Dental
Implants

dental-implants

Dental implants are a titanium fixture serving as a replacement of the tooth root. The titanium surface is biocompatible allowing the implant to fuse with the jaw bone, a process known as osseointegration, allowing the implant to act as an anchor to support a fixed prosthesis such as a crown or bridge or a removable prosthesis (overdenture). Dental implants stimulate the jaw bone through function, reducing the resorption of the bone which occurs overtime when the teeth are missing.

Dental implants are now considered the standard of care for the replacement of singe, multiple or a full arch of missing teeth, restoring your smile, function and providing a renewed sense of confidence. Whilst every effort is made to save failing teeth, there many factors that influence the ability to do so. As the implant restoration offers a fixed, permanent solution, without the need to incorporate the adjacent teeth for support, it is the preferred replacement option for missing or extracted teeth. The success rate for dental implants is very high, and with good oral hygiene and regular routine dental maintenance, the implants can last a lifetime.

Failures, although rare, can occur and are usually attributed to specific factors such as smoking, diabetes or other medical conditions impairing the bodies ability to heal. The longer an implant is in function. the more biologically stable it becomes, which reduces the risk of failure. If an implant fails it needs to be removed and the site left to heal, after a few months the implant can be replaced at no cost.

The Nobel Biocare implant system used in this practice is from the Brånemark System of osseointegrated dental implants. These implants have been in routine use for many decades and have improved the quality of life of many thousands of people all over the world. Currently over 5 million Brånemark implants have been placed worldwide with 93% of these in function. The system has restored not only the patientʼs appearance and function, but in many cases, an increased sense of selfconfidence and self-esteem has resulted from having a fixed dentition.

The implants are placed under sterile conditions with a gentle surgical technique. Much of the equipment used is disposable and used once only, to ensure absolute sterility and quality control. The implants can be placed either under local anaesthesia at our West Perth rooms or under general anaesthesia. Placements under general anaesthesia are carried out at a day stay clinic, we operate out of two centres, Southbank Clinic and McCourt Street Day Surgery. We aim to provide the highest quality professional dental care. All staff are educated and trained in infection control procedures. During treatment of patients all staff wear disposable gloves and masks. All instruments are sealed and sterilised using autoclave after each and every patient to prevent cross infection.

before-after

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Before After

If you are missing a single tooth or require replacement of a damaged tooth, an implant retained crown can offer the most predictable, aesthetic and functional solution.

There are three components which make up the implant restoration. The implant,replacing the root portion of the tooth, the abutment, which is secured to the implant by means of a gold screw and the crown, replacing the visible portion of the tooth.

A consultation appointment will allow the appropriate treatment plan to be established. If the tooth requires extraction, the site is usually left to heal for a three month period prior to implant placement. At this point a Cone Beam or CT scan of the site is required to assess the bone levels and determine if bone grafting is required. In some situations, when replacing one of the front teeth, provided there isnʼt extensive infection or bone loss, the tooth can be extracted and the implant placed immediately. In some cases it is possible to place a temporary crown at the same time.

Single tooth implants are usually placed under local anaesthesia, however, we cater for your individual needs and offer the option of having the procedure carried out under general anaesthesia should you so desire. As the implants are placed into the bone, the procedure must be carried out under sterile conditions, therefore the placement is done in a theatre like environment. For more information on the implant placement procedure click here.

The implant is left to heal for a period of approximately three to five months prior to the construction of the final crown. A temporary suspension bridge or partial denture can be constructed for you to wear during the healing period if required for aesthetics. In some cases, should there be a need for re-contouring of the soft tissues, a specifically designed temporary crown may be constructed and fitted for a number of weeks prior to the fabrication of the permanent crown. (For more information regarding the crown please click here).

2 Adjacent Implants
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Before After

Where there is multiple teeth missing, you donʼt necessarily need an implant for each individual tooth, an implant retained bridge may be an appropriate option. The implant retained bridge acts much like a tooth borne bridge  with two or more implants supporting the crowns one either side of the pontics as opposed to teeth acting as the supports. Replacing several missing teeth where there is strong bite forces more implants may be required.

As per the single tooth implants, a consultation appointment will allow the appropriate treatment plan to be established . Any teeth requiring extraction will need to be removed and the sites left to heal for three months. A Cone beam or CT scan will then be required to assess the bone levels and determine whether bone grafting will be required.

