Dental Implants: Replace Missing Teeth | Elite Dental Group
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Dental Implants

 

A dental implant is a permanent teeth alternative to dentures or dental bridges.

 

Dental implants can help replace missing teeth permanently and are built so that they closely resemble your natural teeth.

 

Implants can feel more comfortable in comparison to alternative teeth replacement techniques. 

Dental Implant Structure

dental implant structure for replacing missing teeth

 

Fixture (Implant)

 

The implant fixture is shaped like a screw and comes with different lengths and widths, designs and surface characteristics. Implant designs differ from implant company to implant company, but all dental implant systems available in Singapore have been approved by FDA and HSA. 

 

 

It is up to the expertise, experience and knowledge of the dental surgeon to choose a dental implant fixture system that can be best suited for the unique circumstances of each case. 

 

 

Did you know

The implant fixture is made of either medical-grade titanium or less commonly ceramic.  The implant fixture is surgically placed into your jaw bone to replace the root of your natural teeth, and to form the support for the abutment and prosthesis

 

 

Abutment (Connector)

 

The implant abutment (connector) is a small attachment that connects to the implant fixture via a small internal screw. The abutment can be made of metal or ceramic and its function is to help to connect and support the implant prosthesis in this 3 piece assembly. Abutments can be either pre-formed by the manufacturer or custom made by the dental technician in the dental laboratory. In some cases, the abutment and prosthesis can be fused together in one single unit. This is the case for screw-retained prostheses versus cement retained ones.

 

Prosthesis (Crown, Bridge or Denture)

 

And finally, the implant prosthesis forms the most significant part of the implant treatment; the part that you can feel, see and chew with. Dental technicians in the dental laboratory spend hours making sure that the prosthesis closely mimics the crown of your natural teeth. 

 

These skilled technicians use tools, materials and equipment to ensure that the prosthesis made are strong, and can withstand heavy biting forces and are custom coloured to be as natural and life-like as possible. Highly skilled technicians can make prostheses that are so life-like that it is indistinguishable from other natural teeth!

 

It can come in various forms such as a:

  • Crown (replaces a single tooth)
  • Short span Bridge (replaces 3-4 teeth)
  • Long span Bridge ( replaces more than 5 teeth)
  • Full Denture (replaces a full arch of missing teeth )

Dental Implant Procedure

 

A new smile in just 3 steps

 

Contrary to popular belief, dental implant placement is fairly straightforward and involves minimal discomfort – especially when performed by an experienced dentist who is extensively trained.

 

4 steps for a Dental Implant in Singapore

 

4 steps for a Dental Implant

 

Step 1: Consultation and Case Assessment

 

At Elite Dental Group, our combined experience of more than 80 years helps us to adopt a very personalised approach to your treatment plan. During the preliminary consultation, we carefully consider the following:

 

  • Overall suitability of dental implants in your case
  • Overall complexity levels of your case
  • Size of missing tooth gaps and types of dental implants that are suitable (if at all)
  • Health of gums and bone and if they can reliably support dental implants
  • Properties and volume of bone surrounding the affected area
  • Presence of nerves, blood vessels and sinuses in the area
  • Systemic health risk factors such as high blood pressure, diabetes, smoking and cardiac conditions.
  • Various other unique patient factors

 

 

A series of routine dental X-rays, 3D CBCT scans and moulds/3D intra-oral scans will then be taken to assess potential dental implant sites in your jaw and to help us in pre-surgical planning. We can also bring in a Ministry of Health-certified medical physician to help assess you if you have complicated medical and systemic health issues that may need to be stabilised first before you are deemed fit for dental implant surgery.

 

 

Step 2:  Dental Implant Surgery

 

1-2 days prior to your surgery, a thorough scaling and polishing is done to reduce bacterial numbers for smooth healing to occur. Many of our patients also begin taking an oral probiotic supplement to boost the numbers of beneficial bacteria in the mouth as well as to aid in post-op healing.

 

 

The surgery duration can be as short as 20 minutes (depending on the number of implants placed). For greater comfort, many of our patients opt to do the procedure under intravenous (IV) sedation administered by a qualified specialist anaesthetist in our clinic.

 

 

During the surgery, the dental implant will be inserted into your jaw bone and restored with a crown at a later stage.

 

 

In certain cases, simultaneous bone grafting and/or gum grafting can also be done at the implant site as part of the overall treatment plan.

 

dental implant bone grafting Singapore

 

Elite Dental Group uses only the highest quality implants from global manufacturers such as Straumann, Osstem, Megagen, Nobel Biocare, SIC and Ankylos. All dental implants that Elite Dental offers are HSA (Singapore) approved, and have gone through years of vigorous international scientific testing. You will be assessed on which brand of dental implant is best suited for your case, as each brand of dental implant has unique design features, pros and cons and different indications.

