We have provided you with a lot of information, in some cases it is good to get a piece of paper and pencil before you begin, so that you may jot down any questions that you might have as you read along. Please feel free to bring your notes with you to your consultation appointment with Dr. Cirgin.
●Natural Teeth ● Supplementing Natural Teeth ● Partial Dentures ● Tooth Supporting Bone ● Chewing Efficiency ● Medical Examination ● Home Care ● X-ray ● Opposing Teeth ● Loss Of Nerve Sensation ● Are All Dental Implants Successful? ● Will Implants Last A Lifetime? ● Is Age A Deterrent? ● Rejection By The Body ● Can Implants Cause Cancer? ● How Is An Implant Inserted? ● Decisions ● Guarantee ● Cosmetic Surgery ● Further Questions
Your own natural teeth present in your mouth in a healthy, well maintained condition are the best natural implants which you can possibly have. There is nothing else which compares with them. It is, therefore, in the best interest of your health and well-being to do anything you can to keep your teeth in the best condition for the longest possible period of time. With good care on your part, and with good frequent dental check-ups, you will be able to accomplish this goal.
When a tooth is lost, it is best to replace the tooth with a non-removable replacement as promptly as possible. With the replacement of a single tooth, a non-removable bridge is often very satisfactory. However, in replacing a number of missing teeth, and at the same time restoring the chewing efficiency, you have increased the support, which was present when the natural tooth was there in the mouth. The artificial tooth of the bridge does not have a root. In reality, this is no great concern when dealing with a single tooth replacement. But, assuming that we have lost two or three teeth in a row, or have lost several teeth spread out intermittently through the entire jaw, it quickly becomes obvious that a considerable amount of root support has been lost. Now, it does make a difference. In effect, we have increased the load on each remaining tooth because there are fewer of them. This can be compared with losing fence posts in a long fence. The fence is not any shorter, but there are fewer posts supporting the fence. The fence is not as strong now as it was earlier. In the case of the fence, it is obvious that fence posts need to be added so that the amount of support will be increased, and similarly these areas in the mouth need to be aided by replacing the missing root structure by means of implants.
Does a removable partial denture replace the missing teeth equally as well? Partial dentures are either tooth-supported or tooth and gum supported. If it is entirely tooth-supported, the space has been replaced or filled in, but the supporting teeth are no more than they were before. In other words, the load has been increased on the remaining teeth. In the case of the partial denture, which is both tooth and gum –supported, the number of teeth has not increased (there is still no more root support than there was before). The areas where teeth are missing have been filled in with gum-supported denture teeth. This means that the gum tissue and bone under these denture teeth areas will shrink gradually, and the partial denture will have to be remade or reline periodically. If these areas are not relined, then a space develops under the denture. It is not bearing its fair share of the chewing load, and the remaining natural teeth are carrying the entire chewing load. The teeth are overloaded. Under these conditions, the remaining teeth will undergo accelerated bone loss. Also this partial denture is removable. It is not permanently fastened in the mouth, as a non-removable bridge or implant would be.
Nature has provided tooth-supporting bone during the years when there are teeth present in the mouth. When the teeth are lost, the tooth supporting bone is also lost. Nature takes away from you what you do not use! For example, the person who is confined to bed for a long period of time loses muscle tone. The muscles get soft and literally wither away. In the mouth, the bone under the gums “shrinks”, and dentures get loose. Notice in the mouth of a person who has lost half of his teeth, the bone is present around the teeth which remain. Where the teeth have been lost, many times it looks like the back of a “sway-backed” horse.
For purposes of comparison, let us assume that the patient with all of his own natural teeth in a healthy, well-maintained, functionally accurate condition can operate when chewing at 100 percent efficiency that will decrease with every tooth lost. How much decrease there will be will depend on whether or not the teeth are replaced and in what manner. Ultimately, if he reaches the point where he has no teeth at all, he may have (with good fitting dentures on adequate bony ridges) a chewing efficiency of perhaps 15 to 18 percent.
If the ridges are not adequate, the percentage decreases. With implants and non-removable bridgework, or well-supported tooth replacement methods, he may get back as high as 85 percent compared with what he had with his natural teeth, depending on the number of natural teeth present and their condition.
This is an absolute necessity! We will provide you with a “Medical History Verification” form to take to your physician. He will verify your medical and current general health. He will provide us with results of recent examination records including blood tests and urinalysis. He will make indications of drug allergies and/or alternative recommendations. We want to make sure you are healthy and that there is no reason why you should not heal very nicely. We also want your medical doctor to be aware of the treatment we will be providing you and the medications we may prescribe
The dental care you provide yourself at home must be excellent. You must keep your teeth and implants cleaner then you may have done before in your life. You must be able to use a toothbrush, dental floss, or other devices (RotaDent) we may recommend to keep plaque off of both your teeth and the implants. If this is not done, there is a very good possibility that the implants will not succeed, and will have to be removed. Smoking and excessive alcohol consumption are a deterrent to excellent dental health as well.
