Dental Implants: History, Technique, and Options

When teeth are missing, it changes your life. Your self-esteem, your eating habits, and your facial construction are all in jeopardy.  There are several kinds of replacement options, but the best one by far is the newest addition to the field: dental implants.

The treatment planning sequence for dental implants begins with the design of the final restoration. After the position and number of teeth replaced and the type of prosthesis is determined, the patient force factors are evaluated.

The greater the force factors, the greater the implant support required. The bone density in the region of the implant abutments is then considered, with poorer bone densities requiring a greater amount of implant support.  The key implant positions and additional implant numbers are then determined, followed by the ideal implant size.  The available bone in the edentulous sites is then evaluated.  When the bone available is present for the size, number, and position of the implants for the planned prosthesis, the treatment proceeds with little compromise.

How Do You Replace Missing Teeth?

Several treatment options are available to most patients who have lost teeth. In implant dentistry, treatment begins with a diagnosis of the patient’s condition. 

Traditional dentistry provides limited treatment options for the edentulous patient because the dentist cannot add abutments (supporting structure), the restoration design is directly related to the existing oral condition of the patient.

The implant treatment plan of choice at a particular moment is patient and problem-based. Historically in implant dentistry, bone available for implant insertion dictated the number and locations of dental implants. The prosthesis then was often determined after the position and number of implants were selected.

Why do I need dental implants?

The goals of implant dentistry are to replace a patient’s missing teeth to normal contour, comfort, function, esthetics, speech, and health, regardless of the previous atrophy, disease, or injury of the anatomic system comprising teeth, jaws, and associated soft tissues. It is the final restoration, not the implants, that accomplish these goals.

In other words, patients are missing teeth, not implants. To satisfy predictably a patient’s needs and desires, the prosthesis should first be designed just as a building is foreseen by the architect. The final restoration is first planned before the foundation is created. Only after this is accomplished can the abutments necessary to support the specific predetermined restoration be designed so that the final result will be satisfactory and functional.

While a removable implant-supported prosthesis can be more affordable than a fixed option, there are disadvantages to consider. The main disadvantage of a removable implant-supported prosthesis is that this choice is less like natural teeth than fixed options. Removable implant-supported options that are partially tissue-supported also are susceptible to bone loss in the tissue-supported areas and the inherent problems associated with any bone loss.

What are Dental Implants?

Dental implants are a type of tooth replacement that occurs with surgery. This must be done by a certified individual, and oral surgery in Houston is top ranking. The American Dental Association offers a web-based resource for finding the best-qualified care for oral surgery in Houston as well as other areas.

To begin, the area of the mouth undergoing surgery is given a local anesthetic to numb the pain receptors for the admittedly uncomfortable process that is about to happen. A titanium rod will then be buried in the jawbone to mimic a tooth root, and this will take six to twelve weeks to heal. The bone will grow around the titanium rod. This is why, unlike dentures or bridges, dental implants do not slip and slide, instead of fitting easily and snugly in the mouth.

Next, the rod is fitted with an abutment. This means that the replacement tooth will not have to be anchored to any of the surrounding teeth, and it can stand independently. The abutment will have a crown attached to it, which is the fake tooth. The crown is formatted to match completely with your previous smile. The fake teeth are molded to be shaped exactly right for your mouth, and they are as comfortable as your prior teeth. The crowns are also colored to match the adjacent teeth, so your smile looks as natural as can be. Dental implants are the most effective option for anyone who needs new teeth.

Have lost teeth, or edentulism is an extremely difficult issue. The dental implants are becoming far more common to assist patients to regain function and quality of life. Even though studies on dental implants materials and procedures have expanded in the previous decade and are continuing to increase, there is still a considerable research underway associated with the utilization of better biomaterials, implant configurations, and understanding of surfaces to enhance the long-term results of implant treatment care. The kinds of implants that have been created and the scope being utilized as a part of dental implant procedure studies will continue to advance successful implant outcomes.

