Some Dental Implant History and How They’re Used
It’s a little known fact the ancient Mayans used to hammer seashells into their jaw to replace their missing teeth! Oouch! Those seashells were probably the first dental implants. Now days, high tech titanium alloy tooth implants are used to fill the gaps where they are screwed in not hammered.
In 1967 the Swedish physician Per-Ingvar Branemarkthe also known as the “father of modern dental implantology” started his research in to the use of titanium as a metal for dental implants. For over 15 years he worked tirelessly in the field of osseointergration (the biological fusion of bone to a foreign body). This research became mainstream when in 1982 at the Toronto Dental Conference Branemarkthe tabled a summary of his findings. Branemarkthe‘s presentation in Toronto on use the of titanium screws to create permanent, long lasting dental implants is widely considered to be one of the most significant breakthroughs in dentistry since the 70’s. If it wasn’t for Branemarkthe‘s reinvigorating the field of osseointergration we probably wouldn’t have the amazing dental implants that we have today.
Turn the clocks forward to 2017 and the dental implant business is a huge, thriving global industry and as the best dentists expand further into this field experts expect it to reach a size of USD $23.8 Billion by the end of 2018. As the market size increases so to does the implant manufacturing industry. Through constant advances in computer aided design (CAD) and computer aided machining (CAM) the implant industry has not only been able to increase the speed of implant manufacturing but also significantly reduce the individual unit cost of the implants and their individual components. This allows dentists like Smile For Life to provide the very best price for their patients.
The implants used at Smile for Life in North Melbourne all begin their life as a solid titanium rod about 4 meters long. This can be used to make over 200 individual implants. At the factory the technician inserts the rod into the lathes holding device (chuck) which keeps it straight as it feeds it into a lathe system. The lathe spins the titanium rod as computerised tools moves back and forth gradually slimming it down before finally cutting threads into it. The threads will eventually be used to anchor the implants in the patient’s jaw. Once the outside diameter has been machined, the lathe pushes the rod out and cuts it to length. The next step in the process utilizes a computerized drill to hollow out the inside of the implant and creates the internal threads for anchoring the prosthetic tooth. Once completed, the finished titanium implant is transferred to a cleaning station where any residue from the machining process can be removed prior to quality checking and packaging. The cleaning process is undertaken using a special piece of equipment known as a solvent vapor degreaser. Inside the degreaser the implants are suspended in a metal basket and are immersed in an atmosphere saturated with n-propyl-bromide (nPB). The nPB condenses on the cool surface of the implants before dripping off carrying with it any dissolved oils or other residues that may have been left on the parts.
The n-propyl-bromide is a very interesting solvent from the point of view that is environmentally friendly, non-flammable, does not affect the ozone layer and contains no chlorine. It is fully approved for use in Australia and is also US EPA Significant New Alternatives Policy (SNAP) approved.
Once cleaned the new dental implants need to be colour coded for easy size (diameter) identification. This is achieved through the anodizing of the implants by immersing them in a weak acid and dye bath and passing a small voltage through them. Different colours and hence size designations can be applied by varying the voltage applied to the implant. The benefits of the anodizing are two fold though, not only does it apply a colour for the dentist to easily identify it also increases the porosity of the titanium’s surface. This increased porosity increases the effective surface area of the screw which assists it in forming a strong bond with the recipients jaw bone.
The final step in the implant production process is a final ultrasonic clean and sterilisation to make sure the parts are 100% ready to take root in recipients jaw when the dentist or dental surgeon screws them in. All going to plan the implant will bond to the bone within a few weeks and the patient can then return to the clinic to have the ceramic tooth attached.
Now with all of the technical details out of the way, what are they actually like?
The good news is that unlike the dentures and false teeth of old, new titanium and ceramic dental implants like the ones used at smile-for-life.site can be cared for just like normal teeth. There is no need for removal for cleaning and they can be maintained with a standard toothbrush. This ensures that patients have the best experience possible.
Due to the fact that they are biologically bonded to the bone dentists claim that the feel of the teeth when eating with the implants is exactly like that of your regular teeth. The direct bonding of the implant to the recipients jaw bone also has the benefit of stimulating the jaw bone and helps to prevent issues like gum recession and bone density loss common with traditional over the gum dentures. This allows modern dentists to improve patient outcomes and reduce any post operative complications to a minimum.
The 6 basic steps of implanting
Soft tissue reflection – An incision is made in the gum over the crest of the jaw bone that allows the gum to be folded back revealing the bone. In recent times “flapless” surgery is becoming more common and a circular punch slightly bigger than the diameter of the implant is used to remove a piece of gum.
Pilot Drilling – A high speed pilot drill and drilling jig is used to place the first hole on the jaw bone.
Hole enlargement – A series of anywhere between 3 and 6 progressively larger drill bits is used to enlarge the pilot hole. This needs to be done carefully to avoid burning the bone. A special saline coolant is often used by the gentle dentist to keep the site cool whilst drilling.
Placing the titanium screw – The titanium implant screw is inserted directly in to the jaw bone (in the case of self-tapping implants) or in to a thread in the bone that was tapped after drilling (to learn more about implants click here)
Tissue repair – The gum tissue is brought up as close as possible to the implant and is allowed to heal before fitting the crown. In some cases the gum is allowed to heal over the implant screw for the gentle dentist to expose at a later date.
Fitting the crown – The patient returns to their dentist for the fitting of the crown. This can take anywhere between 1 and 3 hours depending on the type of implant and crown used.