Losing teeth is attributed to a number of things. It can arise due to missing teeth, fractured teeth or trauma due to certain accidents or can be related to genetics too. People with missing teeth tend to smile less and have less self-confidence overall.. In spite of having a missing tooth, it is the duty of the dentist to rehabilitate the oral cavity to maximize the function of the mouth. There are various options available by which a missing tooth can be replaced Bridges are available that replace the missing teeth with the support of the remaining healthy teeth, while on the other hand we have dental implants which replace the tooth right from the roots to the crown structure. 

If you have chosen implants as an option to replace your missing tooth, your dentist is going to require some tests and scans before he decides to pace one. Your dentist studies your case and then plans the placement of the implant in the area of the missing tooth or teeth.

Whether implant is going to suit your case

Dental implants are made up of titanium screws that replace the root of the missing tooth which is later followed by the placement of crown that represent the upper part of the teeth. If you are considering implants then it’s a must to have a detailed discussion with your dentist to figure out if you are a compatible candidate for implants. Implant placement does not start right away, number of procedures have to be done before placing the implant screws. 

What needs to be done before placing an implant?

A number of investigations are required before placing an implant. After all it’s a surgery the patient is going to undergo. Just like you have various things that need to be tested before going for any other surgery in the body and the patient needs to be admitted prior to the surgery similarly the dentist has to make sure all is well before he performs the implant procedure.

1. Detailed checkup of every tooth in the mouth

A complete assessment of the oral cavity is done by the dentist. A complete examination is required to make sure the remaining teeth in the oral cavity are healthy and are not causing any hindrance while placing the implants in the surgical site. It is necessary to have healthy oral cavity in order avoid any failure of the placed implants. If the dentist observes any presence of plaque or calculus on the adjacent teeth, then that needs to be dealt with first before placing the implants. A complete check-up of the oral cavity helps in the success of the procedure. In that case a deep cleaning and polishing treatment is also advised to increase the life span of the implant.

2. A complete health check-up

Before beginning any dental treatment, complete medical history should be told to the operator treating the patient. Sharing a proper history with your operator prepares them to face any complication beforehand. There are many patients who come to the clinic to get their missing teeth replaced with the help of implants, but sometimes they show various systemic disease like diabetes, bleeding disorders, or on any heart diseases which need to be dealt with first before placing the implant screws.

Individuals have numerous habits like pan chewing, mishri, gutka chewing etc, which can lead to the delayed healing and failure of the implant. In case the patient smokes, blood supply is reduced to and again this affects the overall healing. Instead, the dentist insists the patient to leave smoking before undergoing surgery.

Excess radiation taken for other ailments can lead to low salivary production which can lead to a drier mouth and thereby promote bacteria to grow and cause the failure of the placed implants. It is the duty of the dentist to take a close look into the medical history of the patient in order to have a successful implant surgery.

3. Scans to check your bone strength

The strength, height and width of the bone determines what kind of implant screw is going to be placed into it. This can be determined with the help of X-rays. These images by x-rays are not detailed but they help to determine the height of the implant screw that can be placed in the bone. It also helps to assess the location and size of the various surrounding structures in order to prevent any type of permanent damage to them. X-rays along with other imaging techniques help to decide whether further additional procedures are required to increase the height for e.g. bone grafting. 

4.CT scans to check bone height and width

Other available method to determine the structure of the bone is Computed Tomography(CT) scans. CT scans provide with 3 dimensional images. This method helps in creating cross-section of the images obtained. It includes collection data with fan-shaped beam onto image detectors, thereby producing single slice per scan. Height and width of the bone is determined, with these the quantity and quality of the bone is also studies well. The exact  ideal location and depth of the implant can be decided when the operator has the CT scan of the patient. 

5. CBCT scans to be absolutely sure

On the other hand, the other technology available for scanning of the bone is Cone beam computed tomography(CBCT).  Majority of dentists use this method since the images produced by the scan are 3 dimensional. This is done to make sure optimal and precise placement of the screws. The bone height, width, shape and density along with the proximity of vital structures can be noticed precisely with CBCT.

6. Duplicating your teeth on plaster models

Before starting the implant procedure, it is mandatory for the dentist to obtain the intra-oral impression properly. This can be done either with materials called alginate impressions or using high technology like intraoral image scans.

Making models of your mouth helps the dentist to study and replicate a few things on the model first. It also helps to study the diameter, position of the implant screw going to be inserted in the bone. If the patient has a maligned teeth, the placement of the screw can be pre-determined. This helps the operator to come up with the correct diagnosis and treatment plan for the patient.

The bite should be aligned after placing the implant this can be observed after placing the screws on study models and comparing the difference. With the help of impressions the patient can also be educated about their before and after appearances, taking photographs can also be helpful at the same time. 

7. Blood investigations

A number of blood tests are done to eliminate any risk of further infection after placing implants. Few tests performed by patients are complete blood count test (CBC), thyroid test for women, coagulation test,blood sugar levels etc. If an individual is found to be on anticoagulants it is advised to the patient to seek medical consent from their physician before the dentist performs any procedure. A complete blood count test evaluates patients’ overall health by measuring several components and features of the blood before any surgery is performed. 

Importance of medical history before placing an implant

Along with the dentist noting down the medical history, it is the responsibility of the patient to share a full medical history with their dentist without any hesitation. Not sharing adequate medical history can lead to unwanted consequences that may lead to failure of the implants. Compromised patients will be guided appropriately to take precautions while placing implants or they will be totally refrained from placing any.

And all that effort

A team of experienced and specialized dentists from all the fields of dentistry and the medical field to some extent are required to work hand in hand to bring about the success of the implants. This is one of the reasons for the high cost of implants but it definitely has a high success rate. Patients on their part should not keep any query unanswered. You can freely ask your dentist about the implant procedures and the necessary investigations. After placing the implants make sure you receive proper instructions to maintain good oral hygiene, especially special interdental brushes to be used at the implant site and a regular visit can ensure the proper functioning of the implant.

HIGHLIGHTS

• If implant is your choice for replacing your missing tooth or teeth then it’s definitely the best choice you have made.
• It’s not as simple as a filling procedure and needs more planning and better understanding of the case to place an implant.
• Your dentist will carry our various investigations to undestand whether or not you are a suitable candidate to opt for an implant procedure.
• Your dentist rewuires x-rays, CT scans , CBCT scans to make sure all is well and plan the treatment accordingly.
• Placing an implant is a team effort and though its on the higher side in terms of it’s cost it certainly has a better success rate in comparison to dentures and bridges.