What Is Needed For Dental Implants?

In order for a dentist to be able to place dental implants, a sufficient amount of jawbone needs to be available. The amount of bone required depends on the area in which the implant is to be placed. The back molar teeth require a wider and stronger implant as compared to the front teeth. In order to have a sufficient amount of bone, sometimes a bone grafting procedure may be necessary prior to the placement of an implant.

Careful and detailed planning is required to identify and stay away from vital structures such as the nerve and the sinus as well as to stay within the borders of the jawbone in implant placement.

In identifying these vital structures and determining if one has sufficient bone for implant placement, a three dimensional CT scan has become a crucial planning tool. Until recently, dentists have had to rely solely on two dimensional images in estimating the amount of jawbone available. This resulted in undiagnosed reasons for implant failures as some jaws have a shape that was undetectable in 2 dimensional radiographic images.  The problem has been solved in recent years as CT scans of the jaw became widely available.

Dental implant placement surgery is not a very difficult procedure. A healthy person without any debilitating illnesses or bleeding problems who can withstand minor oral surgery may get a dental implant. There are some contraindications, such as Type II diabetes and heavy smoking, which pose difficulty in healing. Patients with very poor oral hygiene are also known to have a lower success rate.

Recently, “bisphosphonate” medication taken both intravenously and orally for the treatment of osteoporosis and breast cancer has been linked to “bisphosphonate related osteonecrosis of the jaw” (BRONJ): a condition where cells in the jawbone start to die presented as ulceration and non–healing wounds. Intravenous bisphosphonate medication users have a high risk of BRONJ. Oral bisphosphonate users may be asked to take simple blood tests to check for any predisposition of developing BRONJ and if necessary, will be asked to stop taking the medication for a few months, if approved by physician, until an acceptable bone turnover rate level is achieved for implant placement.

Excessive overloading due to an insufficient number of implants or insufficient size (mainly the width and strength of implant abutment support) required to withstand the biting force should also be considered. Those who are known bruxers (a person who grinds teeth at night or clenches teeth constantly) may have unsuccessful implants due to their unusually severe biting force.