What is a dental implant?

Each dental implant consists of three major parts, an implant post, abutment and crown.

A dental implant is an artificial tooth which replaces an entire missing tooth. With dental implants, you can replace a complete missing teeth with a natural looking implant tooth. Each dental implant consists of three major parts which are the implant post, abutment and implant crown. The implant post replaces your missing tooth root which holds the tooth inside your jaw bone. The implant crown replaces the visible portion of your tooth which sticks out above the gum-line. Finally, the abutment is the part which connects the post and crown together and acts as an intermediate between the two.

Why is it important to place enough dental implants?

Example of a failed dental implant illustrating severe bone loss on the X-ray and moving inside the mouth.

If you’ve been shopping around for dental implants then you’re probably aware of the high costs of dental implants. As a result, patients always want to know what’s the minimum number of dental implants they can get away with. While the idea of receiving fewer dental implant posts may appear cost effective, this may not be your wisest long-term solution. After all, we expect our dental implants to last us a lifetime. This makes it very important to properly treatment plan implant therapy to guarantee the outcome. Essentially, you need to make sure that there are enough dental implants to support your biting forces for the years to come. If you fail to place enough implant posts to support your bite pressure, there’s a good chance that your implants will fail and you’ll lose them!

How many implant posts do I need to replace my teeth?

The main question here is how many implant posts are required to support your missing teeth. The number of implant crowns is easy to figure out, as it is the number of teeth that you are missing. So the question becomes “how many implant posts do I need to replace my missing teeth?” The main concept to remember is that each implant post can handle so much bite forces. As a result, you need to make sure that there are enough implant posts to support your entire bite pressure. Here are some of factors to take into consideration when deciding on the number of implant posts your mouth needs:

Number of missing teeth

Obviously, the more teeth that you’re missing, the more implant posts you will require. Here is how this concept works:

  • If you’re missing just one tooth, then you almost always need a single implant post to replace this missing tooth.
  • However, it you are missing 3 teeth, then you require either 2 or 3 implant posts to replace the 3 teeth.
  • Similarly, if you’re missing 5 teeth, then you may require anywhere from 3, 4 or 5 implant posts to replace these 5 teeth.

As you noticed, it’s not always a 1:1 ratio between how many implant posts you need and the number of missing teeth.

Position of missing teeth

Often times, you only require 2 implant posts to replace your missing 4 front teeth.

Another important factor in deciding the number of implant posts required is the location of your missing teeth. Typically, replacing back teeth requires more implant posts as compared to replacing front teeth. Since your back teeth are responsible for chewing and crushing food, they receive lots more forces than front teeth. Here is a demonstration of how this concept works:

  • If you’re missing your 4 consecutive back teeth, molars and bicuspids, then we typically recommend placing 4 individual implant posts. Placing a 1:1 ratio allows your implant posts to better absorb and distribute bite forces and protects them in the long-run.
  • However, if you’re missing your lower front 4 teeth, we rarely recommend placing 4 implant posts. Often times, we recommend placing just 2 dental implant posts to replace the lower four teeth. Since there is not a lot of forces exerted to the implant posts in the front region, 2 implant posts is enough to handle your bite forces within this region.

Oral habits

If you are a teeth grinder or suffer from a collapsed bite, you place much more pressure onto your teeth and require more implant posts.

Having bad oral habits or a compromised bite will affect implant treatment planning. For example, teeth grinders or those suffering from a collapsed bite place much more pressure onto their teeth. As a result, you need to place many more implant posts to handle the additional bite forces and stress. If you don’t use additional implant posts, there’s a chance that your dental implants will get overloaded and fail over time. Consequently, it’s always best to place the maximum number of implant posts in patients with bad oral habits such as grinding, bruxism or those with severe malocclusions.

Jaw bone quality and quantity

In cases where jaw bone has atrophied severely, your only option is to perform a rib or iliac bone graft to restore enough bone for implant placement.

Most dental implant candidates have some level of bone loss in their upper and lower jaws. Lack of sufficient jaw bone makes it difficult or impossible to place the ideal number of implant posts. In these cases, the treatment of choice is to restore the missing bone structure via bone graft procedures. However, bone grafting takes a very long time to integrate and is also a very costly procedure. In certain circumstance, there is the option to simply add more implant posts to compensate for this bone loss. For instance, sometimes by placing an additional implant post or two, you can compensate for bone loss within a region. Alternative bone augmentation procedures are typically far more costly, painful and unpredictable than receiving an extra implant post.

Total number of back teeth in contact

you always want have at least 3 chewing teeth on each side, which means this patient should get at least one dental implant on the lower left side.

Ideally, you should have 4 back teeth making contact with each other on each side of your mouth for a total of 8 back teeth. If you lose one tooth contact on each side, you’re now down to 6 total contacts. While this places additional pressure onto your remaining teeth, you can still function pretty well with 6 contact points. However, anything less than 6 total contact points will jeopardize your bite and stresses your remaining teeth. As such, you always want to make sure that you have at least 3 chewing teeth on each side on your mouth. Anything less than 3 contact points will stress your teeth and compromise long-term prognosis. As such, we always recommend that you place enough implant posts to have at least 3 chewing teeth on each side. Without enough chewing teeth, your implant posts will get stressed and could fail within a few years.

Leave a Reply