Implants Frequently Asked Questions

Dental Implants are artificial substitutes for natural tooth roots. When teeth are lost or missing, implants are used to anchor artificial teeth to the underlying jaw bone and hence closely mimic the natural dentition. They make it possible for people who cannot or will not wear conventional dentures to have very firm, stable and attractive teeth. Implants can replace one, more or all teeth. It is an alternative to conventional techniques such as the bridge technique to replace missing teeth.

• What are the benefits of Implants?
  • • They look and feel just like your own teeth
    • Dental implants restore your confidence to speak, laugh and chew with comfort and without worries of sudden dislodgement
    • Implants preserve the integrity of facial structures.
    • Implants prevent hard and soft tissue collapse that can occur under conventional bridges and removable partial dentures
    • Implant supported crowns and bridges do not require neighbouring teeth for support. When teeth are replaced using traditional tooth-supported bridges, teeth on either side of the missing tooth are trimmed down so that the bridge can be cemented onto them. This tooth structure can never be replaced. Removable partial dentures use clasps, which have to be carved onto adjacent teeth. As the partial denture rocks back and forth, it can loosen the teeth it depends on for anchorage, causing them to be lost
    • Implants replace the entire tooth along with its missing root and hence is a freestanding restoration. This leaves more of your natural teeth untouched and free of restorations, which saves your natural teeth

    Better health and nutrition

    You can eat what you want since implants are like your natural teeth. Patients with dentures often find themselves unable to eat certain foods, such as fruits and vegetables, which can, in turn, compromise their nutrition. With dental implants, it is much easier to bite into and chew your favourite foods.

    Ease of cleansing

    An implant-supported crown can be cleaned like your other natural teeth, i.e. brushing and flossing. Cleaning under a bridge, however, requires the use of floss threads for proper cleaning, while partial must be taken out several times a day and scrubbed clean.

• What is an Implant made up of?
  • Dental implant is made up of surgical grade TITANIUM. This part goes into the bone. It is a biocompatible material with a well-documented track record.
• Who can receive Dental Implants ?

  • You must be in good health with a proper bone structure and healthy gums for the implant to stay in place. People who are unable to wear dentures may also be good candidates.

    If you clench your teeth, or grind your teeth (bruxism), if your oral hygiene is poor, if you smoke heavily or if you have had radiation therapy to the jaw region the success rate for implants decreases dramatically.

    People with well-controlled diabetes, blood pressure or other general medical conditions can also have implants.

    What if I have already lost all of my teeth?

    If you are a denture wearer and have problems keeping your dentures in place or you cannot enjoy some of your favourite foods, implants can make a big difference for you. Depending on the individual situation, anywhere from 2 to 6 implants can be placed in each jaw to anchor your dentures in place. No more wobbling or clicking; no more messy pasties and glues. You will be free to enjoy your favourite foods with confidence and comfort.

• RAJAN DENTAL IMPLANT CENTRE - Matching contemporary international standards.

  • Ours is a Multi-System Implant Centre specialising in

    • Implant systems such as the internationally acclaimed Branemark, Nobel Biocare and Zimmer implants
    • Advanced procedures such as sinus lift and bone grafting
    • Sedation techniques including nitrous oxide and IV midazolam
    • Zygoma and facial implants
    • Several ‘firsts’ in India such as :

      • Zygoma implants technique (graft-less technique)
      • ‘Teeth-in-an-hour’ concept (where implants and artificial teeth are fixed in 1 hour)
      • Computer-based planning and Nobel - guide technique

    
    In - house dental lab facility – All the ceramic work for dental implants and superstructures is done in our in-house lab. Semi-precious, non-precious alloys and metal-free ceramics are used.

• The Procedure
  • Procedures and stages involved in implant treatment:

    Traditionally implant and tooth placement has been done in two stages. But with recent advances in materials and technology, a single-stage procedure is also possible now. This is termed as ‘Immediate Implant loading or teeth-in-an-hour’ concept.

