We are constantly seeing newspaper, TV, radio, and internet ads concerning dental implants. Deciding whether you are a candidate and who is best to provide your care can be daunting. This article is the first in a series of articles dedicated to the understanding of and what is currently available in dental implant therapy.

Osseointegrated TiUnite® implant. Note the presence of the grayish TiUnite’ between the body of the implant and the surrounding bone. Ground section, polarized light
microscopy. (Schupbach et al, 2005. Permission granted by BC Decker Inc.)

Even though dental implants have been used for over 50 years to help patients with terminal dentition, the technology and physiology behind titanium implants is still a medical marvel. We have improved and refined the macro and nanostructure of implant surfaces to improve the body’s response to implants. If placed properly, the bone essentially recognizes the implant as bone, bridges the gap, and biologically bonds with the surface so that the implant, if properly maintained, can remain stable for decades. Although implants are thread-designed to help with initial placement, there is no long-term mechanical retention with the implant. The stability of the implant is due to long-term biological bonding between the bone and titanium.

For this biological bonding to occur, there are certain principals that cannot be ignored. In the majority of cases, attachment of the bone to the implant usually takes around 2-3 months in the mandible and 3-4 months in the maxilla. There are exceptions where we can bypass this healing period by placing multiple implants and rigidly stabilizing each implant to one another with a rigid prosthesis. This technique is only successful if the patient avoids any loading of the implants for a period of 2 months. Implant placement is an extremely sensitive and technical procedure which requires sterile techniques, atraumatic preparation of the bone, and delicate placement of the implant itself. The restorative dentist is also an extremely important part of the implant team. Many integrated implants fail due to poorly fabricated crowns and bridges placed on these fixtures.

Close-up image of the threaded portion of a TiUnite‘® implant, showing the micro- structured topography of the TiUnite® surface
Close-up image of the threaded portion of a TiUnite‘® implant, showing the micro-structured topography of the TiUnite® surface.

I have seen numerous patients who have been told they were not good candidates for dental implants. There are certainly a few medical conditions that may prevent implant placement. These include radiation therapy and certain chemotherapy medicines used for cancer treatment. Other conditions may decrease the success of implants, which include insulin-dependent diabetes and chronic cigarette use. Excluding these exceptions, there is almost no individual that is not a candidate for implant therapy. Some individuals may require additional procedures to rebuild bone or work around sensory nerves or other structures. This may add to the total treatment time, but in the end the patient will be able to enjoy the long-term benefits of restoring their function and health.

What should patients expect from dental professionals and what questions are appropriate when seeking dental reconstruction using implants?

There are certain costs and time associated with implant therapy; therefore a patient should spend time researching individuals providing this care to make sure they are receiving the care that they deserve. Not all implant systems are the same and not all professionals have the same background, training and experience. A recent ADA research article found the implant success rate of 80% when implants were placed by general dentist. This is less when compared to the usual 98% success rate when placed by a specialist.

SEM image of the TiUnite® surface
SEM image of the TiUnite® surface, showing the presence of pores with dimensions around 1-10 μm and smaller pores with diameters below 1 μm.

The questions a patient should ask of their professional are similar to the questions they should ask any medical practitioner providing care: How long have they been placing implants? What sort of training did they receive? What has been their long- term success rate? Another appropriate question to ask is whether or not the individual works with other professionals in a team approach or do they attempt to provide both surgical and restorative care? It is important to ask if there is a warranty in place in case the implant does fail.

Oral and maxillofacial surgeons are uniquely trained to provide comprehensive care in the area of implant dentistry. Oral and maxillofacial surgeons undergo extensive and extended training in an accredited surgical program lasting 4-7 years following dental school. This training is broad-based encompassing medicine, anesthesia, and surgical care. This allows them to provide care that is comprehensive, taking each individual patient’s circumstances into account and customizing treatment that best fits the patient. Research has shown that a team approach of a surgeon working with a quality restorative dentist provides the highest long-term results. If you have any questions, you can contact your dental professional to discuss whether or not you are a candidate for implant placement.

About the author

Dr. Ron D. Thoman is a Private Practice Oral and Maxillofacial Surgeon in Colorado Springs
Dr. Ron D. Thoman
Oral and Maxillofacial Surgeon at 719-590-1500

Dr. Ron D. Thoman is a Private Practice Oral and Maxillofacial Surgeon. He is a Member of the Cleft Lip and Palate team Childrens Hospital. Dr. Thoman is Affiliated with University Health Memorial and St. Francis/Penrose Hospitals. Dr. Thoman specializes in the removal of wisdom teeth, placement of dental implants, orthogathic surgery, along with treatment of head and neck pathology, cleft lip and palate, trauma and sleep apnea.

Oral and Maxillofacial Surgery Specialists, P.C.
8580 Scarborough Drive #240
Colorado Springs, CO 80920