 

 

Post surgery downtime is expected to be around 1 to 2 days depending on complexity.

 

 

Step 3: Implant Crown Placement

 

A period of 3-6 months is usually necessary for complete bone and gum healing around the implant. Once the wound has healed, the abutment and implant crown is fitted onto the implant in a straightforward process.

Benefits of Dental Implants

 

Dental implants are now widely accepted as the gold standard of replacing missing teeth for the vast majority of patients.

 

Having said that, there is still a certain percentage of patients that would not be suitable for dental implant treatment, and they would benefit from alternative treatment options like having a fixed conventional bridge or a removable denture.

 

If done right , and with careful planning, execution and maintenance, dental implants can serve as a permanent solution with minimum risk of complications, thereby significantly improving your quality of life, chewing efficiency and self-confidence. 

 

Unlike dentures, they do rock from side to side in your mouth, making it a stable and strong treatment option. Also, unlike bridges, they do not rely on the support of having neighbouring teeth trimmed down and crowned.

 

There are multiple other benefits of having dental implants over other methods of replacing missing teeth, such as:

Feels and Functions Like Real, Natural Teeth

 

Implants are Surgically Osseointegrated into your jaw bone, providing a strong foundation for the artificial prosthesis (crown of the tooth).

 

The dental technician will ensure that the prosthesis is fabricated in a way that closely mimics the shape, size, surface texture, contours and colors of natural teeth. So that it feels as natural as possible in your mouth. 

 

Besides looking and feeling natural, the maintenance required for dental implants is very similar to that of natural teeth: requiring only brushing and flossing!

 

And you would never need to remove the implant prosthesis on your own to clean and maintain it , which is what you would need to do with dentures.

implantimage1

High Success Rate & Potential to Last a Lifetime

 

Depending on the peer-reviewed scientific journal article cited, and depending on the research university that publishes these articles, the success rate of dental implants range between 90-98%. Provided that cases are planned for carefully, surgeries are executed carefully, and a maintenance program is adhered to diligently.

 

If the above factors are met, it is not unusual for dental implants to last for well over 10 years, with some reports stating that dental implants have lasted a lifetime for some patients!

 

While the dental implant fixture can certainly last a lifetime for some patients, the dental implant prosthesis is subjected to wear and tear from the biting forces in the mouth and typically needs to be replaced every 10-15 years or so.

 

Several factors affect the lifespan of your dental implants including how well you care for them, whether or not you adhere to a strict maintenance program with your dental surgeon, your lifestyle and habits, the density of your jawbone, how prone you are to gum disease and whether or not you have a balanced and stable bite with your remaining natural teeth.

 

Do check in with us to ensure that you have a good understanding about the unique circumstances of your health and of your case, to get a better idea of how long dental implants can last in your unique mouth.

implantimage5

Neighbouring teeth do not need to be trimmed down

 

In conventional bridges,  neighbouring teeth to the span edentulism need to be aggressively trimmed , in order to support a conventional bridge.

 

This gives rise to potential risks of developing sensitivity and pain on those neighbouring teeth ( issues that may only be solved with root canal treatment )  and if any of these supporting teeth develop decay or problems in the future, the entire bridge needs to be sectioned and removed and replaced.

 

Having dental implants placed to replace missing teeth avoids such stress to neighbouring teeth and is a key advantage that is considered during the treatment planning discussion with our patients.

Missing tooth from dental trauma

Avoids Problems Associated with Missing Teeth & Prevents Jawbone Atrophy

 

Having missing teeth is not just a cosmetic problem ( if the missing teeth are visible).

Failing to replace missing teeth could result in remaining teeth becoming subjected to more biting forces and stress than they are designed to withstand.

This could result in remaining teeth to shift or tilt and for inter-dental gaps to worsen and widen.

If this tooth movement and shifting causes crowding and worsening of bite misalignment, your remaining teeth could become more difficult to clean and maintain, thereby resulting in an increased risk of developing dental decay and gum disease.

This is a vicious cycle that could result in even more tooth loss over time.

Also, when teeth are missing, it causes the jawbone and tissues in the edentulous area to atrophy, shrink and decrease in volume. This could affect the bone structure of one’s face and change one facial appearance, making one look aged. This is especially so if the area of edentulism is in the upper or lower front area where lip support is provided by the presence of teeth , bone and gums.

When bone is stimulated and loaded by the presence of dental implants, it maintains its volume and the rate of bone shrinkage over time is reduced.

