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By Dr. Rick Bonomo
Appeared in the Daily American, April 9, 1996
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OUR EARLIEST
EVIDENCE OF A SUCCESSFUL DENTAL IMPLANT is a specimen of human jaw bone that
was discovered in Central America in 1931. It was from the Mayan Empire
(600AD) and X-rays demonstrated that carved sea shells placed into the lower
teeth sockets of the mandible healed in place.
Many
will recall that George Washington suffered from the loss of teeth and that
Gilbert Stuart padded out the lips to restore the natural lines for his
famous portrait of our first president.
Whether
for function or vanity, mankind has a long history of attempts to replace
lost teeth.
Finally,
in the 1970s a device called the Mandibular Staple Implant was scientifically
proven to be successful. The staple is not often used today because it must
be placed through the skin under the jaw and may require a hospital stay.
 In the early 1980s Dr. Per-Ingvar Branemark of
Sweden published his research that showed titanium implants placed through
the gum could be "integrated into the bone" if left buried under
the gum for six months. This was the breakthrough.
Today,
the success of endosseous (in the bone) dental implants is greater than 95%.
This type of implant has been called "the next best thing to natural
teeth". In appearance and function implants are the closest thing to
natural teeth. The future is here.
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The
most important use for dental implants is to stabilize the lower denture.
Whereas the upper denture has suction to
hold it in place, the lower denture tends to move with chewing and talking.
This can lead to painful denture sores and embarrassing moments if the
denture slips out in public. The placement of four implants in the lower jaw
prevents movement of the lower denture and provides a stable, comfortable
lower denture that does not move with function.
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 Another very common use for implants is the replacement
of lost front teeth in the younger population.
The previous standard of care was the
construction of a fixed bridge. A bridge requires that healthy teeth on
either side of the space be ground down and capped. This can significantly
shorten the lifetime survival of the capped tooth because decay can occur
under the cap. The insertion of one or two single dental implants to replace
missing front teeth is rapidly becoming an accepted practice.
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The
third frequent use for implants is to replace a partial denture so that the
unsightly clasps that hold the partial in place are eliminated.
Most
dentists who work with dental implants do so as part of a team. The oral
surgeon inserts the implants into the bone and a restorative dentist makes
the prosthesis (substitute teeth). Both members of the team do an evaluation
to decide which brand of implant to use and where to place the implants. A
dental and medical history is taken and X-Rays are necessary to plan the
treatment.
In
difficult cases computerized X-rays are used, and impressions of the jaw are
taken so that placement of the implants can be more exact. The alternative
treatments are then discussed with the patient, and the risks and benefits of
the procedures are evaluated.
Then
the implants are placed. This is most often done in the surgeon’s office
under IV Sedation. A four or six month period is allowed for the implants to
integrate or bond to the bone while buried under the gum. During this time a
temporary denture or temporary partial can be worn.
The
next step is to attach an abutment to the implant. The abutment is the part
that goes through the gum and will connect the implant to the new tooth. This
surgery is shorter than the first and is usually done with just a local
anesthetic. Following just a few weeks for the gum to heal around the newly
exposed abutment, the new tooth or denture is constructed by the restorative
dentist.
Dental
implants are an exciting option that has changed the lives of many people.
But they are not for everyone. A candidate for implants must demonstrate that
he is willing to spend the extra time on oral hygiene that is necessary to
insure success, and be willing to follow up with regular checkups.
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Copyright by Dr. Rick Bonomo
LEGAL STUFF
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