Depending on the number of implants required and the location within the mouth, the implants may be placed under local anaesthesia or general anaesthesia. As the implants are placed into the bone, the procedure must be carried out under
sterile conditions, therefore the placement is done in a theatre like environment.

For more information on the implant placement procedure click here .

The implants are left to heal for a period of approximately three to five months prior to the construction of the final crown. A temporary suspension bridge or partial denture can be constructed for you to wear during the healing period if required for aesthetics. In some cases, should there be a need for re-contouring of the soft tissues, a specifically designed temporary bridge may be constructed and fitted for a number of weeks prior to the fabrication of the permanent bridge. (For more information regarding the bridge please click here .)

If your teeth are not restorable, as a result of severe gum disease, extensive decay or trauma, needing removal of all teeth in an arch, or if you have complete dentures you can no longer tolerate, a full arch implant retained bridge is one of
the most successful permanent solutions.
When missing teeth for a long period of time, the bone will slowly resorb over time as the bone is no longer stimulated under the function of teeth. Significant bone loss will result in constant movement of the dentures, which can lead to the
development of denture sore spots or ulcerations and even cause embarrassment if the dentures dislodge completely. Ill fitting dentures or a terminal dentition can make it difficult to bite and chew certain foods and can interfere with your speech.

When replacing a full arch of teeth with an implant retained bridge, the All-on-Four protocol may be implemented, allowing the replacement of the teeth in a two day period. The All-on-Four technique is a highly successful treatment method where four implants are used to support a full arch of teeth. The placement of the implants is done under general anaesthesia and the bridge is fitted the next day in our West Perth rooms. The two front implants are placed straight and the two back implants are angled in order to provide increased support in the back of the mouth and this often can avoid the need for grafting. This technique is suitable for almost all lower arch reconstructions and some upper arch reconstructions.

As the bone in the upper jaw is not as dense as the lower jaw, it is usually recommended that six implants are placed in order to provide adequate stability to support the full arch of teeth. In some cases, if the stability of the implants is insufficient to fit the bridge the next day, the implants are covered and left under the gums to integrate for a healing period of approximately five to six months. A  denture is worn for this healing period. After this time the implants are uncovered in a second surgical procedure, the abutments fitted and the bridge inserted the next day.

A diagnostic work up is carried out prior to having the procedure done to allow our technician to get started on the construction of the bridge before finalizing it based on the impressions taken at the time of surgery. This bridge is designed to be a long term provisional bridge, it is made from acrylic with composite resin teeth and reinforced with a titanium bar. These bridges can last several years. Over time, this bridge may wear down or fracture, particularly if you have a strong bite or are prone to clenching or grinding your teeth. Construction of a stronger, titaniumbased permanent bridge will be required if the strength and function of the provisional bridge is no longer sufficient.

As the bridge is fixed, you cannot remove it to clean around the implant abutments or the bridge itself. Once there has been sufficient healing post operatively, approximately three to four weeks after the surgery, an appointment will be arranged with our hygiene department to show you the technique for cleaning under your bridge and how to maintain a high level of oral hygiene.

For more information regarding the procedure please click here.

Full mouth rehabilitation with implants
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Before After
 
Implant bridge
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Before After
   
Upper and lower implant bridges
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Before After
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Lower bridge Upper bridge

If you are missing all of you teeth, have full dentures with poor retention and stability or have a terminal dentition, you may be able to consider a removable implant supported denture, know as an overdenture. This is a less expensive alternative to fixed full arch replacement.

The number of implants required to support the prosthesis will be determined by the quality of the bone and which overdenture system is more suitable for your individual needs.The implants are usually fitted with either ball abutments or with a bar attachment which correspond to precision attachments within the fitting surface of the denture.

Overdentures do provide greater retention, increased stability than a regular denture and the overdenture can still be removed for cleaning. However, it is essentially still a denture, therefore, you can still have slight movement of the
overdenture or irritation of the tissues, particularly if you get small particles of food caught underneath the fitting surface.

Single Implant Overdenture
Ball abutment Fitting Surface of denture
Ball abutment Fitting Surface of denture
pre-treatment dentures frontal
pre-treatment dentures frontal  
2 Implant Overdenture
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Ball abutment Fitting Surface of denture