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Steps Involved in getting a Dental Implant.

The first step in the dental implant process is the development of an individualized treatment plan. The plan addresses your specific needs and is prepared by a team of professionals who are specially trained and experienced in oral surgery and restorative dentistry. The team has the general dentist serving as the quarter back along a periodontist and or oral surgeon,, prosthodontist and a lab technician  This team approach provides coordinated care based on the implant option that is best for you.

Next, the tooth root implant, which is a small post made of titanium, is placed into the bone socket of the missing tooth. As the jawbone heals, it grows around the implanted metal post, anchoring it securely in the jaw. The healing process, called osseintegration; can take from six to 12 weeks.

Once the implant has integrated with  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, the dentist makes impressions of your teeth, and creates a model of your bite (which captures all of your teeth, their type, and arrangement). The new tooth or teeth is based on this model. A replacement tooth, called a crown, is then attached to the abutment.

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

How Painful Are Dental Implants?

Most people who have received dental implants say that there is very little discomfort involved in the procedure. Local anesthesia can be used during the procedure, and most patients report that implants involve less pain than a tooth extraction.
After the dental implant, mild soreness can be treated with over-the-counter pain medications, says Dr Cherukuri, from her Chino, California practice.

How Do I Care for Dental Implants?

Dental implants require the same care as real teeth, including brushing, flossing, and regular dental check-ups, Dr Cherukuri adds.

Handy tips for Implant Care

Dental implant surgery is a popular option for replacing missing teeth. Unlike removable dentures that rest on the gum line, dental implants are surgically implanted into the jaw. These implanted, artificial teeth look like real teeth and have the same functionality as well. They are a more permanent solution to ordinary dentures and bridgework.

 Tooth implants have been used successfully for many years. Good oral hygiene is critical in caring for your implant. It takes special effort to maximize plaque bacteria removal every day. This means along with regular dental visits, you need to brush properly, floss regularly, and clean the space between your teeth (called inter dental spaces) with an inter dental brush. Using an antibacterial toothpaste will help maximize plaque bacteria reduction by continuing to kill plaque bacteria after brushing.

Inadequate oral hygiene can lead to the loss of implants. If oral hygiene is inadequate, bacteria multiply on the surface of the implant to harmful levels. This will result in inflammation of the gums, which is called mucositis. If left untreated, bone loss around the implant may result, leading to peri-implantitis.

Peri-implantitis (inflammation around the implant with loss of bone) can be compared to periodontitis. The two diseases are caused by similar bacteria. This is why untreated periodontitis can increase the risk of failure of an implant. Like periodontitis, peri-implantitis leads to a breakdown of the jawbone. This causes the implant to loose its anchorage and become loose. Peri-implantitis is actually the most common cause of loss of implants.

Caring for Your Implant-

Smoking:  This is one of the greatest risks for implant-related complications. You should therefore try to quit smoking.

Oral Hygiene:  Thoroughly cleaning and caring for the implant during all steps of the treatment is extremely important. Careful attention to your oral hygiene every day is important for the survival of your implant.

Maintenance:  Visiting your dental practice for regular check-ups (recalls), is just as important. The dentist recommends the frequency of the recare visits based health and oral condition, but they are usually at intervals of three to six months. At these visits, your implants, teeth and gums are checked and professionally cleaned. Especially areas which you cannot reach at home are cleaned. Professional cleaning of implants is more complex than cleaning teeth, which means that it takes longer and may require special instruments.

Mucositis and peri-implantitis can develop without any obvious symptoms. This is another reason why regular check-ups with your dentist are so important. Mucositis and peri-implantitis do not usually cause pain, so that patients often fail to notice the development of these diseases says Dr Cherukuri from her Chino California dental practice.

Implants and Diabetes

Implants are replacement tooth roots which provide a strong foundation for fixed and or removable replacement of teeth.

In general dental implants have a success rate of 98% and with proper care they can last a lifetime.

Anyone healthy enough to undergo a routine dental extraction or oral surgery can be considered for a dental implant. Patients should have healthy gums and enough bone to hold the implant. They also must be committed to good oral hygiene and regular dental visits. Heavy smokers, people suffering from uncontrolled chronic disorders -- such as diabetes or heart disease or patients who have had radiation therapy to the head/neck area need to be evaluated on an individual basis.