You must have a very complete examination with x-rays which will include a panoramic x-ray of your entire mouth. X-rays are necessary for proper diagnosis and follow-up after treatment is complete.
The teeth or denture which are in the arch opposite to the implanted area compose a very important consideration in the success of the implant. The load on the implant is not actually in use. There must not be any grinding of the teeth at night (bruxism) against the implant. Also, care must be taken not to overload the implant by chewing ice or hard object which could damage even your natural teeth. The patient should not engage in fights or do anything else which could be damaging to the implant or the underlying bone.
There are cases reported in the dental literature in which there is temporary loss of nerve sensation following certain surgical procedures. This does happen sometimes, but is usually temporary. Unfortunately, there have been instances where complete nerve sensation has not returned even after many years. There have been such occurrences following removal of deeply impacted wisdom teeth. It is possible that such a thing could happen with the placement of implants in the bone. It is usually temporary, and is a loss of nerve sensation only and does not cause a drooping or sagging of the face.
No. There are many variable to be considered in placing the implant. First, the patient must be healthy. There must be adequate healing powers present in the patient. If the patient is an uncontrolled diabetic, for example, the chances for healing are not too good and could be quite a problem. If such a condition develops at a later date after the implant has been done, this will certainly complicate the future of the implant. Secondly, proper diagnosis must be made, and the proper implant must be selected for the patient, and of course, inserted properly. Thirdly, it must be treated properly by the patient and the dentist. If either person becomes forgetful, there could be a problem. Fourthly, if the patient is a heavy smoker or an excessive alcoholic beverage user, the success of the implant will be affected. It certainly is not a help!
Will Implants last A Lifetime?
It is doubtful. Very few things do last a lifetime. There are some implants, which have been in the mouth for as long as thirty years. This is not the average. The average has been in less than that time. In the final analysis, whether they last a lifetime depends on how long you live. Every natural tooth in the mouth of everyone of us now living will have one of two possible fates. It will either last until we die, or it will be removed at sometime. The same thing applies to implants.
No! Health is a deterrent. Many people seventy and eighty years of age are a better surgical risk than someone years younger who has everything physically wrong with him. Older people are more likely to need implants because they have lost more teeth, and have lost more ridge. As long as you live and breathe and are important to someone, you owe it to yourself and family and friends to take the best care of yourself that you possibly can. Incidentally, what is a good age for a heart or kidney transplant or coronary by-pass? If you needed such an operation to stay alive or improve the quality of your life, would you refuse because of age?
Implants are made of biologically compatible materials which have undergone extensive testing over a period of several years in research laboratories using animals. Since these materials are largely metal, titanium, vitallium, etc., and have never been living tissue, there is no likelihood of causing an antigen-antibody response which could cause rejection similar to that which sometimes occurs with heart and kidney transplants.
There are no instances which have been reported in the dental literature in which dental implants have ever been reported as being the cause of cancer.
Although there are many types of implants, the types can be divided into two basic groups – those that are inserted in the bone, and those that are placed over the bone. In both instances, the implants are placed under the tissue, and extend through the tissue into the mouth.
If you have decided that you want to be considered as an implant candidate, and you feel that psychologically it will no emotional problem for you to have implants, then you can be encouraged from the fact that there are many people in the this country and throughout the world who have had hip transplants, pins placed in the hips, kidney and heart transplants, and cornea transplants with excellent results. If you do not feel that you have adequate emotional stability to undergo similar treatment, then I would advise you against having an implant.
There is no way that we can guarantee anything which goes into the mouth, and which is under the control of the patient. The physician does not tell you that the transplanted heart, the kidney transplant, or the coronary by-pass will keep you alive for any specified period of time. We can only tell you that we will endeavor to place the implant properly, will give you the information you need to help care for your implant at home, and will be available for regular periodic check-up appointments to evaluate your continued dental health. We will do everything we can to make the implant succeed, but you will have to make the same commitment. If you do not hold up your end of the bargain, the implant will most likely fail. Also, you must return to our office at regular intervals according to our recommendations for examination and service.
If you do not do this, you could get into difficulty without your knowing it, this could result in the loss of the implant. Under such circumstances, the fault would be yours. Due to the complex nature of oral implantology, it is important that all postoperative examinations and/or treatment be handled by this office. Referrals will be made only to those doctors with experience and training in implant dentistry.
Are dental implants inserted for cosmetics reasons? Absolutely not! The primary objective of dental implants is to give additional support to the replacement teeth. Dental implantology is not a total substitute for facelift plastic surgery. Some cosmetic enhancement is possible, however, and those expectations should be fully discussed prior to treatment.
If you have any questions which have not been fully answered by this monograph, please feel free call our office and set up a free consultation with Dr. Cirgin or a member of our Dental Team.