DENTAL IMPLANTS

A dental implant is an artificial tooth root that is placed into your jaw to hold a replacement tooth
or bridge. Dental implants may be an option for people who have lost a tooth or teeth due to
periodontal disease, an injury, or some other reason.

TYPES OF DENTAL IMPLANTS

Endosteal (in the bone): This is the most commonly used type of implant. The various
types include screws, cylinders or blades surgically placed into the jawbone. Each implant holds
one or more prosthetic teeth. This type of implant is generally used as an alternative for patients
with bridges or removable dentures.
Subperiosteal (on the bone): These 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 are unable to wear conventional dentures and who have minimal bone
height.

Before dental implant

After dental implant

ARE YOU A CANDIDATE FOR DENTAL IMPLANTS?

The ideal candidate for a dental implant is in good general and oral health. Adequate bone in
your jaw is needed to support the implant, and the best candidates have healthy gum tissues that
are free of periodontal disease.

Dental implants are intimately connected with the gum tissues and underlying bone in the mouth.
Since periodontists are the dental experts who specialize in precisely these areas, they are ideal
members of your dental implant team. Not only do periodontists have experience working with
other dental professionals, they also have the special knowledge, training and facilities that you
need to have teeth that look and feel just like your own. Your dentist and periodontist will work
together to make your dreams come true.

WHAT IS A DENTAL IMPLANT PROCEDURE LIKE?

 This procedure is a team effort between you, your dentist and your periodontist. Your
periodontist and dentist will consult with you to determine where and how your implant should
be placed. Depending on your specific condition and the type of implant chosen, your
periodontist will create a treatment plan tailored to meet your needs.

Replacing a Single Tooth If you are missing a single tooth, one implant and a crown
can replace it.
Replacing Several Teeth If you are missing several teeth, implant-supported bridges
can replace them.
Replacing All of Your Teeth If you are missing all of your teeth, an implant-supported
full bridge or full denture can replace them.
Sinus Augmentation A key to implant success is the quantity and quality of the bone
where the implant is to be placed. The upper back jaw has traditionally been one of the most
difficult areas to successfully place dental implants due to insufficient bone quantity and quality
and the close proximity to the sinus. Sinus augmentation can help correct this problem by raising
the sinus floor and developing bone for the placement of dental implants.
Ridge Modification Deformities in the upper or lower jaw can leave you with
inadequate bone in which to place dental implants. To correct the problem, the gum is lifted
away from the ridge to expose the bony defect. The defect is then filled with bone or bone
substitute to build up the ridge. Ridge modification has been shown to greatly improve
appearance and increase your chances for successful implants that can last for years to come.

WHAT CAN I EXPECT AFTER RECEIVING A DENTAL IMPLANT?

As you know, your own teeth require conscientious at-home oral care and regular dental visits.
Dental implants are like your own teeth and will require the same care. In order to keep your
implant clean and plaque-free, brushing and flossing still apply!

After treatment, your periodontist will work closely with you and your dentist to develop the best
care plan for you. Periodic follow-up visits will be scheduled to monitor your implant, teeth and
gums to make sure they are healthy.

Dental Implant
Dental implant adalah gigi palsu (dari bahan sintetik) yang dipasang ke dalam mulut pasien melalui tindakan
pembedahan sehingga gigi palsu ini tertanam ke dalam tulang rahang. Dengan demikian gigi palsu ini dapat berdiri
sendiri tanpa mengganggu gigi-gigi lain yang masih sehat. Dental implant adalah gigi palsu yang paling mirip dengan
gigi asli. Bahan yang dipakai terbuat dari titanium yang bersifat bio-innert dengan jaringan tubuh (tulang).
Bagaimana implant ini berfungsi?
Setelah terpasang (tertanam) dan menyatu di dalam tulang rahang implant disambung dengan mahkota gigi buatan ,
dengan demikian gigi palsu ini tidak perlu dilepas atau dibuka untuk dibersihkan seperti gigi palsu yang sudah
dikenal. Biaya pemasangan implant memang lebih mahal dibanding gigi palsu biasa tapi implant memiliki kelebihan
karena sangat mirip dengan gigi asli.

Siapakah yang dapat dipasang dental implant?

Bila seseorang ingin dipasang dental implant maka pertama-tama ia harus mengunjungi dokter gigi untuk dievaluasi.
Umumnya kondisi pasien harus sehat, tulang rahangnya cukup tebal dan kebersihan mulutnya baik. Keberhasilan
dental implant akan menurun bila pasien mempunyai kebiasaan bruxism, menderita penyakit kronis seperti
diabetes tak terkontrol atau pada pasien yang perokok atau peminum.

