Adelaide MaxFax - Dental Implant Specialists
Dental implants (also known as endosseous implants or fixtures) are artificial (prosthetic) replacements for missing teeth which are surgically “implanted” firmly into the jawbone.
Dental implants are a major part of modern dentistry and is now considered the “Gold Standard” for replacing missing teeth.
Dental implants can be used to replace one, several, or all missing teeth. Dental implants are not removable and provide an excellent alternative for damaged or missing teeth.
Adelaide MaxFax – The Team Approach
Adelaide MaxFax firmly believes in the “Team Approach” when managing patients requiring oral reconstruction with dental implants.
We strongly believe the best long term functional and aesthetic outcomes are achieved when patients receive care from an MDT (multi-disciplinary team). This is clearly evidence based and confirmed in numerous studies in both the medical and dental academic literature.
The team comprises a Dentist or Specialist Prosthodontist, Oral and Maxillofacial Surgeon, and a Dental Technician. All have their specific skill set which combined gives the best results.
Dental implant design
The techniques and materials used in dental implant design and manufacture are being continually improved. There is a wide variety of manufacturers and types of dental implants available to cater for different requirements.
Dental implants are a better, more comfortable and attractive solution than traditional dentures because the prosthetic teeth are firmly attached to the mouth and not removable. For most people with dental implants, the “feel” is much closer to natural teeth.
A dental implant usually consists of three component parts:
The fixture (made of titanium) is surgically placed in the jawbone below the gum.
The abutment (made of titanium), emerges through the gum, and is a separate component. The abutment is attached to the fixture which acts as the foundation for the prosthetic tooth (prosthesis).
The prosthetic tooth (made of white, tooth coloured ceramic) or teeth (prosthesis).
There are several types of dental prosthesis:
- a single prosthetic tooth (implant retained crown).
- several prosthetic teeth in a row (implant retained bridge).
- a full set of prosthetic teeth, held in place by several implants (implant retained denture).
- a full set of prosthetic teeth, held in place by two or more implants, but removable for daily cleaning (implant retained overdenture).
Implant supported crown
Implant supported bridge
“All on 4” concept, Implant supported denture
Removable Implant Supported Overdenture
Deciding when to have dental implants
Your oral and maxillofacial surgeon will discuss with you whether you are likely to benefit from dental implants after a thorough dental and medical history and clinical examination.
Your surgeon will also advise you what type of implant treatment might be best for your needs.
Procedures will only be undertaken after careful discussion with you about your specific needs, allowing you to weigh up the advantages, disadvantages, risks, benefits, and potential complications of going ahead with dental implant surgery.
It is important to remember to maintain realistic expectations about the outcome of dental implant treatment. Very rarely implant surgery may not be successful, or the result may not be as cosmetically or functionally pleasing as you may have hoped.
If you are unsure about your surgeon’s advice, you should seek a second opinion from another oral and maxillofacial surgeon.
Factors that may affect your treatment
Your oral and maxillofacial surgeon will consult with you about your dental and medical history to ascertain the best way forward. Certain aspects of your dental and medical history will allow your surgeon to plan the best course of implant treatment for you.
Most people are candidates for dental implant treatment, BUT implants are not suitable for everyone
Aspects of your Medical or Dental history that may specifically contraindicate implant surgery include:
- Whether you are currently smoking.
- If you have untreated periodontal disease (gum disease).
- If you have had radiotherapy of the head or neck.
- If you have had previous complications of dental implant treatment.
- If you are receiving medical treatment for low bone mineral density (osteoporosis).
- If you are or have taken bisphosphonate medications or injections (Fosamax, Actonel, Aclasta).
- If you are receiving monoclonal antibody drugs by injection for osteoporosis (Prolia, Xgeva).
- If you are currently taking corticosteroids.
Some factors may be a contraindication to having dental implant surgery or may mean that your surgeon will discuss other options or adjunctive surgical procedures (bone grafting).
Factors that may contraindicate implant surgery include, but are not limited to:
- If you smoke.
- If you have a chronic medical illness.
- If you have any medical conditions that may impair healing.
- If you have a psychiatric disorder.
- If you don’t have enough bone to accommodate the implant (often due to ageing and/or tooth extraction).
- If you have difficulty maintaining dental hygiene.
