Dental Implant Treatment Options

If you have more than one adjacent gap, for example three missing teeth, you may be suitable for an implant supported bridge. In most cases, three missing teeth can be supported by two implants alone with clear cost benefits. This is considered to be a better approach than a loose, removable denture.

If the bone is in good condition and implant stability high, an immediate loading approach can often be used. When restoring more than one adjacent implant it is essential to use a surgical guide for accurate positioning. Our latest technology and equipment allows us to scan the jaw and mouth and then digitally place the theoretical implant and crown on screen as part of the comprehensive planning process.

We are then able to design the stent digitally and mill the components in-house. This technically advanced and efficient method produces the surgical guide leading to cost efficiency for the patients (please see our price guide).

In some cases it may be possible to fit an implant on the same day as the old tooth is removed and directly after the titanium rod is placed in the jaw bone, a process known as ‘immediate loading’.

Immediate loading may be suitable where a complete arch of teeth is needed. Here we use a special set of implants to support a complete bridge of replacement teeth. Typically two implants are placed conventionally, complemented by two more slightly larger implants to provide robust support for a fixed bridge of new teeth. Using this technique it is possible to provide a new set of replacement teeth in a single visit to the practice; however it should be noted that this type of treatment is not suitable for everyone.

A further benefit of ‘all on 4’ is that it can be helpful for patients who would otherwise need a bone graft. This is because the implants can be placed at varying angles to access suitable anchor bone in different parts of the jaw.

Implant design has come a long way over the last 50 years. In its earliest form, implants used blades or small blocks of metal with large holes. These required significant surgical procedures with associated trauma for the patient. Today implants are much smaller rods that replace the tooth root like for like and they are evolving continually to reflect advances in material technology and form.
Some implants are now designed with threads that are able to engage the jaw bone with greater force and initial security. Here the surgeon can be confident they can load the implant with the abutment and crown directly in a process known as immediate loading. Many dental practices may call this ‘teeth in a day’ or if more than one implant is placed in this manner, ‘all on 4’.
However, it is important to understand that ‘teeth in a day’ or ‘all on 4’ is really a staged process to the fit of the final tooth or bridge some months later and soft diet eating is still required for some time.

The major benefit, where applicable, is that it circumvents using a temporary tooth that may be denture or sticky bridge in design.

There are times when a patient presents with insufficient bone to support teeth implants. Depending on the nature and extent of the bone loss, simple in-house grafting would be required. Two distinct methods are employed by myself as follows:

If the bone has lost some thickness, animal granulated bone can be placed into the void and allowed to heal in-between 4 to 7 months. The bone is covered by your own gum and you will use your temporary tooth (either a denture or sticky bridge) throughout the healing period.

If the bone is thin in width and height I would use human bone that is fixed into place and allowed to heal for several months.

In both cases the bone is irradiated and has no biological activity. Once either bone form is placed, your own bone repairs itself and eventually replaces the donor bone but in a thicker nature. This results in excellent, resistant new bone to allow placement of a dental implant.

Larger graft requirements, usually involving a hip graft, would be made to my consultant colleague at The Royal Derby Hospital on a day-case referral basis. There are other techniques where the bone can be adjusted (widened) without grafting and allowing implant placement to proceed.