Bagaimana prosedur pemasangan implant?

Implant umumnya dipasang ke pasien dengan menggunakan anestesi lokal tanpa melupakan prinsip-prinsip
sterilisasi dan setelah itu pasien mendapat medikasi yang optimal.
 Berapa lama waktu yang dibutuhkan untuk proses penyembuhan?
Setelah terpasang, implant memerlukan waktu untuk proses osseointegrasi (menyatu dengan tulang), yang
memakan waktu antara 2-9 bulan. Ini tentunya dipengaruhi oleh berbagai faktor antara lain: daya penyembuhan
pasien, kualitas tulang, dan penggunaan graft.

Bagaimana tingkat kesuksesan implant ini?

Saat ini tingkat kesuksesan rata-rata mencapai 95% bila implant dipasang di rahang bawah dan 85% bila dipasang di
rahang atas.

Bagaimana merawat implant yang sudah terpasang?

Faktor utama agar implant tetap berfungsi baik kebersihan mulut merupakan syarat utama. Pembersihan implant
seperti membersihkan gigi yaitu dengan floss dan sikat sekurang-kurangnya 2 kali sehari. Petunjuk spesifik akan
diberikan oleh dokter yang bersangkutan.

Berapa harga untuk sebuah implant?

Karena pemasangan implant melalui suatu proses yang memerlukan alat atau instrumen khusus dan juga implant
sendiri terbuat dari bahan yang diproses dengan tahap-tahap yang rumit maka biaya yang dikenakan ke pasien akan
lebih mahal dibanding dengan gigi palsu lainnya. Untuk lebih terperinci maka dokter akan memberi penjelasan lebih
lanjut.

What Are Dental Implants?

Dental implants are replacement tooth roots. Implants provide a strong foundation for fixed (permanent)
or removable replacement teeth that are made to match your natural teeth.

What Are the Advantages of Dental Implants?

There are many advantages to dental implants, including:

Improved appearance. Dental implants look and feel like your 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 you to
mumble or slur your words. Dental implants allow you to speak without the worry that teeth might slip.

Improved comfort. Because they become part of you, implants eliminate the discomfort of
removable dentures.

Easier eating. Sliding dentures can make chewing difficult. Dental implants function like your
own teeth, allowing you to eat your favorite foods with confidence and without pain.

Improved self-esteem. Dental implants can give you back your smile and help you feel better
about yourself.

Improved oral health. Dental implants don't require reducing other teeth, as a tooth-supported
bridge does. Because nearby teeth are not altered to support the implant, more of your own teeth are left
intact, improving long-term oral health. Individual implants also allow easier access between teeth,
improving oral hygiene.

Durability. Implants are very durable and will last many years. With good care, many implants
last a lifetime.

Convenience. Removable dentures are just that; removable. Dental implants eliminate the
embarrassing inconvenience of removing dentures, as well as the need for messy adhesives to keep
them in place.

How Successful Are Dental Implants?

Success rates of dental implants vary, depending on where in the jaw the implants are placed but, in
general, dental implants have a success rate of up to 98%. With proper care (see below), implants can
last a lifetime.

Can Anyone Get Dental Implants?

In most cases, 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. If you are
considering implants, talk to your dentist to see if they are right for you.

Does Insurance Cover the Cost of Dental Implants?

In general, dental implants are not covered by dental insurance at this time. Coverage under your medical
plan may be possible, depending on the insurance plan and/or cause of tooth loss. Detailed questions
about your individual needs and how they relate to insurance should be discussed with your dentist and
insurance provider.

What Is 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. 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 can take from six to 12 weeks.

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, your 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.

Your 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 painmedications, such
as Tylenol or Motrin.

How Do I Care for Dental Implants?

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

Dental Implants
1. What Are Dental Implants?
Dental Implants are titanium screws that are fixed solidly in the jaw by means of a surgical
procedure. Dental Implants provide support for a single missing tooth to several missing
teeth. Dental Implants have been around for over 30 years.

2. How Can I Benefit From Dental Implants?

Patient have told us that:
 1. they eat better

2. eat foods that they have avoided for years.

3. are more confident and more comfortable when they eat.

4. they feel better about themselves.

3. Are There Different Kinds of Implants?

Yes, there are several types made from a variety of materials. The four main categories are
endosteal (fixed into the bone), subperiosteal (fixed on top of the bone but under the
gums), intra mucosal (embedded into the gum tissue) and augmentation (where natural or
artificial bone is added to the jaw).

