If you have a missing tooth you already have heard or read about dental implants. As an oline savvy dentist with specialty about dental implants and prosthodontics, I wrote this guide to give all the facts and cost related factors which will hopefully answer most of your questions about implants.
This Guide provides info about:
- Dental Implant
- Types of Dental Implant
- Info about Dentai Implant Procedure
- Advantages, Disadvantages and Risks
- Average Cost of Dental Implants
- Factors which Influence the Cost
- Dental Insurance
A dental implant is an artificial tooth root, usually made of titanium alloy or zirconia. It is placed into the bone to to hold crown, bridge or denture in place. The direct anchorage of bone and an implant is called osseointegration. When a tooth is lost, some bone that supports the tooth will resorb. Dental implants help in preventing bone loss and maintaining the bone’s quantity around them. Implants have become the primary option in replacing missing teeth. Dental implants feel much more natural and comfortable compared to clasp retained dentures and soft tissue retained dentures. They are better than traditional crowns and bridges because implants provide an option to retain and support artificial teeth on the missing teeth area without preparing the adjacent teeth for retention. When mounted to implants, bridges and dentures usually won’t shift or slip in your mouth provided that they are prosthodontically driven when they were placed. Stable restoration, which the implant provide, can make talking and eating easier and worry-free.
Types of dental implants according to its location on bone.
Years ago, there are two main types of implants. One is called subperiosteal, which is not used anymore. This implant is a metal frame that is placed on top of the bone below the gums.
This ancient type implant is done by:
- Exposing the bone by lifting a flap.
- Making an impression of the exposed bone.
- The framework is then cast from the impression of the exposed bone.
- After the implant framework is finished, a flap will be lifted to re-expose the bone.
- The implant is placed on top of the bone.
- The flap is then repositioned and sutured water-tighly.
- The denture is placed after healing of the gum tissue.
Another type is endosteal. Which is the most commonly used dental implant nowadays. They originated from the one Branemark pioneered. Branemark implant still exists today under the Implant Company, Nobel.
To be qualified for an implant, a patient must be qualified to undergo surgical procedure. A simple test is if the patient can undergo a simple tooth extraction, he can undergo an implant placement procedure.
Routine visits to the dentist and dedicated, comprehensive oral hygiene are all required to maintain implants. The target is to maintain the implant in the patient’s mouth in his lifetime.
Info about Dentai Implant Procedure
Before the surgery can take place, comprehensive planning must be completed to identify and analyze position of nerves, the sinus’ proximity, and the shape and dimensions of the bone in and around the implant area. During the preliminary examination, your dentist will take panoramic radiographs of your oral and maxillofacial bone. Cepahalometric radiograph, and peri-apical radiograph of implant area are also required. Modern clinics require Dental CBCT scan, to accurately place an implant. CBCT scan are accurate image of bone and surrounding tissues used to analyze and determine the area where the implant will be placed.
Your teeth and gums will be examined for diseases. The teeth are restored and the oral soft tissue are treated prior to the procedure.
Getting implants can be an inpatient or outpatient procedure. It can be performed at your local dentist’s office, provided there is a hospital nearby in cases of emergency.
Dental implant placement requires anesthesia, including local and general. Dentists, periodontists, oral surgeons and prosthodontists can all perform the surgery. Implant placement should be prosthodontically driven to ensure long term success.
The surgery is usually done in two stages. In the first stage, a flap is lifted to expose the bone. A hole is then drilled into the bone under copious saline irrigation . The implant is inserted completely into the bone and lies below the gum tissue. Cover screws are placed on the implant fixture. The soft tissue is then readapted and sutured water tighly.
After healing, usually after 6 months. Osseointegration is expected to have taken placed. The second stage is basically all about abutment connection. The abutment is a metal or zirconia post that penetrates through the gums and connects the crown (bridge or dentures) to the implant. The gums above the implant are opened to install the abutment to the implant fixture. Abutment connection requires local anesthesia. Once the abutment portion is placed, the gum is then adapted around but not over the abutment.
In single stage implant surgery, both the implant fixture and the abutment are placed. Many published researches have shown that doing so has minimum detrimental effects as long as adequate time is given (well, usually 6 months) for everything to heal. In this case, it is important to note that the post will be visible. A provisional restoration can be used to hide it esthetically. There should be no force applied to the implant/abutment during osseointegration process.
It takes about 2 weeks for the gums to heal. But ideally, it needs 6 to 8 weeks, for the gums to be completely stable. You can detect the level of training of your dentist if he/she would wait for the ideal healing time.
Just like any surgical procedure, there will be swelling, bruising, minor pain and bleeding during the healing process. There are several ways to relieve the pain and discomfort during the recovery period. These will be discussed to you by your dentists during treatment presentation and also before the implant procedure.
After the gums are completely healed. An accurate impression of your upper and lower ridge will be made, concentrating on the implant abutment and its surrounding soft tissue. “Die fabrication” will be made from the impression. Maxillo mandibular relationship registration record will also be made. Occlusion is the most important aspect of the implant restoration procedure.
Next the artificial teeth (crown, crown and bridge or denture) is made from the die/cast fabrication.
Before cementation of crown, the fit is checked. Passive fit should be achieved. Failure to do so will result to unnecessary repeat/remake of the restoration. The occlusion is checked. The crown (bridge or denture) is adjusted to optimum occlusion needed, depending on the position of the implant, adjacent teeth, and opposing tooth/teeth.
After the restoration is fully adjusted, it is cemented (or screwed in placed) on the abutment.
Individual implant per missing tooth is more expensive but esthetically superior than an implant retained/supported bridge or denture.