In this way, your facial structure is maintained, preventing premature ageing, and resulting in maintaining a youthful and vibrant facial appearance with good support of the soft tissues in your lips and cheeks.

implantimage8

Enhances Your Confidence and Speech & Chewing efficiency

 

Dental implants can feel almost exactly like your natural teeth, allowing you to chew, drink, smile, laugh and talk freely and confidently as you normally would.

 

Because dental implants are fixed, secure and strong , you don’t not have to feel guarded or insecure that the false teeth may “ fall out of your mouth “ or “ move out of position” thereby causing distress or embarrassment in a social situation.

 

This feeling of insecurity can happen in patient’s who have ill-fitting or poorly made removable dentures.

 

Teeth are also an essential part of speech, pronunciation and sound development. When there are gaps in your teeth, or when there are insufficient teeth to brace the tongue during speech, there could be an inability to pronounce words properly and lisps could occur. With a properly designed dental implant prosthesis,  speech and pronunciation problems can be minimized and/or totally avoided altogether.

implantimage6

Ease of Maintenance

 

In simple, uncomplicated dental implant cases, the dental implant prosthesis or crown is easily maintained. There is very often no need for complicated home maintenance tools and equipment, other than routine toothbrushing and flossing. Just like how regular teeth are maintained.

 

In more complex cases that involved multiple implants and longer span prostheses, specialized home care tools are available to help you care for your implants in a way that is as efficient as possible.

Types of Dental Implants

 

Depending on your particular condition, the specific type of dental implant would be chosen to best suit your needs. For example, if you have low jawbone density, zygomatic or tubero pterygoid dental implants may be suitable for you.

implantimage11

All-on-X Dental Implants / Teeth-in-a-day

 

Also known as teeth-in-a-day, full arch or full mouth dental implants, are suitable for patients who are fully edentulous and no longer have natural teeth in either their upper jaw, lower jaw or both. The “X” stands for the number of implants placed and it usually is a minimum of 4 implants but it can involve 6 , 8 or even 10 implants!

As the name implies, this procedure is completed within a single day( 24 hour period). Depending on the treatment plan that’s unique to the attending patient,  “X” number of implant fixtures are placed within the jaw bone and a temporary implant-bridge prosthesis is then placed over these fixtures, giving you a full set of teeth in a single procedure. Days and sometimes weeks of careful planning is necessary for a successful surgery to occur, with careful consideration of patient risk factors and long term maintenance issues.

This procedure as popularized by the media and clever marketing is sometimes referred to as “ ALL-ON-4” implants .  It is important to note that this procedure is not suitable for all patients and its indication has to be carefully considered.

implantimage16

Single unit Dental Implants

 

These dental implants are suitable for patients who want to replace a single missing tooth.

 

Single unit dental implant procedures can vary from being routine to incredibly complex, requiring multiple bone and soft tissue grafting procedures.

 

As a very general rule of thumb, single unit dental implant surgeries to replace missing teeth in the upper or lower front region are considered to be more complex then dental implant surgeries replacing side teeth or molar teeth.

 

But every case is analysed on its own merits!

implantimage14

Multi unit Dental Implants

 

Multi unit dental implants are suitable for those who require several teeth to be replaced at one time ( usually between 3-5 teeth).

 

Each missing tooth can be replaced by individual dental implant fixtures replacing each tooth, or via multi unit bridges supported by implant fixtures.

 

Again, every case is decided on its own merits and every treatment plan is unique to the unique patient.

implantimage13

Metal-Free Dental Implants

 

Metal-free dental are not common and are usually made of a ceramic called Zirconia.

The vast majority of the dental implant fixtures today are made from medical grade titanium and titanium is still considered to be the gold standard material used for the manufacture of dental implant fixtures.

Zirconia metal free implants are indicated typically only if our patients report that they have some kind of allergy to metals or specifically titanium.

It is interesting to note that because Zirconia implants are new in the market, there have not been many long- term scientific studies published to confirm their long term stability and survival rate, so therefore their widespread use is subject to intense debate in the scientific community.

However, in patients with genuine rare allergies to metals or titanium, metal free Zirconia dental implant fixtures can be a viable alternative to consider.

implantimage12

Zygomatic Dental Implants

 

Zygomatic dental implants differ from traditional dental implants, where instead of having conventional implant fixtures drilled directly into the mandible or maxilla, very long specialized implant fixtures are drilled into the upper jaw bone, close to the Zygoma bone or cheek bone. This treatment is indicated for patients with severe bone loss and/or patients who are deemed unsuitable for bone grafting or bone regeneration procedures.

