Not only are implants indicated for patients who have one or several missing teeth, they also can be the solution for denture wearers whose lower plates slip and slide, making chewing difficult and painful.

Dental implants, in the opinion of many professionals, have emerged as the best option for restorative dentistry.

Not only are implants indicated for patients who have one or several missing teeth, they also can be the solution for denture wearers whose lower plates slip and slide, making chewing difficult and painful.

Dental implants are a large portion of Dr. Michael  Zetz’s practice as an oral and maxillofacial surgeon with the Institute of Jaw and Facial Surgery in Jackson Township.

“The three of us (Zetz’s partners Drs. David Ash and Neil Sundheimer) probably put in 700 implants last year,” said Zetz, who has been in practice for 28 years and is president of the Stark County Dental Society.

Dental implants were released for the public in the late 1980s, he said, and the changes since then “would be comparable to the change in computers.”

Today, they are so easy to use and restore that the standard of care dictates them for patients at Case Western Reserve University’s dental clinic.

At Your Dentist’s Office

The process usually begins with a visit to a dentist such as Dr. Steven Parker of Perry Township. His patients range from infants to senior citizens.

He sees dental implants as “a fantastic option to replace teeth that have been lost.” Parker said he explains the process to patients and, if they decide to proceed with the implant, they then are referred to an oral surgeon, periodontist or an endodontist.

The implant, he explained, is a cylindrical prosthetic root set into the bone. Once the bone fuses, according to Zetz,  the implant “is yours forever.”

Parker lauds implants as the answer for many patients with lower dentures.

“You can see amazing results with people who have struggled with the lower plate. They have lost a lot of bone of the lower arch and nothing is stimulating that bone to regenerate. The lower denture typically just rests on the ridge where the upper dentures go in with a little bit of suction,” he explained. “But the lower denture just rests and relies on muscle and tongue control.

“What surgeons can do in a situation like that where a person has a full lower denture that’s difficult to wear is typically  place two to four implants in the lower arch. After adequate healing, then we can fabricate a denture that will be supported by the implant. We can use a combination of a clasp so the denture is still removable but will click into place. Then it is pretty solid and will not be pushed down vertically when they bear down. When the denture is loose and is pushing down into the floor of the mouth, it can be very painful. I think all dentists have had some patients we classify as dental cripples. They can’t function any more.”

Lifetime Solutions

Zetz and Parker agree that an implant often is a better and more cost-efficient way to handle a specific dental problem than putting in crowns or bridges.

For example, Zetz cited a patient missing just one tooth.

“If you’re missing one tooth between two perfectly good teeth, to replace it the other way is to grind down the two healthy teeth and then put crowns on all three in a bridge,” he said. “The success rate of the implant is much higher and complications lower. It’s just a matter of cost.”

Both, though, say the implant likely is good for life while crowns and bridges can’t claim the same longevity. Either way, most insurance companies decline to pay for implants at this point. Some do respond, however, when dentists stress the logic of long-term cost-effectiveness.

“In the short term, they cost more,” Zetz said. “In the long term, they cost considerably less.”

There is one caveat, however. The Academy of Osseointegration – implant dentistry -- recently reviewed scientific literature published over the past three decades. The organization found that smoking has an adverse effect on implant survival and success.

The Academy estimates 77 percent of smokers will have successful implants compared with 91 percent for nonsmokers in the seven studies it screened. The research team concluded that smoking cessation should be encouraged prior to implant placement.

Parker and Zetz also agree smoking slows down the healing process. Zetz, however, said that in his practice, smokers generally experience only a 10 percent greater chance of implant problems.

“But we do urge them to quit smoking, though they rarely do,” he said.

Elderly patients sometimes balk at implants, said Parker, president-elect of the Stark County Dental Society.

“‘I’m too old for this,’ they’ll throw up to me. What I try and tell any patients, not based upon age is how comfortable you want to be socializing, eating. And what most seniors like to do when they get to together with families and friends is eat. Just watch ‘(Everybody Loves)  Raymond,’” he said.

Satisfied Customers

One of Parker’s earliest implant patients was a woman who was 70 or 75 at the time, he said. One of Zetz’s partners completed the case, putting three implants to support her lower denture.  Parker was pleased with the result.

“But when she returned to Dr. Ash for a follow-up, he comes in to see her and asks how it’s going. She starts in, ‘If I knew it was going to be like this … I would have done this years ago.’”

In terms of pain or even discomfort, Parker said his dental assistant  had a single implant surgery with local anesthesia at 8 a.m. and returned to work by noon.

“It’s more painful for a patient to have a tooth extracted,” Zetz said.

Reach Canton Repository writer Diana Rossetti at (330) 580-8322 or diana.rossetti@cantonrep.com.


THE HISTORY OF IMPLANTS

Swedish researchers were working with a group of orthopedic surgeons who were looking for improved hip replacements.

“It just so happened that the pressure that the jaw exerts equals that of the hip,” Zetz said. “So researchers began using animals for dental implant exploration.

“By accident, they picked up titanium one day, and in two months found they couldn’t take it out of the model animal,” Zetz said.

The animal models were used and studied for 10 years.  Then, at selected sites around the world, a strict protocol for dental implants in human patients was established. All races and ages participated and they were followed closely, compiling extensive data from each site.

A dental implant, said Zetz, “is probably the most researched single item in human biology.”

The Academy of Osseointegration, in its review of all scientific literature over the past three decades, affirmed the survival rate for dental implants is very high, ranging from 91 to 100 percent.