Dental Implants

There are usually three reasons why we place implants. These are:

1. To replace a tooth (or teeth) that has come out.
2. To replace a tooth (or teeth) that are so decayed that you try to hide it or you avoid chewing with it. In these instances, implants will only be considered if we cannot restore the look and function of the natural tooth by less costly means.
3. To replace a set of missing, or significantly damaged adjacent teeth. In this instance, we often use two or more implants to support a bridge (several artificial teeth attached together).

If you have multiple teeth that you would like to replace then we can perform more than one implant placement at a time.

A dental implant looks and functions exactly like an actual tooth because it is designed in the same way as your natural tooth is.

This means that your newly created tooth is attached to your jaw via a titanium root that implanted into the jawbone itself.

Over a couple of months, your bone grows around the implanted root, holding it in place in a very similar way that your natural teeth are secured in the mouth.

This process only happens correctly if you use sterile titanium to create the implanted root.

Sterile titanium is biocompatible, meaning that bone treats it as native tissue and grows around it, cementing your implant in place.

This process is called “osseointegration”. The phenomenon is backed by decades of clinical evidence.

Once the root is perfectly secured in the jaw we attach an artificial tooth to the root via a finely ridged titanium abutment screw.

Do not worry about having a gap in your smile for the 2-3 months that follow your implant being placed.

We can create and fit a natural looking temporary tooth for you during this time.

Your final fixed tooth is custom made to match the shape and shade of your adjacent teeth.

This ensures that your new tooth is so natural looking that no one can tell that it is a dental implant.

If you would like to have whiter teeth generally, then it is best to have your teeth whitened or veneered before your final tooth is created.

This way we can ensure that your new tooth matches the shade of your newly whitened teeth.

It would be dishonest to say that getting dental implants is a quick, easy process.

In simple cases, dental implant treatment lasts 3-4 months from start to finish.

In more complex cases this can be 6-12 months.

You will make several trips to the dentist, and you will have at least one surgical procedure, most likely under local anaesthetic.

A step-by-step process to getting dental implants with us happens as follows:

Appointment 1: You see our implant surgeon and find out whether you actually need dental implants, and whether you would be a good candidate to have them.

This will likely involve taking an x-ray of your jaw in order to find out whether your bone is in good enough condition to grow around the implanted root.

Alternative options will be discussed, and you will also have a wider oral health examination to diagnose any wider issues that may compromise your implants.

If we find that implants are right for you then together we can decide how we want the final implant to look.

Appointment 2: If your to-be-replaced tooth needs to be removed then one of our oral surgeons will do this.

If no extraction is needed then this appointment is not necessary.

A temporary tooth will be made to replace your extracted tooth.

Appointment 3: You will go to CT Dent (in Devonshire Road, London) to have a 3D (CBCT) X-ray taken.

This determines, with exact accuracy, the shape and size of the implant needed, and how it will be implanted.

From this precise data, your implant is created.

Appointment 4: The implant is placed into your jaw.

This procedure is done under local anaesthetic and usually takes an hour and a half.

There may be some swelling and pain in the first week that follows this surgery, and we will provide antibiotics to minimize the chances of infection.

A temporary tooth is bonded to the adjacent teeth that surround your implant.

Appointment 5: We place a healing abutment into the implant to shape the gum to best receive final crown.

This will also be completed under local anaesthetic and although not as invasive as the implant placement, we can provide painkillers and antibiotics to reduce discomfort afterwards.

Appointment 6: An impression is taken of the implant position and the surrounding gum.

This impression determines the shape and size of the final tooth crown (the visible portion of your tooth).

Appointment 7: Your custom made crown is fitted and adjusted for comfort.

Appointment 8 onwards: All future dental appointments with us will involve checking up on your implant.

It is only with this kind of dental implant aftercare that your implant will last as long as possible.

Dental Implants Case Study – combined implant and orthodontic braces.

• HOPELESS TOOTH
• IMPLANT SLEEPING
• TEMPORARY TOOTH
• AFTER IMPLANT CROWN, courtesy of and work done by Dr Goncalo Sanches

As implants are secured in the bone under your gums, that bone needs to be of sufficient volume and condition in order to take the implant.

Certain factors can affect the quantity and quality of bone in your jaw.

These include:

1. Gum disease in the affected area.
2. Having had missing a missing tooth or teeth for more than 3 months.
3. Having ill-fitting dentures (if they cause you pain, they likely are damaging your bone.)
4. As age increases, your bone density naturally goes down, this is particularly true for post-menopausal women.

If our x-rays reveal that you do not have enough bone in your jaw to reliably support implants we can grow bone in 2 ways:

1. Moving bone from one part one part of your mouth (usually the chin as bone here can grow back quickly) to the area that requires extra bone.
2. Placing a material that stimulates bone regeneration (usually either Geistlich Bio-Oss® or EthOss®) into the affected area.

We refer to both of these procedures as bone grafts.

If extra bone is required underneath the sinus, then we may need to lift your sinus in order to accommodate the extra bone. This is an additional procedure to the bone graft.

Dental implant treatment has a 98.2% success rate.

This success rate is equal across all age groups including the elderly.

That being said, there are some ways that dental implants can fail.

By far the most common cause of dental implant failure is that the bone around your implant deteriorates due to gum disease.

We reduce the likelihood of this happening in two ways:

1. We do not recommend implants if you have if you have severe gum disease that we cannot definitively bring under control.
2. We will pay close attention to the health of your gums that surround the dental implant. We will also educate you on how to effectively promote good gum health yourself.

There are other reasons why implants can fail, such as a fracture of the abutment screw or an implant screw loosening.

However, these complications are easily repaired by replacing the damaged components.

In very rare cases, an implant can fail to integrate with your bone. In these instances the procedure has to be redone

You may also experience some mild to moderate pain and swelling in the days that follow your implant surgery.

This pain should only affect the area immediately around the implant.

Usually, over the counter painkillers are enough to manage this pain, and we will also prescribe antibiotics to reduce swelling and lower the chances of infection.

If you require stronger, prescription painkillers than we can arrange that for you too.

Proper implant aftercare is essential for dental implants to last as long as possible.

It is vital that you keep the gum that surrounds the implant clean and healthy in order to prevent infection to the bone that surrounds your implant

If left untreated, this infection may cause loosening of the implant from the bone supporting it.

If you have an implant with us, we will dedicate some time in all future check-ups and hygiene appointments to monitoring and cleaning the gum that surrounds your implant.

We will also monitor the condition of the implant itself and the bone that surrounds it through regular x-rays.

Should we find infection in the gum that surrounds your implant, we can manage it accordingly through:

1. Working out easier ways to clean your gums—perhaps through switching from flossing to interdental brushes.
2. A deep cleaning of your gums with our periodontist

Any other dental problems that we discover in future check-ups will be considered in the light of how they may shorten the lifespan of your implanted tooth, and appropriate measures will be taken to minimize this impact.

In short, we appreciate the additional measures required to care for implanted teeth and will address them in every dental visit you have with us.

If you believe you may benefit from having implants please call our beloved receptionist Jenny on 020 8748 1381.