 

The surgical placement of Zygomatic dental implants are a specialist level procedure and its performed by our resident specialist Oral and Maxillofacial Surgeon. This procedure is typically only performed when it is firmly determined that conventional dental implants are not an option to consider and is seldom indicated as a first line treatment option.

implantimage15

Sub Periosteal Dental Implants

 

Instead of using an implant fixture to support a prosthesis. Subperiosteal implants use a custom made metal frame designed to be fixed onto the surface of the jawbone and beneath the gums. This metal frame has a series of posts that are then used to support the placement of a prosthesis like a crown, bridge or denture.  This type of implant is only indicated when it is determined that conventional dental implant fixtures are not suitable.

Do I Need Dental Implants?

 

dental implants for replacing missing teeth

 

If you have missing teeth, or if your existing dentures or dental bridge is loose and uncomfortable, dental implants may be the right solution for you.

 

You may need dental implants if:

  • You have any missing, failing, or unstable teeth. Missing teeth can cause some severe dental problems down the line, including gum recession and changes in one’s facial structure;
  • You have missing teeth which affect your ability to chew. This not solely prevents you from enjoying the food you love but also could result in indigestion or an inability to break food down small enough to chew;
  • You have missing teeth which affect your ability to pronounce words, and you hence have speech issues. With a hindered ability to express yourself, you might feel a sense of isolation or that you’re not as confident speaking in the same way you once were;
  • You are dissatisfied with your smile, which in turn has a few psychosocial consequences, such as a lowered self-esteem, fear of social interaction, or reduced quality of life;
  • You have an uncomfortable, dysfunctional or destructive bite. This could result in chipped, broken or worn-down teeth;
  • You are dissatisfied with your current dentures.

How Should You Maintain Your Dental Implant?

maintaining your dental implants after surgery

 

The success of dental implants hinges on a patient’s ability to care for them well. From the insertion of the implant fixture to having the crown fit, patients should adopt soft diets where necessary and avoid vices like smoking.

 

Implants have the best long-term success with patients who:

 

  • Consistently maintain stellar oral hygiene and dental care;
  • Regularly attend their dental check-ups;
  • Do not place excessive biting forces on the implant (extreme biting forces could result from tooth grinding habits, having a dysfunctional bite, etc.);
  • Do not smoke

Anxiety Associated with Dental Implant Surgery

 

At Elite Dental, we get it.

 

We have learnt over the years about what truly matters to the vast majority of our patients who are considering dental implant rehabilitation.

 

Many factors go through our patients minds before they eventually decide on getting the dental implant treatment that they want and need.

 

Factors such as cost, perceived inconvenience and whether or not the dental surgeon can be trusted to be caring, ethical and honest … just to name a few.

 

But few factors matter more than having the reassurance that the dental implant procedure can be executed in the most efficient, pain-free way possible, with no down time. So that inconvenience is minimized and other important things in our patient’s busy lives can go on.  We realize that that our patients often have to balance dental appointments with work, medical appointments, family commitments and responsibilities such as caring for children or the elderly.

Having said that, at Elite Dental Group, we constantly have that on top of mind, for every dental implant case that we see, day in day out.

We achieve predictable, efficient and often pain free dental implant procedures by employing Computer Guided , Keyhole dental implant surgery as our default treatment modality. So that patients can go about their lives the very next day.

 

Despite the fact that it would be impossible and wrong to absolutely guarantee outcomes in any medical procedure, many of our patients report:

 

No Pain. No swelling. No Downtime.

 

For those of our patients who would require more extensive and complex procedures, we still aim to achieve the same. And we always manage expectations by under promising and over delivering, because there is simply no better way.

 

We hope our mindset gives you the courage to find out more below!

Dental Implant Fees

 

Our fees for dental implant surgery range from $2,000 to $6,000, depending on the complexity levels of each case.

 

 

The amount is partially claimable under your Medisave account (if you are a Singaporean or a Singapore Permanent Resident). As of 2019, this claim amount is up to SGD$1250. Additionally, you are advised to check with your own insurance company to see if you’re covered.

 

 

Please read the following article written by our Founder, Dr Gerald Tan on average dental implant fees in Singapore, current as of 2019.

 

dental implant surgery costs are Medisave claimable in Singapore

 

Do note that abutments and implant crowns are charged separately. Prices range from $500 to $2,000, depending on the type of abutment and implant crown chosen, and are not claimable under the Medisave scheme.

FAQ

How much do implant teeth cost?

Dental implant costs in Singapore range from an average of about $3500 – $6000 in total for a routine non-complex case.

 

As with any professional service, the majority of the costs associated with dental implant surgery that a patient pays for; is for the experience, skill, reputation and knowledge of the dental surgeon accumulated over years of training and postgraduate education. Also, costs vary depending on the complexity of the case and the time spent in planning for the surgery.

