When a tooth breaks down and needs to be fixed, a decision needs to be made whether the tooth can still be saved or whether it needs the extracted. If the tooth is still structurally sound and the breakage is minimal, a filling can be placed. If the breakage is severe but the root of the tooth is still intact and structurally strong enough, a crown can be used to restore the tooth to its original shape.
Whether a filling or a crown is used, the natural tooth root is relied upon to support all the restorative work. Essentially, the natural tooth root is the foundation that supports any restorative work to be carried out on the broken tooth. If the breakage is so severe that the tooth cannot be saved and needs to be extracted, dental implants can be used to replace the missing tooth. Implants are artificial roots that are inserted into the bone to mimic the natural roots allowing a stable foundation for crowns, bridges or dentures to be placed over them.
The components of a dental implant:
- Firstly, there is the titanium screw referred to as the fixture which is placed into the jaw bone.
- Then there is the abutment which is the connector that joins the crown to the fixture. Finally, the crown which is the artificial tooth placed on top of the fixture.
- There are slight variations on the design but the above are the essential components.
The titanium screw (fixture):
Innumerable substances have been developed for use as dental implants dating as far back as 600 AD, when the Mayans used pieces of shells as implants. Around 800 AD, the early Honduran culture used a stone implant placed in the lower jaw. From the 1500's to about the 1800's, human teeth in Europe were collected from the underprivileged or from cadavers to transplant into recipients. During this time period other materials such as gold silver capsules, corrugated porcelain, and iridium tubes were also used as dental implants.
Fast forward into the early 20th century Dr. Greenfield, in 1913, used implants made of iridio-platinum and gold as an artificial root. In the 1930's, Drs. Alvin and Moses Strock, experimented with implants made of chromium-cobalt alloy and were credited in selecting a biocompatible metal to be used in the human dentition. They were also thought to be the first to place successful implants into the bone.
From the mid 1900's other researchers experimented with cobalt-chromium-molybdenum, cobalt-chromium and aluminum implants, but none had any kind of a reproducible and predictable results compared to the titanium implants Prof P. Brånemark first used in the 1960's. Since then, the surfaces of dental implants had been modified with hydroxyapatite, composites, carbon, glass, ceramic and the exterior surface of the titanium implants have additionally been sand- blasted, oxidized, fluoridated, etched, and medicated to increase bone to titanium contact, decrease the healing time for osseointegration and decrease long-term complications.
Today, titanium implants have a success rate of 10 years after placement approaching the high 90 percentile.
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