The term endosteal implant may sound a confusing to many people. THe truth however is that these are the good old-fashioned dental implants that many of us have in our mouths.

Replacing a lost adult tooth is crucial for maintaining your dental health. Failing to do so can lead to teeth shifting, increased instability within the mouth, and further tooth loss, as well as potential damage to the underlying bone. One effective solution for tooth replacement is an endosteal implant, commonly known as a dental implant. This type of implant is surgically embedded into the upper or lower jawbone through a multi-step procedure.

This article discusses the ideal candidates for endosteal implants, details the implantation process, and provides guidance on post-implant care.

Ideal Candidates for Endosteal Implants

Given that endosteal implants are inserted directly into the bone, the procedure can be invasive and necessitate a significant recovery period. Consequently, this treatment may not be suitable for everyone, particularly children or teenagers whose jawbones are still maturing.

Moreover, certain conditions may disqualify individuals from being suitable candidates for endosteal implants, including:

1. Pre-existing medical conditions such as diabetes, osteoporosis, and hypertension
2. Insufficient bone density in the jaw
3. Gum diseases, such as gingivitis and periodontitis
4. Smoking, although this does not necessarily preclude the procedure

Before proceeding with an endosteal implant, it may be necessary to treat or manage these conditions.

Endosteal Dental Implant Procedure

The placement of a dental implant is a relatively invasive surgical procedure, involving deep incisions. This procedure is typically performed by an oral or maxillofacial surgeon under local anesthesia, ensuring the patient remains awake while the mouth is numbed.

The endosteal implant process comprises three primary steps:

Imaging and Placement

The area where the tooth or teeth are missing is assessed using a dental X-ray or other imaging techniques. Surgeons make a small incision in the gum and drill a hole into the bone. A surgical guide and stent may be used to insert a specialized screw or cone, known as the “implant body,” into this space, leaving a gap.

Installing a Temporary Crown and Healing

During the initial appointment or a subsequent one, the surgeon attaches an extension called an “abutment” and places a temporary crown. A healing period follows, ranging from a few weeks to several months, during which bone matter grows around the screw in a process called “osseointegration.”

Installing a Permanent Crown

Approximately two weeks after placing the temporary crown, the final step can proceed. The permanent false tooth, also known as a prosthesis or crown, is affixed to the abutment. This prosthetic is custom-fitted using scanning technology and color-matched to the surrounding teeth for a natural appearance.

For cases where multiple teeth are missing, a dental bridge can be attached to the implant. Additionally, dental implants can be utilized to stabilize rows of dentures when many teeth are absent.

Supplementary Procedures

When the bone mass in the upper (maxilla) or lower jaw (mandible) is insufficient to support a dental implant, additional procedures may be necessary to ensure a successful outcome. These procedures include:

Tooth Extraction

If remnants of the tooth to be replaced are still present in the gum, they must be removed. Tooth extraction is a standard dental procedure, and full recovery from this must occur before proceeding with implant surgery.

Bone Augmentation

An oral surgeon may perform bone grafting before the implant surgery. This involves bonding bone material, either harvested from another part of the patient’s body or synthetic, to the affected area. This process, which can take several months, strengthens the bone structure. You can red all about this procedure here.

Sinus Lift

Replacing teeth in the rear of the upper jaw (maxilla) can be challenging due to the proximity to the sinus passages and the likelihood of insufficient bone. This procedure involves lifting the sinus and reinforcing the maxilla to create adequate support for the implant.

Ridge Expansion

If the bone mass in the mandible or maxilla is insufficient, an oral surgeon may perform ridge expansion. This involves exposing the affected area by pulling away the gum material and adding artificial bone material to the bone ridge. A significant recovery period is required before proceeding with the implant surgery.

Aftercare

Immediately After Surgery

Following each stage of the implant procedure, particularly after installing the endosteal implant body into the bone, patients may experience:

1. Bleeding within the first 12 to 24 hours
2. Soreness and discomfort around the affected area
3. Swelling in the face or gums for the first two to three days
4. Rarely, temporary numbness in the lower jaw

First Week of Recovery

1. Antibiotics will be prescribed to prevent infection.
2. Patients will receive instructions on how to properly clean and care for their implant.
3. Certain hard-to-chew foods and physical activities should be avoided.
4. For bleeding, use dry gauze to dab excess blood, then press wet gauze on the area for 20 minutes.
5. Avoid excessive head movement and using a straw, as the suction can stress the operated area.
6. Follow provided instructions closely and attend a follow-up appointment within two weeks.

When to Call Your Healthcare Provider

Contact your healthcare provider if you experience:

1. Difficulty opening your mouth, speaking, or chewing
2. Persistent swelling in the face after three days
3. Toothache or mouth pain
4. Persistent bad breath
5. Swollen and painful gums
6. Looseness of the tooth or teeth
7. Emerging gaps between teeth
8. Discharge (pus) from the affected area

Home Treatments and Pain Management

Post-implant home care involves maintaining excellent dental hygiene, including brushing twice daily, flossing daily, and regular dental check-ups. Smoking cessation is also recommended to reduce complications.

For pain and soreness, the following at-home treatments can aid recovery:

Medications

Painkillers, including prescribed opioids like Percocet, should be used cautiously. Over-the-counter NSAIDs, such as ibuprofen (Advil), can also be effective.

Icing

Apply a cold pack or bag of ice wrapped in a wet towel to the affected area for 15 minutes at a time, with 15-minute breaks between sessions.

Careful Positioning

Keep your head upright for the first 12 to 24 hours to minimize blood flow to the region and aid recovery.

Saltwater Gargling

Gargle a saltwater solution (half tablespoon of salt in a cup of warm water) several times a day to help heal the gums. Swish gently for 10 seconds before spitting it out, aiming for at least two rinses daily.

Overall Success Rates

Despite the potential for serious complications, endosteal implants are highly successful, with a success rate of approximately 90% to 95%. The vast majority of implants integrate successfully into the jaw and effectively address the issue of missing teeth without complications.

Alternative Options

If the underlying bone structure is insufficient or there are too many underlying health conditions, endosteal implants aren’t likely to be successful. Other means of correcting missing teeth include:

Fixed bridges

Dental bridges are one or more false teeth (restorations) that are placed in the mouth to correct issues. Crafted to fit in with your bite and smile, they’re bonded to existing teeth using specialized cement.

Partial dentures

Another option is the use of removable partial dentures to correct multiple missing teeth. These rows of false teeth are taken off at night and require cleaning and care, but they’re a non-invasive means of fixing your smile.

Full dentures: In cases where you’re missing all or most of your teeth, full dentures—replacing the upper and/or lower row—may also be considered. As with partial dentures, they’re taken off at night and special care is needed with cleaning them and eating.

Summary

As previously mentioned, endosteal implants are basically the commonly known dental implants. If you would like to know more about them, we highly recommend you head over to our dental implant service page or our dedicated blog here to learn more.

To make sure you do not go wrong with your implant treatment, we highly recommend meeting Dr. Horiyat who is a holistic dentist and dental implant professional for a consultation and a safe holistic treatment plan.