Oral 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.
| So, what are oral or dental implants actually? To find an exact and all encompassing
definition is difficult because of the different types of implants available.
However, one can define them as a
device which is either surgically placed into the jaw bone to replace one
or several lost roots of teeth; or as a device placed onto the bone,
replacing several, if not all roots of lost teeth. The exact definition will depend on the
type of implant being used. |
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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.
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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.
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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.
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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. |
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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).
This, of course, is only a short
overview of the general procedure. A more detailed description can be found in the page
How Implants are Placed and Restored.
