Nickolas S. Maskas DDS, MD
337-888-4771
What is a dental implant?
Put simply, an implant is a high-tech titanium bone screw which serves as a replacement for a missing tooth root. There are 2 parts to every tooth: The root and the crown. The root is under the gums and the crown is the part of the tooth visible in the mouth which contains the chewing surface. An implant is a replacement for the tooth root only. A crown (cap) is later placed onto the implant. Unlike other methods of tooth replacement which attach to other teeth, an implant is anchored within the jaw bone itself, just like a natural tooth.
What are advantages of dental implants over other methods of tooth replacement?
Implant restoration is usually the most natural-appearing and natural-feeling method of tooth replacement. There can be multiple advantages to dental implants over other forms of tooth replacement. The most commonly used alternative method for single tooth replacement is a dental bridge. A bridge requires preparing (grinding down) the teeth adjacent to the missing tooth space. The need for preparing the adjacent teeth is a significant disadvantage of a bridge, unless the adjacent teeth are already in need of crowns (caps) in which case a bridge may be a preferable option. Also, maintaining hygiene in the area can be much more difficult with a bridge because a bridge usually requires a minimum of 3 teeth to be connected to one another, making the passage of dental floss between the teeth and under the bridge impossible with traditional methods.
Which doctors are generally involved in implant tooth replacement?
There are usually 2 doctors involved in implant tooth replacement. In most instances the discussion will start with your general dentist, and your dentist will then make a referral to an implant surgeon. The implant itself will be placed by the surgeon followed by a healing period. After healing, your dentist will take an impression (mold) of your implant and begin fabrication of a crown (tooth with chewing surface) which will eventually be connected to the healed implant.
Why might a CT scan of my mouth be recommended prior to implant placement?
A CT scan can benefit many patients prior to implant placement. CT scans can help determine if there is enough bone to adequately place your implant. A standard 2-dimensional x-ray does not provide as much information to help plan your case as a 3-D CT scan. A CT scan will also reveal exact distances to important structures such as nerves and sinuses so that these structures can be avoided during surgery. See link below for more information on CT scans at Louisiana OIS.
What if I don’t have enough bone for my implant?
If you don’t have enough bone to properly place your implant in the correct position, I will recommend a bone graft to increase the amount of bone before placement of your implant. Please see the bone grafting section of the website for extensive information on bone grafting and the different types.
What are my options for anesthesia/sedation with my dental implant?
Please refer to the “anesthesia options” section of the website for extensive information regarding this topic (link below).
How are implants placed?
In brief, implants are placed first with a small incision in the gums to expose the underlying bone. A precisely sized osteotomy (hole) corresponding to the implant size is then prepared in the bone using a series of drills. Finally, the implant itself is slowly screwed into the prepared site. Afterwards, a radio frequency test is done to verify stability of the implant.
What will I notice in my mouth after implant placement?
In most instances, a short metal cylinder known as a healing abutment will be attached to the implant immediately after placement. This allows the gum tissue to heal around this cylinder which helps shape the gums for tooth placement after healing. In some cases, the implant may be left underneath the gums to minimize forces on the implant during healing.
What should I expect after my implant placement?
Implant placement is generally considered less invasive than tooth extraction. You can expect to experience minor discomfort after your procedure. In some cases, you may experience swelling after your implant is placed. This usually resolves within days. See section on implant post-operative instructions for more information.
Can I chew on my implant right away and how do implants heal?
In most instances you may not chew on your implant right away. Implants must undergo a period of healing before they can be used. Initially the implant is secured only by the screw threads in the bone, similarly to a screw placed in wood; however, this is not strong enough to withstand the extreme forces of chewing. Over a period of 8 weeks, the implant undergoes a process known as osseointegration where your body’s bone actually grows onto and attaches (bonds) to the implant, greatly increasing the implant’s stability. In general, only after this healing period has taken place is your dentist able to place a crown on the implant so you can begin using it to chew.
How long do implants take to heal and when can my dentist put a tooth on the implant?
Implants generally take 8 weeks to integrate with your jaw bone. After this time, your dentist can place a crown (tooth) on the implant.
Will I have a follow up visit after my implant?
Yes. You will be scheduled for a follow up appointment in 1-2 weeks following implant placement to check healing. Of course, if you have any problems in the interim and wish to be evaluated, I would be happy to see you on the same day.
Can I have my implant done at the same time as tooth extraction?
Implants placed at the time of tooth extraction (“immediate implants”) are possible in some cases, but not every patient is a good candidate for immediate implants. My goal is to give you the most predictable and stable long-term results with your implant. This means that immediate implants will only be placed if the site meets certain criteria regarding tissue and bone quantity and quality. Having an immediate implant placed without consideration of these crucial factors could result in poor long-term results.
Do I have to go without a tooth (or teeth) while the implant is healing?
Usually not. In most cases, your dentist can provide you with a temporary tooth replacement while your implant is healing.
How long do implants last?
Implants can last for decades. With proper care and maintenance, implants can last a lifetime in some instances.
Can implants get cavities?
Implants cannot decay like natural teeth; however, regular follow up and cleanings with your dentist are still important for the health of your implant since implants can develop problems such as bone loss or infection.
How do I take care of my implant?
Similar to natural teeth, you should brush and floss around your implant(s) daily as well as have regular cleanings and checkups with your dentist.
What are some of the long term problems that can happen with implants?
Without proper maintenance, implants can have bone loss around them just like natural teeth.
What is the success rate of implants?
A “successful” implant is one that undergoes proper healing and is able to have a tooth placed on it. In general, it is accepted that the success rate of implants is approximately 95% in non-smokers. This means that only 5 out of 100 implants placed will require removal and replacement for various reasons. The reasons for implant failure are not always clear.
What health factors can affect the success of dental implants?
The most common factors adversely affecting implants are smoking, diabetes, a compromised immune system, and a history of radiation to the area. All of these factors can decrease the success rate of implants.
How Does smoking affect implants?
Smoking decreases the success of implants markedly and makes their placement less predictable. The adverse effects of smoking on the mouth are numerous and last up to 6 weeks after the last cigarette/cigar is used. Smoking within 6 weeks before implant placement or within 1 month after the extraction places the patient at increased risk for infection and implant failure. Smoking also increases the risk of the implant failing years after placement.