Dental implants are fixtures of Titanium which are surgically screwed into your jaw bone. The implant is an anchor for a naturally-appearing false tooth or a set of false teeth. Implants are great for replacing missing teeth. It is important that you have enough bone in the area of the missing teeth for the implants to be placed. Implants are not only used to replace one tooth, but those missing most if not all of their teeth benefit greatly as well. Implants are increasingly being used to replace certain types of bridges and removable partial dentures.

If you're missing one tooth or all of your teeth, implants may well be for you. So long as you have enough bone in the area of the missing tooth to facilitate the anchorage of the implants then this procedure can yield terrific results. If you don't have enough bone for this purpose, a bone graft and or sinus lift may be necessary. If you have a dental bridge or dentures (removable type), implants will be a welcome alternative. Implants are also an alternative to a fixed bridge. The implant will last a lifetime if cared for properly.

Implants are surgically placed in your jaw bone while under Anesthesia. It is a very time consuming and exact procedure when having many implants placed. As this procedure is surgical, it is very important to use only an accredited Implantologist for your implants.

At Dental Express we use the very latest Nobel single stage and conventional two stage implants. The advantage of the new single stage implants is they are minimally invasive and have a short healing period before the crown placement. Most implants can be completed during a two week visit. These are full sized implants and not MDI implants also known as mini implants. We do not use mini implants to replace single teeth.

Immediate Loaded Dental Implants Procedure

The treatment procedure and steps for immediate loaded implants are the same as that for conventional implants, the main difference being that the temporary crown or bridge is loaded onto the implants after its surgical placement.

• First evaluation and x-ray to determine implant site and bone condition
• Implant site preparation
• Placing the implant and installing the temporary crowns or bridges
• Placing the permanent crown or bridge

Immediate loaded implants does not apply to all cases and is dependent on the individual's bone quality and condition.

Following placement of the artificial roots in the jaw, the bone may be sore and the surrounding gums tender and swollen. Patients are, however, able to go about their normal daily activities a day after surgery avoiding any rigorous physical exercises or activities.

For your immediate loaded implants, the same post care instructions apply as that of conventional dental implants. Dental implants require the same care as real teeth, including brushing, flossing, and regular dental check-ups.

Inclusion/Exclusion Criteria for Immediate Implants and Immediate Loaded Implants.

Below is a list of some of the inclusion/ exclusion criteria for immediate dental implants and conventional dental implants. This list is non-exhaustive and its feasiblity is also dependent on the judgment of your implantologist on an individualised case basis.

• If you have a fractured or decayed tooth that needs to be extracted, a dental implant may be placed at the time of the tooth extraction. However, if your fractured or decayed tooth is infected, immediate dental implant placement is not advisable. There should be no apical disorder or inflammation at the area of the implant site.
• Good bone quality and quantity is required for immediate implants to be successful, thus immediate implants and immediate loaded may not be applicable to all cases. Different bone volume and density and preparation techniques will influence the level of stability.
• The patient should be healthy and compliant with good oral hygiene.
• Other criteria include having good gingival/ periodontal or periapical status of adjacent teeth as well as favourable and stable occlusal relationship.

As with any procedure, it is always important to consult with your dental specialists on whether a particular treatments such as immediate implant and immediate loaded implants are suitable for you. This is especially relevant if you are traveling to us from overseas.

With conventional implants up to a six month healing period is required before the implant is exposed and the abutment and crown can be placed. Conventional Implants are surgically placed into the jaw and covered with a flap of skin. They are then left to heal for between three and six months. The implant is then exposed and the abutment and crown placed.

Conventional Dental Implants Procedure
The implant procedure is the same whether one or all teeth are missing. Below outlines what you may expect during dental implant treatment:

• First evaluation and x-ray
  * A panoramic x-ray and oral examination is done to determine implant site and bone condition
• Implant site preparation
  * The gum tissue is opened to expose the bone area where the implant will be placed
  * In situations where there is insufficient bone structure, bone grafting may be a recommended procedure
  * Once healthy bone material has been established, the implant is ready to be put into place
• Placing the Implant
  * After the bone has been prepared, the implant is embedded and the tissue is sutured
• Healing Process - Osseointegration
  * The implant is left to integrate and heal with the jaw bone
  * The sutures are typically removed seven to fourteen days after surgery
• Attaching the Abutment or metal bar/ball
  * When the gum tissue is ready, a special abutment or metal bar/ball is attached to the implant
  * If crowns or bridges are opted, an abutment is placed and this provides the support for the new crown or bridge. Today's technologies often include the abutments attached to the implant post.
  * If overdentures are opted, the metal bar/ball is placed and is the clip used to securely retend the set of new overdentures
• Placing the Crown/Bridge or Overdenture
  * After impressions are taken, the crown/bridge or overdenture is made
  * If crowns or bridges are opted, it is then fixed over the post and cemented or screwed on.
  * If overdentures are opted, they are simply snapped onto the metal bars or balls

Dental implants can be rejected. Usually they are replaced with another implant of a slightly larger size. The rejection or "failure" rate is minimal, only 1 to 2% of all implant procedures.

For some people there are varying degrees of discomfort or pain, but this usually subsides in a couple of days. As with similar types of surgery, bruising and minor swelling might also develop shortly after the procedure.

At our Dental Express Manila clinic we use Nobel, Straumann, and Medical Titanium (Swiss)Dental Implants systems.