Dental Implants

What is an implant?

A dental implant is a screw-like surgical component that interfaces with the bone of the jaw to support a dental prosthesis such as a crown, bridge or removable denture. After the implant is placed, a variable amount of healing time is required.

Dental implants come in a variety of shapes and sizes, so there is one to suit every clinical situation. An implant is actually an "artificial tooth root"; the implant surface is ribbed for better integration into bone tissue. Most often, dental implants are made of titanium. Titanium is the most favoured material by most of the dental clinicians and implant manufacturing companies due to its high biocompatibility, non-allergic and tissue friendly nature and its great ability to make a connection of its surface with the alveolar bone for the process of osseointegration.

A completed implant is usually made up of three components:

  1. Implant body: A dental implant most often takes the form of a small, screw-shaped titanium post that replaces the root-part of a missing tooth. The surgical procedure used to place an implant is actually quite minor and routine, requiring only local anesthesia in most cases.
  2. The abutment: After a period of healing is allowed, a healing abutment (sulcus former) is placed into the implant body which will stretch the gum in preparation for the crown to be placed.
  3. The crown: Once the gum is prepared sufficiently, a crown can be fitted onto the implant. This is the last phase of the implant treatment, which is done by your restorative dentist, and not by your periodontist who will be placing the implant.

Why get dental implants?

Many folks as the question, “why get dental implants instead of dentures?”. It is important to understand what happens when we lose teeth, to understand why dentures are not always the viable option.

Our teeth are attached to the jaw bone by a periodontal ligament, which allows micro-movement of the teeth when we chew. This action stimulates the bone and keeps it in the areas. When a tooth is lost or extracted, there is no longer anything in the bone to stimulate it, and we get resorption of the bone which leads to bone and soft tissue defects. When bone loss takes place (the worst within the first 6 months of a tooth having gone missing), we get recession on the adjacent teeth as the bone loss moves to the adjacent teeth, the gum recedes, teeth start to drift toward the open space and ultimately more teeth will go missing as a result. As teeth go missing, the face starts looking saggy and the change in appearance has an effect on our self-esteem.

Conventional dentures are removable devices. As the changes in our mouth takes place when teeth are extracted, the denture will need to be adjusted continually to fit. Dentures tend to move or fall out, they are uncomfortable, and they are a hassle as they need to be taken out and cleaned after eating and before going to bed. Although the initial cost of dentures is cheaper than the initial cost of implants, their maintenance can end up costing you far more. If you do however want a removable option but which are secured when you eat or speak, an implant supported prosthesis such as a ball-clip or bar-retained denture can be considered.

Dental implants are fixed and function as your normal teeth would. Having an implant(s) placed:
  • Stops bone loss
  • Conserves the jaw bone
  • Preserves your appearance
  • Preserves your speech
  • Fits comfortably and feel just like your original teeth did
  • Easier to eat as they do not move around or fall out
  • Improved self-esteem as they look just like your other teeth, so no one could tell the difference
  • Better oral health as you can clean them as you would the rest of your teeth
  • They are far more durable than any denture and most implants, if looked after, will last you a lifetime
  • Implants are also convenient. You have no need for removing it to be cleaned or worrying if the adhesive is going to hold it in place the whole day. You can speak, eat and live confidently.

These are just a few reasons why you should consider implant placement instead of other options. Please feel free to contact us for more information on how implants can make your life easier.

So where do I start?

The first step will be to arrange a consultation with your periodontist. A consultation will generally involve the following:
  • Patient interview–during the interview phase, we would obtain information from you regarding your medical history, habits, dental problems/concerns and what your specific dental requirements are.
  • A full periodontal evaluation will be done to assess your overall dental health and if you will be a suitable candidate for implant placement. Often, patients present with a form of periodontal disease-causing tooth loss, which may need to be addressed before implant placement will be considered.
  • X-rays – various x-rays may be taken to assess your bone levels, ranging from small periapical x-rays to a more advanced 3D scan.
  • Treatment discussion – once all information is collected, we can make a recommendation and discuss the various options available in your specific case.

Prior to any further treatment commencing, you will be supplied with cost estimates for the various phases of the treatment. It is important to note that implant placement happens over a few phases and may require several appointments to get to the final result. To find out more about what to expect at your first consultation, click here (link to consultation page)


Remember, implants do not have nerves so you may not be aware of a problem as the implant will not “feel” pain. Once the implant treatment is complete, regular maintenance appointments MUST be kept to, to ensure the long-term prognosis of the implant(s) and to maintain the warrantee on the implants.

Preparations of tissues for implant placement

By now we would have established if you have any periodontal disease, and if you will need bone augmentation done before implant placement, if you may need sinus lifts, if the implants and bone augmentation can be done together, or if you do not need bone augmentation at all.

