Dental Implants

" Missing teeth are like missing an organ or limb. Fortunately, we have a proven and predictable way to replace these missing teeth with dental implants. Everyone should be able to smile confidently and eat what they want without worrying about their missing teeth. "
- Dr AJ SALMAN
invisalign dental treatment

Implants - Replacing Teeth

What is a dental implant?

A dental implant is a titanium implant that is placed into the jawbone to support an artificial tooth, crown or an appliance for multiple teeth. Dental implants can be used to replace a single tooth, a bridge or dentures. Inquire at Northmed Dental centre if an implant will be suitable for you.

If one tooth is missing then just one implant is used to support a crown. If several teeth are missing then individual implants can be placed to replace each missing tooth or alternatively a small number of implants can be placed and a row of crowns (known as a bridge) can be fitted over the top.

implant and crown implant and crown
Single missing tooth replaced by a single dental implant
three implantsimplant bridge
  1. 1 Three missing teeth replaced by three dental implants
  2. 2 Three missing teeth replaced by two implants and a bridge
full set implants
Six dental implants used to support a full set of upper teeth

If all the teeth are missing from one or both of the jaws then implants can be used to support full sets of fixed teeth or to help stabilise or secure dentures. The most natural feeling results are achieved with teeth fixed permanently to implants. However, many denture wearers find their quality of life is much improved by having their dentures stabilised by dental implants. Whether to use the implants to support fixed teeth or to stabilise dentures depends on many factors such as the amount of available bone in the jaws, the number of implants which can be placed and whether there is any need for lip support to achieve the best possible appearance.

lower denture lower implant denture
  1. 1 Two dental implants used to stabilise and secure a full lower denture
  2. 2 Four dental implants used to stabilise and secure a full lower denture

Dental implants are not new and have been used to replace teeth since the mid 1960’s. Initially implants were only used in patients with no teeth (edentulous) to support a new set of fixed teeth or to secure and stabilise dentures. However, due to the success of these techniques; implants were soon being used to replace single teeth and larger gaps anywhere in the mouth.

How is implant treatment carried out?

Implant treatment is typically staged as follows:

Phase 1 - This involves a thorough assessment of the mouth as a whole and particularly the area of jaw where it is intended to place the implant(s).

This includes the taking of impressions for models of the jaws and x-ray films. Sometimes, more specialised CT scans might be required, to provide a very accurate image of the area where implants are to be placed.

Phase 2 - All implant-related treatment requires a strict sterile protocol be followed in the surgery by the surgeon and nursing staff. The gum tissue is temporarily lifted up to expose the bone at the site for the procedure and the implant is placed very carefully into the appropriate position. If it appears that there is insufficient bone to fully envelope the implant, a bone augmentation procedure will be required so as to cover the implant and build up the bone volume for the long-term.

The gum tissue is then carefully placed into position to cover the site.

Implant placement can be carried out under local anaesthesia alone or with additional intravenous sedation if required. This is inherently a more pleasant way of having potentially stressful surgical treatment carried out and is especially good if you are apprehensive as the sedative’s action actually removes anxiety, so making the treatment much more comfortable.

These options can be discussed with you during the consultation appointment.

implant restoration
Implant-Borne Restoration
  • Restoration on implant.
  • Adjacent tooth.
  • Implant within jawbone
  • Jawbone.

Phase 3 - Following placement, bone starts to fuse to the implant surface in a process known as “osseointegration”. This process can involve a period of 3-6 months, after which a special post (called an abutment) can be attached to the implant to help shape the adjacent gum tissue.

Usually, 1-2 weeks after this, impressions can be taken for the construction of a restoration such as a porcelain crown which will be fixed into position to replace the missing tooth.

How long will the operation take?

This depends on the number of implants being placed and whether the operation is being carried out with local anaesthesia alone or with additional intravenous sedation.

An appointment for surgery under local anaesthesia usually lasts 60 minutes. When intravenous sedation is used, an appointment usually lasts 90 minutes. The longer time allows for the recovery period needed before you can be discharged home.

Will there be any stitches?

Stitches are used in the operation to help complete the surgery. A fine size of thread is used to achieve a good cosmetic result. These stitches are dissolvable and so should disappear after about two weeks.

