Category: Conventional

Dental Implants Cost

The cost of dental implants depends on several factors like: the number of implants to be placed, implant system to be used, the fee of dentists performing the procedure and the location where the implant placement restoration is performed. These are only the major ones that have a big impact on the final cost.

Other factors are: how much bone is left in the patient’s upper or lower jaw, specialization of the dentist, difficulty of the case and fees charged by dental technologist/dental laboratory

Single implants may range in cost from $1,000 to $3,000 while the cost of full-mouth implant restoration can range from $6,000 to $100,000.

Dental implant treatment is usually not covered by dental insurance.

Advantages of Dental Implants

A dental implant replaces the root of your missing tooth. It is basically an artificial root placed by an oral surgeon or a periodontist. Dental implants will hold or support the denture or dental crowns cemented or screwed on top of them. With dental implants, you will still wear a denture. The difference is your prosthesis is more stable and secured.

Dental implant restoration is conservative if you compare it to traditional fixed bridge. Traditional bridgework requires reduction to adjacent teeth for them to hold the prosthesis. While in implant dentistry, the adjacent teeth will remain intact because the dental implant will hold the crown or denture in place.

Implants offer a long term solution to tooth loss. If maintained correctly, dental implants are stable and functionally durable.

Dental Implant Candidate

If you are allowed to undergo tooth extraction in the past, you are normally a good candidate for implants. If not, you should consult a dentist offline. Choose a dentist who has undergone an extensive training on Implant Dentistry.

In implant dentistry, periodontists tend to understand tissue better while prosthodontists can make the most ideal restoration. The concept in the practice of dental implant is prosthodontic driven and not bone driven.

Dental Implant Treatment Indications

Indications for dental implant treatment
1. Edentulous patient.
2. Partially edentulous patient with difficulty in wearing removable partial dentures.
3. Patient with missing dentition requiring long span dental bridge.
4. Patients refusing to use a removable denture.

Dental Implant Treatment Contraindications

Absolute contraindications to dental implant treatment
1. High dose irradiated patients.
2. Patient with psychiatric problems like psychoses, dysmorphophobia.
3. Hematologic systemic disorders.

Relative contraindications to dental implant treatment
1. pathology of hard or soft tissues,
2. patient with drug, alcohol or chewing tobacco abuse
3. Low dose irradiated patients.

Radiation therapy is defined as the therapeutic use of ionizing radiation. In irradiation of implants in bone, it is recommended the removal of all abutments and superstructures and closure of skin and mucosa over the implants prior to radiation. Medical conditions, like active diabetes, cancer or periodontal disease, require treatment before a dental implant procedure can be performed.

Factors to Consider in Dental Implant Treatment

1. How does the patient feel about surgery?
2. Is the patient prepared to pay the costs involved in implant theraphy?
3. Does the patient have sufficient bone to place dental implants? Bone grafting may be required and this could be a barrier to treatment.
4. If bone grafting is required, is the patient prepared to accept this?
5. Is the patient prepared to accept the burden of maintenance associated with implant retained prosthesis?

Success of Dental Implants

Based on recent studies, dental implants have 96% success rate. Bone quantity and quality influence success rates of the Implant Procedure. The upper anterior region has less bone quality and lower bone quantity when compared to the lower anterior region. A fully implant supported prosthesis in the maxilla has a lower success rate than in the mandible due to different bone densities.

Standards for Success of Implants

1. That an individual, unattached implant is immobile when tested clinically.
2. That a radiograph does not demonstrate any evidence of peri-implant radiolucency.
3. That vertical bone loss be less than 0.2 mm annually following the implant’s first year of service.
4. That an individual implant performance be characterized by an absence of persistent and/or irreversible signs and symptoms such as pain, infections, neuropathies, paresthesia or violation of mandibular canal.
5. That in context of the above, a success rate of 85% at the end of a 5 year observation period and 80% at the end of a ten-year period be a minimum criterion for success.

Dental Implant Risks

There are 2 main reasons why implants would fail: poor oral hygiene and wrong prosthodontic treatment (denture component). Sound prosthodontic principles are important to osseointegrated dental implants. Poorly restored occlusion in osseointegrated dental implants could result in deleterious effects to the prosthesis and supporting bone.

Good plaque control is important in preventing complications such as peri-implantitis around dental implants. Periimplantitis is a disease that is similar to the development of periodontitis.

Hygiene maintenance is tedious and requires considerable effort.

Mini Dental Implants

Mini Dental Implants are small diameter implants that are designed to stabilize the lower denture. MDIs should not be used as conventional dental implants. Read the mini dental implants post for more info.

References
Granstrom G, Tjellstrom A, ALbrektsson T: Postimplantation irradiation for head and neck cancer treatment. Int J Oral Maxillofacial Implants 1993;8(4):495-500.
Albretsson T, Zarb G, Worthington P, Eriksson A: The long term efficacy of currently used implants. A review and proposed criteria of success. Int J of Oral Maxillofac Imp, 1:11-25, 1986

Written by:
Jesus Lecitona+, DMD, MScD-Prosthodontics

Dental Implant placement is determined by available bone present in the alveolar ridge. The bone present also determines if there is proper soft tissue contour necessary for an optimum esthetic result. Oftentimes there is insufficient bone to provide a proper foundation for the dental implants resulting to insufficiency of soft tissue contour.

