Straumann Dental Implants

Dental implants are a permanent solution that looks natural and restores the chewing function. Once the dental implant is osseointegrated into the jaw bone, it takes2 to 3 months for the bone surrounding the implant to remodel itself. The implant prevents further bone loss in the jaw bone and can strengthen the bone in the jaw. This process is where the bone fuses with the implant fixture called osseointegration.A dental implant has three constituents: the post, the abutment and the crown.The implant post consists of the implant post which is essentially a titanium+ zirconium screw that is inserted into the jaw. Implants are a biocompatible material that allows for osseointegration over a period of few months. The abutment is a connector piece that acts as the "neck" of the tooth. It holds the implant post to the crown of the tooth. It is typically screwed into the post after the titanium screw is osseointegrated into the jaw bone. It allows for the gingiva (the gums) to heal  just above the gum line before the final crown is loaded. Typically, the crown is placed 2 to 4 months after the dental implant surgery. The implant crown is a custom-made tooth that mimics the natural tooth's appearance. In order for one to be eligible to receive a dental implant, there are steps and measures that must be taken prior. The dental implant consultation is typically a first time appointment where the patient can bring their preliminary questions. It is important to remember that although the surgeon is there to  provide answers, he is also there to ask the patient many questions.The dental surgeon must first assess the bone density and health of the jaw and teeth both clinically and radiographically. It is normal for a panographic x-ray or a CBCT XRAY to be taken initially. The surgeon must see if the patient is qualified for the implant procedure. If the bone density and dental health is acceptable, the dental surgeon will also ask about lifestyle choices, diet, pre-existing health and future conditions. The surgeon must assess whether the patient will be compliant with multiple appointments over many months and if they can remain a long term and consistent patient. The dental surgeon must be able to accurately determine the patient's potential for infection at the implant site. Pre-existing health conditions such as a weakened immune system, uncontrolled diabetes, osteoporosis and low bone density, smoking and certain medications can delay or stop dental implants from properly healing. That is why the dental surgeon must know before placing the implant, whether the patient is qualified to support an implant. Specific medications such as anti-resorptive agents (bisphosphonates) and anti-depressants (Selective Serotonin Re-uptake Inhibitors) can impact healing. Additionally, pre-existing cardiovascular conditions and uncontrolled diabetes pose risks to implant surgery and healing. Age can also be an eliminating factor, as adolescents under 21 are still growing and are not yet ready for a permanent, life-long implant. Once the jawbone is completely finished growing, one may become qualified for a dental implant.Although most conditions are not absolute contraindications, the dental surgeon must accurately assess the pre-disposition for dental infection during implant healing. A consultation with a dental surgeon will help to evaluate the patient's eligibility for a dental implant.The surgeon here DR. Izad Keyhani will perform an examination where the bone height and width is measured both clinically and radiographically (via x-ray). If the bone height and width is acceptable, then a dental implant may be placed. If there is not enough space in the jaw, then alternative steps must be taken. This involves perhaps bone augumentation to help create enough space in the gums and jaw for the dental implant screw and final crown.Common health symptoms can pose a risk to healing, such as peri-implant inflammation or even infection . This is the earliest form of dental implant infection is typically characterized by redness, swelling and possible bleeding around the gum. At this earliest stage, there is no bone loss yet. However, if it is allowed to progress, it becomes peri-implantitis. This painful condition follows uncontrolled mucositis where the infection is able to spread to the surrounding bone. If it progresses and becomes severe, bone resorption takes place, and the implant could potentially become mobile. If advanced bone loss takes place, then one may lose the dental implant. Complications can result in delayed placement of the final crown or reduced success of the titanium post. While the total treatment time with the dental surgeon can span up to 6

months or more, some highly stable and secure cases may call for the final crown to be placed earlier. Lower jaw implants can heal faster, whilst upper jaw implants take longer (six or seven months). Due to time and travel limitations, a patient may specifically request an optional same day crown. One may receive a temporary six month crown or, rarely, a permanent crown immediately. If the dental practice is associated with a dental lab, then a same day crown can be fabricated using 3D printing technology. The dentist will take a digital impression of the patient's mouth with a 3D scanner. In rare circumstances, the digital impression can be sent to the dental lab for a crown on the same day as the implant surgery. If bone grafting is needed due to low bone density, then the healing time is extended. A bone graft can be made from human bone, animal bone or synthetic bone.  A same-day, temporary crown with immediate loading is still a possibility when a bone-grafting procedure is carried out in addition to the osseointegration surgery. Autograft (patient's own bone) is considered the gold standard in the dental industry. The autograft results show fastest healing. An allograft is human donor bone, sourced from human bone other than the patient's own bone. Typically, in sites with hypercementosis, research shows that implants can be safely osseointegrated into the bone, without the need for any special modifications. It is vital for stability, aesthetics and chewing function that the gingiva heals properly around the implant abutment. The surgeon attaches the abutment to the titanium implant fixture using a miniature wrench in a clockwise direction. The dental surgeon must verify that the screw does not hit resistance too early and that it is properly seated. Once the screw driver indicates that they have reached the 35 Newton centimeters torque, then the integrity of the final placement is secure. Usually, the dental surgeon will place the abutment around three to six months after osseointegration surgery, and 3 weeks before loading the final crown. In cases where the implant post is highly stable, the surgeon may wait as little as two to four months to monitor healing before placing the abutment. This is largely down to personal preference, as immediate same day permanent crowns are a possibility, as well as temporary crowns. In cases where there is an infection developing at the dental implant site, medication may indicated to target the anaerobic bacteria underneath the gums. Chlorhexidine gluconate rinses with syringe, can reach the subgingival pockets and clear any debris or pus after meals. Subgingival pearls of Metronidazole can be placed by a dental surgeon underneath the gum line, in order to address any anaerobic infections. Bacteria that are anaerobic can live without the need for oxygen, and therefore, special antibiotics are indicated in order to address these microbes that thrive without oxygen. While amoxicillin is typically the prophylactic antibiotic for implant surgery, it is typically used as routine first line safety measure and can cause anti-biotic resistant strains. For pre-existing, established infections, metronidazole is the go-to medication placed locally at the site of implant placement.