Frequently Asked Questions

What is a dental implant?

An implant is a titanium screw that replaces the root of a lost tooth. The implant then fuses with the healthy bone around it. Once that is accomplished, a dental crown—your new tooth—can be attached on top. Read more about the process, here.

How do I know if I am a good candidate for an implant?

Most people are good candidates for implants—if they have adequate bone and enough room. Only a consultation with a qualified dental surgeon, such as a periodontist or oral surgeon, can answer this question.

How successful are dental implants?

On average, implants are one of the most successful body part replacement procedures. They have a 90% success rate over 10 years, as opposed to hips (75%) and elbows and knees (50%). And in our office, our success rate is 96%. This success rate speaks not only to what we do here, but how well we do it.

When is the best time to place implants?

Generally speaking, the sooner, the better. The best time to place an implant is as soon as there is adequate bone to support ideal placement, as opposed to just “filling the space.” When a tooth is lost, it is better to grow the bone back; because the empty socket may not have the right shape to accept an implant. Therefore, an immediately placed implant may not be successful. When necessary, bone grafting can replace bone that has been lost.

What if I don’t have enough bone?

Modern bone grafting techniques, which promote the growth of new bone, allow our implant surgeons to place implants in jaws where previously there was an inadequate amount of bone.

How do implants stop bone from resorbing when a tooth is lost?

When a tooth is lost, so is the ligament that helps connect that tooth to its socket. When the ligament is lost, this disrupts the healthy blood supply to the bone, which can then begin to resorb—melt away. (This process is also called “alveolar atrophy.”) Bone grafting and a correctly placed implant provide physiological stimulation to bone, to build it up and help keep it healthy. Of course, just like natural teeth, implants require good oral hygiene to maintain healthy gum and bone.

I see a lot of ads that promise “Teeth In A Day,” immediate implants without bone grafting. Are these procedures possible, and available to everyone?

Our practice performs all of the above procedures; however, our standards dictate that specific health and anatomical criteria must be met in order to achieve the best possible results. We won’t just “jump in” without first determining that we are able to deliver successful long-term outcomes.

What are some of the criteria you look for?

Some of the things we look for include:

• Minimal infection in the potential surgical site.

• Adequate width and height of bone.

• For an immediate implant, a “safety zone” between the tip of the implant and vital structures such as the mandibular nerve in the lower jaw or the maxillary and/or nasal sinus in the upper jaw.

• Proper tooth socket size and shape plus adequate distance from adjacent teeth.

What does “All On Four” stand for?

“All On Four” refers to a denture that is attached to four implants, but it doesn’t provide complete biting function in the back of your mouth. We do “All On Six” but we do not do “All On Four.” Why not? As our late partner Dr. Carl Misch (considered by many to be the father of modern implantology) used to say, “All On Four, None On Three!”—meaning if you lose just one of those “Four,” the remaining implants are not adequate to provide sufficient biomechanical support, and these cases fail.

Why is there so much emphasis on immediate implants and “teeth in a day”?

Everyone wants to “get from point A to point B” as quickly and as easily as possible. There is nothing wrong with that, but it’s hard to deliver excellence to people with a fast food mentality.

We say, “For a restoration that we would like to last 15-20 years, what’s an extra 15-20 weeks?” In our implant surgical practice, there is no such thing as “One Size Fits All.” We offer:

• Evidence-Based Care

• Specialized Skills

• Extensive Experience-Based Judgment

• Personalized Treatment Advice That Each Individual Patient Requires And Deserves!

What determines whether I can have an immediate implant?

If you were to look at a cross-sectional view of a tooth, you’d see that the roots have different shapes – some are triangular, some are rectangular, and some are oval. And NONE of these is the same size or shape as a round implant. That’s just one reason why immediate placement is not always the wisest course of action. You don’t want your round implant to be forced into a square or rectangular hole. An incorrect fit or poor aesthetics is unacceptable by our standards.