Edentulism is quite prevalent and occurs because of decay, disease, or injury. Insights provided by the American Association of Oral and Maxillofacial Surgeons demonstrate that 69 percent of grown-ups ages 35 to 44 have lost more than one tooth to a mishap, gum maladies, a diseased root channel or decay. Moreover, by age 74, 26 percent of people over 18 years of age have lost the greater part of their teeth. To help overcome this challenge, the utilization of dental implants has expanded to around 100,000-300,000 dental implants every year, which is close to the quantities of prosthetic hip and knee joint replacement surgeries annually. The current development of the worldwide market for dental implants and the ascending interest in restorative dentistry continues to grow exponentially.

History of Dental Implants

The utilization of dental implants as substitutes for lost teeth has a long and multifaceted history. The historical overview of dental implants dates to Egypt, where seashells, as well as stones, were set into human jaw tissues to replace missing teeth. Other archived cases of early implants include instances in which various metals were formed to produce roots and artificial teeth. The historical dental research has also uncovered the use of artificial teeth as long as 2,000 years ago in South America and North America and countries in what was then Middle Asia and the Mediterranean. Archeological discoveries illustrate that supplanted missing teeth were made up of utilizing polished stones, seashells, bone fragments, and precious metals.

Around the 1930s, archeological digs in the Honduras region uncovered ancient Mayan efforts at dental implants going back as far as 600 AD.  A portion of a jaw was set with implants fashioned from shells cut into the shape of teeth in three missing lower incisor teeth. Later on, other efforts to fashion implants were uncovered, including the use of bone as the method to create artificial teeth.

In the Middle Ages, dental implantation included utilizing allografts and xenografts but the efforts did not provide a viable alternative since infections and deaths sometimes occurred after the use of the grafts.

Present-day dental implants became prevalent by the time of World War II when an Army physician, Dr. Norman Goldberg, began working with metals to supplant various parts of the body. In 1948, he worked with Dr. Aaron Gershkoff to create a novel subperiosteal implant, and their work shaped the establishment of implant dentistry. The research of the research began being used in education at dental schools and by dental practices across the globe.

Contemporary Dental Implants

A standout amongst the most imperative advancements in dental implantology happened in 1957 when a Swedish orthopedic specialist by the name of Per-Ingvar Brånemark started considering bone regeneration and found that bone could develop adjacent to titanium. He discovered that it successfully attached to the metal without rejection and called the reaction as “osseointegration.” He continued experimental studies in work on animals and people. In 1965, he set the primary titanium dental implants into a 34-year-old human patient with missing teeth because of an extreme jaw and jaw deformations. Brånemark implanted four titanium implants into the mandible jaw bone of the man.  He later utilized the apparatuses as prosthetic teeth, and the dental implants lasted for four decades until the end of the patient’s natural lifespan.

Many of the dentist’s studies on titanium implants continued until the early 1980s and Brånemark worked to found an organization for the advancement and use of dental implants with significant effects in dentistry to the present day. As many as seven million Brånemark implants have now been used in implants even as many firms have entered the field to offer variations of implants and technologies.

In 1982, the United States Food and Drug Administration affirmed the utilization of titanium implants, and in 1983, Dr. Matts Andersson developed a product using computer-aided design and manufacturing techniques for more precise and efficient assembly of crowns attached to implants. Current research continues using materials and procedures to enhance both the quality and practices of anchoring teeth while other research and developments have centered on dental implant esthetics to improve appearance and function in edentulous patients.

The advancement of ceramics as viable implant surfaces began in the early 1990s and their use as surfaces on implants continues to grow today even as further advances in the osseointegration process continue to drive advances and new products. Today, figures show that roughly 450,000 osseointegrated dental implants are placed annually. The rate of success is reported in 95 percent of cases in single tooth implants, and fewer and fewer risks or complications are occurring as the practice continues to develop in an aging population where there is growing demand.

