All You Need to Know about Implants


New teeth in a single day

Replacing lost teeth with dental implants was traditionally a long and sometimes painful process. So how has up to six months become just six hours?

Same day versus traditional implants

Maybe you are someone who has never considered dental implants as a viable option, believing the process to be long and painful, with several months of wearing dentures between dentist visits. And not long ago, you would have been absolutely right.

But thankfully things have moved on a long way and today the idea of dental implant treatment taking place in a single day is a reality. So what is at the core of this revolutionary process, and what does it mean for those suffering from tooth loss?

The conventional implant process

Imagine a process that might take three, six or even nine months. A process during which you have to wear removable false teeth (dentures) and make multiple visits to the dentist until the entire procedure is complete.

This is in fact still by far the most common way dental implants are done today. So how does it work and why does it take so long?

Well, this method would typically involve a series of dental appointments during which a titanium implant is used to replace a missing or extracted tooth. This implant then takes on average two months to heal properly (or, rather, to fully integrate with the bone – which is a process known as osseointegration). During this period it is crucial that the implant not receive any force or stress on it – and thus risk affecting the bone growth (osseointegration) around it.

As mentioned, in the interim the patient would wear dentures. Once integration was successful, the dentures could be taken away and eventually the permanent artificial tooth could be fixed onto the titanium implant.

Note: While we mention two months as the average time required for osseointegration, it can often take much longer. In extreme cases, where bone grafting procedures are involved, it can take up to year.

Same day implants

While we are hesitant to call the traditional method of implants “the old method,” we can certainly call same day implants “the new method,” and recognize just how much easier they are making life for the tooth loss sufferer.

I’ll mention at the outset here that both the traditional methods and the same day methods have equally high success rates – that being about 98%.

Nowadays there is overwhelming scientific evidence to prove that if an implant is placed with a primary stability (torque) in excess of 32 Ncm, then the dentist can immediately load the implant with a tooth (crown) and have the same success rate for osseointegration (98%), equal to an implant which is not loaded immediately after placement. To achieve the necessary primary stability, we are using tapered/root form and wide (max) implants.

So instead of augmenting/grafting an area with bone, we are using angulated implants in order to avoid anatomical landmarks like a nerve or the nasal sinus. We are therefore utilizing all available bone and achieving the required primary stability for immediate loading. Finally, in narrow and short alveolar ridges, thin (3mm) and short (6mm) implants are used, diminishing the need for grafting procedures.

We are unique because we are immediately loading the vast majority of our implants and at the same time, we are avoiding bone grafting/augmentation procedures which could lead to pain, swelling, complications, increased treatment time, increased cost, and decreased treatment acceptance by the patient.

The combination of highly specialized dentists (oral maxillofacial surgeons and prosthodontists) with huge experience (23 years), as well as master dental technicians working as one team and using the latest dental implant technology and imaging systems (CT Cat-Scan), is what makes this possible.

Is it for you?

So it is key to note that one of the main benefits of same day implants is that, in most cases, bone grafting is no longer needed. In the past, those with tooth loss who were also suffering from related bone loss actually needed more artificial bone created (bone grafting) so that the implants had something to bed into. For the majority of patients using the same day method, this is no longer necessary – meaning faster implants and quicker results.

This also means that anyone can opt for same day implants over the traditional methods – and enjoy all the benefits and convenience.

I will point out here that more complex, multiple implant cases will require two sessions, In such a scenario, the first session will involve placing the implants and the temporary acrylic teeth on a single day, with the second session following seven days later for the placement of screw retained, fixed porcelain, permanent teeth.

What used to take months is now done in a single day. Most patients experience no pain during the process and very little discomfort afterwards, leaving our clinic with a fully-functioning set of teeth that look and feel very close to natural ones.

Duration of implants

Tooth loss is a growing problem worldwide, affecting about a third of the adult population. The problem is much worse than that in the Middle East, with double that number – two-thirds of the adult population – suffering from missing teeth.

Dental implants are the preferred solution to this epidemic, offering as they do a natural, comfortable and aesthetically pleasing alternative to missing teeth. But are they a permanent, lifetime solution? Or like other solutions for tooth loss such as dentures and bridges, are they just a stop-gap, requiring ongoing adjustments and replacement?

While their permanence depends on several factors, one thing dental implants are certainly not is temporary. Conservative estimates on the lifespan of implants start at a decade and average at around twenty years.

Compare that with the average bridge lasting seven years, and the typical denture needing to be replaced after around five, and we can already see why implants are fast becoming the most popular tooth replacement.

But can they really be considered a lifetime solution? In the right circumstances – and with the right care – absolutely, yes.

