A dental implant is an artificial tooth that completely replaces a missing tooth. With dental implants, you can replace your missing teeth with a natural-looking synthetic implant. Each dental implant consists of three major parts:
- Implant post
- Implant crown
The implant post sits in your jawbone and provides a base for your fake tooth. The implant crown replaces the visible portion of your tooth above the gum-line. The abutment connects your post and crown and acts as an intermediate between the two. It takes all these 3 parts to build one dental implant to replace one missing tooth.
Why is it important to place enough dental implants?
Dental implants are expensive. This is why patients always want to know “what’s the minimum number of dental implants I need to replace my missing teeth?“. While the idea of getting fewer dental implants may seem appealing, it usually is not a wise long-term solution. We expect our dental implants to last a lifetime. Therefore, it’s important to properly treatment plan your implant therapy to improve success rate. You need to make sure that there are enough dental implants to support your bite forces. Failing to place enough implants can overload your implants and cause them to break or fail. This is commonly seen in patients who have all their chewing teeth missing and decide to place one or two implants to chew on. Unfortunately, placing all of your bite forces on one or two implants does not work and your implants will fail within a few years.
How many implant posts do I need to replace my teeth?
The more implant posts you place in your mouth, the more support your teeth will have going forward. Each implant post can handle so much bite pressure. Therefore, you need to make sure that there are enough implant posts to support your bite forces. Here are some of factors to take into consideration when deciding how many implant posts you need:
Number of missing teeth
The more teeth you’re missing, the more implant posts you need. Here’s how it works:
- Missing one tooth – If you’re missing just one tooth, then you need a single implant post to replace your sole missing tooth
- Missing 2 teeth – If you’re missing 2 back teeth then you should place 2 posts and 2 crowns. If you’re missing 2 front teeth next to each other, you could get away with 1 post that supports both crowns (unless you’re missing a canine tooth).
- Missing 3 teeth – When you’re missing 3 adjacent teeth, you could place 3 implants and 3 crowns, or 2 implants and a 3-unit bridge supported by these 2 posts.
You may have noticed that it’s not always a 1:1 ratio between implant posts and the number of missing teeth. In fact, you can replace all of your missing teeth using the all-on-4 implant technique by placing just 4 implant posts. This means that you can replace 12 teeth with just 4 implant posts. Of course, each case is unique, so be sure to consult with your dentist to see exactly how many implant posts you need.
Position of your missing teeth
The location of your missing teeth is another important factor when deciding how many implant posts you need. Replacing your back teeth always requires more implant posts as compared to replacing your front teeth. Your back teeth are responsible for chewing and crushing food, which means they receive lots more forces than your front teeth. Let’s compare what it takes to replace 4 missing teeth that are in the front versus missing 4 back teeth:
- Missing 4 front teeth – If you’re missing your front 4 teeth you can replace them by placing just 2 implant posts and a 4-unit bridge on top. Two implant posts is enough to handle your bite forces in this region since there’s not a lot of forces being exerted here.
- Missing 4 back teeth –If you’re missing 4 consecutive back teeth, such as your 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 which protects your implants in the long-run. Placing a 4-unit bridge on 2 implant posts in the back is a terrible idea and is almost guaranteed to fail within a few years.
Bad oral habits affect your implants the same way they can affect your teeth. For example, heavy teeth grinders and those suffering from a collapsed bite, place much more pressure onto their teeth. As a result, you need to place as many implant posts as you possibly can to withstand the additional bite stress. Otherwise, there’s a chance that your implant posts get overloaded and fail within a few years. The same goes for patiens who have a poor bite relationship, especially those with a crossbite or underbite.
Jawbone quality and quantity
Lack of sufficient jawbone makes it difficult or impossible implant posts. The ideal treatment is to first restore the missing bone, then place implant posts in these regions. However, bone grafting is an expensive process that takes a long time to heal and recover from. Not every patient wants to spend a year building up their jawbone in preparation for dental implants. There is a shortcut here. In some cases, but not all, you can simply add a few implant posts to compensate for the lack of jawbone. For instance, sometimes you can place multiple short implants under the sinuses to avoid a sinus graft. Another example is the all-on-four concept where you place 4 implants in the anterior region to avoid having to restore the lost bone in the posterior area.
Number of posterior contacts
A person with a full set of teeth (28 of them) has 4 back teeth that contact each other on the right and left side, for a total of 8 posterior contacts. As you lose teeth, you keep losing these posterior contacts. Having less than 6 posterior contact, or 3 on each side, jeopardizes your bite and stresses your remaining teeth. Therefore, you should have at least 3 chewing teeth on each side on your mouth. This concept also applies when placing implants. We always recommend that you place enough implant posts to have at least 3 teeth on each side of your mouth. Not placing enough implant posts causes your teeth and implants to get stressed, which leads to failure of implants or damage to your teeth over the years to come.
Getting start with dental implants
As you can see, there’s a lot that goes into properly treatment planning dental implants. This is why you want to choose an experienced dentist for your implant therapy. Your dentist needs to perform hundreds, even thousands, of dental implants before they become proficient at it. Do some research and choose an experienced general dentist with years of implant training, a periodontist, or an oral surgeon to perform your treatment. After all, getting “the best deal” is not nearly as important as getting a set of teeth that last forever!