When the teeth decay, fall out or get removed, the tooth root goes with them. The root is just as important as the tooth itself. It stimulates the jawbone, keeping it healthy and alive. When the teeth are missing from the bone, the jaw will begin to deteriorate. This bone resorption is dangerous and can seriously impact the rest of your life. Not only is it generally unhealthy and rather scary because your bone is dissipating and thereby hurting the rest of your teeth, but it is horrifying because of the damage it can and will do to your face. This process causes the face to cave in around the mouth, creating deep lines in the cheeks and puckering the lips. The chin draws inward and collapses. These deformities are entirely preventable, but only with dental implants. Dentures and bridges do not prevent this from happening—they only provide poor aesthetic repair.

Dental implants are also significantly more secure than any other tooth replacement. They do not slip or trap food against other, healthy teeth. They also provide better eating options. Dental implants stay in place so chewing is easier and the diet is no longer limited. They are more adept at providing higher self-esteem and confidence, too. Because dental implants match the teeth in ways that dentures and bridges could never hope to achieve, there is no need to worry about someone noticing. Smiling becomes frequent again. The teeth are the same color, and they fit perfectly in your mouth.

The surgery is performed by a trained surgeon. It is a minor cosmetic surgery that only involves the local anesthesia for the region being operated on, and this particular surgery has a 98% success rate. It has benefitted a great number of people. Dental implants are now the standard for tooth replacement, as they provide the best and healthiest opportunity for recovery.

The surgery is reported to hurt less than a routine tooth extraction, thanks to the numbing agent. The implantation of the titanium rod takes a while to heal, but that recovery time is not as bad as most surgeries. The surgery itself is fairly routine and commonplace with little to no risks.

What Is The Dental Implant Cost?

Dental implant treatment is partially covered by various insurance policies. Patients whose insurance will not cover the procedure may use other financing or payment plans. The Omega Dental staff can help patients determine which method of payment or financing will best suit them to allow treatment. Ask our team for assistance!

Dental implants are a pricier venture than the other options, but they are the best. Whereas dentures tend to cost roughly between $1000 and $5000, and bridges cost anywhere from $800 to $3000, dental implants tend to be a little more expensive. That being said, they last significantly longer and do not need to be replaced the way that dentures and bridges do. They are a more solid investment in your future and yourself. Dental implants are the way to go when it comes down to it. They are more upfront, but they are a better asset.

For the process altogether, the price can vary from $1100 to $1600. The abutment and crown are usually less than $1200.  Oral surgery in Houston is still a more convenient and beneficial option, and dental implants are more cost-effective than any other dental replacement. If you have any questions about dental implants or any other oral surgery procedures, contact our office to schedule a free consultation and treatment planning appointment. 

What are denture Advantages?

• Dentures are less costly than implants.
• Many people choose to start with dentures. Since they are less expensive a patient may try them out.
• If you have just had teeth removed recently, starting with dentures will allow your body time to heal before considering implants as an option.
• Depending on the location of your missing teeth, dentures may be a viable solution.
• The process to create the dentures is non-invasive. No surgery required.
• If additional teeth are lost in the future, dentures can be modified to accommodate the loss.

What are dentures disadvantages?

• They do not quite look as natural as implants.
• They must be removed and thoroughly cleaned regularly. Many patients find the cleaning of cups and adhesives undesirable.
• Dentures are not worn overnight.
• Sometimes dentures slip around making it difficult to speak and eat.
• Certain foods cannot be eaten with dentures. Examples include caramel, apples, and corn on the cob.
• There’s an increased risk of gum disease if food is trapped by the dentures.
• They frequently need replacement (every 3 to 6 years compared to 20 or more years for dental implants). Also, they’ll break if dropped, requiring replacement.
• Partial dentures are known to weaken the adjacent natural teeth that provide support for the dentures.

What are Dental Implants advantages?

