Oral Dental Implants in General

Oral Dental Implants in General

Oral or Dental Implants have opened the door to the 21st century in dentistry and oral rehabilitation. They have increased the treatment possibilities for patients and improved the functional results of their treatment. Patients who had to compromise their esthetic appearance, chewing functionality and nutritional intake due to complete or partial tooth loss can now be restored back to various degrees of normal esthetics and function. Since the commercial distribution of Dental Implants, the field of Oral Implantology has undergone a rapid and progressive development. Many professionals have branched off and specialized in this particular field. Their continuing research efforts reward this field with new concepts and developments almost on a daily basis. Research efforts from many different disciplines such as material science, physics, medicine, biochemistry and others form the foundation for continued improvements in the field of Oral Implantology as well as the hardware being used. What was several years ago considered to be alternative or experimental treatment in dentistry is often considered Standard of Care now.

Rapid advances in Oral Implantology have also made a tremendous impact in the financial world. In the last five years over 100 different implant companies have formed globally to either capture a share of the market or fill the supply for the growing demand. In the United States alone, there has been a steady growth of about twenty- percent yearly over the past four years, and this trend continues to climb.

Certain terminology associated with Oral Implants needs to be clarified, in order to avoid confusion.

In our context, the IMPLANT is referred to the surgically placed part which goes either into—or sits on top of the jawbone. We will also refer to it as the FIXTURE. The actual tooth or teeth that go on top of the Implant(s) are referred to as the PROSTHESIS.

To the left you can see the different components in a typical implant restoration. The top portion labeled Implant/Fixture is the actual part that is inserted into the bone. The bottom portion labeled Prosthesis depicts an example of different components that make up the tooth. The very left shows the crown (tooth), and an attachment (abutment) with a screw. All these pieces will come together and attach to the implant as shown in the right section of the picture.

This web site will include examples of many different types of implants, however, nowadays, the most common implant used in the dental community is the Rootform Implant.

To the left you can see a typical modern Rootform Implant and to the right of the implant is a picture of a natural tooth. One can see how the implant is designed to replace the root of a tooth by the somewhat apparent similarity.

The reason they are called Rootform Implants is because they closely resemble the shape of the original root of the lost tooth. These, in various derivations, represent the most commonly used implants today. One of the reasons of their popularity is their constantly improving simplicity in use.

The sequence of events with respect to implant reconstruction with Rootform Implants can be roughly divided into two phases:

• Surgical Phase
• Prosthetic Phase

The Surgical Phase includes everything that is concerned with getting the implant into or onto the bone and getting it ready for the prosthetic phase.

The Prosthetic Phase includes everything that is necessary to put a tooth or teeth on top of the implant(s). More detailed descriptions of each of these phases will be given in subsequent pages!

Once the implant is placed into the bone it will need to remain there for a few months unused, in order to allow the bone to grow around it and secure it tightly; this process is known as Osseointegration. (Although, some research is now supporting evidence that under certain circumstances implants can be used prosthetically right after placement) Osseointegration is a fairly natural and usually successful process. Sometimes, however, the implant does not integrate (fuse to the bone) for reasons we will still discuss.

The above picture is a histologic section of an integrated implant in bone under low magnification.   One can see the implant (black) and the bone (red) tightly approximating each other. There is virtually no detectable gap between the black outline of the implant and the contacting (red) bone. This implant can be considered integrated and could be used as a solid anchor for a tooth.		This picture is also a histologic section of an implant in bone, however, one can see that the bone (red) does not contact the implant surface (black) in most areas. This implant would be considered not integrated and could not be used successfully as a solid anchor for teeth.

Once the implant has successfully integrated, it is ready for the Prosthetic Phase. This usually includes an impression of the implant(s) and the fabrication of a Prosthesis (tooth or teeth), which is then attached in some fashion to the implant(s).