Built to last

One key factor in the longevity of dental implants is their lack of dependence on the remaining teeth in the mouth. As both bridges and dentures must be affixed to existing teeth in order to plug gaps, when those supporting teeth begin to deteriorate – which is a common problem with bridges – then the bridge or denture must be refitted and replaced. Implants on the other hand are completely self-supporting and anchor as firmly into the jaw as our natural teeth.

This fixing to the jawbone also works to overcome one of the main reasons why dental prosthesis need to be replaced: Bone loss. When the roots of our teeth are no longer there to stimulate the jawbone’s natural repair and replenishment cycle, the bone itself begins to weaken and resorb over time. This leads to a change in the shape of the mouth and face, which in turn leads to dentures becoming loose and dislodged. Dental implants, on the other hand, with their artificial roots, stimulate the jawbone to minimize bone loss.

Dentures in particular are also known to wear down and break over time. Years of talking and chewing takes its toll on the acrylics and metals that are often used to make dentures, and they soon become susceptible to staining, weakening, cracking and even snapping altogether.

Outside factors

And of course there is another big factor when it comes to how long an implant can last: Namely, oral hygiene. Yes, while dental implants are not subject to decay and erosion, they are susceptible to the most common oral complaint of them all – gum disease – present in almost one-fifth of adults worldwide. If badly looked after, implants can build up plaque deposits which if untreated lead to gum infections and disease. This is just as dangerous to implants as it is to natural teeth, which is why dental implants must be cared for in the same way as your natural teeth.

Ultimately, it is fair to say that implants will last for as long as they are kept clean and the gums kept healthy. In the right circumstances, yes, these can most certainly be expected to last a lifetime.

If you wish to pay special attention to your implant to ensure it goes the distance, there are plenty of shaped and angled brushes on the market specifically designed for keeping implants clean. Interdental brushes are great for cleaning the sides of the implants, and getting in between the teeth – where much of the mouth’s bacteria likes to hide. Equally, tuft brushes are perfect for cleaning the vital area where the implant meets the gum.

A great rule of thumb is simply to treat an implant just like a natural tooth – that means avoiding sugary foods, brushing at least twice a day, flossing regularly and making regular trips to your dentist to check on your overall oral health.

Am I the right age for dental implants?

Tooth decay affects people of all ages. Almost 100% of adults and a staggering 76% of children worldwide. But what happens when this decay leads to tooth loss? Is there a ‘right’ treatment depending on age?

While there can be barriers to implants for younger patients, age itself it’s not a limiting factor. The most important factors are the overall state of health of the individual, the quality and quantity of surrounding bone in the jaw, and for younger patients whether their jaw bone is fully developed or not.

Implants and the elderly

The most common replacement for missing teeth among the elderly are dentures. While dentures are perhaps perceived to be a less invasive solution for tooth loss (as compared to implants), as time goes on dentures become loose, cause discomfort, and interfere with eating and speech. But the most serious disadvantage is that they fail to prevent further bone loss, as they do not stimulate the jawbone.

There are several reasons for this high prevalence of dentures among elderly patients. Firstly, it is the “traditional” method and sometimes its  considered as the “only option”, secondly, there is a common misconception that elderly patients don’t respond well to implant procedures.This could not be further from the truth. In fact, there as many successful cases of implants with patients well into their eighties and nineties, and providing overall health is good, seniors heal with very much the same predictability as younger patients.

Dental implants can be truly life-changing for those elderly patients who have lived years or even decades with inferior solutions such as dentures. Suddenly they are able to eat a richer and more enjoyable diet (something they had long ago given up on), talk without feeling insecure about people seeing their dentures moving about, and most importantly, they are back to stimulating and preserving the jawbone to prevent any further bone loss.

Implants and the younger patient

On the other end of the spectrum, young people are the most likely to face restrictions when it comes to dental implants. To be confident of a successful placement, the jaw must be fully developed, and this is typically not the case until the late teenage years.

However, this is only a guideline, as each young patient develops at a different rate. For this reason an oral and maxillofacial surgeon will take a number of X-rays (often of the wrist as well) to determine the level of an individual’s bone development, and assess their suitability for surgery.

The good news is that there is a temporary solution for replacing the missing tooth or teeth in a younger person while waiting until the jaw has developed sufficiently to withstand dental implant surgery. That option in most cases are single tooth or multiple teeth dentures.This allows young patients to interact and socialise as normal in the interim, without being overly-sensitive about their appearance. Once the jaw has reached the required level of development, implant surgery can be performed, providing a longer-lasting, more comfortable and aesthetically pleasing solution.