Implants are now considered the standard of care to replace a single missing tooth. It can be a very predictable restoration with an excellent long-term prognosis. In our office we fabricate the final restoration after one of our specialists extract the tooth and have placed the implant.
2 Major advantages:
Tooth loss without any subsequent replacement of the root form puts little function on the underlying bone, ultimately leading to resorbtion of the bone. This could result in undesirable changes to facial contours and structure (most notably in the case of front teeth where it could present a difficult cosmetic problem if a bony defect developes). Placing a dental implant helps sustain the supporting bone in that area by ensuring it continues to be stimulated by transferred bitting forces. Since an implant is very stable it is analogous to having natural tooth roots in the jaw bone.
Another major advantage of an implant is avoiding the need to remove tooth structure in preparing adjacent natural teeth. Every time a tooth is drilled on to receive a restoration, it means trauma to the tooth and may result in sensitivity, root canal treatment, future decay and/or fracture, ultimately leading to failure of a restoration or tooth loss. All this can be avoided with single implant treatment because it does not involve other teeth.
What to expect during treatment:
It is necessary to allow for healing after an extraction and placement of the implant. It takes 3 to 6 months for the implant to sucessfully integrate into the bone before the final restoration (crown) can be placed.
During this time the patient typcially will wear a temporary partial denture, mostly for esthetic reasons and to prevent the adjacent teeth from shifting into the implant space. If soft or hard tissue augmentation is necessary (i.e. bone or gum grafts), the time frame may be extended further.
Conditions affecting long-term sucess:
Of course, sucess rates can vary for different indications and circumstances. Any local or systemic condition that would impede the necessary healing response and adversely affect long-term prognosis must be considered. Current scientific literature has identified smoking and diabetes as the principal known conditions that predispose to decreased implant sucess rates. Other conditions and circumstances that may affect implant success in the long-term include, but are not limited to: inadequate oral hygiene, and/or periodontal disease leading to boneloss around the implant and subsequent loosening of the fixture leading to failure.
Implants have become a treatment of choice, and more insurance companies are offering coverage for them. Since it takes almost a year or more for the implant restoration to be finished, it often works well to have the implant placed in one benefit year, allow it to integrate and then place the restoration in the following benefit year, thus maximizing the yearly insurance benefits. If there is no insurance coverage, cost can be spread out over the time required to complete treatment.
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