Dental Implants

Dentista Implant

Dental implants Perth are available with Dr Carla who is experienced in single teeth and bridge implants. Dental implant prices and the cost of implants can be quite prohibitive, so Dentista Dental ensures our fees are reasonable, and that patients have payment options to suit their needs.

 

Before dental implants were widely available, if you had any missing teeth your only options to replace them were a dental bridge, or a removable denture. While both are good options, they both come with limitations. Namely, the bridge requires the shaving down of the support teeth either side, and the denture requires removal after meals to clean, and removal overnight, and traps food and plaque underneath it. Additionally depending on the situation in the rest of your mouth, the denture or the bridge may not be possible. 

Dental Implants can offer a great way to replace a single missing tooth, or several missing teeth. They are widely considered the gold standard to remove a single missing tooth.

Dental Implants Perth

Dr Carla Graneri.jpg

Dentist Dr Carla Graneri (BDSc (Hons))

Dr Carla has been putting the crowns on implants since 2011. Originally a graduate of the University of Western Australia, she graduated with honours back in 2009. She took the next step and began her implant surgery training at the Branemark Centre in Perth in 2017. She went on to complete the Master Clinician of Implantology program (GIDE) with Loma Linda University in California, USA in 2018. This course focused on bone and soft tissue grafting techniques. She is now studying a Diploma of Aesthetic Dentistry with Portsmouth University, UK. She is a strong believer in continuing education and continues to do training to refine her skills at every opportunity.

 

Please take a look at our video about teeth implants Perth then we address some of the common questions related to a tooth implant Perth and the related cost of dental implants Perth.

 

🦷 What is an implant?

🦷 What's involved?

🦷 Am I a good Candidate for implants?

🦷 Timing of Screw Placement?

🦷 Timing of Final Ceramic Crown Placement?

🦷 What is my Final Crown made of?

🦷 What are my Temporary Teeth Options?

🦷 Maintenance Requirements?

🦷 Risks and Complications?

🦷 Cost of an implant?

🦷 Dental Implants Bali?

🦷 The Different Types of Dental Implants

What is an implant?

An implant is a titanium screw, which acts as a replacement root! If only one tooth is being replaced, then a ceramic tooth (also known as the crown) is then fitted onto the titanium replacement root. If more than one tooth is missing there are different ways for the implants to support the missing teeth. These can be as a bridge, or an implant supported denture.

 

Titanium is a very special material because it is one of the only things in the world our bone will actually grow onto and attach to! This is very important. 

Dental Implant
Above, implant replacing a single missing back tooth next to natural teeth.

What's involved?

Like all things, a good outcome starts with a comprehensive plan. You will be directed to a radiology clinic to have a 3D x-ray of your jaws, known as a Cone Beam CT (CBCT)

Dr Carla will take moulds of your teeth and then using the CBCT digitally plan where your implants will go. This plan ensures the implant keeps away from important structures like nerves and your nasal sinuses, and also helps determine if any bone or gum grafting may be required. Then, depending on the situation and which is best, she will either place the implants fully guided with a printed stent that fits over the top of your other teeth, or she will place the implants free hand. Dr Carla and the team are sure to follow sterile surgical procedure at all times. 

Depending on how tight the implant goes in to the bone will determine if a tooth can be placed on top straight away. Generally however the implant needs the bone to heal to it for three months before the tooth (crown) can go on top.

While your implant is healing and you are waiting for the tooth to be fitted to the implant, you can choose to have a removable denture made to replace the teeth that are missing. People replacing missing front teeth often choose the temporary partial denture, while people replacing missing back teeth often opt to go without the temporary denture.

CBCT-digital-plan.jpg
 
Above, Dr Carla digitally planning an implant for a top back tooth

Great! Am I a good candidate for implants?

Implants are a surgical procedure and as such have surgical risks. If you are unwell or have medical conditions that put you at a high risk for surgery, implants may not be right for you.

