With today's advancements in dental implant techniques, materials and technologies, almost anyone with missing teeth can now have dental implant treatments done. Conventional implants techniques have had good long-standing success rates.

Also due to new developments in implant technologies and techniques, immediate implants and immediate loaded implants are now possible that can dramatically shorten treatment.
 

	At initial consultation, all possible alternatives are considered and the feasibility of implant treatment is assessed.
	Should you wish to proceed with implant treatment, a full and detailed assessment is done which involve the taking of impressions, x-rays and in some cases CT scans. This completes the diagnostic planning and treatment details including sequence of treatment, costs and possible complications are discussed with the patient.

Implant Placement - This is generally a simple procedure that is performed under sterile conditions in a dental surgery using local anesthesia. If required, bone saved from the drilling procedure and some artificial bone may be used augment the contour of the ridge and gum around the implant.

Healing Process - Osseointegration

	The implant is left to integrate with the jaw bone for a period of 2 to 6 months
	The sutures are typically removed seven to fourteen days after surgery
	The patients own denture or in some cases a simple adhesive bridge can be worn during the healing phase.

The Restorative Phase –

	When the gum tissue is ready, a special abutment or metal bar/ball is attached to the implant
	If crowns or bridges are opted, an abutment is placed and this provides the support for the new crown or bridge.
	If overdentures are opted, the metal bar/ball is placed and is the the clip used to securely retain the set of new overdentures
	After impressions are taken, the crown/bridge or overdenture is made and fixed in place.

Maintenance –

	Patients are demonstrated brushing and flossing around the implant
	Patient is scheduled on recall program to monitor the health of gums, implant integrity and bone levels and to perform professional prophylaxis if required

In cases where bone condition and density are favourable, dental implants can now be embedded after tooth extraction. Such techniques being referred to as immediate implants, one-day implants, single day implants or same day implants. This means that the patient have new tooth roots upon leaving the office.
 

Immediate Loaded Implants ( Teeth-in-an-Hour)

In addition, for certain cases, permanent or temporary prosthetics may be placed immediately during the same treatment visit when the dental implants are surgical placed. This is known as immediate loaded implants. This forms the basis of "Tooth in an Hour" concept that is widely being used by dentists the world over. The immediate loading of dental implants shortens the treatment time and makes it possible to give the patient an esthetic appearance during the whole treatment period.

Benefits of Immediate Loaded Implants

 

	Good esthetic results
	Shorter treatment time with minimized pain
	Immediately functioning teeth

However, immediate loaded implants does not apply to all cases and is largely dependent on the individual's bone quality and condition.

There are certain conditions that preclude the procedure of immediate loading. The decision to immediately load the implant is largely dependent on a large extent on the clinical judgment of the operating surgeon. However, certain rules must be kept in mind:

 

	The patient should be healthy and compliant with good oral hygiene.
	Good bone quality and quantity is a prime requirement for immediate implants to be successful
	The site selected for immediate loading should be free from any infection. Infact even the neighboring teeth should be free from radiologic/clinical signs of infection.
	Even in good bone quality and quantity cases, if the drilling technique removes a lot of bone so that primary implant stability is not attained, immediate loading should not be attempted.
	Stable relationships between opposing teeth.

Implants supported Fixed Bridge
 

	The best remedy in situations where there are no posterior teeth or where there are no healthy natural teeth available for fixed bridge support
	Patient can chew better because the bridges are tightly secured.
	Gives better strength and stability than dentures
	Renewed confidence and improved quality of life as well
	Save adjacent teeth. Prevents bone loss and exisiting teeth from drifting into surrounding space of the missing teeth
	Requires less maintainence than implant supported overdentures.

There is a choice in the type of teeth (crowns) that can be placed- metal, metal ceramic or all ceramic.

Installing Implants with Fixed Bridge

FAQ's regarding implants:

Who is a good candidate for dental implants?

Anyone in reasonable health who wants to replace missing teeth; those who are dissatisfied with their current denture; those people who would like to eat better and with more comfort, smile more frequently and feel more secure when they talk and laugh. Age should not be a deterrent. If the treatment is properly planned, the surgery accomplished following accepted rules of practice, the prosthesis fabricated correctly and properly maintained by the patient, success rates are in excess of 98%. In the majority of situations, only one or two implants are required. Patients that have had implants placed eat better, eat foods that they have been denied before, are more comfortable when they eat, and don’t have to use adhesives to retain their dentures. They can talk and laugh without feeling self-conscious and without fear of their dentures slipping out. All these improvements make people with dentures feel better about themselves increasing their self-confidence while improving their social and business lives.

Do implants require special maintainence?

No, dental implants require the same care as real teeth, including brushing, flossing, and regular dental check-ups:
 

	Brush after eating and before bedtime around the implant with a soft toothbrush
	Floss at least once to twice a day. Use the proxy brush or floss threader to remove plaque under and around these areas to maintain good oral hygiene. Buildup of food debris and plaque on your teeth and gums can become infected.
	Rinse with fluoride rinse before bed. Swish the fluoride rinse vigorously in your mouth for at least one minute. Do not swallow any of the rinse and do not eat or drink anything for 30 minutes
	See your dentist for regular professional check-ups and cleanings

Which Implant ?

Currently the market is flooded with companies marketing dental implants. Barring few and negligible differences almost all have same design and pattern. Choice for a particular product is purely based on user preference and being friendly to a particular product. Common systems available in the market include Nobel Biocare, Xive, Endopore, Alpha Bio etc

What to do in cases where bone volume does not support implants?

The success of a dental implant primarily depends on its ability to bear chewing forces which in turn is very much dependent upon how much bone is available in the site where the implant is placed. There are lots of things that affect the bone volume like gum diseases, trauma and age and it is not unusual to open up a site in the mouth for implant placement and find out that some of the critical supporting bone is missing. No problem.... Modern dentistry has gifted us new techniques to augment missing bone. We can increase both the height and width of bone by using bone substitutes called as Bone grafts. We can even use grafting techniques to prevent the loss of bone in circumstances where bone would normally be lost like the extraction of a tooth.