Dental Implants

By: Dr. Presley-Nelson

Many patients, today, are confronted with the choice of implants in their dental treatment plans. Perhaps they have had a recent extraction. Or maybe they have had some missing teeth for some time, and want to restore their dentition. Perhaps they have struggles with removable dentures or partial dentures and wish to have more solid functioning. For many reasons, the public needs to be informed about what implants are and how implants can help them. San Francisco periodontist and implantologist, Dr. Paul Speert, reports that “Dental implants are now the treatment of choice in most instances for the replacement of missing teeth, and is one of the most predictable treatments we have in dentistry. They can be done for single tooth as well as multiple tooth replacements. There are very few contraindications.”

Dental implants are artificial substitutes for natural tooth roots. These implants are like a metal screw or rod and are inserted into the jawbone by a periodontist or oral surgeon. Then a prosthesis is built over it by a general dentist, such as Dr. Presley-Nelson or Dr. Fung. That prosthesis may be a crown or a bridge or some sort of removable partial denture or full denture. Occasionally a second specialist, a prosthodontist, may be needed if the case is particularly difficult.

In Dentistry Today Magazine, October, 2007 ,in an article entitled “Implantology”, Dr. Americo Frenando, ’84 graduate of the University of Manitoba, states: “Knowing what is known today about implant dentistry, it is surprising to me that dental schools are still teaching dentists to cut down healthy teeth to replace missing teeth with bridges. A mountain of evidence unequivocally supports that replacement of teeth with implants is the new standard of care.” Here Dr. Fernando seemingly makes the case for implants even stronger.

The procedure to receive implants is performed comfortably, by the periodontist or oral surgeon, with local anesthesia and often IV medication, within their offices, and takes only an hour or two. Then the work is closed up and let heal for some months. Upon healing, an abutment or small metal piece is installed, which protrudes out of the gum and allows the crown or other prosthesis to be made upon it. Several months and usually 2 dental offices are involved.

The dis-advantages are more time and monetary investment. The advantages are a more life-like restoration that does not harm or rely upon neighboring teeth, and that offers very solid and long lasting support.

To be eligible for an implant, a visit to the periodontist or oral surgeon is necessary to see if you are able to receive one. Quoting periodontist Dr. Paul Speert again, here he relates what he looks for in an implant candidate:

There are very few contraindications for having a dental implant. One must be in reasonably good health. Diabetics can have implants, but it is important for the diabetes to be controlled. Smoking is not a contraindication although there is a slightly decreased success rate compared to nonsmokers. The main requirement for dental implants is having enough bone. If a tooth is to be removed and an implant is to follow, we will do a procedure to preserve the bone, called socket grafting, and whenever possible, we place the implant at the time of extraction. We call this immediate placement. If the tooth is already missing, and there is a question about whether there is enough bone, we can do a special x-ray called a tomogram (like a cat scan). This gives us a picture of the bone in cross section; from this we can see bone volume, bone density, and locate vital structures that we want to avoid. If the bone is adequate, the placement of a dental implant is a fairly simple procedure with very little postoperative discomfort. In situations where there is an insufficient amount of bone, we have bone graft procedures to create more bone. If we don’t need a lot of grafting, in many cases the grafting can be done at the time of implant placement, resulting in reduced treatment time and expense All in all, we work to make implants a successful choice for you.

Further reading material is available in the office upon asking. An article comparing the cost, insurance coverage, and viability of a fixed bridge versus an implant appeared in this Newsletter 2 years ago. It can be obtained in the office.

Dr. Speert maintains that “dental implants are the biggest change to come along in my 36 years of practice. I have been placing dental implants since 1989. There have been many improvements in dental implants, especially modification of the surface that which has shortened the treatment time due to more rapid integration into the bone (called osseointegration). Dental implants are costly, but their long term predictability and desirable results compared to more conventional treatments makes them well worth it. Patients are extremely satisfied with this treatment.” Dental implants are here to stay, and here to serve your dental needs reliably and well.