Maintenance Of Dental Implants

 Dental implants have become an everyday part of modern implant dentistry to replace missing teeth. In the past, a dentist gave options to patients…go without a tooth or teeth, wear uncomfortable conventional dentures, or have a dental bridge fabricated. Dental implants have given patients and dentists a conservative option.

One that does not cut down existing teeth and is strong and durable. It is vital to note dental implants need to be cared for just like regular teeth.

What Are Dental Implants?

Implants are artificial tooth roots (typically fabricated from titanium) that your dentist places into your bone to support dental restorations that can replace missing teeth. Dental implants can replace a single natural tooth, multiple natural teeth, support a dental bridge, or support a denture (making it far more comfortable and secure).

Dental implants are the perfect option for overall good oral health patients who have lost a tooth or multiple teeth due to periodontal disease, trauma, fracture, or decay. A dental implant is more conservative than traditional crowns and dental bridges.

Since implants do not allow for removal of healthy tooth structure or rely on adjacent teeth for support, sufficient bone and good overall oral health will give you the highest chance for ideal osseointegration (the way bone and implant become connected).

Implant Dentistry

Dental implants – intimately connected with the underlying bone and gingival tissues in the mouth. Proper fit, good occlusion, and excellent dental hygiene are integral for long-term success. With dental techniques and advances in dental materials, dental bone grafts are now more successful than ever and can be used to add to your natural bone. Gum disease, diabetes, bleeding problems, etc., can increase the difficulty in the placement, healing, and longevity of dental implants.

Be honest with your dentist regarding possible health issues to take the proper steps to give you the best success. There is an increased implant failure risk in patients who are active smokers. For this reason, placement of dental implants occurs only after a patient has ceased smoking.

Common Dental Implant Questions

What Are Dental Implants?

A dental implant is an artificial titanium implant used to take the place of the tooth’s root in the bone. A replacement tooth (dental crown) is placed on top of the dental implant to replace the missing tooth or multiple teeth in your smile. Dental implants can support a single crown, a dental bridge, or even a complete denture.

What Are The Advantages Of Dental Implants?

Dental Implants can provide the following life-changing benefits:

• -Dental Implants Feel Natural. They are an ideal solution for replacement teeth. They look and feel natural.
• -Similar Dental Maintenance As Natural Teeth. Not only will they feel comfortable, but they are maintained just like our natural teeth. This maintenance includes brushing, rinsing, flossing, and regular dental visits for professional cleanings.
• -Restored Ability To Chew. Dental implants give you the ability to chew all your favorite foods without pain/discomfort or fear of teeth falling out.
• -Improved Communication. With a full complement of teeth, your new smile will improve your speech.
• -Conservative Treatment. Most surgery is not often considered conservative, but in this case, it is. Dental implants preserve natural tooth structure by avoiding the need to prepare adjacent natural teeth for conventional bridgework. The dental implants procedure is quite straightforward with a high success rate.
• -Cosmetics. Dental implants can restore a smile, increasing your attractiveness to others. 
• -Bone Preservation. When teeth are lost, the bone in the jaws remodels and resorbs. When a dental implant is in place, the bone levels stay where they should, maintaining healthy bone levels in the face and jaws.
• -No Tooth Decay. Dental implants are not susceptible to tooth decay. 
• -Increased Confidence and Self-Esteem. With a renewed smile, you will feel better about yourself and confident in knowing you can smile fully.

How Many Dental Visits Will I Need For Dental Implants?

The number of dental visits for a dental implants procedure depends on the individual patient’s natural tooth replacement needs. Generally, 1-2 dental visits are necessary to diagnose and formulate a comprehensive dental implant treatment plan.

The visit will include record taking (including models, x-rays, and possible 3D CT Scan) is done, and a thorough dental examination with the entire team of clinicians that includes the surgeon (periodontist or oral surgeon) and the cosmetic dentist. Then for most dental implants, usually, one or two surgical procedures are performed, each requiring 1 or 2 post-operative visits.

Are Dental Implants Painful?

Pain or discomfort is generally quite minimal if any at all. After placement of most dental implants, the amount of pain or discomfort experienced typically ranges from mild to moderate and is usually controlled easily with appropriate over-the-counter and prescription medications.

Longevity of Dental Implants?

Dental implants can last a lifetime with proper dental care, although nothing is guaranteed. It is the dental crown, dental bridge, or denture that usually will wear down over time due to the extreme forces placed on it from chewing. As a result of this wear and tear, dental crown replacement is necessary on average every 10-15 years. Factors contributing to dental implant failure include:

Failed Integration of Dental Implants

This occurs when the bone does not fuse properly between the threads of the dental implant. This binding between the bone and dental implant is called osseointegration. If this integration does not occur, the dental implants will become loose or come out completely.

