Dental implants are screw-like devices that are used to replace missing teeth. When dental implants are placed in your jawbone, they bond with your natural bone providing a sturdy base for supporting one or more artificial teeth, called crowns. An abutment acts like a connector, it is placed over the dental implant to support the crown.

The dental implant is usually made of Titanium or Titanium alloy. The dental implant itself can be coated with different coatings that increase the stability and bone integration. Dental implants have revolutionized the way teeth are replaced. They have been successfully in use since the past 50 years. Scientific studies, research and clinical trials worldwide have proved that dental implants are more predictable than conventional bridges and endodontic therapy. Without doubt dental implants are the most predictable option available today to support replacement of missing teeth. Teeth replaced with Dental Implants look and function naturally and they also preserve natural bone by actually stimulating bone growth.

We at Dr. Malhotra's with our highly experienced and globally trained team of dental implantologists evaluate your individualistic requirements and using the latest 3D diagnostic and planning technology, customize the treatment plan that is best suited to address your dental problem.

What is the right age for Dental Implants?

Dental implants can be a smart and safe choice for adults of all ages, whether you were born without a tooth, have had your teeth removed due to infection or decay or have lost teeth due to any traumatic injury. The golden rule is to wait for the facial growth and development to complete, this generally occurs at the age of 18 in boys and may occur a year or two earlier in girls.

What are the advantages of dental implants over other available options?

There are several advantages of dental implants, compared to other alternatives such as dentures and bridges:

• Now look beautiful and young forever - Dental implants help restore and maintain the beauty of your face and keep you looking young forever. Dental implants not only retain your natural face shape, aesthetics and smile, they also feel, look, fit and function like healthy, natural teeth. You can brush and floss them just like you do your natural teeth without any need to remove them for cleaning.
• Comfortable - The deep flanges and palatal extensions of complete and removable dentures cause substantial discomfort to the patients. On the other hand dental implants are so comfortable that you forget you ever had them done. It only takes a few days for the patient to get used to them as they fit and function just like natural teeth.
• Durability: Built to last - We use the best global brands and highest quality dental implants in our practice, placed with good planning by our experienced, globally trained, expert team of dental implantologists can last much longer than many other options if properly cared for by the patient. It has been proved by scientific research that well planned, placed and maintained dental implants last much longer than dental bridges and dentures that may need to be replaced more often, requiring a more significant investment of time and money in the long run.
• Live life with confidence- Dental implants like your natural teeth, don't move, slip or click when you talk, eat or laugh. You'll also find that your speech is more natural. With dental implants, you'll have the peace of mind to eat what you love, say what you want to say, be as active as you want to and smile confidently.
• They protect facial bone and healthy teeth. Leaving empty spaces in your mouth after losing one or more teeth can lead to health issues such as jawbone deterioration. Dental implants are the only tooth replacement option that actually helps stimulate bone growth and prevent bone loss. Getting dental implants as soon as possible after losing a tooth helps prevent bone loss at the site. Also, dental implants don't require grinding down adjacent teeth to anchor bridges or attach partial dentures.

Types of implants and techniques

Dental implants come in different sizes, heights and types. Your dental implant expert can help you determine which option is best for you, depending on your particular needs.

There are four main types of implants:

• Endosseous Dental Implants: These dental implants are placed in the jawbone. Typically made of titanium, they may be shaped like small screws or blade. They are the most commonly used type of implants.
• Screw type/ Threaded/ Tooth form- These are by far the most commonly used and most preferred dental implants. They resemble the root forms of teeth.
• Blade type implants
• Cylinder type/ smooth type
• Subperiosteal:  These dental implants are placed under the gums (Periosteum) and fixed over the jawbone. This type of implant may be used in patients who do not have enough healthy natural jawbone, or are in close proximity to vital anatomic structures or in patient’s do not want to undergo a bone augmentation procedure to rebuild bone for placement of endosseous dental implants.
• Transosteal Dental Implants:  These implants are usually inserted in severely resorbed mandibles where placing the endosseous implant may lead to mandibular fracture. They are mostly used to stabilize loose dentures. The posts are inserted through the basal bone and stabilized with the mandibular basal bone and then stabilized with a submandibular metal plate which prevents the mandible from getting fractured.
• Basal Osseointegrated Implants:  These implants are integrated into the high-density basal bone or their basal discs are engaged bicortically, to avoid any movement during function.

If your jawbone is not able to support dental implants, several techniques can be used to rebuild bone, restore your natural jawline and provide a sturdy foundation for implant-supported teeth. These include:

• Bone grafting/ augmentation. This technique involves restoring or regenerating bone in your jaw when we do not have enough healthy natural jawbone to support implants. This deficiency of natural bones can be caused by:
• Development defects
• Gum disease
• Face Injury or trauma
• Empty space after teeth were removed

Scientific evidence has proven that that using bone additives and growth factors (GFs) have significant positive impact on osteoblast behaviour, and thus have been widely utilized for bone tissue regeneration to achieve the best results.

