abutment – is attached to the post to securely hold the new tooth. To make the new tooth or teeth, we
dentist make impressions of patient’s teeth, and creates a model of your bite (which captures all the teeth, their type, and arrangement). The denture is based on this model. A replacement tooth, known as a crown is then attached to the abutment.”

He further adds, “Instead of one or more individual crowns, some patients may have attachments placed on the implant that retain and support a removable denture. A dentist also will match the color of the new teeth to the natural teeth. Because the implant is secured within the jawbone, the replacement teeth look, feel, and function just like own natural teeth.”

Maintaining Dental Implants
To ensure the longevity of an implant, specific techniques and efforts are necessary in order to maintain the implants. Implant recipients play a significant role in the success of their own restoration and must be motivated to take care of the implant.

Dental implants however advanced are still artificial replacements and need to be taken care of and maintained just like any other part of the body. Dr Bhandari suggests the points one should keep in mind:
• Adequate oral hygiene is a must when it comes to dental implants. Patients need to understand that food can accumulate around teeth and dental implants and need to
be cleaned meticulously. Regular brushing followed by water flossed are recommended techniques of maintaining hygiene.
• One shall not bite onto unnatural products such as bottle caps with implant crowns as they have not been designed to be used that way.
• Avoid excessively hard foods such as bones and “Til Ladoo” or chikki directly on the implant crown.
• Do not eat sticky things such as sticky candy or chewing gums as this can cause the crown part to come out over a period of time.
• Usually regular follow up with your Dentist/ Implantologist is a must every 6 months where gum health and bone levels around implants are assessed.

Dr Wankhede says, “It is important to practice good daily oral hygiene, including brushing and flossing to control bacterial bio-film. It is also important to see your dentist on a regular basis. The dentists will need to examine implants to make sure the integrity of the osseointegration is stable and that the implant bridgework, crowns or dentures are functioning adequately. Special equipment are necessary to clean dental implants that will not damage their metal surface beneath the gum tissues.”

Advantages of Dental Implants
Dental implants offer advantages that other tooth replacement options, like dentures or bridges, just can’t offer. Dental implants may actually endow with better long-term value than conventional teeth replacement options. Dental implant technology has become the state-of-the-art tooth replacement solution because of its benefits over earlier treatments. And, with new innovations in dentistry, most patients can benefit from them. Here, our experts share their views on the advantages of dental implants.

Dr. Bhandari points the advantages as, “Dental implants are the best treatment options as far as available treatment options go. They do not need to cut adjacent teeth as is needed in other treatment options such as dental bridges. Adjacent teeth are healthy and maintained as they are not over loaded as in dental bridges. Functionally satisfying as bite force generated by implant prosthesis is equal to natural teeth, aesthetically pleasing as the effect of tooth coming out of gum is achieved and dental implants are biocompatible.”

Dr Wankhede said, “One of the biggest advantages of an implant is that it restores full chewing power. In most of the cases, the patients can’t tell the difference between their natural teeth and the implant tooth.”

According to Dr Wankhede, the other advantages to dental implants include:
Improved appearance: Dental implants look and feel like the own teeth. And because they are designed to fuse with bone, they become permanent.
Improved speech: With poor-fitting dentures, the teeth can slip within the mouth causing one to mumble or slur words. Dental implants allow to speak without the worry that teeth might slip.
Improved comfort: Because they become part of one’s mouth, implants eliminate the discomfort of removable dentures.
Easier eating: Compared to natural teeth, sliding dentures can make chewing difficult. Dental implants function like own teeth, allowing to eat with confidence and without
pain.
Improved oral health: Dental don’t require reducing other teeth, as a tooth-supported bridge does. Because nearby teeth are not altered to support the implant, more of own teeth are left intact, improving long-term oral health. Individual implants also allow improving oral hygiene.

Disadvantages of Dental Implants
There are some disadvantages that are important to consider when choosing dental implants as a procedure.

Dr Wankhede says, “Surgical procedure is necessary for implant placement. There may be insufficient bone for implant placement. This may necessitate bone grafting and additional expense. While implant fixtures (roots) have a 95 per cent success rate, a porcelain crown placed on the implant may still fracture with time. Primary implant expense may be costly, but in the long term, is actually more cost-effective.”

Dr. Bhandari points out the disadvantages as:
• Involves surgery.
• May not be possible in patients with advanced medical problems.
• Initial cost may seem high to some but long term benefits are more.
• Treatment time is longer as bone needs to heal up around the implants.

Conclusion
There are very few disadvantages of dental implants, but they are overweighed by the benefits and value that they provide to the patient for the rest of a person’s life. The only thing to keep in mind is about maintaining the implants carefully to ripe more benefits. Placing dental implants requires a great deal of knowledge in this area. Dental professionals are overwhelmed by the variety of implants available on the market. The dentist should choose a dental implant system based on evidence-based study.