To decrease this risk, your implant dentist will examine the quality and quantity of the jaw bone prior to dental surgery. This evaluation will allow the implant dentist to only place dental implants in areas with an increased rate of success. If osseointegration does not occur, your dentist will need to remove the dental implants, and you can try implant surgery again following complete healing of the area.

Dental Infection (peri-implantitis – Peri implant diseases)

While very rare, this is the #1 complication of dental implant surgery. The bone and gums surrounding the dental implant can get infected during or after the dental implant placement of the dental implants. This infection can happen due to poor surgical technique, a contaminated implant, poor healing ability (diabetic, smoker, osteoporosis medications).

The most likely time to occur would be during the placement of the dental implant into the bone. Implant infection is a condition referred to as peri-implantitis. Peri-implantitis – characterized by inflammation of the surrounding tissues of the dental implant. Peri-implantitis can also show up as a secondary infection later on. It is a form of periodontal disease that can lead to inflammation, bone loss, and implant failure if not treated quickly and properly.

Although bacteria usually cause dental implant infections during or immediately after the surgery for the placement of the dental implants, an infection can still occur down the road after the dental implants are placed.

Damage To Surrounding Tissues

Dental implant complications related to errors in surgery affecting adjacent teeth, nerves, or the sinus are connected directly to the experience and skills of the implant dentist.

An implant dentist with the proper skills and experience can identify potential problems by examining x-rays or CT scans (computer tomography), design the correct treatment plan (including ideal location and angle), and execute the plan properly without any complications. Even with the most experienced implant dentist, there is always a possibility of dental implant complications. It is important to note that with this experience comes an understanding of what can happen when placing a dental implant.

An experienced implant dentist will easily handle any complications that might come up either at the time of surgery or afterward.

Can Anyone Tell I Have A Dental Implant?

No. Only you and your dentist should know that you have a dental implant. Even the patient will not feel the dental implant in the jaw bone. The only way to know is with an x-ray which shows the dental implant in the bone.

What Is The Success Rate Of Dental Implants?

Studies have shown the success rate to be greater than 98% for all dental implants.

When Are Dental Bone Grafts Needed?

• –The existing bone has insufficient width. This lack of bone can likely be a genetic factor where the bone width is naturally lacking, or it could be due to damage over time from the presence of periodontal disease.
• –The existing bone has insufficient height. The bone height is just as vital as the width of the bone. It ensures the dental implant is secured correctly to support the stress of function (biting and chewing food).
• –The maxillary sinus is too close to the area of placement. This closeness usually means that there is not enough bone between the tooth area and the sinus. Generally, your dentist can fix this by performing a sinus lift (or sinus augmentation) procedure and placing bone graft material.
• –Inadequate bone as a result of the previous removal of natural tooth or teeth. Occasionally, when teeth are removed or fall out, your dentist can remove bone as well. The bone structure will also decrease and remodel once the tooth is removed. The bone is no longer is needed to hold a tooth in place so that it will resorb over time.
• –Inadequate bone structure due to periodontal disease or trauma. Periodontal disease and trauma can lead to not having enough bone present for dental implant success.
• –Inadequate bone due to developmental defects that affects the growth of bone in the jaw.
• –Insufficient bone is caused by the removal of cysts or tumors in the mouth. If the tumor or cyst removal is required, there will also be the removal of some bone. This may leave insufficient bone levels present for dental implant success. After removing oral pathology, healing time is required so your dentist can reevaluate that bone quality and quantity.

Bone Grafting Procedure

Where Does the Bone Come From?

Bone grafting procedures involve using your bone, cadaver bone, cow bone, and synthetic bone for bone growth. Your bone will most likely come from your chin or ramus (the back part of your lower jaw). If your dentist cannot get sufficient quality bone from either of these areas, there may be a need to get bone from your hip or shin bone (tibia) instead. The hip is considered a better source.

The hip bone has the ability to provide a large amount of bone. The marrow that comes from either the hip or shin (tibia) contains bone-forming cells. However, bone taken from your hip will require a visit to the hospital along. General anesthesia is required.

Cadaver and cow bone are sterilized and broken down into small chips for easier placement. Manufactured synthetic materials are also widely available for bone grafting. The synthetic bone acts as a scaffold for new bone to build on.

There are ewer products on the market containing growth factors. Some growth factors are used to enhance bone graft materials, and others are used in place of bone grafting. One of these products, BMP-2, stimulates specific body cells to turn into bone. The BMP-2 protein is a naturally occurring protein in the body.

What Happens During Bone Grafting?

A good example is a patient who needs to have a single tooth extracted and wants replacement with a dental implant and dental crown. Bone defects in the tooth area that is large and needs to have some bone placed to fill in the space. In this particular case, a dental bone graft is ideal and reasonably necessary to support the future dental implant by aiding bone growth.