Can immediate implants be placed anywhere?

Some research has shown that immediate implants are not always aligned optimally, and not as successful as those placed in regenerated healthy bone. However, if ALL the anatomical criteria are met, immediate implants have a similar success rate compared to those placed subsequently, after bone grafts.

Is there pain associated with putting in an implant?

There should be no pain when an implant is placed. In fact, implant surgery is less invasive, with less discomfort than most other dental procedures.

When do I get my new teeth? How long will I have to wait after implant surgery?

You can’t speed up Mother Nature! After placement of the implant, it takes anywhere from two to six months for an implant to fuse firmly with the bone. Upper jaw implants will take longer to fuse, because the bone there is less dense than in the lower jaw. Once the implant(s) has fused, your dentist can then place a restoration (crown or bridge) on the implant.

After the implant is placed, and before the new crown is made, what can I do about the empty space so I don’t have a “hole in my smile”?

During the transition period, temporary appliances can be used to take the place of any missing teeth. We—or your restorative dentist—can make these for you.

Why do I need an implant if a bridge can do the same job?

First, an implant has the advantage of being a non-removable replacement instead of just a temporary “placeholder.” Also, an implant actually replaces the tooth you have lost without negatively affecting your surrounding teeth or increasing the load and pressure on those teeth.

Also, placing a bridge requires “tooth reduction”—the grinding down of adjacent teeth to anchor the bridge. Not so with an implant; your nearby teeth can stay as they are, and the implant stimulates maintenance of the bone. Plus, research shows that implants last two to three times longer than bridges.

Is a removable partial denture as efficient as an implant?

No, not at all! Removable partial dentures have only 20% of the chewing efficiency of natural teeth or implant-supported teeth. Also, removable partial dentures “rock” the remaining teeth loose.

How do I choose the right dental surgeon to place my implant?

You already have. Dr. Modarressi is one of the most highly regarded practitioners, with many honors and distinctions. “The best never rest.” Our PAL periodontal surgeon is constantly enhancing her skills and expertise with the newest technology and techniques to benefit patients. You can read more about our surgeon, here!

I would like to know more about implants generally. Are they new? Are they still experimental?

Implants are neither new nor experimental. The first dental implants were placed over 4000 years ago in China. In Egypt, gold implant posts were used over 2000 years ago, and just recently, a cast-iron implant was discovered in the jaw of a Roman soldier dating back 1900 years. Contemporary dental implants—titanium screws —have been in use since the 1940s, after World War II. The results have been outstanding.

What happens if my implant fails?

If it fails, the implant is removed, and bone is grafted into the site so that a new implant can be placed in the exact same site.

Does smoking affect dental implants?

Implants fail four times more often in the mouths of smokers than they do in the mouths of nonsmokers.

I wear dentures. Can I still have implants?

Yes, even if you’ve worn dentures for years. It’s just a question of how much bone you have available for implants, or how much bone, if any, needs to be regenerated through grafting. Dentures can be stabilized with a few implants or replaced completely with multiple implants, supporting crowns or bridges.

Are younger people better candidates for implants?

No, age is not a factor. What matters most is the health of the patient. In fact, younger people (teens) should not have implants while their jaws are still growing.

Will implants really last a lifetime?

In healthcare, it is unethical to guarantee your work, but at PAL, our implants have a 96% success rate over ten years. There is a reasonable degree of certainty that the procedure will be long-term successful in the mouths of nonsmokers.

I have a lot of allergies. Is there a chance I that will be allergic to the metal used for the implant, and that my body could reject it?

Not likely. Implants are made of titanium—the same metal used successfully in joint replacements (hips, elbows, and knees) for over 50 years.

How long will I have to miss work after surgery?

That is your decision. Depending on the extent of the surgery, most people can go back to work the next day, or the day after.

Are implants expensive?

If replacing your teeth and having a healthier mouth are important to you, then you won’t consider implants expensive. Remember, you are investing in you!