• They’re easy to care for with normal oral hygiene routines. Just brush and floss as you do your natural teeth.
• Implants look and feel like natural teeth since the root and tooth are replaced.
• Implants allow you to eat any food including things that are sticky and crunchy.
• Dental implants don’t affect speech as dentures may.
• Bones and adjacent teeth are preserved. Further deterioration is not a problem. They’re less likely to require future dental procedures that dentures.
• With proper care, dental implants will last for decades.

What are the Disadvantages of Implants?

• They cost more than dentures (cost-effective after about seven years).
• Surgical procedure(s) is required to install them

What are my implant options if I have a lot of bone loss?

When the bone is not present, a modification of the treatment is necessary. These modifications include (1) bone augmentation to fulfill the ideal treatment plan; (2) consideration of optional implant locations, usually with additional implants, or an increase in implant size; or (3) optimization of implant design. A favorable implant design may compensate for risk for occlusal loads over normal, poor bone densities, less than ideal implant position or number, or less than an ideal implant size. 

There are many different implant body designs available in implant dentistry. They may be categorized as a cylinder type Implants, screw-type Implants, press-fit Implants, or a combination of features. Dental implants are often designed to answer a primary focus or belief that implant failure may stem from implant surgery, bacterial plaque complications, or loading conditions. For example, in the past, the implant body design was driven by the surgical ease of placement. A surgically driven implant design will tend to have a tapered, short implant body or a press-fit insertion. These features permit the implant site and implant to be surgically placed most easily. As a result, cylinder, or press-fit implants are the easiest to insert, were very popular in the 1980s, and were reported to have high initial success rates. However, after five years of loading, reports of the cylinder implant included loss of crestal bone and implant failure more often observed.

Most likely, this was related to a fatigue overload condition and harmful shear loads on the bone causing large bone turnover rates, and ultimately less bone-implant contact percent and a higher risk of overload failure. The most predictable aspect of the implant appears to be a surgical success. After many years of clinical studies and evaluations, the surgical success rate from implant insertion to implant placement is usually higher than 98 percent, regardless of the implant design or size. As such, designing an implant for surgical ease does not appear to be the most important aspect of the overall implant-prosthetic-related process to reduce the incidence of complications.

Another focus of several implant designs is to reduce the plaque-related complications of treatment. With this concept in mind, one consistent implant body design features smooth metal surfaces at the crestal portion of the implant. A smooth crest module (the area between the implant body and prosthetic platform) of the implant is easier to clean related to oral hygiene methods and collects less plaque than rougher surfaces. The rationale is that if the bone loss occurs at the marginal regions of the implant, the smooth implant surface will harbor less plaque and be easier to clean. The problem with this philosophy is the smooth crest module is initially placed below the crest of the bone and is a design that encourages marginal bone loss from the extension of a biological width after the implant procedure and shear forces after occlusal loading. As a result, this plaque-reducing design feature increases the peri-implant sulcus depth. Paradoxically, the feature designed to decrease bacteria complications increases the risks. Therefore, an implant body designed for ease of surgery or to reduce complications most often does not address the most common complications observed in implant prostheses.

Most implant body complications in the literature are related to early implant failure after loading, marginal bone loss before loading but after exposure of the implant, and marginal bone loss after the loading of the implant-bone interface. Implant failures are most often observed as early loading failures in softer bone types or shorter implant lengths. implant body designs should attempt to address the primary causes of complications (i.e., factors that address the loading conditions of the implant after the implants are placed in function). Different implant survival rates and different marginal bone loss after loading have been reported for different implant body designs.

The implant body design is responsible for transmitting the occlusal stress of the prosthesis to the supporting bone. The product used by the implant team may increase or decrease the risk of screw loosening, crestal bone loss, implant body bone loss, peri-implantitis, the esthetics of the soft tissue drape, implant failure, and implant body fracture. Therefore, it is prudent to make a selection based on a scientific approach, rather than on advertising or marketing opinion. This decision is even more important when force factors are greater than usual, bone density is poorer than usual, or implant body size is reduced.