Dental Implants

1. What are dental implants?
It is an independent artificial tooth root that is used to replace a natural tooth root that has been lost to accident or disease. These implants are typically placed to secure bridges, partials, dentures and crowns. Implants don’t require support from adjacent teeth and thus cause them no harm. Better yet, teeth replaced with these implants look, function, and feel just like natural teeth.

2. Is implant dentistry suitable for me?

Advancements in design and placement protocols of implants have made this gold standard for the replacement of missing teeth for almost everyone. Patients with specific health conditions including uncontrolled diabetes, osteoporosis, or irradiation of the mandible or maxilla for the treatment of cancer, may be at increased risk but they are still candidates and can usually be managed by a highly experienced practitioner. Certain cosmetic conditions can be a challenge as well but advancements in cosmetic implant dentistry procedures routinely produce beautiful, natural, esthetic results that patients often describe as far more beautiful than their natural teeth ever where. One of the most difficult conditions to overcome is actually a habit or an addiction rather than a condition; cigarette smoking. This is an annoyingly difficult addiction to overcome and many wonderful people who have extraordinary will power and a strong desire to quit, simply can’t. That is unfortunate because as smoking is a strong contributing factor to tooth loss, smokers form a disproportionate number of those in need of implant dentistry. The majority of the patients I see for the All on 4 procedures are smokers. So though smoking is not a contraindication the patient and doctor must realize that they will be faced with a higher than normal number of complications. Fortunately if the doctor is highly experienced and the patient is persistent, cooperative, and determined a satisfactory outcome can almost always be achieved.

3. What are the benefits of implants over other dental procedures?

Dental implants:

• Are permanently fixed and thus the teeth attached to them will not slip or move insuring comfort and avoiding embarrassing moments.


• Are easily maintained and are not susceptible to cavities.


• Allow you to eat all of the foods you enjoyed with natural teeth.


• Look like natural teeth providing a beautiful smile so you don’t have to live with the stigma and embarrassment associated with missing teeth or false teeth.


• Promote bone growth and help maintain a youthful facial structure.

4. How comfortable are these implants?

These are amazingly comfortable. Most patients are given aids such as Ibuprofen and methyl prednisone and report little or no discomfort. All on 4 patients can usually enjoy a light meal the evening after their surgery and most return to work in a day or two.

5. Who is authorized to perform implant surgery?

Dental implants can be placed by any licensed dentist but very few offer this service. Significant additional training is required to place or restore these implants. To provide both the surgical and prosthetic phases of dental implantology the demands for additional training is even greater but the benefits to the patient are substantial. Advanced implant dentistry procedures such as bone grafting and especially full mouth reconstruction with the All on 4 protocol or traditional protocol requires years of training and extensive experience. In choosing an implantologist you should look for a doctor who has additional post graduate training, has certification by the American Academy of Implantology or the International Congress of Oral Implantologist, has cat scan imaging technology , an in office dental laboratory, and extensive experience. Offices like this are very rare but it is worth your effort to find one.
6. Are dental implants easy to maintain?

You need to take care of your implants, the same way you would of your natural teeth. It is always recommended that patients meet with their dentist regularly and maintain proper dental hygiene to insure long term satisfaction with implant dentistry.

Tremendous resources are being dedicated to finding better solutions and indeed progress is being made. We can now synthesize proteins and stem cells in the lab that make bone substitutes almost as reliable as natural bone harvested from the patient. New and better techniques are being developed for the use of these materials almost daily. I attended a meeting in Hamburg, Germany recently and much was dedicated to this. I’m going to another one in October in Boston specifically to study new grafting techniques. All in all great progress is being made. But still, over 40% of all grafts have some level of complications. The problem with bone grafting for dental implants is not primarily with the graft materials. It is with the membrane, which looks like a sheet of paper, that the graft must be covered with prior to suturing the tissues over it. All grafts with the exception of autogenous block grafts, those taken from the patient, require this covering. There are literally dozens of different membranes on the market, each with its’ advantages and disadvantages, but they all become exposed too often. Exposure occurs when the tissue over the membrane develops an ulcer that creates an opening that will allow saliva and bacteria to penetrate into the surgical site. If this happens too early the graft is likely to fail and if it happens any time before 4 months, and it often does, the graft will be less substantial than initially desired.

All things considered I see the potential for many patients to be helped who previously could not because the risk – benefit ratio was too great. And on a daily basis more autogenous block grafts will be used because new procedures and instrumentation make them simpler. I am confident that this will open the door for many patients who were previously not good candidates for the upper All on 4 prodedure as well as more routine dental implant procedures. It looks like another great year ahead with much to be learned and shared in the field of dental implantology

According to dental researchers, advanced research and superior technology will bring radical changes in the dental care industry during the 21st century.Dental implants are the most notable of these changes. Thirty years ago they were considered “quackery”. Now they are the “gold standard” for replacing one or a full mouth of missing teeth.Most dentists agree that dental implants are a great example of advanced dental care technology. A dental implant is an artificial tooth root that replaces a patient’s missing natural tooth root. It constitutes an ideal treatment option for those who have lost one or more teeth in the upper and or lower jaw due to accident, gum disease or some another traumatic experience. Whether missing only one or two teeth or all of your teeth, dental implants have become the standard of care for replacing them. New technologies, new implant designs, and new procedures have consistently made the use of dental implants quicker, easier, more reliable, and more affordable.Dentures have been in use for more that 30 years. However, dental implants long ago surpassed dentures in providing a reliable treatment option for those missing all of their teeth. Fixed and removable bridges were once the standard of care for one or a few missing teeth. No more; now single unit dental implants are used to replace one or a few missing teeth and do so without causing damage to remaining teeth. This minimizes the need for further corrective dentistry and the future cost and discomfort associated with it.There are two basic approaches for placing and reconstructing dental implants. One is called immediate load, the other delayed load. With the immediate load technique a tooth or teeth are built on one or more dental implant the same day the implant is placed. The All on 4 technique is an example of immediately loading. Remaining bad teeth are removed, implants are place, and the patient leaves that day with a new set of natural looking and functioning non removable teeth. Delayed loading is commonly used when only one or two teeth require replacement. Because of bio-engineering concepts related to force and stress vectors it is often best to let single dental implants integrate for 4 to 6 months before they are loaded. A common exception to this single tooth delayed protocol is when a front tooth is lost by accident. In those cases, whenever possible, the remaining root is carefully removed, the implant is placed, and a temporary crown is secured to the implant all in one appointment. It is essential that this temporary crown not make contact with the other teeth when chewing but if that can be accomplished this technique can be used with excellent success and the patient leaves with an attractive smile. This is appropriate for front teeth were as it might not be for back teeth for two reasons:

1. When we close together the front teeth do not touch one another so there is less pressure against front dental implants than back dental implants.


2. The accidental loss of a front tooth results in a sudden and dramatic change to our appearance thus justifying the slightly increased risk [approximately 5%] associated with immediate implant placement and loading

So if you need a dental implant to replace a natural tooth either delayed or immediate loading will be options. An experienced Houston Dental Implantologist will be able to discuss the pros and cons of each method with you so you can make an informed decision.