Will I be in any pain afterwards?

You should not feel any pain immediately after the operation, as the area of surgery will be numb from the local anaesthetics that have been used. As the numbness wears off, the area might become uncomfortable and then you should take painkillers. We will supply you with these, with information about doses.

When can I return to work?

This depends on your occupation and how you are after your treatment. It may be possible to return to work the next day. Some people need to take some time off work, especially if the operation has been carried out under intravenous sedation. We will give you appropriate advice for your particular circumstances.

Could there be any complications or after-effects?

After the procedure, there is likely to be some swelling and bruising in the area of the surgery and possibly some discomfort. The bruising is usually most obvious after two to three days and will vary in amount between patients. It normally resolves itself in 10 to 14 days.

If an augmentation procedure has also been carried out, the operation site will now be of a larger volume. The area is likely to feel quite enlarged even after the bruising has subsided and the overlying gum tissue may feel different to that of the adjacent areas.

These changes in sensation generally tend to become less noticeable over time and gradually resolve as the augmented area integrates with the surrounding bone. At the time of implant placement, there is a risk of accidental damage occurring to adjacent anatomical structures (eg:, teeth, nerves) although this should be avoidable with accurate planning.

The risk of failure of implants after the first year in function is low as long as general health is maintained and in particular that of the bone and gum around the implant. Regular maintenance appointments for the periodic examination of the implant and the surrounding tissues are an essential requirement towards the long-term success of the treatment.

Could there be any complications or after-effects?

After the procedure, there is likely to be some swelling and bruising in the area of the surgery and possibly some discomfort. The bruising is usually most obvious after two to three days and will vary in amount between patients. It normally resolves itself in 10 to 14 days.

What are the advantages of implant treatments?

The main advantages of dental implant treatment are that it provides a permanent restoration and the adjacent teeth are not involved in any way. Success rates for implant treatment can be in excess of 95% and so in most cases can be regarded as the ideal substitute and the first choice for the replacement of missing teeth.

The implant system used is that of the Swiss company Noble Biocare whose clinical effectiveness has been extensively studied and verified by multiple independent clinical trials over many years.

A success rate of 95%+ does conversely mean a failure rate of 1-5% and in most circumstances, if an implant should fail, it can be replaced although additional surgical procedures may be required.

What are the alternatives to implant treatment?

The alternatives to dental implant treatment to replace a missing tooth/teeth are removable dentures and fixed bridges. The removable denture option has the advantages of avoidance of surgery, a relatively short period of time for provision and potentially a lower cost. However, a denture is not a fixed restoration and so can be unstable and consequently difficult to tolerate.

Fixed bridgework can also usually be completed in a short period of time and avoid the need for surgery. However, the adjacent teeth would need to be prepared which might in turn compromise their health and once in place, it can be difficult to keep the bridgework adequately clean.

More questions?

Click here to view more frequently asked questions about dental implants and treatment.

After your operation

After your surgery, we will give you an information sheet with instructions to help bring about a quick recovery. We will discuss this with you before you are discharged home, to ensure that the information is clear and understood.

The main points are as follows.

On the day of the operation
  • Get plenty of rest in the first few hours after your operation.
  • Relieve discomfort by taking the supplied painkillers as directed and use ice packs to reduce discomfort at the operation site.
  • Do not rinse your mouth or drink hot fluids.
From the following day
  • Keep your mouth as clean as possible by gently brushing your teeth as usual.
  • Use salt water mouth rinses (one teaspoon of salt in a cup of warm water) every four hours for seven days. This will help to keep the operation site clean and clear of debris.
  • Continue to take the painkillers and any other supplied medications as directed and use ice packs for the next two to three days.
  • If bleeding is troublesome, you can usually control it by placing dampened gauze over the wound and applying pressure for 15 to 20 minutes (slight oozing can be expected for a short time following surgery).
  • Avoid smoking. The local action of nicotine in the mouth has been shown to have a detrimental effect on healing after surgery and greatly increases the likelihood of wound infection developing.

If you have any other complications or require advice after treatment, please call 09 215 8234 and leave a message including a contact telephone number. We will return your call as soon as we can.