What are dental implants? Types, procedure, pros and cons

Richard Hattaway

Written by Richard Hattaway DDS, Jack Lawrence DMD, Henry Hackney DMD, Benjamin Wang DDS, Greg Grobmyer DDS

Dental implants are posts (titanium screws) that are surgically placed in the jawbone. Through a process called osseointegration, they merge with the bone to provide a stable base for an abutment or post which will support a crown, bridge, or denture.

Implants are said to feel and function almost as if they were natural teeth, providing a great, permanent replacement option.

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Types of dental implants

Dental implants can be divided into two main categories, depending on how many teeth they replace. You can restore a full arch or a single tooth.

Full-mouth dental implants

Implant-supported dentures

Picture by Authority Dental under CC 2.0 license

It's possible to replace all the teeth to give the patient a completely restored smile. Full-mouth dental implants are either permanent or removable. The first is usually mounted on four implants, like the All-On-4. The second option, called denture implants, can sometimes be done with just two.

If any teeth are remaining, they might be extracted. The artificial dentition is customized to fit the face and mouth, giving a natural look.

Single-tooth implant

Front tooth implant

Picture by Authority Dental under CC 2.0 license

If you are just missing a singular tooth, your implant will support one crown. It will still replace the root, which means bone will be stimulated. Single tooth implants are often recommended for front tooth replacement.

A single tooth implant is a great alternative to a bridge, as it does not damage adjacent natural teeth. It stands on its own, providing the patient with full functionality and impressive aesthetics. 2 implants can be used to support a bridge if a patient is missing multiple neighboring teeth.

Dental implant parts

A tooth restoration in the form of an implant is composed of three main parts. Those are the fixture, the abutment, and the artificial tooth.

Fixture

Also called an implant body or post, it goes into the hole in the gum where the tooth is missing. The implant post resembles a screw and it is the part that fuses to the bone. Placing this is a short surgical procedure.

After the fixture is in place, a healing cap is put in to make sure gums grow around it properly. The surgeon may wait 6-8 weeks before placing a healing abutment.

Abutment

When the post and bone have fused, the gum will be opened up again to attach the dental implant abutment. It looks like a short, metal version of a tooth and it is screwed or cemented in place. The dental implant screw acts as a connector between the post and crown or bridge (fake tooth).

Crown or bridge

A crown is used for single-tooth implants. It is the only part that is visible in the mouth once the restoration is complete. Gums grow around it, giving the tooth a natural appearance. Dental implants crowns can be matched to the color and size of surrounding dentition for a fully customized look.

When having multiple teeth replaced, you will be fitted with a bridge or denture.

What are dental implants made of?

Zirconia vs. metal dental implants

Picture by Authority Dental under CC 2.0 license

The most common dental implants material is titanium. They can also be made from zirconia. Both of these are durable and cosmetically pleasing. Your dentist will help decide which is right for you before scheduling your dental implant procedure.

Titanium

Titanium dental implants have been used for decades. It is a biocompatible material, which makes it perfect for osseointegration. Titanium is durable, lightweight, and resists corrosion.

Implants made of titanium have a success rate of roughly 97%. Patients who have allergies should take the MELISA test to make sure the implant won’t cause any issues, although this rarely happens.

Zirconia

Ceramic dental implants require a higher level of expertise from the dental practitioner to place correctly, because they are less durable. This kind of implant comes in two pieces. The abutment and crown connected together are made of zirconia, while the actual implant body is still titanium.

Zirconia implants are often marketed as more aesthetic. Such implants are tooth-colored, which makes them appear even more natural. Titanium rods can sometimes be slightly visible at the gumline.

Dental implant procedure

Tooth implant process

Picture by Authority Dental under CC 2.0 license

Getting a single implant can take as little as a couple hours or as long as 2 years. There are a few things that indicate how long the whole thing takes:

  • your general dental and gum health,
  • the number of teeth you want to replace,
  • which teeth you want to replace,
  • whether you need extractions, and
  • whether your jawbone requires grafting.

If you don’t need additional procedures and your oral health is up to par the implant process can take around 9 months. There are solutions that give you one-day implants, but not everyone is a candidate for this.

The first step of the tooth implant procedure is a consultation. It may take a few weeks to schedule. This visit may include X-rays and/or teeth impressions to inspect inner structures of your mouth. It is not uncommon to see a few different specialists. A treatment plan is devised.

The dentist will review your medical history. Make sure to disclose any underlying conditions and what medication you are regularly taking. If you are suffering from periodontitis, this should be treated before the process begins.

Tooth extractions and bone grafting are the most common procedures associated with the tooth implant process. The latter may involve up to 12 months of healing. Neither might be necessary in your case, but it’s worth knowing what they are if it does come up during your consultation.

If you still have a tooth (or teeth) where you want the implant (or implants), an extraction will take place. Most often, though, dental implants replace missing teeth or dentition that is badly damaged.

