By Lee R. Cohen, D.D.S., M.S., M.S. –
The phrase “Dental Implants” can make some shudder just saying the words. If we were back in the infancy of implants, this feeling might be well deserved. Today, this option for tooth replacement is often performed with NO scalpel, sutures or significant post-treatment discomfort. In the simplest terms, a dental implant can be viewed as tooth root replacement.
The Tooth Being Replaced
To understand an implant, one must first have a simple understanding of the tooth being replaced. A tooth consists of 2 parts: Crown and Root. The Crown of a tooth is the portion we see in our mouths and is used to chew. The root is the supporting portion of the tooth that is below the gum tissue and is anchored in the bone. If a tooth is removed (extracted), both the crown and root are removed leaving an empty socket in the bone. It is important to remember that this remaining socket, which is made of bone, will resorb away if nothing is put into it such as a tooth replacement or bone graft material.
A Dental Implant
A Dental Implant is a tooth root replacement. This new root is placed in the empty socket where the old tooth root used to live. An implant is made of surgical grade titanium, the same material used in artificial joints.
This titanium is not seen as foreign by the body and therefore does not stimulate any type of allergic reaction. Over time, the bone “glues” itself to the implant. In most cases we let the new root (or implant) heal under the gum until this gluing occurs.
The time for this healing will vary based on the presenting quality of bone in the area. In some situations we have the opportunity to place a dental implant in a location where a tooth has been removed a long time ago and new bone has already formed and hardened. When an implant is placed in this type of site, only a few months may be required before the gluing (known as integration) has occurred. In other situations, such as simultaneous tooth removal and implant root placement, more time may be needed to allow bone to develop, harden and glue to the implant. It is important to remember that each case is different and treatment needs to be determined on an individual basis. Analysis of the area often includes use of an in office oral CT scanner which provides 3-dimensional information regarding the bone and location of important structures such as nerves and sinus cavities.
Once the implant has integrated with the bone, the dentist can then begin taking molds of the area and start making the new crown. At this point, the new implant is treated just like the root of your original tooth. If your original tooth had a cavity, the decay would be removed and a mold taken so a crown could be fabricated. Once the new crown is made, the dentist can then attach it to the implant in a similar fashion to how a crown could be attached to a tooth root. In cases where multiple teeth may be removed or are already missing, multiple implants can often be placed in the mouth and their crowns attached (bridges). In some instances, implants can be used to support dentures or other appliances in lieu of supporting crowns.
One of the most common questions we are asked regarding dental implants is the time frame until the final crown may be placed. In some situations we are able to remove a tooth, place an implant and glue a crown all in the same day. In other cases, a tooth must be removed and the area allowed to heal before the implant is even placed. Proper diagnosis of each situation is critical to the overall success and safety of dental implant procedures. Overall success with dental implants can be in the high 90th percentile, but this may vary based on medical conditions and habits such as smoking.
Dental implants truly are a wonderful option for patients looking to replace one tooth or all their teeth. Proper evaluation regarding a patient’s bone anatomy and medical history must be made to help each patient understand their unique situation and what possibilities exist regarding treatment.
Lee R. Cohen, D.D.S., M.S., M.S., is a Dual Board Certified Periodontal and Dental Implant Surgeon. He is a graduate of Emory University and New York University College of Dentistry.
Dr. Cohen completed his surgical training at the University of Florida / Shands Hospital in Gainesville, Florida. He served as Chief Resident and currently holds a staff appointment as a Clinical Associate Professor in the Department of Periodontics and Dental Implantology. Dr. Cohen lectures, teaches and performs clinical research on topics related to his surgical specialty.
The focus of his interests are conservative approaches to treating gum, bone and tooth loss. He utilizes advanced techniques including the use of the Periolase Dental Laser (LANAP procedure) to help save teeth and treat periodontal disease without the use of traditional surgical procedures. Additionally, he uses in-office, state of the art 3D CT imaging to develop the least invasive dental implant and bone regeneration treatment options. Dr. Cohen and his facility are state certified to perform both IV and Oral Sedation procedures.