Dental Implants

Dental implants are changing the way people live. They are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything, knowing that teeth appear natural and that facial contours will be preserved. Patients with dental implants can smile with confidence.

What Are Dental Implants?

The implants themselves are tiny titanium posts that are surgically placed into the jawbone where teeth are missing. These metal anchors act as tooth root substitutes. The bone bonds with the titanium, creating a strong foundation for artificial teeth. Small posts that protrude through the gums are then attached to the implant. These posts provide stable anchors for artificial replacement teeth.

Implants also help preserve facial structure, preventing bone deterioration that occurs when teeth are missing.

The Surgical Procedure

For most patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. For the first three to six months following surgery, the implants are beneath the surface of the gums gradually bonding with the jawbone. You should be able to wear temporary dentures and eat a soft diet during this time. At the same time, your dentist is forming new replacement teeth.

After the implant has bonded to the jawbone, the second phase begins. Dr. Brousell will uncover the implants and attach small posts that protrude through the gums and will act as anchors for the artificial teeth. When the artificial teeth are placed, these posts will not be seen. The entire procedure usually takes six to eight months. Most patients experience minimal disruption in their daily life.

Surgical Advances

Using the most recent advances in dental implant technology, Dr. Brousell is able to place single stage implants. These implants do not require a second procedure to uncover them, but do require a minimum of six weeks of healing time before artificial teeth are placed. There are even situations where the implants can be placed at the same time as a tooth extraction – further minimizing the number of surgical procedures. Advances in dental implant technology have made it possible, in select cases, to extract teeth and place implants with crowns at one visit. This procedure, called “immediate loading”, actually performs the implant placement?

Implants are a team effort between an oral and maxillofacial surgeon and a restorative dentist. While Dr. Brousell performs the actual implant surgery, initial tooth extractions, and bone grafting if necessary, the restorative dentist (your dentist) fits and makes the permanent prosthesis. Your dentist will also make any temporary prosthesis needed during the implant process.

What Types Of Prosthesis Are Available?

A single prosthesis (crown) is used to replace one missing tooth – each prosthetic tooth attaches to its own implant. A partial prosthesis (fixed bridge) can replace two or more teeth and may require only two or three implants. A complete dental prosthesis (fixed bridge) replaces all the teeth in your upper or lower jaw. The number of implants varies depending upon which type of complete prosthesis (removable or fixed) is recommended. A removable prosthesis (over denture) attaches to a bar or ball in socket attachments, whereas a fixed prosthesis is permanent and removable only by the dentist.

Dr. Brousell performs in-office implant surgery in a hospital-style operating suite, thus optimizing the level of sterility. Inpatient hospital implant surgery is for patients who have special medical or anesthetic needs or for those who need extensive bone grafting from the jaw, hip or tibia.

Why Dental Implants?

Once you learn about dental implants, you finally realize there is a way to improve you life. When you lose several teeth – whether it’s a new situation or something you have lived with for years – chances are you have never become fully accustomed to losing such a vital part of yourself.

Dental implants can be your doorway to renewed self-confidence and peace of mind.

A Swedish scientist and orthopedic surgeon, Dr. Per-Ingvar Branemark, developed this concept for oral rehabilitation more than 35 years ago.  With his pioneering research, Dr. Branemark opened the door to a lifetime of renewed comfort and self-confidence for millions of individuals facing the frustration and embarrassment of tooth loss.

Why Select Dental Implants Over More Traditional Types Of Restorations?

There are several reasons: Why sacrifice the structure of surrounding good teeth to bridge a space? In addition, removing a denture or a “partial” at night may be inconvenient, not to mention that dentures that slip can be uncomfortable and rather embarrassing.

Are You A Candidate For Implants?

If you are considering implants, your mouth must be examined thoroughly and your medical and dental history reviewed. If you mouth is not ideal for implants, ways of improving outcome, such as bone grafting, may be recommended.

What Type Of Anesthesia Is Used?

The majority of dental implants and bone graft can be performed in the office under local anesthesia, with or without general anesthesia.

Do Implants Need Special Care?

Once the implants are in place, they will serve you well for many years if you take care of them and keep your mouth healthy. This means taking the time for good oral hygiene (brushing and flossing) and keeping regular appointments with your dental specialists.

Why Should I Replace My Missing Teeth?

When you lose a tooth, it is best for your oral health to have it replaced. Missing teeth can affect your "bite," as well as your ability to speak and chew. Loosing a tooth increases the burden on your remaining teeth, leading to premature wear and loss of additional teeth. Your teeth work best as a set, and removing teeth weakens the integrity of your set of teeth.

Most importantly, when a tooth is lost, the bone from which the tooth was removed starts to atrophy or melt away without an implant to serve as a functioning unit of the jaw bone. This is a natural process called resorption. Within the first year of an extraction, over 25% of the bone support of the extracted tooth is lost to resorption. This process, if allowed to take place, makes necessary more complex treatments of bone reconstruction if implants are desired later on.

What Are My Tooth Replacement Options?