 

The fee you pay is Medisave claimable, up to a limit of $1250 for one dental implant ( rules subject to change *)

 

The Ministry of Health website also provides a rough gauge of dental implant costs in Singapore. As of 2015, public hospitals charge $1600 – $1944 per surgical implant fixture placement, while private clinics charge $2000 – $4815.

 

These costs are for the implant surgery alone and do not include any associated costs as broken down for you below.

 

What are you paying for in the final price for a dental implant?

Here’s an example of an average bill breakdown:

PROCEDURECOST

Consultation$40 - $80
2D OPG or Periapical dental X-rays$80 - $120
3D CT scans (if required)$350 - $500
Implant study models and diagnostic wax ups (if required)$100 - $250
Surgical guides and/or CT guided planning (if required) $350 - $800
Bone and/or Gum grafting (if required)$800 - $2500
Sinus lifting (if required)$1000 - $3500
Dental implant crown (depending on type of crown)$1000 - $3000
Dental implant surgery (depending on difficulty)$2000 - $4000
Medication and post op reviews$35 - $150
 

A surgical guide is a piece of custom made guiding plastic that’s placed in your mouth during surgery. This enables your dentist to place the dental implant with a high level of precision, in the correct angulation, position and depth.

 

Bone grafts are required when there isn’t enough healthy bone to place the dental implant. The cost varies according to the volume of bone graft is required and the complexity of the procedure.

 

Sinus lifting is a bone-grafting procedure that increases the amount of healthy bone to place dental implants in the upper posterior areas near to the maxillary sinuses.

 

Therefore, due to the many variable costs mentioned above, the final cost of a single dental implant in Singapore can range from $3500 to a whopping $15,000! (Before Medisave deductions and claims)

 

Other factors which affect the total cost you pay include:

  • High expectations: do you prefer an impeccably natural-looking result over a basic, functional “tooth replacement” ?
  • Your dental surgeon: a vastly experienced, skilful and well trained dental surgeon with registrable postgraduate qualifications in dental implant surgery and with a good reputation will be more expensive!
  • Lab fees: customized and full bespoke hand- crafting of required dental implant materials in certain cases could result in higher fees
  • Addressing Dental Anxiety: Local anaesthesia vs IV sedation vs general anaesthesia will vary greatly in costs.

 

The take home message is that there no one size fits all solution for dental implant surgery, and every case has to be carefully planned on its own circumstances and merits, as every patient is different and unique!

What is the downside of dental implants?

There is a possibility of a few negative side effects of dental implants. Complications that may result from implant surgery and anaesthetics include but are not limited to:

 

Expected complications

  • Numbness lasting a few hours.
  • Soreness, bruising visible on the overlying skin and localised swelling lasting up to a week.
  • Oozing of blood from the wound a few hours later when the local anaesthetia has worn off.

 

Common risks and complications

  • Trauma to other parts of the mouth including adjacent teeth, gums, cheeks, corners of the mouth, tongue etc.
  • Jaw joint/muscular pain from prolonged mouth opening
  • Prolonged post-operative pain due to poor healing or infection. This tends to happen if you smoke, are diabetic or if your immune system is weak (due to illness or immunosuppressive drugs).
  • Need for bone grafting or sinus lift in the implant site.
  • Need for gum grafting (especially for a front tooth) later on when the gum shrinks.
  • The implant MUST receive a crown within 3-6 months. If the opposing tooth drifts towards the implant, there will be insufficient space for the crown and you may need braces (at full fee) to move the opposing tooth back into position.
  • After the implant crown is completed, there may still be a gap between the implant crown and the adjacent teeth. You will need to maintain this area using Superfloss/interdental brushes.

 