Bone Graft Procedure on buccal bone plate. Photo credit: Oris Neobiotech


Read More »

The establishment of optimum and predictable esthetics is one of the most important and challenging aspects of rehabilitation with dental implants. Rehabiliation of esthetics has to be predictable. There is no rejection with dental implants. Only the maintenance of height of crestal bone and esthetic outcome is yet to be universally successful. While there are multifactorial factors to this, the implant abutment connection has an influence to the esthetic zone. The atrophic ridge remains to be a challenge in the placement of implants in the esthetic zone.

Dental Implants in the Esthetic Zone, or anterior maxilla.

Read More »

Implant Therapy

Dental Implant Therapy constitutes the principal technique in dental rehabilitation. Nowadays, it is not imaginable to exclude dental implantology from the daily dental practice. According to a accredited data in international literature, one can attain success rates of more than 90% in 10 years. Scrupulous selection of patients and the formulation of a correct implant prosthodontic plan allows high predictability and implant success.

A good implant prosthetic treatment plan allows high dental implant success rate.


Read More »

Implant Supported Complete Denture is an optimum solution for Completely Edentulous patient. Implant Supported Denture virtually eliminates slipping and movement. Patients will be able to laugh and speak with confidence and eat food with ease.

Dental Implant supported complete denture have the following advantages:

  • It increases comfort and stability.
  • It restores a secure biting ability.
  • Maintains integrity of facial structure.
  • It eliminates need for adhesives.
  • It improves facial appearance.
  • It improves eating.
  • Improves speech and confidence in speaking.

Multiple Dental Implants

Implant Supported Bridge is an optimum solution for multiple missing teeth. Implant supported dental bridge stays secure and strong. It is comfortable, natural and look like natural dentition.

Dental Implant supported bridge have the following advantages:

  • It looks, feels and performs similar to natural teeth.
  • Sound adjacent teeth are not compromised to support a bridge.
  • Preserves sorrounding bone.
  • Dental bridge attached securely to dental implants.
  • It prevents resorption of bone.
  • Recurrent wear around abutment is eliminated.
  • Seld esteem of the patient is improved.

Dental Implants will maintain surrounding bone and soft tissue, as well as replace missing teeth.

These are functional and esthetic problems that can be solved by prosthetic gingival reconstruction in Dental Implants:
1. Narrow and longer prosthetic teeth.
2. Inverted smile line.
3. Misalignment of the tooth axes.
4. Unsupported lip profile.

Individual papilla loss and situations of horizontal and vertical tissue dificiencies of the anterior region are some of surgical limitations of augmentation that can be solved by prosthetic gingiva.

Wax-up of Implant Supported Prosthesis with Artificial Gingiva

Indications for Dental Implant Treatment

1. Edentulous patient.
2. Partially edentulous patient with history of difficulty in wearing removable partial dentures.
3. Patient with missing dentition requiring long span fixed partial denture (bridge) treatment.
4. Patient who refuses using removable type dental prosthesis.

Reference
Hobo S, Ichida E, Garcia L T: Osseointegration and Occlusal Rehabilitation, Quintessence Publishing Co., Ltd. 1989

Radiation therapy is defined as the therapeutic use of ionizing radiation. The 2 principal types of ionizing radiation are electromagnetic irradiation and particle irradiation. In irradiation of implants in bone, it is recommended the removal of all abutments and superstructures and closure of skin and mucosa over the implants prior to radiation. [1] Radiation therapy can begin when healing is complete.

Irradiation of dental implants in bone results in backscatter. The tissues on the radiation source side of the implants receive a higher dose than the other tissues in the field. The dose in increased by about 15% at 1 mm from the dental implant. [2]

References
1. Granstrom G, Tjellstrom A, ALbrektsson T: Postimplantation irradiation for head and neck cancer treatment. Int J Oral Maxillofacial Implants 1993;8(4):495-500.
2. Wall JA, Burkee EA: Gamma dose distribution at and near the the interface of different materials. IEEE Trans Nucl Sci 1970; 17:305.

Filling of Implant Cavities

Application of chlorhexidine gel for filling implant cavities prior to connecting implant components:

1. After removal of the existing implant component such as the insertion post, healing cap or abutment, rinse the implant cavity with 0.2% chlorhexidine solution for cleaning and disinfection, using a syringe with a plastic cannula.
2. Remove the remaining chlorhexidine solution with suction.
3. Fill the implant cavity completely with 1% chlorhexidine gel, again using a syringe with a plastic cannula.
4. Connect the previous or a new implant component to the implant using a torque device and the torque recommended by the implant manufacturer.
5. Remove any excess chlorhexidine gel that is extruded from the implant cavity during insertion of the implant components of suction.
6. Rinse chlorhexidine gel remnants with water spray.
7. Complete subsequent procedures.

Reference
Kern M: Antimicrobial Filling of Implant Cavities, The Journal of Prosthetic Dentistry May 2010