Dental Implants

Evaluating Your Professional Options for Care

By Cynthia Bollinger and Dr. Kathelene Williams-Turk

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Crown Manufacture and Placement

After the successful osseointegration (osseo – bone, integrate – join or fuse with) of the implant(s) to the jawbone your general dentist or prosthodontist (crown and bridge specialist), together with a skilled laboratory technician, will make a crown to fit on top of the implant that will precisely mimic a normal tooth both in form and function. Even this is not a simple task. It requires accurate record-taking and the transfer of this information to the dental laboratory for “abutment” fabrication (the part that fits into the implant and holds the crown in place). The crown of the tooth is then made of porcelain-like materials that look and function exactly like natural teeth. Implant success rates are extremely high and give patients many years of function and satisfaction.

Questions to ask your dentist

Doctors who are actively involved in implant dentistry should be more than willing to provide patient testimonials and references, as well as before and after photos of their cases. Also, ask about membership in professional associations related to implant dentistry. It does not certify proficiency, but it is a statement of commitment to this growing area of dentistry.

If the doctor who is surgically placing the implants is an oral surgeon or a periodontist, they have had a residency program in surgical procedures as part of their training. Pose the following questions to assist you in selecting the right option for implant treatment:
- How long have you been placing implants, and how many implants do you place each year?
- Do you have before and after photos to show the results?
If a general dentist will be placing the implants, ask them the following questions about training:
- How many surgical training courses have you taken?
- Do you routinely attend continuing education courses on implants?
If your treatment plan requires procedures to enhance the final aesthetic and functional results, such as bone augmentation, ask how many of these procedures the doctor has performed.

Technical Challenges — Aesthetic Areas and “Teeth In A Day”

Achieving acceptable aesthetic results with implants is most challenging in highly visible areas like the front of the mouth, particularly in people who show not only teeth but the gum tissues as well. In these cases the whole tooth/gum tissue complex must be recreated including the papillae, the pink gum tissues that fill the triangular spaces between healthy teeth. It's at this point where knowledge and experience really come to the forefront.

There is a lot of advertising about “teeth in a day” where implant results can seemingly be achieved in a lot less time. In the right circumstances where multiple implants replace missing teeth, and where crowns (the portion of the teeth you see in the mouth) can be attached to them in such a way as to prevent any movement, “teeth in a day” is a possibility. This is accomplished by “splinting” the crowns to multiple implants — a precise fitting splint that keeps them movement free. However, this still requires multiple appointments for proper assessment, diagnosis and treatment-planning prior to “teeth in a day.” It also requires experience, great precision and care.

In some instances implants can be placed directly into extraction sockets and occasionally temporary crowns placed simultaneously. This also includes single tooth replacement, but stabilizing an implant in this situation is even more precarious and critical for success.

Our advice can be distilled to this: successful dental implant treatment can't be accomplished overnight and shouldn't be hurried. Anyone who is serious about dental implant treatment should first secure the services of well-trained and experienced dental professionals. Embracing this prudent route will greatly enhance the chances of a successful outcome.

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Review Date: 8/1/2009
Authored By: Cynthia Bollinger and Dr. Kathelene Williams-Turk
Reviewed By: Dr. Garry A. Rayant, Editor-in-Chief, Dear Doctor, Inc.