Bones grow. Muscle grows. Hair grows. Nail grows. Unfortunately, teeth, once they fall out, do not grow back in place. You can live with the gap, which is not advisable, as any dentist will tell you, or opt for a bridge-crown or the newer and better implant. Now is the time to state that taking good care of teeth helps delay or avoid the issue of decayed teeth leading to extraction followed by the expense of an implant. Yes, implants are expensive so prevention is better. In any case, it is good to know about implants and how your dentist will choose one that suits you best.
Implants the best alternative to crown-bridge
Long before implants arrived on the dentistry scene in the 1960s the most common solution was to use a crown-bridge combination. A false tooth is made to fill the gap created by the fallen tooth and that tooth is held in place with the help of a bridge that rests on other adjacent teeth. This combination works when you have lost one tooth or more. Dentures replace an entire set of upper or lower teeth. Bridges, crowns and dentures are inconvenient, to say the least. The implant is a far superior alternative. There are different kinds of dental implants as regards materials and types that you may like to know about.
The dental implant
A typical dental implant has three parts. One is the titanium screw that your dentist embeds in the bond. Then, an abutment goes over the screw once it has fused to the bone. Thereafter, the dentist places a made to measure porcelain crown that looks just like a tooth over the abutment to complete the implant.
Titanium was and still is the most commonly used material because it integrates well with bone and tissue and it is biocompatible. The implant screw and abutment are made of titanium whereas the crown is made of porcelain tinted to match shade of existing teeth.
In recent times another material has arrived on the scene and holds lots of promise. Zirconia is fast proving to be a worthy alternative. Whereas the titanium implant is a three-piece assembly the zirconia implant is a single-piece unit with the crown fixed to the screw and abutment.
Type of implants
There are different kinds of dental implants to suit local conditions.
- Not so common is the cylinder dental implant, which, unlike the screw type, has a smooth cylindrical shape to the part that goes into the bone.
- The screw type implant is the most commonly used. Even within this there are two types. One is the straight screw dental implant in which the diameter remains the same from top to bottom. The other type is the conical screw dental implant with a tapered end.
- The part that goes into the bone has corrugations and it looks like a screw. The purpose for this is to let bone cells stick to the surface and hold the implant in place. The upper part is smooth so that gum tissue can grow around it and work as a seal.
Then there are special-purpose implants:
Mini or thin implants used in narrow spaces such as lateral incisors.
Special-purpose mobile denture stabilization implants aimed at helping the elderly to help keep dentures in place and masticate properly.
- The screw-type implant may not always be the best type of dental implants. There are other different kinds of implants too that are not so widely used or which have been discontinued:
- The sub-periosteal implant has a flat blade-like structure that goes into the bone and it is capable of holding two to three abutments over which crowns may be placed. This type is ideal when a gap left by the extraction of two or more teeth need to be filled.
- In situations where the bone structure is not strong enough or when it does not have sufficient depth to support the screw then dentists will make use of a bar. This is actually a framework made up of titanium wires to fit over the jawbone. This type is usually used when you need to replace an entire set of teeth. It is better than dentures since the teeth stay in place permanently.
- The transosseous implant finds more use in the front of the mouth in cases where there is bone atrophy. Clamps fit a curved titanium wireframe to the bone. Dentures go over the curved titanium wireframe structure.
- Sometimes, depending on the condition and need, your dentist may make use of a zygomatic implant. These are extra long with the tips anchored to the cheekbones. This type of implant involves a complex surgical procedure.
You will find that only two main types of implants are in general use. One is the endosteal type made up of a screw, abutment and crown. The second is a subperiosteal type of implant in which the implant is placed on or above the jawbone. This type of procedure is for those whose bone structure cannot support the endosteal implant.
Implants and supported procedures
The normal endosteal implant suits most people with sufficient amount of healthy bone mass that allows the screw to be placed at a sufficient depth. Where bone is inadequate your dentist may recommend bone augmentation before the implant procedure. The sinus lift is another procedure used for upper tooth implant. The area below the sinus receives additional bone material. If the jaw is not wide enough for the implant then a ridge expansion procedure may be carried out before the implant procedure.
Which type of implant for you?
It is not up to you to take the decision of choosing an endosteal or subperiosteal implant. Your dentist is likely to X-ray the area to know which type of implant will suit you best. If bone augmentation, ridge expansion or sinus lift is deemed necessary it means extra costs for you. In such cases, you may make do with a crown-bridge combination. Trust your dentist to make the right choice of dental implant for you.