    One stage procedure

    When sufficient quantity and good quality bone is available, as established using pre- operative scans and software based planning, implants and teeth can be fixed within one hour or within one week. ‘Key hole surgery’ can also be done to minimize tissue trauma.

    However all patients cannot avail the benefit of this technique. Patients wanting ‘teeth-in-an-hour’ need the following pre-requisites:

    Good oral hygiene, satisfactory medical health, adequate bone volume and quality (no osteoporosis), good range of mouth opening, and no tobacco abuse.

    
    In some patients where one stage procedure cannot be done, the conventional 2-stage procedure is followed.

    Two stage procedure

    In this technique, in the first stage, the titanium implant is placed in the jawbone and the gums are sutured around it. After a healing period of 3 to 6 months, the teeth are placed on the implants.

    First stage: The implant is placed in your jaw and the gums are closed over it.

    Second stage: After a healing period of 3 to 6 months the implant will be checked and measurements will be taken for the artificial teeth.

    Your definitive prosthesis will be placed over the implant. In some situations a single stage procedure can also be done. In certain situations implant placement soon after extraction of teeth is also possible. When the implant has bonded to the jawbone, a small connector post called an abutment is attached to the post to securely hold the new tooth. To make your new tooth or teeth, your dentist makes impressions of your teeth, and creates a model of your bite. Your new tooth or teeth are based on this model. It will match the colour of your natural teeth. A replacement tooth, called a crown is then attached to the abutment.

    In patients with good volume of bone and morphology of soft tissue it is possible to do implant placement and artificial teeth placement as a single stage procedure. With computer aided planning it is possible to fix implants and artificial teeth within an hour. These procedures do have some prerequisites that will be discussed with the patient by the implantologist.

• Do I have to get hospitalised for the procedure?
  • Hospitalisation is the exception and not the rule. 95% of patients can be managed under local anaesthesia in the dental clinic itself. Anxious patients are helped with nitrous oxide sedation or intravenous sedation techniques. Few patients, especially those requiring extensive bone grafting, will require general anaesthesia. If you can tolerate a tooth extraction, you can cope with implantation.

    Will I have pain and discomfort?

    Pain and discomfort will be within tolerable limits. You will be given adequate medication after the procedure.

• Duration of the procedure
  • This varies according to the individual and the jaw (upper and lower) in which the implant has been placed. Under normal circumstances it requires a 2-stage procedure with a period of 3 to 6 months in between to complete the entire process.
• How do I care for Implants?
  • Your overall health may affect the success rate of dental implants. Poor oral hygiene is a big reason why some implants fail. It is important to floss and brush around the implants at least twice a day, without metal objects. Your dentist will give you specific instructions on how to care for your new implants. Additional cleanings of up to four times per year may be necessary to ensure that you retain healthy gums.
• Team of Doctors
  • Prof. Dr.R.Gunaseelan, MBBS, BDS, FDSRCS (England)

    • Oral & Maxillofacial Surgeon & Implantologist Has the distinction of holding degrees in Medicine and Dentistry.
    • Fellow in Dental Surgery, Royal College of Surgeons (England)
    • Underwent Post-Graduate Training in John Radcliffe Hospital, Oxford
    • Is a pioneer in Dental Implantology in South India with more than 15 years experience in the field
    • Has published several scientific articles including those on Implant Dentistry in International, Indexed Dental specialty journals
    • Has had advanced Implant training in the Branemark system in Sweden, University of Frankfurt, Walden burg, Malo clinic (Lisbon) and is one of the few invited speakers from India to the Nobel Biocare World Conference in Las Vegas in May 2007
    • Has several ‘firsts’ in Implantology in India, to his credit, on very advanced techniques such as Zygoma implants, Computer based Nobel guide implant surgery and ‘teeth in one hour’ procedure

    
    Other Team members are -

    Dr.B.Praveen, MDS
    Maxillofacial Surgeon & Implantologist

    Dr.Manoj Rajan, MDS, DNB
    Prosthodontist & Implantologist

    Dr.M.R.Baig, MDS, MRD, RCS(UK)
    Prosthodontist & Implantologist

    Dr.Harinath, MDS
    Periodontist

    Dental Technician
    Dental Hygienist

• ‘Nobel-guide’ computer simulated implant placement
  • Key benefits

    • Accurate placement
    • Safe placement
    • Key hole technique

    
    All this is possible with high resolution CT scans converted into 3D images by special software.

