Missing teeth can make you feel self-conscious. They can also give plaque and bacteria extra places to collect, allow your other teeth to move out of alignment, and make it more diﬃcult for you to eat and speak eﬀectively. The answer to your problems may be dental implants in Grand Junction, Colorado. Our dentist, Dr. Bob Johnson, will be happy to meet with you for a consultation to help you decide if dental implants are the right choice for you. To make an appointment at Horizon Dental Care, call 970-245-3633 today.
What is an implant?
Depending on the situation, I may recommend an implant as an option for tooth replacement. An implant is a medical grade titanium screw body that is placed or implanted into the bone during a precise surgical procedure. It is important to note that implants are now being made out of several types of materials such as zirconia and porcelain ceramic. While these seem promising they are not quite time tested enough for me to place them. The biggest issues we are seeing with these are fracture of the actual implant body, which of course means the whole implant has to come out. This is why I am still placing titanium implants. Titanium is considered to be the gold standard and has been used in dentistry and orthopedic medicine many years.
What are they placed for?
Implants can be placed with several ideas in mind. You may have chosen to have an Implant placed for a single tooth replacement. This is relatively simple to understand being that there is only an implant screw, a connector called an abutment and a new tooth or crown. See the animation below to help you visualize this. These look and feel like real teeth. Patients often forget which of their teeth is the implant.
You may have chosen to have implants placed to hold in or retain your denture or partial removable teeth. This makes your removable more stable and useful. These teeth literally click in and out and are quite serviceable. There are several types of connections such as O-rings, nylons, clips and bars. I can tell you which would be most useful for your situation. Often you can chew and eat more. You don’t have to worry about your denture coming loose or falling out.
You may have chosen to have several implants placed to replace several individual or bridged teeth or the have the entire upper or lower arch of teeth replaced. This can be beneficial if you don’t want to deal with teeth that are removable. These types of rehabilitations go by many names such as Hybrid or Hybridge or some other trademarked names. It depends on the substructure, implant components chosen and the completed materials of the final prosthesis. The dental term is actually ISCP or Implant supported complete prosthesis. This means the entire restored arch, top or bottom, is supported on implants. There is a lot of detail that goes into these sorts of prosthesis and they can cost a lot or a little depending on your chosen requirements.
Are there different kinds of implants?
If you have read the previous reasons for placing implants, you can imagine that one implant isn’t going to fulfill all the needs of why we are placing them. Implants come in all sorts of shapes, sizes, tapers, and connections. The choice of implant comes down to familiarity with the components, the availability to do certain procedures and the risk associated with failure. In most instances, I choose to place a cylindrically shaped bone level implant with a platform switched internal connection. I have these in several different lengths and diameters. The reason for this is multiple but the main reasons are success of the restoration and the ability to restore almost all indications with this type of implant. I also place my implants guided with a 3D model and a virtual placement of the final crown or restoration. This means there will be virtually no issues with the final restoration placement now or in the future.
What are mini-implants and why don’t you place them?
Mini-implants are no different than what we call traditional implants except that they are so skinny or narrow that there is no room for an internal connection meaning the connectors or abutments can never be changed out. The Academy of Osseointegration calls mini-implants, NDI’s or Narrow Diameter Implants. To be quantified as a narrow diameter implant the diameter has to be smaller than 2.2mm. You should look at that on a ruler.
The biggest issue I see with mini-implants are fracture of the implant, bone loss and subsequent failure of the implant. This can be avoided if they are used for the right purpose but some choose to place them for cost savings in areas that end up costing the patient more money in the long run. I would place a mini-implant if a patient chose it. Once I explain the different options to patients they have always chosen traditional implants. I suppose I am still waiting for the right case.
Are some people better candidates for implants and what is failure?
There are serious implications that must be considered and discussed when placing an implant. There are definitive reasons why someone shouldn’t receive implants and some suggested guidelines for when individuals would be considered high risk for failure. On average you will hear a dentist quote a 95% success rate for implants, meaning five out of one hundred implants placed will fail. A failed implant by definition is an implant that has not healed or osseointegrated. They can also become infected later and come out of the bone which we would be considered a late failure. The academy of osseointegration through which I am a member considers the rate of implant failure to be much higher, around 85%. There are several instances in which I would consider implants as failed where a patient has no obvious problems yet. This is something I deal with every day. A serious issue with the dental community that we see is the haphazard placement of implants some consider to be just fine or okay. Just because the implant is still connected to the bone and the tooth functioning doesn’t mean it is ideal or healthy or that it is going to stay that way. Did you know that the average implant is 10mm long and they will not become unstable until the last 1 mm of bone becomes detached? There have been numerous studies correlating infections in your mouth to your overall body health such as heart disease and diabetes. Poor initial implant placement is a disastrous issue that leads to long term loss of health, time and money due to re-treatment or removal. Not all bony sites are still good enough to place implants due to bone loss that occurred during the initial tooth loss or just due to settling of the bone. I let my patients know their specific situation, the risk and advocate for the best long-term solution. In good overall health, I always tell my patients, “You can always get an implant, it just depends on how hard you want to work for it”. You may require bone grafting, sinus lifting, or guided bone regeneration prior to placement that may extend the timeline and risk of treatment. Some patients might find that the time and money are worth it, while others may choose an alternative means of restoration.
Are they the best solution or a cure-all?
There are definitely times when implants are not a good solution to my patients needs or removal of an existing implant is needed. I do my best to help patients make decisions based on education with the goal being long term health. I enjoy placing, restoring and rebuilding smiles with implants but want to avoid an implant failure or complication at all cost. I let my patients tell me how risk tolerant they are to place implants based on their complete understanding of the risks and benefits in their specific situation. I will be happy to meet with you for a consultation to help you decide if dental implants are the right choice for you. To make an appointment at Horizon Dental Care, call 970-245-3633 today.
– Dr. Bob Johnson