Sinus Lifts


When teeth have been lost in the maxilla (upper jaw) we sometimes find that bone resorption has taken place under the sinus, or that the sinus has drifted down into an extraction site. If there is not enough bone height in the maxilla, a sinus lift(s) may be necessary to create adequate bone height in the areas. Depending on the amount of bone that needs to be placed, the areas may be left to heal before implant placement to allow for the bone to heal sufficiently.

Bone Augmentation

If you recently lost a tooth or a tooth is extracted, the extraction site is usually filled with bone material and closed up for a period of 3–6 months to allow healing and new bone formation, before the implant will be placed in the area. If the bone defect is too large and an implant is placed immediately, it increases the chance of implant failure.

Three-dimensional imaging is now the standard of care when planning implants. CBCT systems provide a wide range of fields of view to cover all your implant indications.If a tooth/teeth have been lost for a period of time, bone may need to be built up in the area to allow for enough bone height and width for implant placement. In this case, the area will be closed up and left for a period of 3–6 months to allow for healing and new bone formation, before an implant/implants will be placed in the area(s).


Soft Tissue Grafts


In some cases where there are soft tissue defects (receded or too little gum) where the implant(s) is to be placed, this can be corrected by doing a soft tissue grafting procedure. When an implant is placed, we want there to be enough bone structure to support the implant, and also enough thick soft tissue to adequately cover the bone around the implant for a natural appearance when the crown is placed. If the soft tissue defects are left untreated it will lead to implant complications.

With a soft tissue graft, soft tissue is harvested from the palate and transplanted into the defect site(s). The new tissues are sutured into place and left to heal for 14 – 21 days before the sutures are removed. The patient is monitored throughout the healing process to ensure that should any complications arise, it may be addressed promptly. When the tissues are healed, it forms part of the natural gum and is most often not recognizable by scarring.

Success of implants

Based on recent dental literature, dental implants have an overall success rate of 97% over a period of 10 years and longer.

Implant Supported Prosthesis


Replace One Tooth—When you have one tooth missing, a single implant is inserted into the bone to replace the root part of that tooth; a crown then goes on top to simulate an actual tooth. This treatment choice has the highest success rate, making it the best long-term investment for replacing a single missing tooth. Even if the initial cost is slightly higher than other options, it is the most cost-effective solution over time. An implant will never decay or need root canal treatment and feels just like the tooth that was there.


Replace Multiple Teeth - When you have more than one tooth missing, implants provide an ideal replacement mechanism. You don’t even need one implant for every missing tooth. Instead, implant teeth can act as supports for fixed bridge work. For example, if you are missing three teeth in a row, we can place two implants, one on either side of the gap, and a crown in between that has no implant underneath. That way, you won’t need to use any of your remaining natural teeth as bridge supports, which could weaken them and make them more susceptible to decay and root canal treatment.


Replace All Teeth Permanently - Implants can support an entire arch of upper or lower replacement supported by as few as 4 implants. It’s comparable to the structure of a table, which only needs 4 legs to hold it up. In cases where jaw bone density and volume have deteriorated, 6 or 8 implants might be needed to support a row of teeth. Dental implant replacement teeth protect your jaw bone, won’t slip, and may last 10 to 20 years or longer if maintained regularly.


Support Removable Dentures - Implants can even make removable dentures more comfortable, effective and healthier to wear. Traditional dentures rest on the gums and put pressure on the underlying bone. This accelerates bone loss so that the jaw shrinks, and the dentures slip, particularly on the bottom. But today a dental professional can attach a removable denture onto implants, transferring that pressure into the bone structure rather than the bone surface. This prevents the dentures from slipping while you eat and speak and preserves the bone directly beneath.

Implant Diseases

Just as with normal teeth, implants too can become infected and present with diseases if not maintained properly. Peri-implant diseases are inflammatory conditions affecting both the soft and hard tissues surrounding the implant. If not maintained in a healthy state, bacteria will build up and irritate the gum tissue causing it to become inflamed (much the same as in Gingivitis) and if left untreated it will cause the bone below the gum to deteriorate. As it progresses, and the condition become more severe, it could lead to loss of implants.

There are two forms of implant diseases:

Peri-implant mucositis is when only the gum is infected and inflamed. This can usually be treated, and the condition reversed if caught early.

Peri-implantitis is when the infection has regressed to such an extent that the soft tissue and the underlying bone is affected. It is noted by blood or pus draining from the gum around the implant. The gum around the implant will be swollen and may even recede to expose the underlying implant body. On a radiograph, bone loss around the implant will be seen. This usually requires surgical treatment.