Rare risks and complications

  • Complications from IV sedation.
  • Trauma to tissues underneath the tooth including bone, sinus, nerves supplying other teeth etc.
  • Damage to the nerve supplying TASTE sensation to the tongue. This may be temporary (lasting up to 6 months) or PERMANENT.
  • Damage to the nerve supplying sensation/feeling to the lower lip or skin of the chin. This may be temporary (lasting up to 6 months) or PERMANENT.
  • Nerve damage from anaesthetic injections. TASTE or feeling on the tongue, palate, lips, cheeks, or chin may be affected. Occasionally, the upper eyelid may not be able to close. This may be temporary (lasting up to 6 months) or PERMANENT.
  • Allergic reaction to something used during the procedure.
  • Swallowing/inhaling part of the tooth/root fragments, surgical instruments used
     Implant surgery requires fine and small componentry for handling the implants during placement, removal, adjustments and fitting. The utmost care will be taken to prevent complications such as this however, there is always a risk that the fine componentry can be accidentally swallowed during the procedure. If this occurs, there is a requirement to have appropriate x-rays and surgical treatment to have it removed.
  • Bone loss around the implant which may require further treatment/implant replacement (at full fee). This is more likely to happen if you have a heavy bite or if you grind or clench your teeth at night (bruxism). A nightguard is essential.
  • Implant fracture. This is more likely to happen if you have a heavy bite or if you grind or clench your teeth at night (bruxism). A nightguard is essential.
  • Peri-implant mucositis is a reversible inflammation of the soft tissue around the implant that is induced by bacteria from plaque build-up. It is confined to the soft tissues alone and without loss of supporting bone around the implants. If detected early, it can be managed with optimizing daily oral hygiene and anti-microbial therapy at the dental office.
  • Peri-implantitis is a more severe and destructive inflammatory response of the soft tissues and bone surrounding the implants. This involves gingival inflammation, progressive loss of the supporting bone and loss of the connective tissue attachment supporting the implant which can occur at ANY TIME after implant placement.
      The treatment for peri-implantitis may require a combined anti-microbial and surgical therapy to manage this and promote regeneration of the supporting tissues.Unfortunately, not all peri-implantitis lesions are favourable to regenerate resulting in the loss of the implant. The implant can be replaced (at full fee).
      These can be attributed to risk factors similar to those found in periodontal disease (gum disease) such as overall medical health, smoking status, stress, hormonal imbalances, poor plaque control, occlusal overload (bruxism), sub-optimal surgical or prosthetic execution and/or improper maintenance care.
      Peri-implantitis management requires ongoing maintenance with 3-6 monthly check ups and daily home maintenance to prevent, monitor and treat these complications in the early stages.
  • Reactivation of latent endodontic (root canal-related) infections around the root(s) of adjacent teeth.
  • Gum swelling/discomfort caused by a bulky implant crown. This is corrected by making the crown more tapered.
  • Cheek biting. This tends to occur in areas where teeth have been missing for many years and the cheek tissue has become loose with increasing age.

 

Long term complications

  • Loosening or fracture of the implant crown.
  • Fracture of the screw holding the implant crown in place. In certain cases, the entire implant may need to be replaced (at full fee).
  • Wear of the crown ceramic: Over time, the ceramic may become worn, chipped, fracture or break from functional forces of eating, grinding and clenching. If the fracture is small then it may be repairable, but on most occasions this will need to be replaced and a new ceramic crown/bridge will be made (at full fee).
  • Tooth migration that leads to a gap between the implant crown and the adjacent teeth. These areas tend to trap food and will decay more easily.
  • Discrepancy between the implant crown height and the adjacent teeth. This tends to be an issue especially with implants in the upper front due to continued adult skeletal downgrowth and tooth migration.
  • The implant crown may not match the adjacent natural teeth after natural ageing changes occur (colour, opacity). Replacement of the implant crown may be needed (at full fee).
  • Gum shrinkage and bone loss around the implant crown. This may lead to exposure of the metal implant threads above or through the gum.
  • Progressive bone loss can occur over time with implants and can be related to surgical, occlusal, periodontal implications associated with implants. An implant is an artificial tooth and does not have the natural supporting periodontal ligament and anatomical architecture of a natural tooth. It relies solely on the surface of the implant screw to be fixated into bone which means implants are more prone to minor or progressive bone loss than compared to a natural tooth.
Do teeth implants hurt?

The simple answer to that question is that it depends.

 

The truth is there are many variables that might contribute to whether or not a patient experiences pain when undergoing dental implant surgery.

 

Some examples of these variables are:

  •   Subjective pain threshold of the patient
  •   Medical health status of the patient
  •   Whether or not the planned surgery can be done in a minimally invasive way to minimize surgical trauma ( for eg: computer guided keyhole surgery)
  •   Whether or not there are anatomical risks near to the dental implant site, for example: major nerves, blood vessels or the maxillary sinuses.
  •   Whether or not extensive bone grafting and/or gum grafting is needed in conjunction with the dental implant surgery.
  •   Whether or not the patient is known to have a resistance to local anaesthesia
  •   Whether or not the patient has extreme dental fear and anxiety
  •   Whether or not multiple implants are planned in one surgical procedure
  •   The skill and experience of the dental surgeon

 

The interplay of these 9 variables makes it hard for any dental surgeon to promise with a 100% certainty that the surgery will be absolutely painless 100% of the time for 100% of all patients.

