1. Single Tooth Dental Implants

You may have lost a single tooth as a result of an accident or injury. This can be replaced with an implant and in fact, having a dental implant in between your natural teeth is the most successful dental procedure. Success rates are nearly 100% perfect.

A single tooth implant does not affect your other teeth, looks better and is easy to keep clean. It is kept clean in exactly the same way as your other teeth.

If your jawbone is not deep or strong enough for an implant then a bone graft will be required.

Single tooth implants can be carried out on both front and back teeth. Mini implants can be used although some dentists prefer the normal, full sized ones.

The procedure is as normal: the dentist will make a tiny incision in your gum in order to access your jawbone. He or she will then drill a small hole in this bone before inserting the implant. The implant will look like a small metal rod and is either cylinder or screw shaped.

This is inserted into the jaw. The incision is closed and given time to heal. This is usually a period of 3 to 6 months. During that time the implant will fuse with the jawbone in a process called osseointegration. A temporary tooth or crown will be fitted during that time, purely for cosmetic reasons.

Once this has happened, a second procedure will be carried out. The dentist will open up the original wound before fixing a small attachment or abutment to the implant. This will enable him/her to fasten an artificial tooth or restoration to the abutment.

This is usually done in two stages although there is the option of having this done all in one go, known as 'immediate loading'.

2. Few or Several Teeth (partially edentulous)

This section is aimed at those patients who are missing a few or several teeth. The technical term for this is 'partially edentulous'. If you have lost a few teeth, either as a result of an accident or an injury then you are basically looking at a crown and bridge implant system.

If, however, you are missing quite a few teeth then you could be looking at extensive dental work. This type of treatment will involve implants but will also include bone/sinus grafts and quite possibly some major reconstructive work.

Are you missing just a few teeth?

If so then there are several different ways of performing this treatment although they all involve attaching crowns or a bridge onto an implant. These can be cemented or screwed onto the implants.

Crowns and bridges are constructed from a variety of materials such as ceramic, porcelain or a combination of metal and porcelain.

The traditional crown and bridge system was a short term answer to the problem of missing teeth but required the dentist to file down a couple of healthy teeth to act as 'posts' to support the bridge.

Another issue is that of bone loss. The traditional crown and bridge system does not prevent bone loss. Bone loss tends to happen when a tooth or teeth are lost and are not replaced. The jawbone becomes thinner and less dense and results in a sunken cheeked appearance.

The only way to prevent this is to combine the crown and bridge system with dental implants. The implants stimulate the bone cells within the jaw and stop any bone loss.

This procedure can be performed as part or all of the following:

• Implant crown and bridge
• Major maxillary reconstruction
• Major reconstruction
• Replacement of a failed blade implant
• Total dental care

Implant crown and bridge

This procedure involves several stages which start with the initial diagnosis, x-ray and wax impression of the patient's jaw. Once this has been completed then the next stage is that of the insertion of the implant itself.

Once sufficient time has elapsed for osseointegration then the final stage is that of the restorations. The patient will have had temporary restorations during this time, but once the implants have completely fused then they are ready for the final restorations.

A bridge is required to span the gap left by the missing teeth along with laboratory constructed crowns.

Major Maxillary Reconstruction

This is an extensive procedure, designed to treat problems with teeth in the upper jaw or maxilla. If you have missing maxillary teeth, for whatever the reason then this procedure is an option.

This procedure is carried out on those patients who have been diagnosed with a tumour or have a maxilla related injury such temporomandibular disorder.

The procedure involves implants, a cast and restorations.

Major reconstruction

The same rules apply as above. The patient can be looking at the insertion of several implants, bone augmentation (possible) and/or sinus lift, and temporary restorations before the placement of the final restorations.

It can involve either the upper or lower jaw, or both.

Replacement of Failing Blade Implant

A blade implant or plate form implant is a type of endosteal implant (implanted into the bone) which is less commonly used than the root form implant. It consists of a flat piece of metal (blade) with two prongs on one side of this metal. It is inserted into the jaw in such a way to support a bridge or crowns.