• Ridge expansion. If your jaw isn’t wide enough to support dental implants, bone graft material can be added to a small ridge, or space by ridge expansion which involves surgical, lateral widening of the residual ridge (i.e., buccolingually) using chisels and/or osteotomes. This expansion process is done to make enough room for the patient to receive a bone graft and/or a dental implant.
• Sinus lift. Generally, when a maxillary molar or premolar is lost, the maxillary sinus pneumatizes in this region which diminishes the thickness of the underlying bone. Sinus augmentation or sinus elevation involves grafting bone in between below the surgically lifted sinus membrane, to achieve sufficient bone volume for success of the planned dental implant.

3D Imaging and Treatment Planning

Radiographic Imaging is a critically important aspect of treatment planning while placing dental implants. High quality, accurate images collected at the pre-surgical stage can yield dividends both in implant outcomes and patient satisfaction. 

Traditional radiographic methods are not ideal for planning implant placement because we are visualizing a 3D object in 2 D and missing important information along the way. State-of-the-art, highly precise 3D digital imaging and implant surgical planning software have made implant procedures faster and highly predictable. Our expert team and senior dental implantologists use these tools to analyse the anatomy of your jaw and determine the best sites for implant placement before surgery by simulating the implant surgery using the 3D software   in advance, this makes the procedure highly predictable and accurate. This saves time and money, and shortens recovery time.

Implants versus dentures and bridges

Dental implants are increasingly becoming a popular alternative to dentures and bridges. Compare the options and see why:

Tooth-supported fixed bridge: 

Dental implants are most common alternative to tooth supported bridges for a single tooth replacement. The procedure requires grinding adjacent minimum of two teeth which might also require them to be intentionally root canal treated, this whole process compromises minimum two healthy teeth and affects their lifespan adversely. As there is no natural tooth in the missing area to stimulate natural bone growth, it leads to gradual deterioration of the underlying bone. Moreover subsequent bone loss, food retention and increasing difficulty in maintaining hygiene, makes the root surfaces below and around the bridgework highly susceptible to decay.     

Removable partial dentures

Although these don't require grinding down adjacent teeth, removable dentures look relatively artificial and are not nearly as stable or comfortable as dental implants hence compromising their functionality. Removable dentures can affect speech and eating. This type of restoration is less expensive but doesn’t look as natural or function as well as an implant-supported crowns. The bone underneath a removable partial denture may deteriorate over time, changing the appearance of your smile and face and the constant placement and removal has a detrimental effect on the remaining teeth.

Resin-bonded bridge.

These bridges are called Maryland Bridge. This is sometimes considered for replacing front teeth. The resin-bonded bridge option offered a more conservative method of tooth replacement; tooth preparations may or may not be required but are limited to the lingual surfaces of abutment teeth. However, these preparations are more technique sensitive because they must remain in enamel yet provide occlusal clearance and adequate room for the restorations. A major disadvantage of the resin-bonded bridge is the frequency of debonding as they can’t endure the biting and chewing demands of back teeth. A resin-bonded bridge looks and functions better than a removable denture but isn't as strong as fixed bridgework and typically doesn’t function or last nearly as long as dental implants.

Removable complete denture.

This denture sits on top of the gums where the missing teeth were. It can be uncomfortable, affect your ability to experience the full taste of food, cause sore gums, and shift and click in your mouth when you speak, eat, smile, yawn or cough. While the initial costs are low, they only last an average of 7 to 15 years, and the replacement costs can be significant over the long term. They need to be removed regularly for cleaning, which can be a time-consuming hassle. Also, as with a partial denture, the natural bone underneath a complete denture may deteriorate/ resorb over time, permanently changing the appearance of your smile and face.

Alternative Dental Implant Techniques

Depending on the health of your jawbone and your specific needs, your dental implant dentist may suggest some alternative treatment options in addition to the traditional multi-step dental implant procedure. Options may include:

• Immediate Load Dental Implants. Also called same day implants or Teeth in a Day®, immediate load dental implants allow placement of a temporary tooth during the same appointment as your dental implant placement. This may be a good option if you have enough natural bone and an implant secure enough to support immediate placement and pressure on the new temporary tooth.
• Mini dental implants (MDIs). Also called small or narrow diameter implants, these toothpick-sized implants are narrower than most commonly used dental implants. They are placed through less-invasive techniques and are used primarily to stabilize a lower denture.
• All-on-4®/ All on 6. All-on-4 is an alternative to placing a top or bottom set of replacement teeth, called a full arch. Four dental implants are placed in available bone, avoiding the need for bone grafting. Special abutments are used so that a temporary set of replacement teeth can be placed the same day. You follow a modified diet while the gum tissues heal and the implants bond with your natural bone. After about six months, the permanent replacement teeth will be placed and you can resume a regular diet.