All about implantology
Implantology, a branch of dentistry dedicated to dental implants
A natural tooth has two main components: the crown which is the visible part of the tooth and the root which is the part of the tooth lodged in the jawbone below the gumline.
Implantology is the branch of dentistry that deals with dental implants. A dental implant acts like an artificial root of a tooth, as it is inserted into the jaw bone, either the maxilla or the mandible. It very often has the shape of a screw and the type that is most used today is made of titanium or a titanium alloy to make it even stronger.
The implant to replace one or more missing teeth
Dental implants may be considered as a treatment plan when a client has one or more missing teeth. A variety of reasons can explain why a client may end up with one or more missing natural teeth, the main ones being the extraction of diseased, heavily decayed or broken teeth or a congenital absence.
A dental implant alone cannot replace a missing natural tooth. An abutment must be installed over the implant after the implant is placed in the jawbone.
An artificial crown, a bridge or a prosthesis is made and then installed on the abutment, depending on the number of teeth to be replaced. If the client only has one missing tooth, a single crown is sufficient. If several teeth need to be replaced, the choices are multiple: use a single implant with several crowns welded by a bridge or a prosthesis or use several implants with separate crowns. This choice is up to the client, depending on the treatment plan recommended by the implant dentist.
An intervention in the clinic under local anesthesia
The installation of dental implants is a surgical procedure that is usually performed in a clinic under local anesthesia, an environment very similar to that used during dental extractions.
Several dental health professionals are qualified to install dental implants, including certain dental surgeons, oral and maxillofacial surgeons, periodontists and other dental specialists. These professionals must have more advanced and comprehensive knowledge and training in the placement of dental implants to advertise themselves as dentists in implantology. Dental professionals who specialize in making crowns, bridges and dentures that are installed over implants are often general dentists and prosthodontists.
Implant history
It was during the 1950s that the affinity of titanium to living bones (biocompatibility of the material with the human body) was discovered by the Swedish Per-Ingvar Brånemark. After many years of research, it was finally in the mid-1980s that the technique of placing dental implants became known and spread around the world.
Professor Brånemark, who is recognized as the “father of modern dental implantology“, is also the one who discovered the phenomenon of osseointegration, i.e. the ability of living bone to colonize and to integrate or to be welded to the titanium of the implant. Osseointegration thus allows the implant to play a role of stable and resistant anchorage, just like a natural dental root. Indeed, it has been shown that dental implants made of titanium are resistant to masticatory forces and reliable over time. Moreover, when osseointegration is completed around the implant, the only way to remove this implant is to drill the bone that is located all around.
Titanium, a biocompatible material
The notion of rejection, a frequent complication when dental implants were made of materials that could not be osseointegrated, such as steel and tantalum, disappeared with the advent of titanium in the dental field, because this material is one of the few to be biocompatible.
Implantology is becoming more and more widespread and it is taught in all dental schools around the world. To date, millions of osseointegrated implants have been placed in the mouths of clients with at least one missing tooth.
The advantages of dental implants over removable prostheses
They allow the placement of fixed (which the patient cannot remove) or removable (which the patient can remove) prostheses.
They are more comfortable and discreet, because they do not cause unpleasant friction or movement on the gums as in the case of removable prostheses not fixed by implants. Some prostheses attached to implants may not even cover the palate at all.
No nasty adhesive (glue) is required to hold implant-supported prostheses in place.
They provide better stability of the artificial teeth, which facilitates chewing and digestion, improves comfort and facilitates the patient’s speech.
The patient is not forced to adapt his diet when implants are placed as in the case of removable prostheses not fixed by implants.
They give the patient the impression of having natural teeth, both aesthetically and functionally, due to its role as an artificial root anchored in the jawbone, like a natural dental root. The patient can therefore regain natural features of his face impacted by the loss of several teeth and even his self-confidence.
The success rate of an implant procedure, over a period exceeding 15 years, is around 95% for all jaws combined and more specifically 90% for implants installed in the maxilla and 95% for implants installed in the mandible . The difference between the success rate of the two jaws is explained by the fact that the maxilla has a lower density than the mandible, which makes osseointegration a little more difficult to achieve.
The price of dental implants varies according to your health condition
Each client’s situation is unique and only your dentist can provide an accurate cost for a treatment plan. Beneficiaries of a dental plan may have a portion of these costs reimbursed depending on their insurance coverage.
Although they cost more than other treatment options, dental implants are mostly a long-term, durable solution. The costs required for their installation are non-recurring and can save money in the long run. In short, because of its benefits, you should view dental implants as a long-term investment rather than just a short-term expense.
In Quebec, uninsured expenses can be reported on your next tax return as a tax credit similar to medical expenses, both federal and provincial. It is therefore important to keep the receipts for the dental treatments you will receive in order to be able to claim this tax credit.
Contraindications to implantology
Certain conditions that the client may present are contraindications to implantology surgery, as the complications that may arise can be serious. Here are examples of possible contraindications:
- Immuno-compromising illness such as AIDS or the client whose immune system is weakened.
- Osteoporosis with bisphosphonate intake.
- Cancers in progress (which are not in remission).
- Cardiovascular disease
- Smoking, drug addiction or alcoholism.
- Pregnancy (involves risks; X-rays and local anesthesia).
- Poorly controlled or uncontrolled diabetes.
- Disease requiring the taking of anticoagulants to thin the blood.