Quick Answer
The most common and popular dental implant is the endosseous implant, also known as the root form implant. Endosseous implants are placed directly into the jawbone as artificial tooth roots to support crowns, bridges or dentures. They are made of titanium and come in various shapes and sizes. Over 95% of implanted fixtures are endosseous implants.
What is a Dental Implant?
A dental implant is an artificial tooth root replacement used to support restorations like crowns, bridges or dentures. Implants are placed surgically into the jawbone, where they fuse with the natural bone through a process called osseointegration. Once integrated, they can support prosthetic teeth to replace missing natural teeth.
Dental implants have two main components:
- The implant fixture – This is the artificial root portion screwed or placed into the jawbone. It is usually made of titanium as this material integrates well with bone.
- The abutment – This connects the implant to the crown. It is usually made of titanium, gold alloy or ceramic.
Benefits of Dental Implants
Dental implants offer several advantages over other tooth replacement options:
- Improved appearance – Implants look, feel and function like natural teeth.
- Prevent bone loss – Implants prevent jawbone deterioration by mimicking the root.
- Improve oral health – Nearby teeth are not altered to support the implant.
- Long lasting – With proper care, implants can last decades.
- Improved speech – Implants allow natural teeth movement and placement.
- Easier eating – Implants perform like natural teeth while eating.
- Improved comfort – Implants are stable and do not interfere with oral function.
- Improved self-esteem – Implants allow patients to smile, speak and eat with confidence.
Types of Dental Implants
There are three main types of dental implants:
1. Endosteal (Endosseous) Implants
Endosteal or endosseous implants are the most commonly used implants in dentistry. They consist of screws, cylinders or blades that are surgically embedded into the jawbone. Each implant holds one or more prosthetic teeth.
These implants are further categorized into two main types:
- Root Form Implant – This is the most popular and successful type of endosseous implant. They resemble the root of a natural tooth and are placed directly into the jawbone. Root form implants integrate with the bone and can last many years.
- Plate Form Implant – These are flat, rectangular-shaped implants with holes into which bone grows. They are easy to insert but less successful long-term as the bone does not integrate as well.
Over 95% of implants placed are endosseous implants as they most closely replicate natural tooth roots.
2. Subperiosteal Implants
Subperiosteal implants are metal frames placed under the gum tissue but on top of the jawbone. They consist of a metal framework and posts that protrude through the gums to hold the prosthetic teeth.
These types of implants are less common today as they are more invasive and higher risk. They may be an option when the jawbone has less density.
3. Transosseous Implants
Transosseous implants pass completely through the jawbone and are affixed with screws on either side. They are not very common as they require highly invasive surgical procedures.
Today, endosseous implants are preferred as they integrate better with the jawbone and have higher long-term success rates.
The Endosseous Implant Procedure
Endosseous implants are the gold standard in implants due to their similarity to natural tooth roots. Here is an overview of the endosseous implant procedure:
Step 1 – Site Preparation: The dentist will take x-rays and a CT scan of the jawbone to precisely evaluate bone quality and quantity. This ensures adequate bone is present to securely place the implant. Local anesthetic is administered before the procedure.
Step 2 – Inserting the Implant: The dentist will make a small incision in the gums and shape the bone to create a space for the implant. The titanium fixture is then screwed or drilled into place. Stitches may be required to close the gums over the implant site.
Step 3 – Osseointegration: The implant must fuse with the jawbone in a process called osseointegration. This may take 3-6 months in the lower jaw and 6-9 months in the upper jaw. The gums are allowed to fully heal before the next step.
Step 4 – Placing the Abutment: The abutment is connected to the implant after it has integrated with the bone. This acts as an anchor for the new prosthetic tooth.
Step 5 – Creating and Securing the New Tooth: After the abutment is placed, an impression is taken and used to create the prosthetic crown, bridge or denture. This restoration is designed for optimal comfort and appearance. It is attached securely to the abutment.
Step 6 – Follow-up Appointments: The dentist will schedule regular visits to monitor the implant, ensuring the site is healthy and the restoration remains securely attached. Proper oral hygiene is essential for the long-term success of implants.
The Ideal Implant Candidate
While most patients are candidates for dental implants, the procedure is ideal for those who:
- Are missing one or more natural teeth
- Can commit to diligent long-term oral hygiene
- Have adequate bone density and volume in the jaw
- Have healthy gum tissues that will heal well
- Are nonsmokers or willing to quit smoking
- Are in good general and oral health
Certain conditions like bruxism, diabetes or osteoporosis may impact the success rate but do not necessarily preclude implant treatment.
The Success Rate of Dental Implants
With over 50 years of clinical research, dental implants have proven to be a highly successful and predictable treatment for tooth loss. Success is generally measured by:
- Survival of the implant in the jawbone
- Effective osseointegration with the bone
- Functionality of the restoration long-term
- Maintenance of healthy bone and gum tissue around the implant
The success rate of dental implants depends on many factors:
When performed under optimal conditions by an experienced dentist, dental implants have proven to be a highly effective and predictable permanent solution for missing teeth.
Reasons an Implant May Fail
While dental implants have a high long-term success rate in ideal candidates, there are some reasons an implant may fail:
- Infection – This is the most common cause of early failure. Infection may develop from poor oral hygiene, improperly fitted devices, or decreased immune resistance.
- Loosening – An implant may loosen if osseointegration does not proceed adequately or bone loss occurs around the implant.
- Inadequate bone – Lack of sufficient quality or quantity of jawbone can lead to loosening or lack of integration.
- Implant damage – Improper surgical placement or forces from grinding/clenching can damage the implant.
- Rejection – In rare cases, the body rejects the implanted foreign material.
- Recurring periodontal disease – Gum disease that is poorly controlled or recurs can affect the supporting bone.
- Failed osseointegration – The implant does not properly fuse with the bone. This is often related to poor bone density.
- Trauma – A blow or injury to the face can fracture or dislodge the implant.
Proper planning, technique and aftercare help minimize failure risks. Additional bone grafts or implant removal/replacement may be needed in cases of failure.
Comparison of Dental Implants to Tooth-Supported Bridges
Dental implants differ from traditional tooth-supported bridges in a few key ways:
| Implants | Bridges |
|---|---|
| Replacement root fused to bone | Pontic fused to abutment teeth |
| Require a surgical procedure | No surgery involved |
| Preserve bone at site of missing tooth | Can lead to bone loss at site of missing tooth |
| Do not rely on other teeth for support | Use adjacent teeth for support |
| Equally effective single or multiple tooth replacement | Works best for short spans of 1-2 missing teeth |
| Higher initial cost | Lower initial cost |
| More comfort and natural function | May require adaptation to placement |
| Esthetic outcome very natural | Esthetic limitations near gumline |
| Effective long-term solution | Higher long-term failure rate |
In general, implants provide a longer-lasting, functional and esthetic outcome compared to conventional bridges. However, bridges may work well for short spans in patients unwilling or unable to undergo implant surgery.
Conclusion
The endosseous or root form implant is the most common and successful dental implant used in dentistry today. Made of titanium, these screw or cylinder implants fuse with the jawbone to permanently replace missing tooth roots.
Over 95% of dental implants placed are endosseous implants due to their similarity to natural teeth, high success rates and good long-term prognosis. With over 50 years of clinical success, endosseous implants have proven to be a predictable and effective option for permanently replacing missing teeth and restoring smile esthetics and function. When performed by a skilled dentist in an ideal candidate, dental implants can greatly improve quality of life.