The next step is surgery. Implant procedure pain can be managed with some type of anesthesia. The most popular means are local injection, IV, or general sedation.

Your gum will be cut open to expose the bone. A drill will be used to make a small hole that will allow the titanium rod (implant) to be inserted. That can take up to a couple hours. You will leave the office with sutures and might have a separate appointment to remove them.

Osseointegration is the implant and bone fusing. This stage is key for a successful dental implants process. The material of the rod is biocompatible, which means bone can grow into it. This is what makes dental implants such a durable solution.

The process takes 3 to 6 months on average, with up to 7 for the upper jawbone. You will get a healing collar once this is complete. It is a piece of round metal that keeps gums from growing over the implant. It will stay on for 10-14 days.

The healing collar will be removed when the gums are finished recovering. The next step is placing the abutment, a piece of metal that will secure the crown (tooth cap), bridge, or denture. This can be “skipped” if this step takes place at the same time as the implant.

Despite the fact that recovery from this procedure takes only 2 weeks, you will have to wait about 6 for the next one. This is how long it takes to make a permanent crown. Until then, you might wear a temporary one. Otherwise, the abutment will be visible in the tooth gap.

The final stage is placing the dental crown, bridge, or denture. This looks like natural dentition. If you are not getting a full arch, the color and shape will be matched to the neighboring teeth.

Impressions of your healed mouth will be taken and the artificial teeth will be made. The crown, bridge, or denture is placed, screwed, or cemented into the abutment. In the case of snap-in dentures, you will be able to remove it yourself for cleaning.

Pros and cons of dental implants

  • Life-long solution

  • Most durable tooth replacement option

  • No issues with smiling, eating, or talking

  • Stimulate the bone and prevent reabsorption

  • High success rate

  • Look just like natural teeth

  • Expensive

  • Expensive

  • Additional procedures might be necessary

  • Some patients are allergic to titanium

Dental implants data and facts

- Implants fuse to the bone and stimulate growth, making your jaw stronger. - Implants can’t get cavities. - 3 million people in the US have dental implants, and 500,000 more are installed every year. - Almost 90% of people can’t afford the cost of dental implants. - The first successful dental implantation in a human was performed in 1965. - Dental implants can be done in just one day. - Studies show that smokers have a success rate of 84.2%, while for non-smokers it is 98.6%.

FAQ

If you have enough bone volume, an implant can be placed the same day your tooth falls out or is extracted. Dentists often recommend 3 to 6 months of healing nonetheless.

If you lost a tooth a long time ago, you are likely going to need grafting to make the bone thicker. It will ensure the base is stable enough to support an implant.

The surgery itself takes about two hours. The whole process including the initial consultation, extractions, bone grafting or sinus lifting, healing, restoration placement, and recovery can take about two years in total.

One-day dental implants are possible, but only the surgical procedures are done in one day. Sometimes you can walk out with a new set of teeth, but they are often temporary and have to be replaced with permanent ones about 6 weeks later.

Dental implants have an incredibly high success rate, about 93%. The method has only gotten better since 50 years ago when it was first conducted. There is little to no risk if the surgery is performed by an experienced specialist. Complications are rare, and mostly due to lack of patient compliance.

If cared for properly, implants can be a lifelong solution and they are considered a fully permanent restoration. The crown might have to be replaced after about 15 years, but there is almost never a need to change the post. The first successful implant stayed in the patient’s body for over 30 years. He was able to take it to his grave.

Yes. Smoking is the number-one risk factor for implant loss when it comes to what patients can control. Tobacco use increases the risk of peri implantitis. This disease is responsible for loosening of the implant, making the jawbone no longer able to support it.

You should not smoke for at least 2 months after your placement surgery. The longer you abstain, the better. E-cigarettes still contain nicotine. The substance works to constrict capillaries preventing proper blood flow. This can impair recovery and bone growth, both very important processes in implant placement.

The best choice for diabetics are traditional dental implants. Mini or same-day implants are not recommended. Dental implant survival in well-controlled diabetic patients is comparable to that of the general population. If you are on top of your disorder, it is not a contraindication.

The success rate is similar to that of non-diabetics, about 96.4%-100%. This concerns both type I and type II diabetes. Nonetheless, diabetics must go through an antibiotics course. This is becoming a more and more popular practice among all patients.

References

  1. The Impact of Edentulism on Oral and General Health - PMC
  2. Tobacco as a risk factor for survival of dental implants - PubMed
  3. Titanium allergy tests - Melisa
  4. Diagnostic Imaging for Dental Implant Therapy - PMC
  5. Treatment planning for implant restorations - Nature
  6. The importance of a thorough medical and pharmacological history before dental implant placement - PubMed
  7. Osseointegration - ScienceDirect
  8. Bone growth around dental implants - Europe PMC
  9. Tooth Implant vs Bridge: What Top Dentists Are Recommending - ADA
  10. Air-Abrasive Disinfection of Implant Surfaces in a Simulated Model of Periimplantitis - Semantic Scholar