What is an implant?

An implant is a titanium post, cemented in the bone, substituting for the root of the tooth and supporting a crown. Implants are an excellent replacement for missing teeth. They restore both appearance and chewing ability.
In dentistry they are regarded as being the gold standard of care.

What makes them better than all other alternatives?

  • They are fixed in the gum – like a tooth.
  • They are very lifelike – like a tooth
  • They help to preserve the remaining teeth – like a tooth
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What are the alternatives?

a denture

A denture can very effectively fill the space of a missing tooth.
It can be a great solution when multiple teeth are missing, the drawbacks to wearing a denture are not as great.
When a denture is made the design of it means that it doesn’t just touch the teeth on either side of the space but needs to go across the mouth and clasp onto natural teeth on both sides.
A denture is also designed to be removed during sleep.

So what’s the problem with a denture?

Both these features mean that a denture can be loose, some teeth just don’t have natural undercuts for clasps. It also means that plaque is trapped between the denture and the teeth it touches, creating the risk of gum infection where previously there was none and decay in teeth where previously there wasn’t any.

a bridge

A bridge can be a great solution to replace a missing tooth, particularly if the tooth behind the space would already benefit from a strengthening restoration.
The bridge feels quite similar to the implant in that it is fixed in position and maintenance procedures are quite similar to your natural teeth.

So what’s the problem with a bridge?

The risk with placing a bridge is that when the tooth has been prepared for the bridge abutment that holds the false tooth in position the nerve can die off underneath the abutment and require root canal treatment or in severe cases even extraction. Not a great outcome when the tooth didn’t need to be extracted before the bridge preparation, to say the least.

Are all bridges created equal?

There is another type of bridge, called a Maryland bridge, which does not depend on filing down adjacent teeth for it’s retention. A Maryland is suitable for replacing missing teeth in a small percentage of cases. Where it is suitable a Maryland is a viable alternative to an implant. Case selection and diagnosis is very important.

How does an implant address the problems in these alternatives?

The implant is fixed in position – it does not move at all.
The teeth on either side are not drilled away in order to retain the implant.
The only teeth it touches are the teeth on either side of the space and the teeth in the opposing arch. Exactly the same situation that the natural tooth is in.

When is an implant not suitable?

Implants are generally very successful but there are certain patients who do not have the right conditions for success. Who are these patients?

  • people who suffer from uncontrolled gum disease
  • people who have poorly controlled diabetes
  • people who smoke

It is important to note that these factors are not absolute bans on placement of implants but what they do is that they reduce the chances of success to a great extent. Implants can be successful in all of these conditions but the chances of success are reduced.

When recommending implants diagnosis is the most critical aspect to get right.

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An implant can restore chewing ability in your back teeth or transform your smile in your front teeth.
Not everybody can have an implant and your dentist should be able to advise you on whether you are a good candidate for this state-of-the-art technique.

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