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Tooth loss is a challenge for both the patient and the dentist. Patient has to deal with reduced chewing efficiency and altered appearance. The dentist, on the contrary, is faced with restoring the lost tooth to the maximum natural extent possible, functionally and structurally.
The fixed dentures came close with their ability to providing fixed teeth that were stable and aesthetically appealing. However, there was one big disadvantage, the adjacent teeth that were being used as abutment were reduced in size and therefore strength though they could be perfectly normal teeth.
In an effort to avoid this, the dental community started looking at options, the result of which was implant. Not just replacing the crown part of the tooth, even the root portion of the tooth is replaced here.
A biocompatible material, titanium, is put into the tooth to serve as the root. Titanium is strong, light, biocompatible (does not cause autoimmune reactions in the surrounding tissues) and most importantly osseointegrated (fuses to the surrounding bone). Once placed as the root, it gets absorbed into the bone after a period of about 2 to 6 months. Then, a crown or a denture is literally built on this root to simulate the natural appearance as close as possible. This provides not just the complete natural tooth structure but also provides support to the surrounding tissues like the gums and the cheeks.
Implant dentistry is a perfect example of teamwork including surgeons to operate and place the bone, prosthodontists to do the crown or the bridge, a periodontist to manage the gums health, and a lab technician who can do the finest job on the crowns or the bridges.
Types of implants:
- Three common types include: Single tooth replacement: In cases where a single tooth is lost, the implant would be one root that is allowed to fuse to the bone and then a crown is placed over it.
- Fixed multiple teeth replacements: If more than one tooth is lost, then bridges are fabricated by placing one or more implants and then custom-made crowns are placed over these implants.
- Removable implant supported complete denture: If all the lower teeth are missing, implants could be placed at pre-identified locations and then a complete denture fabricated over it. This is commonly done in lower jaws as stability is always a cause for concern.
The success of the implant requires good bone health. The most common contraindications would be patients with chronic diseases like poorly controlled diabetes, cancer in the line of jaws, chronic smoking, or poor periodontal health.
However, if managed well, even these patients can have implants after a detailed assessment by the dental team.