Dental Implants - Tooth Implants

     Dental implants serve as anchors for teeth that don't move when you speak or chew!  Dental implants may be thought of as artificial tooth roots which allow the fabricated teeth to be firmly attached to the mouth.  They may be used to replace all teeth missing in a jaw or just to replace one or several missing teeth.  The treatment choices can vary tremendously.
     Most dental implants are made from commercially pure titanium, a very biocompatible metal.  This metal is so biocompatible it is used with heart pacemakers.  A dental implant could, however, develop an infection around it similar to a tooth, and this could lead to a need to remove it.  Titanium is also very strong.
     To understand how dental implants work one may consider the jawbone as a piece of wood and a dental implant as a screw.  There needs to be enough length, width and depth of wood to contain a screw of a given size without the wood fracturing during insertion.  In addition, a longer and wider screw in dense wood will hold better than a shorter, narrower screw in soft wood.  The anatomy of the individual patient determines the amount of bone (length, width and depth) that is available for dental implants.  This can vary greatly in different areas in the same jaw or in the opposing jaw.  This anatomical variation may be due to osteoporosis, traumatic loss of a tooth or teeth, infection around a tooth destroying jaw bone, prolonged cigarette smoking, and the presence of normal anatomic landmarks like nasal sinuses and facial nerves that travel through the areas involved.  Lastly, the upper jaw may generally be consider to be a soft wood like balsa while the lower jaw may be considered a hard wood like oak.  Therefore, with all other things being equal, the prognosis of implants in the lower jaw should exceed that in the upper jaw. 
     The most common type of implant technique involves a dental implant screw that is made in two pieces:  1) The first piece is about 10 millimeters long and at its top there is an internal female screw threading.  2) The second piece is about 5 millimeters long and at its bottom there is a male external screw threading.  The first piece of the dental implant screw is placed and left to heal in the jawbone under the gum, unseen and undisturbed, for 3 to 6 months.  After 3 to 6 months the gum is minimally surgically opened and the second piece is screwed into the first piece.  The gum is sewn back and this second implant piece now protrudes through the gum and a crown (cap) can now be made to cement to it.
     There are other types of dental implants; some also go into the bone like that described above but have very different shapes.  Other types of dental implants sit on top of the bone (not in it) but under the gum.  There are other types of dental implants that just sit in the gum.  Patients should seek dental implant care from a premium implant dentist who is skilled and very experienced with all types of dental implants.  Some dentists learn one technique over a weekend course and start offering services in implant dentistry.
     The type of implant chosen for each patient depends upon a complex interaction between functional and cosmetic needs, available bone, quality and quantity of remaining teeth, medical health, emotional temperament, treatment time and finances.
     The treatment options available for patients are frequently quite varied and are better discussed in the office on an individualized basis.

--Dr. Jeffrey Dorfman, Director
The Center for Special Dentistry
NYC