If you are missing one or more teeth and choose to have them replaced, several treatment options are available:

1. A flipper is a removable plastic tooth that is inexpensive but fragile and temporary.
2. A cast partial denture also is removable but is precision cast in metal for longer service life. Wire clips help hold it in place.
3. A fixed bridge is cemented into place using crowns or "caps" on the teeth adjacent to the open space for support. Crown placement requires removing or reducing the outer layer of the tooth.
4. In some cases, a "Maryland" bridge is glued onto the back of the teeth adjacent to the space so that minimal tooth structure is removed.

Complete dentures or plates are the traditional solution for people who have lost all their teeth in one or both jaws. The success of a full denture depends upon the individuals jaw size and shape, his or her oral habits, and his or her adaptability. Some people adapt well to full dentures, while others are not able to adapt.

Dental implants can be used to provide support for the replacement of one tooth or all of an individuals teeth. After years of research and clinical trials, we can now provide this option in addition to the traditional treatments just described. Implant-supported teeth can be cemented, screw-retained, or removable and can be made attractive, stable, and comfortable for almost any patient.

What is a Dental Implant?

The best way to describe a dental implant is to compare it to a real tooth. A natural tooth consists of a root and a crown. The part of the tooth that you see and eat with is called the crown. Beneath the crown is the root, which anchors the crown and is in your jawbone. When you lose a tooth, you lose both the root and the crown. To replace a tooth, we first have to replace the root. Essentially, a dental implant is a new root. This titanium root is fitted into a socket that we create in your jaw, replacing the lost root of your natural tooth.

Dental implants come in various shapes and sizes and have different types of surfaces. The actual implant selection will depend on a variety of factors related to your specific treatment needs and the most appropriate one will be used. Once an implant has been placed in the jaw, the bone around the implant will need to heal for six weeks to six months, depending upon how hard the bone is. When this initial phase of healing is completed, a support post called an abutment will be placed into the implant itself and then a new crown or replacement tooth will be placed on top. If all of your teeth are missing, a variety of treatment options are available to support the replacement teeth.

How are Dental Implants Placed?

Usually, the office procedure to place a dental implant takes about an hour for one implant and no more than two or three hours for multiple implants. The placement process consists of the following steps:
Dr. Brousell will discuss anesthesia options at your consultation appointment. On the day of implant placement, you may be given sedation and local anesthesia to make you comfortable.

A small incision is made in the gum tissue, revealing the bone into which the implant is placed. In many cases, incisions are not necessary.

Using special instruments, a space (socket) is created for the implant.

The titanium implant is then inserted into the socket.

Finally, if necessary, sutures will be used.

After the implant is placed, the area will need to heal for six weeks to six months. The length of time is determined by a variety of factors.

Follow-up appointments are scheduled at your convenience to ensure that your mouth is healing well and to determine when you are ready for the restorative phase of your treatment.

What Happens After the Implants Have Healed?

After healing, your jawbone is firmly fused to the implants. The restorative phase of your treatment - when your missing teeth are actually replaced - is now ready to begin. Depending on a variety of factors, it may be possible to begin the restorative phase of your treatment earlier. In certain cases, teeth can be made immediately after implant placement. We will review the most appropriate treatment sequence and timing for your particular situation. When Dr. Brousell has determined that your implants are ready to be restored, the tooth replacement process is begun.

The dental work required to complete your treatment is complex. It is, however, considered more comfortable and more pleasant than conventional dental care. Frequently, most of the work can be done without using even local anesthesia.

Your restorative treatment begins with specialized impressions that allow us to produce a replica of your mouth and implants. We will also make "bite" records so that we see the relationship of your upper and lower jaws. With this information, we will make the abutments (support posts) that attach your replacement teeth to your implants. Various types of abutments exist. Frequently, we can use "off the shelf" abutments. Other times, custom abutments must be made of gold or a tooth-colored ceramic material. As you can imagine, these custom-made abutments add to the cost and treatment time involved. Which abutment to use is a decision that often cannot be made until after healing is complete and impressions have been made.

The number of appointments and the amount of time required for each appointment is different for each patient. No two cases are exactly the same and regardless of the number of teeth replaced, the work must be completed with great precision and attention to detail. If you are having only a few teeth replaced, as few as three short appointments may be required. Between appointments, we will need time to complete the necessary lab work to make your replacement teeth.

What Does It Cost - And Does Insurance Cover It?

Before treatment begins, every effort will be made to give you an accurate estimate of all the expenses involved in placing and restoring your dental implants. This includes the implant placement itself plus any additional procedures that are needed. In many cases, there is an initial charge for the diagnostic work-up, including study models, x-rays, and the fabrication of a surgical template to ensure the best possible result. You also will be charged for the support posts, plus the replacement teeth (crowns or dentures), temporary restorations, regular maintenance visits and repairs due to "wear and tear".

What If I Have Questions Before Surgery?

If this information, combined with information you receive at your consultation appointment doesn't answer all of your questions, please call Dr. Brousell's office to speak to one of the Patient Care Coordinators.