Dental Implants explained by Dr. Gunaseelan Rajan

Dr. Gunaseelan Rajan explains what Dental implants are all about in this Q&A published by The Hindu newspaper:

 “A dental implant is an artificial substitute for a normal tooth. Natural teeth are lost due to damage in accidents, poor dental hygiene, genetic and other factors. Dental implants using the new Zygoma technique give the patient a new tooth or set of teeth through a treatment that is quick with long-lasting effects and almost pain-free.

What is a dental implant?
The normal tooth structure consists of a root and a crown. The root is enclosed in the jawbone and gums and the crown is the visible part of the tooth.

A dental implant is an artificial substitute for the root. It is usually made of titanium, which is a bio-compatible material i.e. it will not be rejected by our body.

After a healing period, an artificial crown is placed on top of the implant. Thus the implant closely resembles a natural tooth.

How many teeth can be replaced with implants?
If all the teeth are missing, the complete set of teeth in the jaw can be supported by four or six implants. The number of implants is determined on a patient to patient basis, depending on criteria such as bite force, location of missing teeth, quality of jawbone…

Are implant teeth fixed or removable?
Implants are placed in, fixed and integrated to the jaw bone. However the artificial teeth placed on top of the implant can be fixed or removable. The former is more common.

What are the benefits of dental implants?
They feel and look like your own teeth. Dental implants restore confidence in speaking, laughing and chewing with comfort and without worries of sudden dislodgement. Implants preserve the integrity of facial structures.

When teeth are replaced using traditional tooth-supported bridges, the teeth on either side of the missing tooth are ground down so that the bridge can be cemented on to them. This structure can never be replaced. Implants do not need the grinding down of the adjacent natural teeth.

Can anyone receive dental implants?
The patient must be in good health and have proper bone structure and healthy gums for a successful implant. People who are unable to wear removable dentures may also be good candidates. Patients with well-controlled diabetes or blood pressure can also undergo implants.

In patients with bruxism(grinding or clenching teeth) and poor oral hygiene, heavy smokers or those who have undergone radiation therapy in the jaw, the success rate for implants reduces.

Does the treatment take a long time?
Usually the treatment is done in two phases. In the first stage, the implant is placed in the jaw and the gums are closed over it.

After a healing period of three to six months, the implant will be checked and measurements made for the artificial teeth (prosthesis) ,which will be placed over the implant.

However, thanks to the combination of CT Imaging Technology and software for implant planning, implants are placed as a ‘key hole’ procedure and artificial teeth are fixed immediately on the implant within an hour.

This ‘teeth in an hour’ concept, however, has a few pre-requisites such as normal volume of jawbone, good range of mouth opening and adequate primary stability of the implant.

Does the patient need to be hospitalised?

Hospitalisation is an exception and not the rule. Majority of patients can be managed under local anaesthesia. Anxious patients are helped with nitrous oxide sedation or intravenous sedation techniques. A few patients, especially those requiring extensive bone grafting, will require general anaesthesia.

Can implants be done for elderly people?
Implants can be done in older people also. However certain issues such as osteoporosis (especially in post-menopausal women not on HRT), long history of heavy smoking, uncontrolled diabetes have to be kept in mind while planning implants.

Can implants be done for children?
Implants are generally contra-indicated in growing ages. Continued jaw growth can lead to altered implant levels and difficulty in fabricating the artificial teeth. However, in certain conditions such as ectodermal dysplasia, implants can be given during childhood.

What is Zygoma Implant?
In some patients, the upper jaw bone is not adequate to take implants. In such cases the hip bone is grafted into the upper jaw. Later implants are placed and artificial teeth fixed. In the new zygoma technique, bone grafting is not necessary.

The zygoma implant is a longer implant, which is placed in the upper jaw bone extending up to the zygoma (cheek bone) and artificial teeth are placed on it (without the need for extensive bone grafting procedure).”

Dr. Gunaseelan Rajan

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