Implants are surgical devices that are implanted into the bone. They can be used for single tooth restoration with a crown, as multi-units to fabricate a bridge, with locators to attach removable dentures, with a fixed hybrid prosthesis. They rely on Osteo-Integration. This is a term used to describe the phenomenon that bone will grow and fuse to titanium.
Implants require adequate bone in the area to be placed. The bone must be dense and strong to support the load from the implant. The tissue around the site must also be what is known as keratinized tissue; the tissue that surrounds the teeth normally, to have the best outcomes. Implants come in different lengths, diameters, and thread design, selected based on what would be best for your particular needs
Implant Design:
When implants were first designed for dental applications, they were basically a solid piece of titanium that was embedded in the jaws. Since then they have developed quite a bit.
The body of implants come in two forms, straight and tapered. The region at the neck of the implant contains microthreads, which allow a greater surface area for the soft tissue to attach to which creates a stronger and thus more esthetic tissue around the implant. The platform switch, is designed to move the connection between the implant and the abutment (what connects the crown to the implant) away from the crest of the bone. This prevents plaque build up and decreases bone loss around the neck of the implant. The surface of the implant is usually coated with a surface that accelerates bone growth around the implant.
Implant Restorative Options:
Single Tooth Crowns: Implants can be used to restore a tooth in two ways; Cement or Screw Retained crowns
- Cement Retained Crowns: This is used (or should be) in the anterior region where a customized abutment is fabricated to place the margins of the crown slightly below the gingiva. This gives the best esthetic outcome, and most importantly, prevents cement from being trapped too far subgingivally under the gumline with a 'stock' abutment.
- Screw Retained Crowns: These should always be used in the posterior if possible. This is when the abutment is fused to the crown, and the crown is attached with a screw inside the tooth. This allows for future retrieval of the crown without having to cut the crown off.
Implant Bridge: Multiple Implants can be splinted together with a bridge so that less implants can be placed, or if there is inadequate bone for single tooth implants.
Overdentures: Conventional Dentures are retained by suction and denture paste. Implant retained attach to the implants through a housing called a locator. There is a male and female component which snaps in. This allows removing and cleaning of the denture, but excellent retention, and no worry about a denture that moves around!
Fixed Hybrid Prosthesis: If multiple implants are placed, and the patient does not want a removable option, we can fabricate a full arch that is made out of the ceramic materials of a dental crown. This very hard, very esthetic material is the best choice for replacement of all teeth!