Diabetes affects about 15.7 million Americans and nearly 800,000 cases are diagnosed every year.  Diabetes can lower the body’s resistance to infection and can slow the healing process. As a result, periodontal diseases often appear to be more frequent and more severe among persons with diabetes.

Prior to dental implant placement, your dentist may request a test of blood sugar to see whether diabetes is under control and may prescribe antibiotics to minimize the risk of infection. A modification in diet and medication may also be considered to improve healing. Good maintenance of blood sugar levels, a well-balanced diet, good oral care at home and regular dental check- ups significantly improve the chances of implant success.

Additionally, modifications in surgical technique can also enhance and ensure implant success says Dr. Cherukuri, from her Chino, California practice.

Check with your dentist if you are a candidate for implants!

Dental Implants for Smokers

         For years, dental implants were not an option for those who smoked.

 “Concerns about periodontal health caused dentists to recommend other treatment instead,” says Dr. Vijaya Cherukuri, from her Chino, California Cosmetic Dental Practice. “Infection is always a concern when a dental implant is placed and those who smoke have been shown to have a greater risk of this.” Current smokers are at risk of developing periodontal disease four times more than non-smokers.

Smoking and other tobacco products affect the attachment of tissues to teeth.  More specifically, it appears that smoking impairs blood flow and interferes with the normal function of tissue cells.  This interference makes smokers more susceptible to infection and adversely affects wound and bone healing.

But newer techniques have shown that smokers can also benefit from dental implant treatment. “New research suggests that an implant submerged so there is no exposure during the healing time can greatly reduce the risk of infection and the ultimate success of the implant,” Dr. Cherukuri adds.

 “We are finding more and more how dental implants can help restore function to those missing teeth from a variety of causes. To learn more about how implants are placed, restored and maintained, please visit our website at: www.chinosmiles.com

Why did my Implant fail?

Dental Implants provide a wonderful way to replace missing teeth, but there can be implant failure. Failure is said to occur when the implant is lost, mobile or when there is significant bone loss surrounding the implant.

“Implants generally fail due to one of three reasons,” says Dr. Vijaya Cherukuri from her  Chino, California Dental Practice. “1. Poor case planning,  2. Pre-loading, or 3. Retained cement around the final restoration.”

Your dentist should evaluate carefully the proposed area where the dental implant is to be placed. Usually a surgical guide will be created, thereby making sure the implant is placed in an area that ensures the proper angulation for long-term success. Certain medical conditions like diabetes and osteoporosis, risk factors  like smoking and medications including bisphosphonates do need to be factored in to assess their role in the implant placement.

Pre-loading refers to placing the final restoration - crown, bridge, or denture - prior to proper implant integration with the bone. Generally your dentist will give you a window of time in which to allow for your implant to integrate to the bone. For some, the time may need to be extended beyond the average 4- 6 months to provide for proper bone integration. 

Finally, excess cement not removed after the placement of the final restoration can also cause failure.

“While failure is disappointing, remember, the vast majority of dental implants are successfully placed and restored,” Dr. Cherukuri says. “Dental implants provide another way to keep you smiling.”

Rationale for Dental Implants

The ideal goal of modern dentistry is to restore the patient to normal contour, function, comfort, esthetics, speech and health.
What makes implant dentistry unique is the ability to achieve this ideal goal regardless of the disease, atrophy or injury to the mouth. However, the more teeth a patient is missing, the more challenging the task becomes.

More than 700,000 implants are placed each year.  The number of implants continues to increase steadily, with more than $150 million of implant products sold in a year.

The increased need and use of implant related treatments result from the combined effect of  a number of factors-

-An aging population living longer
-Tooth loss related to age
-Consequences of fixed prosthesis failure
-Anatomical consequences of edentulism
-Poor performance of removable prosthesis
-Psychological aspects of tooth loss and needs of aging baby boomers
-Predictable long term results of implant supported prostheses
-Advantages of implant-supported prostheses

Implant prosthesis may return the function to near normal limits compared to 60% of function with wearing a denture.  Implants stimulates the bone and maintains dimension in a manner similar to healthy natural teeth As a result, facial features are not compromised.  Implant-retained restoration does not require soft tissue support and improves oral comfort.

"Implant prostheses offer a more predictable treatment course than traditional restorations"  says Dr Cherukuri from her Chino, California practice. Thus the profession and the public are becoming aware of this dental discipline.