These along with other types of implants enjoy a high degree of success, usually around the 95% mark. But, failure can happen in a tiny minority of cases. This is usually due to a failure to fuse or 'osseointegrate' with the bone, inflammation (peri-implantitis) or fracture. Sometimes, implants can move around or shift out of position.

Whatever the reason an implant which is said to have 'failed', needs to be removed and replaced with a new one.

In this scenario, the failing blade implant will be removed and replaced by root form implants as part of a two stage process. The first stage will involve the removal of the defective implant and the second stage will be the placement of the new teeth or restorations.

Total Dental Care

This is the 'full works' in regard to dental treatment. It involves implants, crown and bridge restorations and porcelain veneers (also known as laminates).

This comprehensive treatment will involve a sinus lift plus a cast for the crown and bridge restorations. The veneers (laminates) are wafer thin shells, comprised of porcelain or ceramic, which are fitted over the front of the teeth in order to improve their appearance.

If your teeth are stained or damaged then consider this as an option.

3. No Teeth (fully edentulous)

Edentulous is a dental term, used to describe a state in which a patient has no teeth at all. This may sound strange but there are a great many people who do not have any teeth, either as a result of an accident or illness.

If you are in this position then dentures are often the only solution. This means having to use a messy 'glue' to fix their dentures in place which can be awkward and off-putting.

Dentures are a tried and tested answer to the problem of missing teeth but they are not without their problems which include the tendency to become loose, soreness and irritation.

These problems will resolve themselves over time as you become used to wearing dentures but there are some patients who never come to terms with denture wear. For that group of patients, dental implants are the answer.

There are several treatment options available to the patient:

• Crown and bridge restoration
• Fixed/detached restoration
• Implant overdenture
• Mini implant overdenture

Crown and bridge restoration

This involves the use of restorations or crowns (artificial teeth) and a special bridge (a temporary denture). The crowns are attached to this bridge and are a permanent fixture unlike the usual removable restorations.

Fixed restorations (teeth) are more realistic looking than the removable type of restoration but are also more expensive.

And, they are more difficult to clean and generally, care for.

A crown and bridge restoration can be carried out as part of a major reconstruction or as a means of converting from a removable restoration to a fixed restoration.

This is an extensive process which includes initial diagnostics, the taking of an impression of your jaw - for purposes of casting, and the insertion of the implants. The second stage includes the fitting of the abutments and the final replacement teeth (crowns and bridge).

Fixed/Detachable Restorations

These are as the name says: they are a type of restoration which is fixed in place by a series of screws. It is a permanent fixture and can only be removed by your dentist.

These tend to appeal to those patients who find dentures to be awkward or plain unattractive.

Fixed restorations are harder to keep clean than removable ones.

This restoration takes the form of a metal framework, dentures (teeth) and an acrylic resin.

Implant overdenture

This form of treatment combines dental implants with an overdenture and so may appeal to those patients who want a cheaper yet effective dental treatment.

An overdenture is made to fit over existing tooth roots or dental implants. This is supported by the natural tissue of your mouth and is designed to work as a working alternative to natural teeth.

One advantage of this over conventional dentures is that this stays firmly in place. This means no risk of 'slippage' or any other problems associated with a conventional denture; plus it is easy to look after.

It is also cheaper than other types of hybrid restorations such as crown and bridge restorations.

Mini Implant Overdenture

This is very similar to the normal sized overdentures: the only difference being that mini dental implants are used instead. Mini implants are cheaper than the standard sized ones and easier to insert but have us

ually been seen as a temporary measure.

But, they have proved to be useful in situations where patients don't want the full implant, are unable to pay for a full implant or just need something to secure a loose denture.

There are still ongoing discussions about mini implants as compared to the normal, full sized implants. Some sources view them as a suitable form of treatment if there are no other choices, or if normal implants are not an option.

Other sources see them as providing a good, solid foundation for bridges, crowns and overdentures.