Before the surgery, you will need a CT scan or a cone-beam computed tomography (CBCT) scan. The images of a CT or CBCT will provide vital information about the bone quantity and locate the important nerves and sinuses are located, which need to be avoided. A CBCT provides a 3-D image of your bone and any defects present at the implant site.

Local anesthesia will be necessary to anesthetize the area where the bone augmentation is needed (called the recipient site) and where the bone will be removed (donor site) if using your bone. An incision in the gingival tissue where the dental implant will be placed is made to determine the amount and type of bone grafting necessary.

The most common type of bone graft is called a socket graft. This graft is used to fill the space left from the lost tooth. The material most often used in a socket graft is made up of cow bone. This bone is harvested from healthy cows and is manufactured through a freeze-drying procedure that gives a sterile product containing only the mineral content needed.

The graft is inserted into the empty hole immediately after the extraction of the tooth and is secured using sutures. After completing the procedure, the patient will be administered antibiotics, pain medicine, and an antibacterial mouthwash. You will need to stay away from certain foods. You will also be given instructions on avoiding putting pressure on the area or damaging it while it heals.

If you wear a removable denture, you may not be able to wear it while healing takes place. If there are natural teeth around the bone graft, your dentist may fabricate a temporary removable bridge or denture to protect the area on the future implant site.

Bone Grafting Success

The success rate for bone grafts in the jaws to place a dental implant is relatively high. However small, there is always a chance that the bone graft will fail, even if your bone was utilized. Bone grafts are not rejected like organ transplants.

The full understanding is not known why some dental bone grafts fail. There is an increased risk of failure in patients with diabetes who smoke or have periodontal disease. A failed graft can be removed. Once bone healing is complete, your dentist may choose to place a second bone graft.

Top Dental Tips For Caring For Your Implant

• –Toothbrushing. Usual toothbrushing rules apply. It is recommended that you brush at least twice a day, but it is recommended to brush after every meal if possible.
• –Flossing. Yes, flossing is still important with dental implants. Flossing can keep the area around the dental implants along the gum line clean. Just because dental implants cannot get tooth decay, it does not mean you cannot lose them. Bone loss is still possible around dental implants. If bone loss occurs, it can lead to dental implant loss.
• –Maintain Regular Dental Visits. Dental implants should be cleaned with specialized types of dental instruments as not to scratch the coating on the outer surface. Your hygienist should not clean your dental implants with ultrasonic or vibrating dental instruments of any kind. It is essential to thoroughly examine the dental implants at least 1x per year along with your regular dental cleaning schedule.
• Your dentist will evaluate the health of your bone levels along with the soft tissues and occlusion. The critical takeaway is to have frequent examinations to catch any issues that might arise early enough so your dentist can make proper corrections.
• –Use A WaterPik. A practical and safe way to clean around dental implants is to use a WaterPik. The WaterPik uses a water spray that gives it the ability to clean in between and around your teeth. But keep in mind to use the right amount of pressure as it may cause damage to the gum tissues around your new implant.
• Keep it at the lowest level possible. Recent studies have shown that WaterPik can remove up to 145% more debris than regular dental floss alone. Adding Periogen in the Waterpik can help remove tartar buildup around implants making it easier to keep them clean.
• –Stop Smoking. Studies have shown that smoking will decrease oxygen flow to the gum tissues—decreased oxygen results in healing delays, breakdown of the oral tissues, and loss of bone. Bone loss and inflammation will eventually cause your implant to loosen and fall out. If you want to protect your new dental implants, do not smoke.

Conclusion

Just like our natural teeth, dental implants should be maintained if you wish to keep them. Implants can last a lifetime with proper maintenance at home and with your dentist. Implants can strengthen, beautify, and enhance your smile for years to come. Implant dentistry has come a long way in the last two decades.

Contact Marielaina Perrone DDS at (702) 458-2929 to schedule a no-cost cosmetic consultation appointment if you are ready for a smile makeover. We cannot wait to help you with your smile makeover to create the smile of your dreams in Summerlin, Henderson, and Las Vegas, NV.

Author Bio

Dr. Marielaina Perrone is a passionate and experienced dental professional with over 20 years of expertise in the dental industry. She is committed to providing her patients with exceptional care and innovative solutions to help them achieve optimal oral health and beautiful smiles. Dr. Perrone is widely recognized as a leading authority in her field and has a reputation for personalized care, attention to detail, and compassionate approach. She offers a wide range of dental services, including cosmetic dentistry, restorative dentistry, and preventive care. Dr. Perrone is dedicated to staying up-to-date with the latest dental advancements and technology to ensure her patients receive the best possible care.