John C. Chao, D.D.S.

Research Associate Professor, University at Buffalo, SUNY
Adjunct Assistant Professor, Ostrow School of Dentistry, USC

(626) 308-9104

News & Press

A Dentist Is Like An Architect When Designing Implants

A dental implant is an artificial tooth root replacement and is used in dentistry to support restorations that resemble a tooth or group of teeth. In other words, an implant is an artificial root on which a crown or a bridge is placed. The earliest known example of an implant was discovered in 1931 in Mayan burial sites throughout Honduras. They date back at least 1350 years before the advent of present-day titanium implants. The Mayan implants consisted of tooth-shaped shells placed into sockets of missing teeth.

Instead of shells or other experimental materials, most implants currently are made from a titanium alloy (Ti6AIV4) that has high tensile strength and fracture resistance. It is shaped in the form of a screw that is placed into the bone by a procedure called osteotomy (drilling a precise hole in the bone). Bone then "integrates" or grows over a period of time into the treated surfaces of the implant. When the bone completely integrates with the implant (osteointegration), a crown is placed on to the implant.

One of the most common questions patients ask is, "How much does an implant cost?" It is a good question. However the answer is not always simple. Before an implant can be placed, the dentist must discover the answer to a number of important questions. What are the shape, size, and density of the bone that will support the implant? What vital structures such as nerves, blood vessels, and sinuses are in the vicinity of the implant site? What is the condition of the adjacent teeth and the teeth which will bite against the implant? All these factors will influence the kind of implant that will be needed and the surgical procedure by which the implant will be placed.

Asking a dentist how much an implant costs, is analogous to asking an architect how much a building costs. The eventual cost of a building will depend on the size, shape, and soil condition of the building site. It will also depend on where the underground power cables and other utilities are located. Just as importantly, the architect needs to consider the neighborhood in which the building is planned. Are all the other houses in good shape, or is there a termite problem or other environmental conditions that might negatively impact the building?

The dentist, just like the architect, needs to survey the site by taking impressions of your teeth and Cone-Beam-Computerized-Tomography (CBCT), or 3-dimensional x-rays, to determine the exact size, shape and density of the bone. In addition the CBCT will disclose the exact location of vital structures, such as nerves and blood vessels in the bone. Lastly, the condition of the rest of the teeth must be considered. For example, if all the other teeth are in good condition, doing one implant will be feasible. If the other teeth are deteriorating because of gum infection or cavities, the implant specialist may suggest eliminating the infection and restoring the remaining teeth before the implant procedure. This is because infection of the gums can cause the breakdown of the bone supporting the implants. Broken down teeth may result in the implant having to support forces of chewing beyond its tensile strength or ability to resist fracture.

Although in some cases your dentist can give you an estimate as to the cost of an implant because the case is obviously simple, there are many more cases where the answer is not so easily available without taking impressions of your teeth, taking CBCT of your jaws, and carefully studying the various elements that can impact the final result. Like the architect, the dentist uses the same laws of physics to build bridges, design implants or make dentures. A dental implant is a worthwhile investment in the lifetime care of your smile. It is important that you make this decision based on complete knowledge and understanding of all the pertinent facts. Don't hesitate to consult your dentist for any questions you may have.

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