In a bridge retained/supported by implants, minimum of 2 implants are required. It is more affordable complared to implanting each tooth separately. Implant retained denture also requires minimum of 2 implants.
Advantages, Disadvantages and Risks
There are many advantages to tooth implants. It is a wrong notion that it is permanent. There’s no permanent restoration that exists in dentistry. Just like natural dentition, if you don’t take care of them, your dental implants will be lost.
Dental implant is not a permanent solution to tooth loss but it is durable. It needs maintenance just like your natural teeth.
Implant supported dentures, crowns or bridges is almost the same to conventional dentures, crowns or bridges. They need maintenance.
Implant retained crowns are esthetically pleasing than tooth supported bridge.
Compared to tooth/tissue supported removable dentures, implant retained/supported bridge, offer convenience as they do not need to be removed or kept in place by messy adhesives (in case of ill fitting dentures).
They also improve oral health by making it easier to clean between teeth and they do not require modifications to adjacent healthy teeth in order to be placed.
Success rates depend on a number of factors including the quantity and quality of bone that will hold the implant body. According to studies, the success rate is above 90% and are always improving because of new discoveries about implants. More specifically, the success rate is around 90% for the maxilla and 95% for mandible. The bone in the maxilla is less dense than the mandible which makes successful osseointegration more challenging.
The risks are minimal as problems and causes of failure are rare and are often easily treated. They include but are not limited to: the bone not integrating with the implant (due to immediate loading after placement), bleeding, injury or numbness of the nearby area due to nerve damage, perforation of sinus cavity, and the chance of infection due to inadequate oral hygiene.
If you take care of it, it will last for a long time just like your natural teeth.
It can be more cost effective over many years provided that you maintain your implant according to the instruction of your dentist.
Natural looking and comfortable, provided that the prosthodontic restoration is done correctly.
Look and function more like natural teeth, provided that the prosthodontic restoration is done correctly.
Don’t require modifications to adjacent teeth for its prosthodontic portion (crown, bridge or denture)
90% and up success rate (success rate is lower in upper jaw due to bone quality)
Require greater maintenance than natural tooth.
It costs a lot, that is, if you think about short term.
Pain, swelling and bleeding due to surgery.
Bone not accepting the implant (rare, it has something to do with loading the implant instantly without healing)
Perforation of sinus cavity
Dental implants are always more expensive than conventional restorations. Because you will pay for the implant, the placement procedure and the special skills of your dentist. The cost depends on a number of factors including the skills and knowledge of your dentist, the type of implant body, and whole procedure, how many missing and number of teeth you need replaced, how many implants are required to support these artificial teeth, how much insurance coverage you have and your location. Once you get a thorugh examination and discussion with your dentist, they will be able to provide you with a price estimate. A single tooth implant typically costs $1000 to $3,000. If additional procedures such as bone grafts, extractions and extensive radio-imaging are required, the price can go up to $10,000. Your dentist will be able to give you an idea of what costs you are looking at after a preliminary examination.
It is important to ask the cost of the whole implant procedure and restoration. Make sure the price includes the whole procedure, all the surgeries required, including the final restoration. The final restoration is either crown, bridge or denture. Some dentists will tell you only the cost of placement of the implant fixture. Just to make it appear that they offer cheaper dental implants.
Cost of Additional Procedures
An implant fixture placement is only part of the dental implant procedure. That’s why it’s important to ask your dentist if the cost includes everything up to final restoration.
Many dentists will say that the price indicated on their advertisements only includes the placement of the fixture. An abutment and crown for a single tooth adds an extra $400 to $3,000. The average total cost paid by consumers for all procedures, abutment, crown and implant in US is $4,000. A 3 or 4 tooth bridge mounted on two implants can cost up to 10,000. A set of upper and lower implant supported complete bridge can cost up to $100,000. A set of implant retained upper and lower complete dentures can cost up to $50,000
Most of the time these procedures are neccesary to ensure a successful implant procedure.
A. Bone augmentation procedures is done to add and improve the quality of bone on implant area.
B. Soft tissue graft is necessary to improve the overall esthetics of gums around the implant compared to the adjacent natural tooth.
C. Frenectomy is sometime necessary to relieve the area from pulling of muscles creating extra tension on the soft tissue around the implant.
Many people travel to foreign countries to take advantage of affordable implants. The most popular places for affordable implants are in Asia, like Philippines, Thailand and India. Eastern Europe countries are also good places for affordable implants.
Single Dental Implant Cost
|US||$3,000 – $4, 000|
|UK||$3, 250 – $4, 250|
|Australia||$4, 000 – $5, 000|
|Philippines||$1, 200 – $2, 000|
|Thailand||$1, 200 – $2, 000|
|Vietnam||$1, 280 – $2, 180|
|India||$1, 390 – $2, 190|
|Hungary||$1, 380 – $2, 180|
|Germany||$3, 250 – $4, 250|
|Croatia||$1,390 – $2, 190|
|Costa Rica||$1, 300 – $2100|
Remember that “you get what you pay for”. Safe, good quality and long lasting implants come at a price.
Factors that Influence the Cost
- Brand of implant fixture
- Type of abutment
- Type of crown/type of final restoration.
- Cost of the implant surgery
- How many teeth need to be replaced
- Specialization of dentist
- How many dental professionals are involved in your case (multi-specialty is always the best option)
- Bone grafting.
- Additional procedures needed such as sinus elevation, bone and soft tissue graft.
Implants are not covered by Insurance. Majority of insurance companies around the world classify implants as cosmetic procedure.
For more information about dental implants, please talk to your dentist. Remember, “There is no online material nor website that can substitute for professional advice.”
Dental Implants Cost Guide