    This is used for virtual planning of implant placements, and is then sent to a laboratory in Sweden, which fabricates the surgical guide (Nobel-guide), which reaches the clinician with in the next 6 working days anywhere in the world. This Nobel-guide is used to place implants through a keyhole technique rather than the open technique practiced earlier.

    This guided implant placement was introduced only in the USA in 2005. Rajan Dental Implant Centre introduced it in India on 8th April 2006 and we have been using it ever since.

• ‘Teeth-in-an-hour’ technique

  • Usually, implants are placed in the jawbone and after a healing period of 3 to 6 months artificial teeth are fixed to these implants. Over the last few years, however, this waiting period between implant placement and tooth fixing has been progressively reduced to six weeks, one week and now stands reduced to one hour, thanks to advances in computer based technology that enables better diagnosis and virtual treatment planning. This results in precise implant placement and stability, which allows the immediate fixing of artificial teeth.

    Implant Treatment(Teeth in -an-hour)

    

    ‘Teeth-in-an-hour’ has the following Key Benefits:

    • Keyhole surgery (less tissue trauma)
    • No stitch technique
    • Less pain & swelling
    • Less numbers of visits to the dentist
    • Early restoration of artificial teeth

    
    ‘Teeth-in-an-hour’ is possible due to revolutionary advances in the implant structure and use of CT Scan technology. Scans of the patients jaw are used to perform virtual implant placement. This data is transferred to a sophisticated lab in Sweden or US from where a surgical template is prepared and sent to the different clinics. This template is then used for keyhole surgery to place implants (without stitches), thereby reducing patients’ discomfort.

    However all patients cannot avail the benefit of this technique. Patients wanting ‘teeth-in-an-hour’ need the following pre-requisites:

    Good oral hygiene, satisfactory medical health, adequate bone volume and quality (no osteoporosis), good range of mouth opening, and no tobacco abuse.

    
    This technique of ‘teeth-in-an-hour’ using the ‘Nobel-guide’ and ‘key hole surger’ was performed for the first time in India at Rajan Dental Institute, Chennai in April 2006. There are very few dentists in the country who have had international training in this technique and Dr. R. Gunaseelan is one of them. He had this computer-based implant training in Europe. This advance in dental implant treatment places India on par with international standards of dental rehabilitation.

• Branemark zygoma implant

  • People start wearing dentures (artificial teeth) when they lose their natural teeth. These dentures are called ‘removable dentures’ since they are placed and removed by the patient.

    These dentures can also be `fixed` to the upper jawbone using titanium implants, thereby resembling the natural jaw-teeth relationship. Such `implant dentures` increase the comfort and confidence of the patient.

    However, many a time sufficient bone is not present in the jawbone to anchor the implants. We then need to do ‘bone graft’ surgery i.e. take some bone from the hip region, graft it to the jawbone, wait for few months for it to heal and then do implant denture treatment.

    A new technology was developed in Europe where upper dental implants could be done without the hipbone graft. This ‘graftless technique’, also called the ‘Zygoma technique’ (developed by Prof. Branemark & Nobel Biocare, Sweden) uses the cheekbone (Zygoma bone) for anchoring the implants. This has the following advantages:

    • Reduced treatment time
    • No need for hipbone graft (graftless technique)
    • Less discomfort for patient

    This ‘ZYGOMA IMPLANT MAXILLARY DENTURE’ – a type of ‘graftless implant denture’ technique, was performed for the first time in India in Chennai at the Rajan Dental Institute by Dr. R. Gunaseelan and his team on 30th March, 2007