Dental Implant FAQ
What is a dental implant?
There are two parts to a dental implant. The implant itself is a titanium screw that is placed into the bone, which replaces the “root” of a normal tooth. Once the implant has healed to the bone, then an artificial tooth (crown) can be attached to the titanium screw. The titanium screw is usually 4-5mm in diameter, and 8-12mm in length, depending on your clinical situation.
Are there any alternatives to dental implants for tooth replacement?
Yes, other options include bridges (cemented to the teeth on either side of the missing tooth), partial dentures (removable), or no treatment at all (not all teeth need to be replaced). Partial dentures are usually the most cost-effective option, however they are not ideal in that they are not fixed in place, and there is excess bulk of the framework which extends all the way to the other side of the arch. Compared to bridges, implants are usually the most ideal tooth replacement option as they do not require removal of tooth structure on the adjacent teeth, and they don’t rely on the health and longevity of those adjacent teeth. If you still have questions about what tooth replacement strategy is right for you, schedule a consultation with Dr. Robertson to talk more about the options that are available to you in your particular case.
What is the success rate of implants?
In experienced hands like Dr. Robertson’s, implants generally have a 95-98% success rate. Certain factors can decrease that success rate, including diabetes, smoking, or any condition that causes a problem with bone healing. If there is a significant deficiency of bone requiring bone grafting or a smaller implant than usual, success rates can be lower.
How long will implants last?
As long as they are placed and restored properly and patients keep up with hygiene and maintenance of their implants, they can last 20+ years (in fact, the very first implants placed in a human were done in 1965, and that patient died in 2006 with the implants still in place and functioning well – a total of more than 40 years!). However, occasionally implants fail to heal to the bone (osseointegrate), or develop gum disease (peri-implantitis), in which case they may need to be removed and possibly replaced.
Am I too old for implants?
Absolutely not! Dr. Robertson has placed many implants in patients over 90 years old, and their comment is typically that they should have gone forward with it sooner! As you age, your quality of life becomes increasingly important, and the ability to chew and enjoy your food is a big part of that. We can help you achieve this.
Can a general dentist place implants?
There are some general dentists with training in placing dental implants, but oral surgeons are generally better suited for more complicated implant cases requiring more precision or additional surgical procedures. These include cases that involve bone grafting, sinus lifts, immediate implants, or full arch cases with multiple implants. In these cases, typically a surgeon will place the implant in the bone, and then your general dentist will fabricate and attach the artificial tooth (implant crown).
Do I need to have a bone graft placed at the time the tooth is removed?
This is a great (and controversial) question. Dr. Robertson will be able to tell you if he thinks the site will be best suited by bone grafted at the time of tooth removal, although sometimes that decision is made during the procedure after the tooth is removed and it can be visually assessed. If bone grafting is required (also called socket preservation), this is most commonly performed with processed and sterilized bone chips (allogenic bone) and a resorbable membrane to protect it. It is best for this procedure to be done by the surgeon who will be placing the implant at that site. In certain situations, it may actually be best to proceed without placement of a bone graft, and Dr. Robertson will let you know if that is appropriate in your particular case. The goal of a bone graft is to maintain (or reconstruct) the height and width of bone that was holding the natural tooth in place. This ensures a good foundation for an appropriately sized implant to be stabilized in solid bone.
What is the standard timeline for replacement of a tooth with an implant?
One thing we cannot change with surgical advancements in implant dentistry is human biology. The standard timeline for the whole process takes approximately 6 months and includes:
- Removal of the tooth, clean out any infection present, +/- placement of a bone graft to preserve the dimensions of the socket
- After 3-4 months, the bone has healed and at this time the implant can be placed in that site
- The implant requires 2-3 months to heal to the bone, at which point it is usually ready to be restored with a tooth
In select situations (particularly with upper front teeth), the timeline can be sped up by placing the implant at the same time as the tooth removal, and sometimes a temporary tooth can even be made for it that same day. This is called an immediate implant and an immediate provisional, and Dr. Robertson will let you know if this treatment is suitable for you. Additionally, if you’re having all of your teeth removed and implant placed, these cases can often be loaded immediately with a full arch of teeth.
Do implants need to be done right away after a tooth is removed, or can I wait?
Implants can always be delayed until later. However, the longer a tooth has been missing, the more likely an involved bone grafting procedure is required prior to insertion of the implant. This is because after a tooth is removed, the bone in that area slowly “resorbs” over the coming years if an implant is not placed. The reason for this is that the bone in the alveolus (the part of the jaw that holds the teeth) exists primarily to support the tooth, and if the tooth is missing, the bone thinks it is no longer necessary there. So while implants can still be done later (with or without additional bone grafting procedures), it is best to place them soon (3-4 months) after the tooth is removed.
Does each implant just replace one tooth or can they replace several teeth?
Both situations are quite common! If you are just missing one tooth, you can have one implant to replace the one tooth. If you are missing three or more teeth, you may be a candidate for an implant “bridge”, where two implants are placed to replace three or more teeth as a bridge.
Can implants be used to replace all of my teeth?
Yes, and in fact this is a type of implant procedure that Dr. Robertson specializes in. It’s sometimes referred to as an “all-on-four” procedure, or “teeth in a day”. Typically the procedure involves removing any remaining teeth, placing 4-6 implants throughout the upper and/or lower jaw, and then attaching the implant-denture onto the implants. This happens all on the same day as removal of the teeth! Since the prosthesis is fixed to the implants, it is as close to the functional capacity of your natural teeth as can be achieved. This is usually the most ideal plan whenever someone is faced with having to remove all of their remaining teeth. See more information here
Do you do computer-guided implant surgery?
Yes, Dr. Robertson does many of these cases. Every case he does is planned on the computer using a Cone Beam CT (CBCT) scan. Then, when combined with a virtual model of your existing teeth, a guide can be fabricated to achieve the exact implant position that was planned on the computer. This helps make treatment more predictable, reducing risk of error, reducing complications, and is often less invasive than standard implant surgery.
Can I have my implants placed in a foreign country where it is cheaper?
Of course you can! However, keep in mind you generally get what you pay for. Canada has a very high standard for dental and surgical care, and other countries may not necessarily have the same standards. Dr. Robertson has personally had to repair many cases of “dental implant surgery gone wrong” in other countries around the world, and unfortunately often at that point much of the bone has resorbed and it is much more difficult (and expensive) to get the patient back to where they would have been had they been treated in Canada from the beginning. Dr. Robertson only uses the highest available quality of implants that have a proven track record, and this is very rarely the case in certain other countries around the world.
How much do dental implants cost?
Every case is unique, so precise estimates cannot be given for your particular case until you have been seen for your consultation appointment. At your consultation appointment, we will review all of the costs for your treatment plan – including any insurance coverage you may have. If different doctors are involved in your care, you will be charged separately for their services, so you will need to check with your dentist about their restorative costs. Please click here if you’d like to schedule a consultation appointment.