Torrey Pines Oral & Maxillofacial Surgery
The Science of Dental Implant Dentistry
There are different types of dental implants ranging from blade to cylinder to screw type, with the screw type being the most commonly accepted design nowadays. Titanium is the ninth most abundant metal on Earth. It has a light weight, is resistant to corrosion, and is biocompatible with living tissue.
Swedish surgeon Dr. Per-Ingvar Branemark discovered that when titanium makes contact with living bone tissue, they grow together to form a permanent adhesion. He named this process osseointegration.Osseointegration – defined as direct structural and functional connection between ordered, living bone and the surface of a load carrying implant – belongs to the category of primary bone healing. Right after implant placement, the inflammatory bone healing phase takes place. This is followed by the proliferative phase where initial bone, known as woven bone, is formed four to six weeks after the implant placement surgery. This bone is low in density but forms rapidly. The third phase is the maturation phase, where osteoid type bone deposited. Loading the implant (using the implant) stimulates transformation from woven bone to lamellar bone. This bone is the weight-bearing bone that is formed; lastly, the resorption and remodeling phase occurs throughout the lifetime of the implant.
The implant complex is composed of multitudes of structures: bone tissue, implant, abutment, abutment screw, prosthetic superstructure, retention screw, esthetic facing, chewing surface. Bone tissue, placement of implant, and generally the healing abutment is dealt with by a surgeon or the implant placing practitioner; the rest of the structures are dealt with by the restoring dentist. Your surgeon and restoring dentist work together to provide the best coordinated care.
Most people are candidates for dental implants except for a small group of patients who are compromised medically and/or dentally, demonstrating delayed healing such as immunosuppression, antimetabolic treatment, or uncontrolled diabetes.
It takes time for dental implant dentistry to take place due to the rules of the physiology of osseointegration. Conventionally, after a tooth is extracted, with or without bone grafting, it takes about three to four months until the site is ready for the actual implant placement. This time period might slightly vary depending on the quality of the patient’s existing bone quality. Following the dental implant placement, roughly another four months is needed for osseointegration of the titanium to the native bone due to laws of bone physiology. Then the patient’s restoring dentist works on the actual delivery of the crown, which is the only visible portion of this complex. There are also other variations of treatment in regards to dental implant placement and bone grafting, these are discussed on a case by case basis with a patient’s restoring dentist and surgeon working together to reach a customized outcome at the patient’s best interest.