This page is designed to answer frequent questions that come up from patients or visitors of this site and is frequently updated.  So, please feel free to submit your questions to the e-mail address below.

What do dental implants offer over conventional dental treatment?

Increase in bone anchored support:

When a tooth is lost it is best to replace it with a non-removable replacement as soon as possible. For the replacement of a single tooth, a conventional “Bridge” is often very satisfactory. However when more than one tooth needs to be replaced, the problem of decreased support enters the picture, in conjunction with decreased chewing efficiency. The bridge will replace the missing teeth, however, due to the increased loss of root support, it will not restore the chewing efficiency, on the contrary, when the patient is trying to apply the same force onto the bridge, the abutment teeth may suffer biomechanic overload. Bone anchored fixtures (implants) will compensate to a great degree for the lost root support and thus restoring chewing efficiency to a greater degree.

As a comparison, a patient with all teeth in place will have 100 percent chewing efficiency. If the very same patient lost all of his or her teeth and was provided with a properly fitted upper and lower denture on an adequate ridge, the chewing efficiency would only be between fifteen and eighteen percent. With bone anchored implants and a fixed Prosthesis that same person may recover around 85 percent of his or her original chewing efficiency.

Prevent bone resorption:

There is a strong relationship between teeth in function and preservation of alveolar bone. If a person maintains his or her teeth well periodontally and is free of any systemic diseases, the alveolar- or ridge bone will be maintained as a response to the load it is subjected to during normal function (chewing). However, when teeth are lost, the alveolar bone will undergo atrophy in the areas where teeth are missing as a response to the lack of direct load. Again, a Bridge will only supply a marginal amount of load to the underlying bone and even less so a Removable Partial Denture or a Full Denture. A bone anchored fixture or implant, on the other hand, will transfer the chewing force directly to the surrounding bone and maintain its volume, if the crowns on top of the implants are properly adjusted to a correct bite.  The Bone Grafting section shows several images of the kind of bone resorption patterns that are frequently encountered as a result of  tooth loss.

Below to the left, you can see an image of how the bone has resorbed in response to loss of an incisor.  Below to the right you can see how the defect was restored through a Bone Grafting procedure and placement of an implant (the blue line will aid you in gauging the amount of resorption shown in the left image and the amount of volume re-gained in the right image):

Maintain healthy teeth:

Even in some single tooth situations an implant can offer advantages. If teeth adjacent to a toothless area are perfectly healthy and have no fillings, it would be to the patients advantage to leave them unprepared and deal with the replacement prosthesis as a separate unit, instead of a Bridge, which requires the two adjacent teeth to be ‘shaven down’ for. Furthermore, especially in the front part of the mouth (the Smile Line), a single tooth implant restoration may offer better long term esthetics, due to the prevention of  bone resorption (such as shown in the above image) in the toothless site.

How successful are implants?

There are many variables to be considered when placing implants. First, the patient must be in good health. Systemic problems such as uncontrolled diabetes or habits such as heavy smoking will translate into inconsistent healing and could complicate the procedure. Second, a proper diagnosis must be made and the proper implant placement procedure must be selected for the individual patient in reference to the final prosthetic  result. Third, the implant must be treated properly by the patient and the doctor. Under favorable conditions, success rates vary from 90% to 98% across most published studies.

Is age a deterrent to implant treatment?

Age is not a deterrent to implant treatment. Health is the determining factor. Many people seventy and eighty years of age are better surgical candidates than someone who is years younger with physical or systemic complications. There is really no preferred age for a hip replacement or a coronary artery bypass. As long as a person is in good health and is important to someone, including him- or herself, one should strive to improve the quality of one’s life.

Is Osteoporosis a deterrent to dental implants?