While this is not an exhaustive list, below are listed some medical conditions that place you at a higher risk of implant complications or failure 

  • gum (periodontal disease)

  • uncontrolled diabetes

  • smoking

  • autoimmune diseases (particularly those treated with steroids)

  • if you have ever taken a class of drugs known as bisphosphonates (often used to treat osteoporosis and metastatic cancer)

If your gums are already thin and receding, then you may benefit from a gum graft. 

If you don't have enough bone where your implant needs to be, you will most likely require a bone graft. This is why the CBCT (3D x-ray) is necessary to see how much bone is under your gums.

Other things that can make an implant more difficult are;

  • thin gums

  • receded gums

  • if your teeth are very triangular in shape

  • if you clench or grind your teeth 

  • limited gap between other teeth to place your implant

  • you show a lot of gum when you smile/laugh etc

Timing of Implants (screw placement)

There are different options for when is the best time to place your implant. Some of the common options are listed below.

1. Immediate

An 'Immediate' Implant means that your tooth is extracted and the implant (screw) is immediately placed. It does not necessarily mean that the tooth can be placed on the implant straight away. An immediate implant may be suitable in cases where there is no infection, and there is adequate bone around the tooth the place the screw. What determines if the tooth can go on top of the implant at the time the implant is placed largely depends on how tight the screw went in, and if you need any other gum or bone grafting at the same time.

2. Early 

Early placement is when the implant is placed 6-8 weeks after the tooth has been removed. The benefit of this technique is that it allows the gum tissue (which heals fast) to heal, and if there was any infection in the tooth prior to its removal, the body will have had a chance to completely remove any bugs left over. Usually at the time of implant placement, a bone graft is required. Early placement is suitable for front teeth that have infection present. 

3. Delayed

Delayed placement is when the implant is placed more than 3 months after the tooth has been extracted. At this time the bone would have had a chance to fill in where the root(s) of the tooth used to be. While this is beneficial in some ways, it has it's disadvantages as well. The reason for this is that once a tooth is removed, the bone that supported the tooth actually disappears over time because the tooth is what kept the bone there. If you require a tooth to be extracted, and are considering an implant in the future (i.e. longer than three months) it may be beneficial to have a socket preservation procedure (small bone grafting) to keep more bone there longer. 

See below for some before and after pictures about teeth implants Perth

 
 

Timing of final crown (tooth on top)

The timing of when the tooth goes on top of your implant depends on when the bone has healed. Bone is quite slow to heal. Our natural bone heals faster than the material from a bone graft (which acts as a scaffold for our natural bone to grow into). 

No bone graft

If you have not required a bone graft, and if you are fit and healthy (i.e. no systemic medical conditions), then usually the crown (tooth) can go on top of your implant 3 months after the implant was placed.

Bone graft

If you required a bone graft to have your implant placed, then this bone takes a bit longer to heal. Usually we need to wait 6-9 months after the bone graft procedure before placing the tooth on top.

Gum graft

A gum graft usually requires 2 months of healing before the tooth can be placed on top.

What is my final crown crown made of?

Your final crown will be made from Zirconia and may be layered with ceramic to enhance the translucency, which is important for front teeth. Zirconia is a very strong material that is white. The base that screws into the implant is made from Titanum.

Zirconia Implant Crowns
 
 
Above, Zirconia Implant crowns with Titanium bases

What are my temporary teeth options?

If waiting up to 9 months without a tooth is not going to work for you, then there are several temporary options. Some times you will b given a combination of the temporary options. 

1. Suspension Bridge

A suspension bridge 'suspends' the replacement teeth in a rigid clear plastic tray which is held up by covering your other teeth. Because the replacement teeth are held up by your other teeth, there is nothing making contact with your gum. This is very very beneficial because after your implant and any bone or gum grafting surgery you do not want to have fake teeth touching or rubbing on the delicate gum area. For this reason, the suspension bridge is usually to go-to temporary for a month or two immediately after your surgery.

