What is dental implant?
It is noble metal made screw. That implant is put inside the bones of jaws. And these
screws get integrated inside the bone. And that becomes as strong as the tooth´s
root. After that, the artificial tooth will be fitted over that screw, and that whole
integrated thing becomes implant supported tooth inside the mouth, working just as a
natural teeth inside the mouth. That is called dental implant.
With the growth of technology, latest advancements and easy supplies, implant
dentistry in Himalayas (in Nepal) has been growing in leaps and bounds.
Before putting implant needs other advanced technology based feasibility study just
like before building a house. You have to see the bony structure, you have to know
the bone´s thickness, You have to be clear about the bone´s density, bone´s height
because this is the place where you put your pillar. Just like you dig a hole before
pitching a pillar in a land, you have to do a feasibility study, you have to do soil test,
you have to do some landslide possibilities and same thing is done for dental
implant. So, In Nepal, as I said with the growth of all the necessary things to do
before implant is done are available like X-rays CBCT, test of health conditions of
patient and availability of screws and the best dental labs. Implant training is
growing, general dentists are becoming implantologist, even other specialists in
dentistry are also doing implant curiously.
Implant is supposed to be next to natural thing for a person to experience in terms of
look, function: perfect chewing and esthetic ( good looking teeth) experience.
When somebody loses teeth, an area becomes empty. Possibilities to fill that area
for function and look, you need teeth/ tooth. Removable dentures slowly weakens
adjacent tooth, fixed bridges demands damaging or cutting of adjacent healthy teeth.
But, for implant, a soft tissues is opened, and bone underneath is drilled and after
putting screw, it is closed and left to heal.
Prosthodontists in Nepal
A person who wants implant has longevity questions if he has smoking habits that
harms gums, blood sugar that compromises in certain conditions and his laziness
(who forgets to brush his teeth to keep it clean) deteriorates hygiene. Because good
oral hygiene gives rise good gums, good gums nourish bones and bones support
implant as implant goes inside the bone, just like a screw goes inside the wood, and
integrates to the bone. So bone has to be healthy, bone has to be responsive, bone
has to be well supported by gums and system. All together bone has to be Healthy
BONE.
There are fast track implants as well but usual implant takes a little more than a
couple of months to unite with the bone. Artificially made tooth/teeth in dental lab
nice lab then fitted in from above the gums area, tightened with that screw. So,
implant or that screw represents natural teeth´s root. And, that lab-fabricated artificial
tooth head which is tightened to screw works perfectly as tooth crown for function or
look being above soft tissue level.
Oral and maxillofacial dentists in Nepal
It can work for another 10/ 20/30 or even 40 years, but nothing is fail-safe or fool
proof in life even natural teeth dies unnatural death. So, It can fail. No guarantee is
given by good and trustworthy clinician.
This is how implant works. After putting implants, you have to maintain hygiene, you
have to follow up your dentist and proceed time and again to maintain it and be
aware to know whether it is working well.
What is implant failure. Implant failure means implant, not working. As I said before,
because of not healthy bone, because of less dense bone, because of poor oral
hygiene, implant may fail. The less dense bone means, if you put pillar in sand it
loses its grip and falls/comes out, it doesn’t stay as firm or it may not support the
load above.
What is implant success?
implant success means it has to work tirelessly, incessantly just like other life
activities, do grinding lifelong. Implant success is possible. If you follow certain
guidelines before going for it and after wearing it ( Some your authentic Dentist
practicing in Nepal tells, like bone height, size of implant as per bone status and the
general health conditions or lifestyle diseases and some you have to do like
maintaining oral hygiene, quitting smoking)
Regions of implant use:
Implant is used anywhere inside the oral cavity where natural teeth were except
third molar region because these regions can be less maintained, and these regions
are around the corners where space is compromised. Even natural teeth in that
areas are taken out so no use of implant in that area.
Length of the implant, implant quality, implant brand, and the clinicians who do
implant can be different and predictability can also change with all these determining
factors. Its failure and its success also varies in all these situations.
Implant dentistry in Nepal is not that old. It started 15 something years ago. One
dentist remembers his first implant he did for his father( that, as he says, still
working), another young dentist who has done lot of implants has also did his first
implant for his friend. I mean it is easy to see its predictability and track the record by
doing some of the cases for near ones or people who are at your disposal. Unknown
client may not follow, so.
Implant is done by every general dentist and even specialist dentists( trained for
something special) do implants as it is rewarding thing: rewarding for patients as it
works naturally and it doesn’t harm adjacent teeth as well. Rewarding for dentists too
as it is more satisfying job in terms of naturally restoring person´s chewing and
smiling activities. And, payment and bill can also be rewarding. But, one regular
implant practitioner said to me some years ago, single implant is not financially
beneficial. It is just for patient´s good help.
The cost ranges ( depending on clinician, brand of implant, clinic’s establishment
cost and procedures done line adding bone and doing gums surgeries) from 50K to
200K or even more. As dental implant is growing in the Himalayan country Nepal
with the increase in number of implant suppliers, more dental clinician ( dentists in
Nepal) becoming available, more dental hospital (in Nepal) doing implant dentistry,
price should soon become competitive by not hampering the quality of treatment.
So this is what implant is, how implant works, where implant available.
In a nutshell,
When favorable condition is there after X-rays, investigation, first off screw is
inserted inside the bone. Then it is let heal for months. Artificial teeth is made
somewhere in the lab and brought to the mouth, and it is tightened, and then it
becomes integrated system of root and tooth head and that looks like natural or resembles natural tooth system.
Implants can be done for a single tooth and for multiple teeth, even implant
supported fool mouth fixed denture can be done for those who do not have not a
single tooth in their mouth. For that you have to screw four to eight implants just like
pillars of the building to bear the brunt of collective load.
By Dr Dinesh Karki, Kathmandu based Dentist and curator of DentistNepal and DentalTreeNepal.