Dental implants are metal screws or cylinders that are inserted in the jawbone and used to support artificial teeth. The majority of modern implants are made of commercially pure titanium. Titanium implants are able to bond with bone. Some implants are coated with materials that enhance the attachment of the implant to the jawbone.

Implants may be used to replace teeth in single-tooth spaces, groups of two or more missing teeth, or where the teeth are completely missing in one or both jaws. Once placed, the implants are used to support individual crowns, or bridges that are retained rigidly to the implants. Implants may also be used to help retain removable dentures more securely (implant-retained over-dentures).

Implants bond with bone by a process known as osseointegration. When first placed into bone, the implant is held by mechanical locking and frictional grip with bone. Microscopic spaces remain between the implant surface and bone. Over a period of 2 to 6 months, bone gradually grows up against the implant surface until no space remains. The implant is then said to have integrated with the bone.

Most patients who are healthy and not restricted from undergoing minor dental surgical procedures, and who have good oral hygiene can have dental implants. Your dentist will assess the potential implant site to determine whether there is sufficient bone volume and gum thickness to allow placement of an implant.

The dentist begins by undertaking a clinical examination that will involve inspection, palpation and gentle probing of the potential implant site and adjacent teeth. In straightforward cases, simple dental x-rays are usually sufficient to examine the bone. In more complex cases, specialized implant x-rays, known as tomograms, are usually required (either plain x-rays or CAT scans).

Nothing will function as well as natural teeth. However, implant crowns and bridges function much better than removable teeth and can feel very similar to the natural dentition. Implant-retained over-dentures will feel much more secure than conventional full dentures.

Implants that fail do so because the bone has not integrated sufficiently with the implant surface. Hence, implants are not "rejected" like an organ transplant, they simply fail to bond with the bone. This may occur if the bone is very soft at the time the implant is placed, or if the implant is initially unstable. Other reasons include inadvertent loading of the implant via a removable denture or by the action of chewing hard food over the implant site at the early stages of healing. Infection may also cause an implant to be lost. Most modern implant systems report success rates of 85-95% over a 5 to 15 years period.

Smoking is one of the biggest risk factors in failure of dental implants. Recent studies estimate that the chances of failure increase by two to three fold in a smoker. Smoking affects the healing of bone and soft tissue, by reducing the nutrients and minerals in the tissues and by reducing blood supply.

In most situations, an implant can be readily replaced if it fails to bond with the bone provided that adequate bone and gum tissue is present.

In most cases, dentures and other temporary appliances can be worn immediately after implant surgery. The exception would be in cases where many teeth are missing, or where all the teeth are missing in one or both jaws. In these situations, dentists will often recommend that dentures not be worn for up to two weeks following surgery.

In most cases, implants may be placed using local anaesthesia in the dental office. Sterile drapes and gowns are used to maintain optimal cleanliness. In more complex cases, your dentist may recommend that treatment be performed while you are under general anaesthesia in a hospital environment.

In most situations, a healing period of between 3 to 6 months is required before the artificial teeth can be attached to the implants. A temporary appliance can usually be made to provide function and aesthetics during this period.

After initial implant placement, regular follow-up visits are required to ensure that healing is progressing satisfactorily. After completion of the artificial teeth, regular check-ups are needed every 6 to 12 months. At these check-up appointments, the implants are inspected and examined to ensure that the supporting gum and bone remains healthy. X-rays are taken to examine the bone structure around the implant.

For the implant to function well and to remain healthy, proper oral hygiene must be performed at home on a daily basis. Special cleaning aids (brushes, and floss) are widely available. Your dentist will provide instruction on the proper use of these cleaning aids.