The success of Osseointegration depends in part on the state of the host bed. Concerns have therefore been raised about osteoporosis, a condition believed to be associated with a decrease in bone quality and quantity. However, the orthopedic literature indicates that osteoporotic fractures heal readily and that the level of bone mass and estimates of the parameters associated with bone remodeling present considerable overlap between patients with osteoporosis and control subjects. It also appears that osteoporosis, as diagnosed at one particular site of the skeleton, is not necessarily seen at another distant site. Although the prevalence of osteoporosis increases among the elderly and after menopause, the results of this study indicate that implant failure rate is not correlated with age and sex. A review of the literature and of results of a series of patients treated does not provide a compelling theoretical or practical basis to expect osteoporosis to be a risk factor for osseointegrated dental implants.

How Many Implants Do I Need?

This question is not always easy to answer.  A general rule of thumb is to replace each tooth with one implant, however sometimes we are not that lucky, because there are anatomical or financial limitations and we have to compromise somewhat.  We try to get similar type of ‘anchorage’ out of implants, as we had in natural teeth.  In order to achieve that, we need to consider the total surface area of a natural root that is embedded in bone and compare that to the surface area of an implant.  The two images below illustrate that somewhat.

Your back teeth have two or three roots having a total anchorage area of 450 mm²to 533 mm² in bone whereas a  typical implant of 3.75 mm diameter consists of a single “root” with a surface area of 72 mm² to 256 mm², depending on its length. Therefore, the tooth can dissipate biting forces (as much as 1600 lbs) efficiently, whereas the implant may be less capable of doing so.  Furthermore, the crown of a back tooth (molar) has a surface area of approximately 100 mm², whereas the cross-sectional area of a 3.75-mm diameter implant is only 10.95 mm². Thus, the chewing forces, when exerted at an angle in relation to the implant post, will create, that may put too much stress on the implant bending and torquing vectors.  Luckily toady the implant companies have responded with wider-diameter implants (5mm – 6mm) which improves the discrepancy of the figures above somewhat.  So, in view of the above discussion, we usually recommend at least one implant for each tooth lost, however this can change depending on the individual situation and what type of restoration the patient wants.

For instance, if the patient has no teeth and wants basically only his or her lower denture be more stable, but essentially keep the lower denture as the prosthesis of choice, we might get away with only two implants.  Generally, the more implants placed, the more stable the prosthesis and the better the long-term prognosis of the implants will be.

Does it hurt to have dental implants placed?

This question is difficult to answer, in view of people’s different pain tolerance levels and the complexity of the procedure itself.  For a straightforward situation (single tooth implant without any Bone Grafting), most patients reported very mild post-operative pain.  Almost all patients considered a simple extraction a lot more painful post-operatively, than an implant placement.  During the surgery, there should be no pain due to the prior administration of local anesthetic agents.

What about the cost of dental implants?

Implant procedures, which vary in complexity and extent, depending on the patient’s dental condition and requirements, can involve a significant investment. A survey of 350 patients after completion of their implant treatment revealed that not only was it worth the investment, but they would happily do it again.

Oral rehabilitation involving dental implants is generally considered an expensive procedure, especially as the number of implants increases. However, the benefit of having chewing efficiency restored, preserving alveolar bone and not having to prepare sometimes-healthy teeth for a Bridge should be well worth the expense.

Are implants covered by insurances?

Generally, the great majority of dental or medical insurances do not cover oral implants yet, although last year there were isolated insurances that covered certain modalities of implant reconstruction.  Sometimes, certain medical insurances cover a portion of the surgical cost.

One has to understand, however, that most insurances do not necessarily look out for the patients best interest, but rather try to restore the patient’s health in an “acceptable manner”.  Now this term may be very vague, but usually does not cover “State-of-the-art” medicine or dentistry.

The annual insurance benefit amount or whether a procedure is fully covered or not are very poor motivating factors for restoring one’s health.  Our health is the only precious thing we have and should deserve nothing less than the best that medical and dental sciences have to offer.

For any further Questions, please contact us at 310.542.6988 or e-mail us here.