Implant History!

Today dental implants have become a common recommendation to replace missing teeth. 

 “There has been an evolution with implants and they are very predictable,” says Dr. VijayaCherukuri from her Chino, California Cosmetic Dental Practice. “But many do not realize the long history of dental implants.”

Dental implants, according to archaeologists, may have had their start more than 1,350 years ago. Evidence found in Honduras show Mayan civilization also replaced missing teeth with implants^.

“Only the implants were not made of titanium as you would find today,” Dr. Cherukuri says, “instead these dental implants were formed from shell.”

 Archaeologists found a mandible that has been dated to about 600 A.D. It is believed that the bone belonged to a woman in her twenties and contains three tooth-shaped pieces that replaced her missing lower incisors.

Modern implant  research began in the 1950’s with the use of titanium, which has the ability to osseointegrate with the bone well. Since that time, more than 700,000 implants are placed each year. 

A dental implant is a "root" device, usually made of titanium, used in dentistry to support restorations that resemble a tooth or group of teeth to replace missing teeth.
Virtually all dental implants placed today are root-form endosseous implants, i.e., they appear similar to an actual tooth root (and thus possess a "root-form") and are placed within the bone (endo- being the Greek prefix for "in" and osseous referring to "bone"). The bone of the jaw accepts and osseointegrates with the titanium post. Osseointegration refers to the fusion of the implant surface with the surrounding bone. Dental implants will fuse with bone; however, they lack the periodontal ligament, so they will feel slightly different from natural teeth during chewing.

Prior to the advent of root-form endosseous implants, most implants were either blade endosseous implants, in that the shape of the metal piece placed within the bone resembled a flat blade, or subperiosteal implants, in which a framework was constructed to lie upon and was attached with screws to the exposed bone of the jaws.

Dental implants can be used to support a number of dental prostheses, including crowns, implant-supported bridges or dentures. They can also be used as anchorage for orthodontic tooth movement. The use of dental implants permits unidirectional tooth movement without reciprocal action.

Restoring smiles and general health, perhaps today you should see if you are a candidate to replace your missing tooth with a dental implant.

Bridge or Implant?

                                            How do I decide?

It is always devastating when a tooth or teeth are lost.  All the teeth work together to help chew, speak and smile. When teeth are missing , it is difficult to do these things. Loss of a tooth may cause the mouth to shift and make the face appear older. Teeth maintain the shape of your face by lip and cheek support. Fortunately, missing teeth can be replaced and should be as soon as possible.

What are the options and then, which option is the best for you?

“The decision on how to replace a missing tooth is best handled after an honest discussion with your dentist" says Dr. Vijaya Cherukuri from her Chino, California Cosmetic Dental Practice. There are many factors that go into making this decision.

 A dental implant is much like a natural tooth, which has a root into the jaw bone, topped by a crown that is seen in the mouth. Most patients find that an implant is secure and stable replacement for a missing natural tooth. However, a dental implant is not an option for everyone. Because implants require surgery, patients should be in good health and have sufficient bone and healthy gums. patients should also be committed to thorough hygiene every day and regular dental visits. A full evaluation by a dentist will determine if you are a good candidate.

Advantages:

• An implant is most similar to a natural tooth.
• Adjacent teeth do not have to be involved in the placement procedure

• Implants may help decrease shrinkage of the jaw bone from tooth loss.

Disadvantages:

• Implants are not intended for everyone
• Implant placement takes longer and may require more dental visits 

  Fixed bridge is another alternative.. This is a restoration that replaces or spans the space where one or more teeth have been lost. A fixed bridge is commonly cemented or bonded to the natural teeth next to the space left by the missing teeth. An artificial tooth, replacing the lost natural tooth is retained by crowns cemented on the adjacent prepared teeth.

Advantages:

• Look, feel and function like natural teeth
• No need to remove from mouth for cleaning

Disadvantages:

• Affects adjoining teeth

When a patient has lost a tooth that is between two other teeth, it is important to also evaluate the adjacent teeth. If the adjacent teeth are heavily restored with crowns or larger fillings, a bridge might be the better option. “But if the adjacent teeth are healthy, an implant is generally the best option,” says Dr. Cherukuri.

If you, or someone you love, is considering how to replace a missing tooth ask your dentist which is the best option for you.