4. How Many Kinds of Dental Implants Are on the Market?

There are over 60 dental manufactures in the world. However, in our practice we only utilize
Implants with a proven track record.

5. What Materials Are Used?

Almost all endosteal implants today are made from C.P. Titanium or its alloy, 6/4 Titanium.
Subperiosteal implants generally are made from either Vitallium TM or 6/4 Titanium. Also
some implants are coated with synthetic bone (Hydroxylapatite, HA).

6. What Are The Benefits of HA Coating?

Studies have shown the HA to actively participate in the healing process. Instead of bone
healing from only the bone surface, healing also occurs simultaneously from the HA surface.
HA coated implants are recommended for areas where bone quality and or quantity are
limited.

7. Are There Side Effects From Dental Implants?

Allergic reaction to titanium is extremely rare; except for some anticipated discomfort due
to the surgical procedure dental implants are very predictable.

8. How Long do Implants Last?

Using modern techniques, and appropriate surgical and denture protocol, expected success
rates are in excess of 90 %. With proper hygiene habits and maintenance implants are
designed to last a lifetime.

There are several factors beyond the control of both the patient and the provider, which can
affect the life of an implant-retained denture. Accidents and illnesses can have a deleterious
affect. It is therefore impossible to make promises or guarantees regarding the longevity of
an implant.

Should a problem arise, it normally does so during the first six months to a year following
surgery, during the period of bone healing. After this period, problems appear to be less
frequent. However, follow-up by our office and the proper home care by the patient are
mandatory.

9. Who is Good Candidate for Dental Implants?

Those who:

1. are dissatisfied with loose, uncomfortable dentures.

2. wish to eat better.

3. wish to talk and laugh with confidence.

4. are tired of using adhesives to secure their dentures.

10. Do Implant Over-dentures Feel Different Than my Regular Dentures?

Implant retained over-dentures are far more comfortable to wear than regular dentures.
You can finally smile, talk, eat, laugh again naturally with confidence and not worry about
them lifting or dropping.

11. Is Special Care Needed for Implants?

The success of a dental implant depends upon regular dental visits and meticulous oral
hygiene. A healthy mouth helps ensure the best possible functioning of the dental implant.

12. How Long Will a Dental Implant Treatment Take, From Start to finish?
Typically, In a lower Jaw the total treatment time will be around 3 to 5 months. The upper
jaw will usually take about 4 to 6 months. If a bone grafting procedure is required to
increase the height of the bone an additional six months will be necessary.

Also recent extractions must be allowed to heal completely before implants are placed.

13. What are the Medical Requirements for Dental Implant Surgery?
Dental implant surgery is a minor procedure generally done in the dental office. If you are
healthy enough to have a tooth/teeth "pulled", you are healthy enough to undergo dental
implant surgery. Comparatively, it is less traumatic than having an impacted wisdom tooth
extracted.

14. What are the Potential Risks and/or complications of Dental Implant
Surgery?
The chance of complications in dental implant surgery is directly related to the amount of
bone in the jaw. In the back part of the lower jaw, injuries to a nerve may cause numbness
to that side of the lower lip either temporarily or permanently. In the back part of the upper
jaw, the dental implant may cause perforation of the sinus. For some individuals who have
severely resorbed jaws, (very little bone) there is a tendency of bruising in the chin and
neck areas. The bruises usually take ten days to disappear.
However, during the consultation, the oral surgeon will be able to discuss these with you as
well as the ways to minimize these risks.

15. How Long Does the Implant Surgery Take?

Single stage implants usually take 2 to 3 Hours.

16. Will it Hurt?

Patients are told that there will be some post-operative discomfort and swelling but this will
be minimal. In addition patients are reassured that they will be provided with appropriate
analgesics and antibiotics as necessary. The oral surgeon will also be available at any time
to manage any complications that may occur and that the patient should call if they have
any concerns.

17. What Are the Chances of Rejection?

Modern dental implants are made from the most biocompatible (body acceptable) material
known to man, Titanium. Titanium is used in hip replacements and in pins used to hold
broken bones together. There are no recorded cases of rejection. Dental implants differ from
transplants of body parts, such as hearts, lungs, kidneys, etc., where an immune reaction
can occur and rejection result. The possibility of infection around an implant is similar to
that found around natural teeth. Good oral hygiene is a must for gum tissue to remain
healthy and normal around your implants.

18. How Long is the Healing Period?

Reaction to the placement of implants vary from patient to patient and are directly related
to the number of implants placed. Typically, you can resume normal activities one to two
days following surgery. In those cases where extensive surgery is performed, you may
require 3 or 4 days to resume normal activity.