 

However, from my years of experience, the only way I would guarantee a pain free procedure 100% of the time is by offering Intra-Venous Sedation or full General Anaesthesia. These sedation options are commonly chosen by my patients, and there are instances when I would not proceed with dental implant surgery unless the patient agrees to sedation.

 

 Any post-surgical pain and discomfort can be easily managed with effective medication and adequate rest.

 

Again, the risk of post-surgery pain and discomfort is also influenced by the variables above.

 

Generally speaking, the easier and less traumatic the surgery, the less the pain should be. For simple, uncomplicated dental implant surgery without sedation, many of our patients report very little to absolutely no pain whatsoever!

 

And this may sound clichéd, but the skill of the surgeon is probably the most important factor!

Who is not suitable for dental implants?

Although there can be many reasons why a patient could be deemed generally unsuitable for dental implants, here are some of the more common ones :

 

  • Patients who are deemed unfit for any kind of dental surgery due to radiation oncology therapy in the head and neck region, uncontrolled auto-immune disease and patients taking bisphosphonate medication.
  • Patients with a history of multiple failed dental implant surgery in the past.
  • Patients with uncontrolled severe generalized periodontal/gum disease.
  • Patients with uncontrolled Diabetes
  • Patients who are heavy smokers
  • Patients who have poor manual dexterity

 

These are just some of the common factors that would deem a patient at high risk or totally unsuitable for dental implant surgery.

 

However, this list is not exhaustive and it is best to have a detailed and thorough examination with an experienced dental surgeon to determine if your unique circumstances, oral condition and medical history would make you a good candidate or poor candidate for dental implant surgery.

Can dental implants be done in one day?

We have heard of some dental practices or dental surgeons promoting or advertising “ Dental implants in a day”, “ Teeth in a day” or “ Same day All-On- 4 dental implants “.

 

These procedures involve :

 

  •     In a fully edentulous case, having multiple implants surgically placed in the upper jaw and lower jaw, and on the same day, a provisional implant supported denture or fixed bridge placed for immediate function.
  •     In a partially edentulous case, having all of the patient’s remaining teeth extracted, followed by the procedures outlined in the previous point.

 

Let me begin by saying that these procedures can certainly be successful when indicated correctly for suitable patients and in suitable circumstances.

 

However, it is important to note that the indications for dental implants in a day are to be considered very carefully and are by no means considered standard, mainstay or first-line treatment for all patients seeking dental implant treatment.

 

Dental implants in a day require complex treatment planning and also require more extensive surgery as compared to simple uncomplicated cases. Such procedures may also lead to considerations of difficult long-term maintenance and long term complications.

 

If you are considering dental implants in a day, please consider seeking a proper detailed examination and consultation from an experienced and reputable dental surgeon to find out whether or not you are a suitable candidate, and to discuss all other available treatment options, before making an informed decision.

Is it better to get dentures or dental implants?

Whether or not dental implants would be “better” than dentures depends on various factors.

 

It is true that no one likes to go for surgery, and for dental implants to be even considered, it must be determined that the benefits of the surgery far outweigh any risks. Generally speaking, dental implants are far superior to dentures in terms of strength, longevity, stability, comfort and even aesthetics.

 

Having said that, removable dentures still remain a viable and less expensive treatment option for many of our patients. 

 

Dental implants would be a good option to consider if the patient is:

  • Medically healthy and cleared by his medical doctors to undergo dental implant surgery.
  • Not adverse to surgery.
  • Has overall good dental and gum health.
  • Has had a history of significant dislike for dentures with inability to chew well with them.
  • Motivated to commit to see the dentist regularly to maintain and clean the dental implants.
  • Able to accept any risks involved in the planned surgery.
  • Adverse to trimming down his natural teeth to fit a dental bridge.

 

At Elite Dental, we routinely perform dental implant surgery for all patients regardless of age who have no significant medical problems, provided the above factors are met.

 

Older patients take longer to heal so we are more careful to make sure that the benefits that they get for going through the dental implant surgery is well worth any risks or inconveniences to the patient and family members.

How long is the time frame for immediate dental implants?

The duration of the surgical procedure really depends on the number of implants being placed. If one implant is placed, removing one tooth, a typical procedure like that could be an hour long. But if you have 2 or 3 immediate implants, that could take up to 2 to 3 hours, sometimes even 4 hours.

 

Sometimes, when we put immediate implants, we also do simultaneous procedures like a bone graft. Sometimes we do immediate implants with a simultaneous gum graft. So we can do a few simultaneous procedures with the implant which could lengthen the duration of the procedure.

When are immediate Dental implants required?

