CHAPTER 10 Implant Dentistry
Substitutes for Tooth Roots Placed into Your Jaw
Dental practitioners have tried to develop artificial teeth to be placed in the jawbones since the origin of dentistry, but in recent years activity has increased in the area of implant dentistry. Initiated by Swedish research in the 1960s, the placement of small titanium cylinders or screws into the jawbone has progressed from an experimental (and highly criticized) procedure to common usage by many dentists (Fig. 10.1). The titanium-screw concept popularized implant use, but other types of implants were available much earlier. Examples are blades placed into the jawbone, with heads protruding above the gums (Fig. 10.2), and subperiosteal implants placed on top of the bone, between the bone and gums (Fig. 10.3). These types of implants are still used, but the screws or cylinders are more popular.
Do these tooth substitutes (dental implants) work? Yes, in the mouths of healthy people, without abusive oral habits or excessive smoking. Their ability to function rivals that of natural teeth. In severe cases they have allowed persons unable to wear conventional artificial dentures to chew well and appear normal. The most popular current concept (cylinders and screws) requires one or two clinical sessions.
Not all dentists provide implants. There are two distinct divisions in the implant procedure described. The placement of the implant into bone is a surgical procedure performed by oral and maxillofacial surgeons, periodontists, prosthodontists, and some general dentists. If your general dentist does not provide this service, he or she will refer you to a practitioner who performs the surgical portion of the procedure. Both portions of the implant procedure are exacting techniques requiring high skill, and experienced practitioners must be found for an optimal result. Prosthodontists or general dentists usually accomplish the second portion, or attachment of the artificial teeth (prosthesis) onto the implant(s).
If implants are so good, why doesn’t everybody have them instead of natural teeth? Numerous aspects of the implant concept are complicated and difficult for dentists placing them, making the procedure less predictable than desired. Implants are expensive, and, as with natural teeth, require upkeep by patients and dentists. When implants are really needed, they do not have satisfactory substitutes. The task for you and your dentist is to determine whether your oral needs would be served best by using dental implants to replace the root structure of the natural teeth, followed by some form of prosthesis (artificial replacement) for the missing tooth structures. The following pages will help you make that decision with the help of your dentist.
(Fig. 10.7). This type of condition is called edentulous. Loss of all teeth is decreasing in frequency because of the use of fluoride, better diet, and improved oral hygiene. However, millions of people around the world have lost all their teeth. Unfortunately, much of this tooth loss is among those persons who are least able to afford having implants placed.
(Fig. 10.10). A high percentage of people lose some of their natural teeth during their lifetime because of accidents, tooth decay, gum and bone disease, or other reasons. Although there are numerous solutions for replacing several teeth, dental implants are an excellent alternative.