WHAT DO I NEED TO HAVE TO GET DENTAL IMPLANTS?
The two most important things necessary for success of a dental implant is
good health and good bone.
Many people are in excellent health and have good bone, for them implants
are a great option and can easily and predictably be placed. For others
with health problems or habits that affect their health we need to take a
closer look.
The following is a list of health conditions
that must be addressed or that may affect the proper bonding of the implant
to the bone:
SMOKING:
Smoking is the number one cause of dental implant failure.
The nicotine causes a 50% reduction in oxygen to the bone. Implants
require oxygen to bond to the bone. Nicotine patches and gums have
the same effect as smoking on the bone and healing. While smokers can
still have implants succeed, the success rate drops to about 75%. If
a person stops smoking the tissues slowly recover.
ALCOHOLISM:
Alcohol also affects the body's ability to heal. Those
that drink excessively are at much higher risk for infections and even cancer.
For some reason home care goes down and this also affect the long term
outlook for implants.
DIABETES:
Diabetes, in its uncontrolled state puts the patient at
a much higher risk for infections. These can at times be life threatening.
When the diabetes is properly controlled, the person is just like any
other person in terms of their healing abilities and their resistance to
infection.
OSTEOPOROSIS:
Osteoporosis can result in reduced bone mass and
bone volume. It is made worse if the teeth are lost because there is
no longer the necessary stimulation to encourage the bone to remain strong
and the jaw bone can atrophy. Although osteoporosis can affect the
success of the implants, usually if the implant is buried initially in the
bone and undesturbed for six months the bone can bond to the implant and
as the implant is used it can stimulate bone development and strength.
Certain medications like Vitamin D, Calcium and Estrogen can help increase the
bone mass.
HEART DISEASE:
Heart disease normally does not affect dental implants
as long as normal oxygenation of the tissues is occuring.
HIGH BLOOD PRESSURE:
High blood pressure does not normal affect dental
implants.
ARTHRITIS:
Arthritis normally does not affect implants, but some of
the arthritis medications like methotrexate which is used in severe cases
can cause implant failure. This usually only occurs when the implants
are placed. If the implants are already in and bonded to the bone,
there usually is no problem.
CHEMOTHERAPY:
Chemotherapy as used for the treatment of most cancers
involves using a chemical which kills rapidly growing cells. While
cancer cells are normally rapidly growing and therefore subject to attack,
areas of new growth such as around recenly placed implants can also be subject
to attack. This can often cause the loss of the implant. We normally
recommend that patients wait at least one year after chemotherapy before
placing implants.
RADIATION THERAPY:
Radiation therapy also kill rapidly growing cells,
but only if they are in the path of the x-ray beam. If a person is
having radiation in a distant part of the body, there is usually no problem.
If the radiation is in the area around the cells it can cause implant
failure. If a patient has had radiation to the jaws the walls of the
blood vessels thicken and the amount of oxygen that gets out to the cells
is substantially reduced. Hyperbaric oxygen can be used to stimulate
blood vessel growth and development and may allow a person to receive implants
successfully. There is little research available on this so it should
be undertaken knowing that there are risks to both the implant and the bone.
The risk to benefit must be carefully studied in this area with a competent
medical professional and prosthodontist working together.
COVID VACCINE:
We are beginning to see reports of adverse affects
of the Covid Vaccine on not just dental implants, but breast implants and other
types of implants. There is not enough information to make a definitive statement,
but we are seeing an increase in dental implant failures in otherwise healthy people.
If a person does not have enough bone then a there are techniques which can
be used to grow new bone.
A sinus lift is a very effective way to increas bone
mass for implants in the upper posterior region. This is the most predictable
bone graft that we can do. There is usually minimal
discomfort and most patients are back to work the next day. Sinus
infections do occur on occasion and can cause the loss of the bone graft.
This usually occurs only about 3% of the time.
Click here to see our list of
instructions for patients that will be having a sinus lift bone graft.
Usually we wait about six months after the graft before placing the
implants unless there is at least 5 mm of bone to stabilize the implant.
If there is 5 mm of bone and the implant can be stabilized, the implant
can be placed at the same time as the graft. We like to allow the implant
to bond to the grafted bone for nine months before uncovering and restoring
the implant.
There are also ways to use a water powered cutting device to create a split in the bone
which is then spread apart with dental implants to provide more room. The bone then
fills in from each side and the bottom for one of the fastest ways to increase
the amount of available bone for dental implants.
An onlay graft can be done if there is not enough width or height of bone.
The donor site is often the chin or the posterior portion of the jaw
although bone from the hip or shin can also be used. The bone graft
is attached to the ridge with titanium screws. Often it is allowed
to bond to the ridge for six to nine months before implant placement. This type of
graft is less predictable and often must be done multiple times because the bone only grows
from one side of the graft.