For example, if you have an emergency which involves the loss of an upper front tooth. You know that if you lose the upper front tooth or several upper front teeth, it can be quite distressing. If you have all these upper front teeth removed due to trauma or an accident, you can’t smile, you can’t go out and engage in any kinds of social situations. In those cases, of course, bearing in mind the contraindications factors mentioned, we typically plan for immediate implants in those situations where we extract the upper front teeth and replace them with implants.

How do I take care of my immediate dental implants?

Don’t smoke, not even a single stick. Secondly, keep meticulous oral hygiene. But having said that, don’t over brush the area because if you overbrush the surgical site, it can destroy or disturb the wound. When you have a wound, you want to be very gentle when brushing around the area of the surgery but still you need to brush to keep good oral hygiene. Thirdly, take all of your medication religiously: all the antibiotics, antiseptic mouth rinse, sometimes even prescribed probiotics. All these will help and aid healing. Lastly, please do not bite the implant.

What are the common risks associated with immediate dental implants?

The risk for immediate implants is higher than for one placed in a delayed fashion. The risk is, of course, delayed osseointegration of the immediate implant. Osseointegration is a concept where the implants and the bone fuse together and this concept of Osseointegration is relevant not only for dental implants but also for hip implants or any kind of implants placed in the body.

What is the difference between an immediate and a delayed dental implant?

As the name suggests, the immediate implant is done when you extract the tooth and on the same day of extracting the tooth. ie. You replace the tooth with an implant immediately. So, the tooth gets extracted and the implant goes in immediately all in the same procedure on the same day. Whereas a delayed approach will involve extracting the tooth and waiting for a typical period of anywhere within 3-6 months. After that typical wait, in the second procedure, you place the implant in. So, that’s the main difference has to do with timing.

How do I know when I need dental implants?

That’s a good question. When a patient has dental trauma and the trauma isn’t that severe, that means the tooth can be saved, the first step is always to do root canal treatment to save the tooth. After root canal treatment you might need to do a porcelain crown to cover the tooth. But the dentist would also say that the root canal treatment doesn’t last forever. Root canal treatment just buys the tooth extra time. It could be 5 years, it could be 10 years, it could be 15 years or even 20 years.

After a dental implant, is it necessary to have follow-up visits at the dentist?

After a dental implant procedure is completed, it is imperative that you go back to your dentist for follow up visits. Regular active maintenance visits are so important to keep the state of your oral health in tip-top condition and to prevent painless and undetected dental problems from worsening. Additionally, your trusted dentist will also help you to maintain your dental implant and to periodically make adjustments or repairs to the implant as needed.

How long do I have to wait after tooth extraction to get dental implants?

The short answer is that it depends. Every patient is different and each case is decided upon on its unique merits and clinical situation. Sometimes you can have an immediate implant placed right after the tooth is extracted. Other times, it is best to wait 3-6 months for the site to heal and regenerate before the implant is placed.

How do I maintain my dental implants so that they last as long as possible?

Brush and floss your dental implants regularly as you would any natural tooth and have them maintained at professional dental hygiene appointments with your trusted dentist at least 2 times per year. Avoid using your dental implants to open up beer bottles, crush on ice cubes, or pork bones and chilli crab shells!

How do mini dental implants differ from traditional dental implants?

“What are mini implants? ” Mini dental implants, as its name suggests, are generally of a smaller diameter (<3mm), thus they are thinner than that of normal implants. They normally come with the abutment and the implant as a piece, whereas for conventional dental implants the pieces are separated. You could picture the mini implants as nail screws and traditional implants as bolt and cap nuts.

How do I know if mini dental implants are suitable for me?

The use of mini-implants has certainly been controversial.

 

The key to success for any mini-implant case starts with understanding its indications and contraindications and its pitfalls when indicated wrongly.

 

Latest scientific evidence concludes that Mini implants have limited applications, and should be considered only in certain cases. Here are some common examples when Mini Implants can be considered:

 

  • Supporting a removable denture
  • Replacing very small lower front teeth in adults , where the stress of the bite is low.
  • In certain orthodontic cases for anchorage, and only for period before they are removed.

 

Mini dental implants are not indicated to replace back molar teeth whereby the bite forces are high. Mini implants are too narrow and structurally not strong enough to withstand the stress of the bite in these areas.

 

It is difficult for patients sometimes to discern regarding the appropriateness of mini-implant use, because professional opinions regarding mini-implants can vary from dentist to dentist.

 

Patients find the low fees very attractive, they get mini-implants done, and sometimes as soon as months later, the mini-implants fail.

 

Mini-implants have their place in modern dentistry, but it is imperative that the dentist knows when to recommend for their use, in order to achieve the best long term success for the patient.

 

This only comes with experience, training and an honest mindset.

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