What Are Dental Implants?

Dental Implants. 3D illustration concept | What are dental implants | My Dental Advocate

Dr Advocate Avatar IconUpdated: January 30, 2023

By: Dr. Advocate

Replacing a permanent tooth is not new; our ancestors had to contend with it for generations, with some creative solutions. Replacement teeth, or dental implants, were found in 2000 BC in China. Back then, they used carved bamboo pegs to replace missing teeth! Today, dental implants consist of titanium hardware surgically inserted into the jaw bone to replace missing teeth.

Implant technology has dramatically advanced over the past 50 years and has shown great promise for predictable longevity. There are multiple implant companies today, and most use bioactive titanium-coated implants that assimilate with the jaw bone. Oral surgeons and periodontists place most implants; however, many general dentists have completed advanced training and are also competent.

There are two types of implant techniques: immediate and delayed implants. Immediate implants occur immediately after the extraction and require adequate bone for retention and engagement of the implant. Premolars and anterior teeth are the most common sites for immediate implants. On the other hand, delayed implants occur four months after extraction and are considered less risky for implant failure.

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Why do implants fail?

Dental implantation concept | Why do dental implants fail | My dental advocateAccording to multiple retrospective studies, dental implants have a 98% success rate. Although rare, implants can fail, and the most common reasons are poor oral hygiene, medical issues with delayed healing (diabetes), smoking, and poor surgical technique.

After the implant is placed, the gum tissue is sutured closed, and the healing process begins. If the surgical site is not cared for or cleaned properly, bacteria can congregate and penetrate the vulnerable tissues, impeding the healing process. Like smoking, failure will occur if contaminants interfere with the healing process. If a failure occurs, it often occurs soon after the implant is placed.

If the patient has diabetes or other medical conditions that inhibit healing, it may affect the success rate of dental implants. Having your primary care physician verify that your physical health is stable and controlled for a predictable outcome is essential. Lastly, the surgical technique can affect the success rate of dental implants.

If contamination occurs during the placement process or the implant is torqued too quickly, the bone tissue may be altered, leading to poor osseointegration and implant failure. Therefore, it’s paramount that the clinician is well-trained and competent in the placement of dental implants.


Implant occlusion

After the final crown is secured to the implant, ideal occlusion is required for the implant’s long-term success. Preserving the bone structure that houses the implant is done by limiting excess occlusal forces, limiting excursive chewing forces, and limiting bacteria buildup around the implant. Natural teeth have a ligament around the tooth known as the periodontal ligament (PDL), which acts as a shock absorber when chewing.

Unfortunately, dental implants lack this, so the occlusal contacts should compensate for this. This means that the impact with the opposing tooth should be light when your teeth come together and are non-existent in an excursive or side-to-side movement. If contacts are present when you chew side to side, the forces will negatively affect bone integration and may lead to implant failure. A nightguard is highly recommended to prevent unnecessary force if you grind your teeth.

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Implant care and maintenance

The “waist” of an implant is more narrow than a natural tooth, so it’s essential to floss well below the gum line to remove plaque located on the metal abutment. The abutment connects the crown to the implant post, inserted into the bone. Also, because the “waist” is more narrow, food impaction around the implant is possible, as the gum tissue cannot fill the space between the implant and the adjacent natural tooth.

As a result, over time, the bone around the implant may slowly resorb away from the top of the implant, causing the gum tissue to recede and expose a gap between the teeth, known as a “black triangle.” This can be unsightly, especially between your front teeth, so it’s essential to limit plaque build-up that could accelerate the formation of “black triangles.”

When your implants are being cleaned, your hygienist will use a rubber-tipped ultrasonic scaler or a titanium hand scaler to carefully clean away plaque and tartar without damaging the implant surface. Like natural teeth, the gum tissue will attach to the abutment to seal and prevent bacteria from penetrating the bone. If bacteria begins to formulate along the gum line, it can damage this attachment and potentially lead to bone loss and implant failure.

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Final thoughts


Dental implants are expensive and require months of healing. Therefore, it’s essential to understand the pros and cons of your dental implant options and how to maintain them for long term success properly. Have you recently been diagnosed with needing an implant? Do you understand your alternative options? My Dental Advocate’s team of board-certified dentists can provide a second opinion on your planned treatment. We look forward to bringing you peace of mind by verifying your treatment plan, suggesting an alternative, or answering your questions.

The more you know, the more healthy habits you can develop, saving you and your family from avoidable and potentially expensive dental procedures. Talk to your dental professional for more suggestions on improving oral health and check back for more blog posts and relevant information. Please share this site and let us know what else you’d like to know!


Related topics

Dental Implants | Dentures | Oral Appliances | Partial Dentures


Dr Advocate Avatar IconAbout the Author

Dr. Advocate is a board-certified dentist with 5+ years of clinical practice experience on a mission to provide accurate dental patient education. He believes everyone should access easy-to-read dental resources presented in layperson’s terms with relevant, up-to-date dental research and insight to improve their oral health.