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FAQ - Health How healthy do I have to be to have implants? Can the body reject an implant? Do implants require special care?
How healthy do I have to be to have implants? If you are OK to have general dentistry, fillings or extractions, you are certainly up to having implants. Some VERY serious illness might preclude most elective procedures but this would be rare. A thorough examination and discussion would reveal the complexity or simplicity of any intended procedure. We would then speak with your physician about your suitability for this minor surgical procedure which would again be discussed and coordinated by the anaesthetist. Primarily the volume, density and shape of the implant site determine whether you would be a suitable candidate. Can the body reject an implant? Kidney, heart or organs transplanted are sometimes rejected due to a cascade of many complex reasons associated with the body’s acceptance or rejection of foreign protein and cellular components. Titanium implants are different because bone thinks that titanium is self and that bone grows up to and into the metal’s microstructure without any space or defensive boundary. The successful implant surface has bone cells lying in happy cohabitation right up against the metal. No chrome nickel hip implant or nose ring has such a tranquil environment at a microscopic level. The body’s defense mechanism, called inflammation (heat, swelling and discomfort) is similar to a nations army – when there is danger of invasion, troops are sent to the border. So too, with implanted materials other than titanium – and interestingly, sapphire – warrior cells called lymphocytes can be seen surrounding the material, ready to defend. These cells are NOT present around a successful titanium implant suggesting a healthy symbiotic harmonious environment of mutual acceptance. The failure of an implant to integrate into bone - what we call osseo-integration - is due to many factors, some of which we don’t even yet know about; we don’t really know why 90% work, let alone why one in 10% don’t succeed. Factors such as the pre-treatment bone health, nicotine (via smoking or perhaps nicotine chewing gum) might alter blood flow through bone. Patient selection, oral hygiene and patient adherence to the prescribed medicines and mouthwashes may also influence success. Regular follow-up care, assessment of the gums and bite are small investments towards success. Do implants require special care? Not really! They will function just like your God-given teeth and will require the same frequency of cleaning by brushing and flossing and annual checkups too. The good news is that the pink tissue around a tooth is less hardy than the pink tissue surrounding an implant. The gingival tissue of a tooth is a bit hysterical, if you don’t clean it swells and bleeds but, once a tooth is removed, the gingival tissue reverts to ‘mucosa’ which is different in its response to irritation. It is tougher and sturdier and more forgiving. At birth the sinus space was almost non-existent but with growth and aging, the bone hollow increases, accelerated by tooth loss. Instead of the bone being 1 inch thick between the gum and the sinus cavity, time and neglect can result in the bone becoming paper-thin. This process of pneumatication where the sinus expands like a balloon causing destruction and erosion and eventually the disappearance of future implant beds. Techniques are possible where some bone can be moved or remanufactured into the thinner portions allowing implants to support teeth that stay in all the time. A large sinus will not drain as quickly and as easily as a smaller sinus. Teeth and implants stabilize the bone and prevent expansion of the sinus cavity. Waiting or avoiding the implant option could eventually mean having to have a sinus lift procedure with additional complexities, costs and reduced chances of success. The procedure is worthy and sensibly yet, it could have been avoided by the early replacement of extracted teeth with implants ideally 8 weeks following an extraction. No big deal and easier than the extraction because no force is required, no concern about "will it be possible to remove my tooth" and the site will be free from any infection after 8 weeks. Your plight is common, so researchers have been busy trying to find ways of moving or making bone and luckily, sound tested methods are now available. Moving bone is easy. You end up with bone where you need it and the site that surrended its bone just regrows! These donor sites can be anywhere where bone exists; head, hip, wisdom tooth area or perhaps in the near future, a gelatin sponge will be soaked with a bone stimulating hormone and presto, bone! The research on recombinant human bone morphogenic protein II by Genetics Institute is most promising in doing just that task as might be the possibility of taking a teaspoon of your blood, growing some of those cells in the laboratory and then re-implanting them where you need bone. So, a person with inadequate bone that cannot have implants or bone augmentation is rare. The procedures have % success outcomes, so explanations of the matter can assist decisions. Remember "if you cannot make up your mind – you don’t have sufficient information". Bone grafting can be done in the chair in the dental office or sleeping in hospital and importantly, most of my patients would state that the procedure and recovery was easier than an extraction, which, lets face it, has a certain amount of necessary force, the worry of "will something break?" or even "will it come out". Implanting bone or titanium implants is a gentle sequence of gentle processes. |
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