 


Caring for your suspension bridge: This type of temporary is prone to wear and tear, especially if you chew food while wearing it. It is important to remove the suspension bridge after you eat and drink to rinse it and rinse your teeth to remove any food or drink residue. Rinsing your mouth and suspension bridge helps keep it clear longer, and reduces the chance of damage to your other teeth. As the clear tray is made of plastic, is is likely to stain. Avoid eating and drinking things that would stain a white T-shirt (e.g. beetroot, turmeric, coffee, tea, etc). The plastic can change shape if it gets too hot, so avoid putting very hot things like hot drinks and soup in your mouth, or using boiling water to clean. The clean, use liquid soap and a soft tooth brush twice a day. Every couple of days you can soak it in denture cleaning tablets for a few minutes. DO not use harsh chemicals or bleach. 

 
Suspension Bridge Replacing 4 front teet
suspension-bridge-on-model.jpg
Above, Suspension bridge replacing 4 top front teeth and gum. Two implants will support a new 4 unit implant bridge

2. Denture

A denture is a removable plate that rests on your gums, and hooks onto your teeth with metal clasps. Because it rests on your gums, it is best avoided to use for a couple of months after any implant, bone or gum grafting surgery.

 

The benefits of the denture over the suspension bridge are that because it does not cover the biting surfaces of your teeth, it is more comfortable to chew your food. It is also made from a much stronger acrylic which makes it is more durable. It is also more stain resistant, and can last several years. 


Caring for your denture: The denture is more robust than the suspension bridge. Remove after eating to rinse your mouth and the denture. Clean twice a day with a soft brush and liquid soap. Do not use harsh chemicals, toothpaste, or bleach. A couple of times a week soak for a few minutes in denture cleaner.   

Denture
Above, acrylic partial denture on stone model replacing four top teeth 

3. Immediate Temporary Implant Crown 

If you don't require any bone or gum grafting, and when your implant is placed into your bone it is nice and tight there is the option to have an immediate temporary crown fitted to your implant. The temporary crown is made from composite resin (white filling material). It is screwed into the implant the same way your final ceramic crown is. The temporary implant crown is only for fashion, not function. It will have the shape and colour of a tooth, however it should not be used for biting or chewing. Any pressure placed on the tooth will travel down to the implant. Just like a broken arm or leg, the implant needs to be very still to heal properly. After the 3 months of healing of the bone to your implant screw, a mould is taken and your temporary composite crown is swapped for a new ceramic crown. If you would like to know about tooth crown cost Perth then please see our fees page here.


Caring for your immediate temporary implant crown: The area needs to be kept very clean with gentle tooth brushing and mouth rinsing for a couple of weeks after it is placed.

4. Long Term Temporary Implant Crowns 

You may benefit from a long term temporary crown if your implants have been placed in an 'aesthetic area', for example your front teeth. This is because sometimes it can take the gums several months to settle, and having a long term screwed in temporary crown (or bridge) means that you have a more comfortable temporary than a denture and your gums have an opportunity to stabilise before your final crown in ceramic is made. The temporary crown is screwed into your implant. It is made of plastic. The colour will not be as beautiful as the ceramic, and it won't be as strong. Normally the long term temporary crowns can be made once your implant has finished healing (see above). You may wear the long term temporary crown for several months.

Caring for your long term temporary implant crown: The area needs to be kept very clean with gentle tooth brushing. You can use small interproximal brushes to clean around your temporary implant crowns.

What about maintenance?

Implants need to be closely maintained and monitored by a dentist for the rest of their life! The seal of the gum to an implant is no where near as strong as the seal of your gum to your natural teeth. This means that the gum around the implant is vulnerable to getting damaged and infected. This can lead to bone loss around your implant! Bone loss is the nemesis of implants, and is very hard to treat!

 

My implant dentist Perth - maintenance and check ups are the key!

 
biologic seal implants
Above, the connection of gum to an implant is much weaker than gum to a natural tooth. Notice a deeper gum gap ('pocket') which allows plaque and food to sneak in, and  fewer connecting fibers 

At home maintenance 

Cleaning around your implant at home is super important!  

Brushing:

You want to brush gently and thoroughly (we recommend an electric tooth brush). Do not do any sort of scrubbing as this can damage your gum.