19. Can I Wear My Dentures After Surgery?

Yes and no, the denture will require a minor adjustment for the placement of a soft
cushioning liner so your not to disturb the healing process. The liner may require
replacement every one or two months. However we recommend that you not wear the
denture for at least one week after surgery and not to eat with it for at least 2 - 3 weeks.

This initial healing time is very critical to the success of the implants.

20. How Much Time Will I have to Take Off Work?

Most people recover in one or two days. We recommend allowing three to four days for
recovery. Arranging the procedure to be done on a Thursday or Friday, will allow the
weekend for recovery.

21. What Happens When a Dental Implant Fails?

A failed dental implant will be loose and is uncomfortable when pressure is applied. The oral
surgeon can remove the dental implant quite easily and a new dental implant can be re-
implanted in the same area after 3 months. Reputable Dental Implant Manufacturers
provide guarantee replacement of failed implants, at no charge to you.

22. How Does The Cost of Implant Overdenture Compare to Regular

Dentures?
Fees for dentures vary. If implants are used to retain the denture, the additional investment
can range widely depending upon the number of implants required and the design of the
prosthesis.

23. Does Dental Insurance or OHIP Cover Dental Implant Treatments?

No, the surgery and implant placement is not covered. But if you have dental insurance
procedures such as the oral examinations, radiographs (x-rays), dentures etc. may be
covered, as well as the parts used.

24. Are There any Payment Plans Available?

Yes. Since most dental implant treatments take a few months to complete, payments can be
made by instalments with no interest charged.

25. How Much Will a Personal Consultation Cost and What is Included?
The cost of a personal consultation in our office is provided free of charge. This includes a
clinical evaluation, oral examination and a written estimate. Referral to the Oral Surgeon will
be necessary and some costs may be involved.

26. Does Implant Treatment Require Special Training for the

Dentist/Denturist?
Yes. The construction of Implant overdentures requires special knowledge and is not
practised by every dentist or denturist.

27. Where Can I have My Implant Placed?

We will be happy to provide you with a free examination and consultation.

Potential Risks and Side Effects of Dental Implants

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Dental implants are a wise solution for replacing missing teeth, however, before committing to such a surgery, you
must be aware of the potential risks and side effects of dental implants. Dental implants have a high success rate.

Surgery Risks
If the position of the sinuses and the nerve are very important during the first surgery, one or several radiographs are
needed. If the dentist touches a nerve while screwing in the implant, you may feel constant numbness in your gums,
chin and lips.

Also, there must be enough bone in the jaw for the dental implants to be properly integrated. If the dentist does not
estimate properly the amount of bone or if the bone hasnt enough strength, the implant will be rejected. If there is not
enough bone, a bone grafting procedure or a bone augmentation must be performed prior to the insertion of the
implant titanium screw.

The implant may also be poorly positioned, which may lead to failure eventually.

Peri-implantitis
Dental implants cannot develop caries, but the surrounding area may get infected and cause complications or the
loss of the implant.

Peri-implantitis is an inflammation of the area surrounding the dental implant; the tissue or bone near the implant may
get infected due to different bacteria, viruses or poor dental hygiene and this will eventually cause the loss of the
implant screw and the bone surrounding it.

If detected in timely manner, an infection may be treated and the loss of the implant is not imminent. Make sure to call
your dentists whenever you feel something is wrong or have swollen gums in the implant area.

Make sure to keep your teeth clean and use an interdental brush to prevent the deposits of plaque and bacteria in
between the teeth and the implant. Diabetics and smokers are also exposed to developing peri-implantitis.

Rejection of the Implant

A low percentage of people may reject the implant. This may be due to intolerance to titanium, but the exact causes
have not yet been established.

The implant is also considered rejected if it is mobile or if the bone loss around the implant screw that is exceeds 1.0
mm in the first year and more than 0.2mm in the second.

People who grind their teeth may reject the implant, due to the additional pressure that is added on the implant. Teeth
grinding may also lead to bone resorption or even fractures.

Smokers are more likely to reject a dental implant, so dentists recommend quitting prior to the installation of the
implant screw.

Receding Gums
In some cases, receding gums may reveal part of the implant screw and this will facilitate the access of bacteria,
leading to frequent infections and possibly the loss of the implant.

The success of a dental implant surgery depends on the skills of the dentist as well as the initial health of the bone
and the surrounding tissue and the maintenance after the surgery. However, dental implants are successful about
95% of the times.
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