Dental Implants

Dr Alok Mehta, MDS, Specialist Dentist (Implantology & Periodontology)

Got a tooth extracted and thinking of replacing the same???
Dental Implants is the best way to replace a missing tooth.

It’s obvious the following questions arise ….
Why Replace missing teeth??
Why & What are Dental Implants??
There are various reasons why a tooth is removed. It can be because of Deep dental caries, Fracture/crack in your tooth, Periodontal diseases (gum diseases), inadequate space for tooth to fit in an arch. Basically, a tooth is extracted when it’s non restorable.
But after a tooth is removed the site as well as overall body undergoes various changes which many a times are neglected.

These changes include:

  1. Bad aesthetics on smiling or talking: In case a tooth from your front region of mouth is missing we feel conscious embarrassed of our looks which makes us reserved in public thus affecting our self confidence.
  2. Change in facial shape: Due to missing teeth the support for the cheek or the lips depending on region is lost which causes the cheek or the lip to sink in. And in case multiple missing lower back teeth the bite collapses giving an appearance of an aged person. Thus affecting overall appearance
  3. Diet & Speech: Missing teeth can have great impact on your general health and that is mainly due to difficulty in chewing, which ultimately leads to digestive problems and eventually causing nutritional deficiencies.
    Missing teeth cause change in pronunciation of certain words or letters due to missing teeth which can be very embarrassing.
  4. Causing localized bone and tissue loss: Absence of tooth causes disuse of bone in that area as it does not have any structure to support. Due this disuse of bone the bone in that area starts resorbing away thus leading to decrease in the thickness as well as vertical dimension of bone height of jaw. This can affect the adjacent teeth causing the bone and tissue to shrink over adjacent teeth leading to other dental problems like sensitivity, caries, poor aesthetics etc.

Hence in order to avoid the above mentioned changes it is important to replace our missing teeth…
But why Implants????
There are many ways to replace missing teeth:

  1. Complete or Partial Dentures:
    Most of us must be familiar with Denture’s. We must have seen many elders using them. Dentures is one of the old way of replacing missing teeth. But dentures have many disadvantages over advantages.

    1. Dentures though are cost effective & least time consuming process, over the long run they become loose fitting due to bone/ridge resorption or changes in jaw bone dimension, because of which they frequently have to be modified or replaced thus increasing the overall cost and causing bone changes and discomfort to user.
    2. Dentures are not fixed. Dentures are a removable option of replacing missing teeth. Thus making them least preferred because of its loose fit, inability to apply complete bite force and altered speech.
  2. Fixed Crowns & Bridges:
    These are much preferred option over dentures due to its fixed immobile nature.
    They tend to give complete satisfaction to the user from aesthetic and functional point.
    But, crowns and bridges or fixed dentures have few important requirements which need to be met for their proper functioning and longevity.

    1. Fixed crowns and bridges are used to restore missing teeth using support of teeth on either sides of edentulous space.
    2. It is difficult to make a good bridge if there are no teeth present behind the missing teeth area or
      If the supporting teeth themselves are weak.
    3. The healthy supporting teeth(abutment) need to shaved/ trimmed down to accommodate the crown material, thus compromising the health of sound good teeth.
    4. The abutment teeth in future have very high chances of being affected by dental caries or sensitivity or need to undergo root canal treatment. Sometimes even fracture under excessive stress.
    5. Under surface of bridges is inaccessible by our cleaning aids and thus difficult to maintain.
    6. Bridges do not stop the bone loss and recession in the edentulous area (missing teeth Area) due to disuse which can lead to very bad appearance of space between gums and bridge over time, especially if it’s in the front teeth and is seen during smile.
  3. Dental Implants
    Dental implants have been around since ancient times. There have been evidences where humans have tried using different materials to replace missing teeth by inserting them in the tooth socket.

    With progress in science humans were able to develop a material which is inert and is bio compatible with the body and can wit stand the bite force thus helping in restore the complete function of tooth.

    Dental implants are made of Grade 5 Titanium or Titanium alloy which is medically approved. It is light in weight but has good resistance to breakage.
    With evolution of Dental implants, it has helped solving many problems or short comings arising due to use of dentures & crown and bridges.
    Comparing Dentures & Dental Implants:

Dentures Dental Implants
1. Removable prosthesis 1. Fixed prosthesis
2. Less Patient satisfaction due to fear denture falling off during various oral activities 2. Greater patient satisfaction due firm fit
3. Reduced self confidence 3. Improved self confidence
4. Due to removable in nature, do not provide adequate satisfaction while chewing 4. Adequate satisfaction in chewing
5. Reduced biting force 5. Helps provide adequate biting force
6. May alter speech 6. No change in speech
7. Requires increased daily maintenance 7. No separate maintenance
8. Need for replacement or adjust the base frequently to bone resorption. 8. No need to replace or adjust.

So, as you see in the above table the Dental implants clearly have an upper hand over dentures. Dental Implants require more treatment time compared to Dentures and are also costlier compared to dentures but if average cost calculated over 10-15 years Dental Implants are cheaper or equivalent to dentures as they require least replacement or maintenance.

Similarly, we will also try and compare the Dental Bridges and Dental Implants:

Dental Bridges Dental Implants
1. They are faster to fabricate and deliver 1. It requires comparatively more time
2. Bridge teeth (Abutments) need to be shaved down to accommodate the new material over it 2. No need to damage or alter adjacent teeth. Thus protecting the natural structure of teeth.
3. Bridge teeth often develop sensitivity and pain over time hence eventually need to be root canalled 3. No damage to adjacent teeth so no need for any treatment to adjacent teeth.
4. Average bridge life is 10-12 years. 4. Implant success rate is 95-98%
5. Bridges do not help in preserving the bone or the soft tissue in the missing teeth area causing recession which can be aesthetically not good. 5. Implants do not cause any bone loss, thus helping preserve bone & tissue shape.
6. Abutments (Bridge Teeth) can still develop cavities or can develop cracks/fracture in tooth. 6. Implants do not get cavities and have very less possibilities of developing cracks/ fracture.
7. Needs support teeth in front and behind the edentulous space (missing teeth area). 7. No requirement of support teeth. It can stand individually.
8. Less costly 8. Costly, but average cost over the long run is equivalent or less.

The above comparison clearly shows the advantages of Dental Implant over dental bridge in the long run, preserving the natural tooth & bone.
With development of Dental Science, Dental Implantology is also evolving in thus helping in providing a precise and accurate implant for ideal functioning and health of the oral cavity.
Dental Implants help restore missing tooth without altering or damaging the natural dentition.