Cleaning between or around your implants:

To clean between implants we recommend ditching the floss!  This is because studies have shown that the tiny fibers of floss can get stuck under the delicate gum around your implant and lead to bone loss. We want to avoid bone loss at all costs! So, to clean between your implants we recommend the small interdental brushes. You can still use floss around your natural teeth if floss works well for you.

Picksters
electric toothbrushes
Above, interdental brushes
Above,  electric toothbrushes

Professional Maintenance

You should have your implants reviewed by the dentist every six months at least. There, the health of the gum can be checked and x-rays can be taken to check the bone levels. As described above the attachment of the gum to the implant is very delicate. Additionally the implant titanium is actually very delicate as well and prone to being scratched. To avoid any accidental damage to your implant, make sure you only have it cleaned with the AirFlow Master. If there is tartar build up on your implant (hard white stuff that doesn't come off with the Airflow powder), the Airflow Master actually comes with coated tips to gently remove the tartar from your implant screw without scratching it.

World's 1st Dental Spa Experience Dentis
 

What are the Risks and Complications of Implant treatment?

Implant treatment is a surgical procedure and carries risks. Some risks associated with implant surgery include bleeding, swelling, infection, damage to near by teeth, damage to near by nerves or structures such as the nasal sinuses, and failure of the bone to attach properly to the implant and the implant failing and requiring removal. If you have a bone graft or a gum graft there is also a risk that they may fail and require removal and replacement. The medical conditions listed above increase your risk of complications. 

There are also risks you get bone loss or infection around your implant (this may happen years after the implant is placed). This is called peri-implantitis, and requires treatment. If there is too much bone loss the implant may require removal. 

The crown and screw attached to your implant may also chip and require replacement. 

Regular maintenance helps to catch any complications early.

 

Cost of an implant?

Dental implant prices - The cost of an implant depends on several factors. As outlined above sometimes you will need bone, and or gum grafting which are additional procedures and incur additional costs.

 

Dental implant prices for a straight forward implant, that requires no additional bone or gum grafting, will usually incur the following codes and fees

 

688 Implant (screw) $1,861

661 Abutment (connects implant crown to screw) $912

671 Implant Crown $1,592

Dental implant price for one implant and crown $4,365

Please note there are other fees you will likely incur

CBCT scan (3D x-ray to see your bone) Fee Payable to Radiological Clinic

Medications you will require for your treatment (antibiotics, pain killers, anti-inflammatories)

679 Surgical Guide $350

022 Radiographs taken throughout treatment $40

Any temporisation you may choose to have (see above for temporary teeth options) Cost depends on option

235, 236 Any bone or gum grafting $550-$1,000

****All surgical procedures carry risks and benefits.  

Click here to watch how an implant crown is attached to the implant in a real life patient!

If you'd like to learn more about dental implants click here to return to the top

Dentista Dental Centre - your Morley Dentist and Noranda Dentist

Dental Implants Bali

 

Are you considering getting dental implants in Bali or dental implants in Thailand? Please consider the risks of this before you proceed with this treatment. As stated in the section of risks involved with an implant, there are some complications that can be involved with dental implants. You need to think of any follow up appointments that may be required or aftercare that is needed. This is obviously very difficult if a month after your implant, something goes wrong, is not quite right or one of the complications mentioned earlier such as swelling, nerve pain or damage, infection or even removal and replacement of the implant occur. Implants can often also become quite complicated with bone grafting or gum grafts, As the complication of a surgical procedure increases, so too does the risk or needing some sort of aftercare or follow up.

It should go without saying but obviously as well the materials used and the dentist and their training and experience also needs to be taken into account. Your smile and dental health are important.. please choose an experienced, regulated and trusted dentist when it comes to a procedure such as a dental implant. Your perceived savings could cost you alot more in the long run. We don't want to be negative but unfortunately we have seen the damage and pain caused by going overseas for dental treatment.

Different Types of Dental Implants

 

Not every case and mouth is the same. Therefore,  there are different types of implants, categorized by their material, system, and placement.

 

This allows you and your dentist to choose the possible solution and guarantee the treatment's success.