Where to have dental implant surgery
Your surgeon will advise whether you will need to have your procedure in our office or in a private hospital. Your surgeon will also advise what kind of anaesthesia they recommend for your procedure and it will usually be one of these three types:
- Local anaesthesia alone – Administered into the surgical site to numb the area. Usually used for straightforward procedures.
- Local anaesthesia with conscious intravenous sedation – In addition to the local anaesthetic, you may benefit from having a sedative drug administered intravenously. This will help relieve anxiety and is great for nervous patients or more invasive procedures. We use a specialist anaesthetist from Adelaide Anaesthetic Services to administer intravenous conscious sedation in our rooms.
- General anaesthesia – For more complicated surgery you may be “put to sleep” in hospital for the duration of the procedure with a general anaesthetic administered by a specialist anaesthetist (Adelaide Anaesthetic Services).
The dental implant procedure
It’s important to remember that implant surgery is not always an “instant fix”. Some surgeons do use a single-stage procedure where the fixture and prosthesis are fitted at the same time. This process is not suitable for all patients and there is usually a healing period of three to six months between placing the fixture and placing the prosthesis.
STEP 1: Placing the fixture (First Stage Implant Surgery)
An incision is made in the gum and an osteotomy (slot) is gently and carefully prepared in the jawbone with a small implant drill.
The implant (fixture) is then gently threaded into the prepared site in the jawbone. The overlying gum is sutured with dissolving stitches and the fixture is then allowed to osseointegrate (heal) over a period of three to six months.
The fixture is made from titanium, the same metal used for hip replacements. Titanium is a very biocompatible metal, enabling bone cells to grow directly onto the titanium implant surface which forms a strong bond with the jawbone. This process takes 3 months.
First Stage Implant surgery is normally very gentle and there is minimal post-operative discomfort.
STEP 2: Placing the abutment (Second Stage Implant Surgery)
An abutment connects the submerged implant in the jawbone, to the mouth through the gum. The abutment acts as the foundation for the prosthesis.
The abutment is inserted through the gum onto the fixture after the bone has healed. This can usually be done under local anaesthesia or local anaesthesia and conscious intravenous sedation. The gums are sutured (dissolving stitches) and left to heal for 10 – 14 days, at which time you can see the dentist for the crown or prosthesis.
STEP 3: Fabrication / insertion of the prosthesis (The dentist or specialist prosthodontist will complete this stage of treatment)
Before the prosthesis is made by the dentist, your surgeon will need to check that the fixture(s) has fully integrated with the bone in order for the implant to withstand normal tooth function.
If judged successful, as in about 98-99% of cases, the prosthesis can then be placed on the implant.
Depending on the type of implant chosen, it will be screw or cement retained (unless it is a removable overdenture). Your dentist or prosthodontist will discuss this further with you as they are the experts in this area.
STEP 4: The final implant-borne restoration
Once the implant surgery has been completed you will need to recover from this minor surgical procedure. Some patients may need to take several days off work. You may be prescribed antibiotics for several days so it important not to consume alcohol as it may interfere with the medication. It is also advisable to have a soft diet for the first few days after oral surgery. Drink plenty of fluids and use ice packs to reduce any swelling and pain.
Detailed post-operative instructions will be provided on the day of surgery.
Success rates of dental implants depends on many factors including the quality of the jaw bone and its capacity to heal. Your general health, medications you may be taking, and your smoking status may also affect the healing of dental implants.
We would expect dental implants to last a lifetime in most instances.
After dental implant surgery
After you have recovered from the anaesthetic and returned home, rest is an important part of your recovery. Because you have had an anaesthetic you must avoid driving, operating machinery, or signing legal documents for 24 hours.
You may require a few days off work to recover from surgery and you should avoid alcohol while you are taking pain medication or antibiotics.
Any discomfort or swelling should start to subside a few days after your procedure.
You may need a follow-up appointment so your surgeon can review you and also check the implant placement with a post-operative x-ray.
Possible risks and complications of dental implant surgery
Any surgical procedure can have complications despite the highest possible standards of practice and the many steps taken to minimise risk. The vast majority of patients will not experience complications, and your surgeon will be happy to discuss any concerns you may have. You will be required to sign a surgical consent form prior to surgery.