 

Depending on the placement, the implants can be:

 

  • Endosteal Implant:

 

The most common type of implant. Endosteal implants are drilled or screwed inside the bone to act as a root. They offer more stability than their subperiosteal counterpart while feeling more natural in the mouth.

 

Although initially the bone quality to place these types of implants had to be optimal, recent technological and technique developments have made it possible to place dental implants with bone graft in cases where the bone does not meet the requirements.

endosteal implant.JPG

Endosteal implant is shown being screwed into the bone

  • Subperiosteal Implant:

 

This type of implant is not as common as the endosteal, and, unlike it, it is not drilled inside the bone.

 

The subperiosteal implant is a metal frame that rests over the bone and under the gums. It has only a metal post sticking out to place the prophetic restoration. Yet, they are rarely used nowadays and can only hold dentures.

subperiosteal implant.JPG

Superiosteal Implant with metal frame avoiding using the bone as the support structure

The implant material alternatives

You can choose from two different biocompatible materials if you are getting an endosteal implant.

 

Biocompatibility is a trait that every implant material must-have. This means that the material should not cause allergies or be identified by the body as a foreign element that the immune system could attack and result in implant rejection.

 

Traditional dental implants are made of titanium. Although it is a metal, it is highly biocompatible with a high success rate. Furthermore, it is resistant and perfectly capable of withstanding the forces applied to it while eating and biting without breaking.

 

The development of medical materials resulted in the birth of Zirconia implants as an alternative to traditional titanium.

 

Zirconia is a metal-free material obtained through the chemical oxidation of the metal Zircon. The metal atoms are separated throughout the process, leaving biocompatible porcelain behind.

 

One of the main characteristics of Zirconia is its optical properties, which turn it into an excellent alternative for cases invisible zones of the mouth.

 

Although not as resistant as titanium, Zirconia possesses a white color similar to a natural tooth. Although the implant lies inside the bone, there is a portion called "abutment" staying under the gum. If the gums are thin, the titanium implants can show through them or even pigment them, turning the gums gray and giving an unpleasant appearance.

 

However, Zirconia's white color prevents this downside. Even with some complications, the color showing will be similar to the tooth and not a noticeable gray tone.

 

However, titanium and Zirconia possess remarkable characteristics that make them excellent biocompatible materials. Moreover, your dentist can help you decide which one is your best option based on your needs and case.

One-piece or two-piece implant system 

The material is not the only thing you can choose while deciding what implant is more suitable for you. There are two types of dental implant systems which play a crucial role in how the treatment is performed.

 

Every dental implant is made of two elements:

 

  • Implant post or fixture: The screw-like portion drilled inside the bone and acts as a root.

  • Abutment: The structure that functions as the base for the restoration. It sits right above the bone.

 

Depending on the system selected, these two elements are connected differently.

One-piece system

As its names suggest, the fixture and the abutment come together as a single unit. Therefore, they can not be separated and do not require multiple procedures. This allows the dentist to perform a treatment procedure called immediate load.

 

Usually, it is necessary to wait a few months for the implant to heal and fuse with the bone before placing a crown. With an immediate load, on the other hand, it is possible to place a temporary restoration over the implant right after the surgery.

 

It is essential to know that this restoration is not as stable as a permanent one and must be replaced for the definite version once the implant has

Two-piece system

In these types of implants, the fixture and abutment are two separate pieces that the dentist attaches through a screw. This is highly beneficial as it gives the dentist more freedom while planning.

 

It is vital to understand that the abutment is parallel to the crown. Therefore, if the abutment is placed at a different angle from the teeth axis, the crown will be misaligned.

 

The dentist can choose between different abutments with different angles in complex cases where the position of the implant inside the bone won't be the most favorable.

 

Additionally, the abutment can be selected, allowing the dentist to choose one that aligns with the teeth on the arch, even if the implant has to be placed at an odd angle.

 

Also, with this system, the implant is placed alone inside the bone with the gum stitched over it. Once the implant has fused with the bone, after 4-6 months, the dentist performs a second surgery. This procedure reveals the implant and screws a special abutment to help the gums heal in the correct shape to receive the crown. Afterward, it is replaced with the final abutment and the crown.