Dental Implants - Walter Reed Army Medical Center

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Dental Implants - Walter Reed Army Medical Center
The purpose of this section is to inform you of the course of events that patients may normally expect during treatment with dental implants at WRAMC. It emphasizes the need for patient cooperation and points out the risks and limitations of dental implant treatment. Treatment with dental implants requires commitment by both doctor and patient. The Dental Implant Team at WRAMC consists of dental specialists with advanced training in dental implant placement and restoration.
WHAT ARE DENTAL IMPLANTS?
The term ǃ?dental implantǃ? refers to a medical device that is used to replace the root portion of a missing tooth or teeth. These artificial root replacements can then be used to support natural looking teeth crowns. This allows the patient to return to having fixed teeth. It is not a transplant, which is taken from another person. The Implant Team will consider your specific needs and general dental condition in selecting the specific type of implant you would receive. All available information is reviewed to decide which type of implant will be of greatest benefit to each patient.
IS THERE A CHANCE OF REJECTION?
The body does not ǃ?rejectǃ? a dental implant, as it might an organ transplant, such as a lung, heart or kidney. This does not mean that implants never fail. Implant failures while relatively rare, are commonly due to factors such as poor bone volume or density, improper force on the implant or other conditions or co-existing diseases of the patient. Dental implants are made of a material, titanium, which is totally biocompatible. Biocompatible materials are not recognized by the body as foreign and therefore the body does not reject them.. Titanium actually integrates with the surrounding bone and is accepted as part of the body. Titanium is also being used more and more in the medical field to replace body parts, such as hip and knee joints.

WHAT YOU CAN EXPECT DURING THE PROCESS
1. Pre-Treatment Records Will Be Necessary
To determine the best treatment options, a set of records is needed. This would typically include stone or plaster dental models, intraoral and extraoral photographs, x-rays of the teeth and jaws, and a comprehensive review of your medical and dental history.
2. Dental Examinations Will Be Performed
A thorough dental examination is necessary before starting any implant planning or treatment. You MUST have had a recent exam and not have any dental caries present, and you MUST be in good periodontal health. During the course of treatment you are expected to have a dental exam every six (6) months. This is your responsibility.
3. Implant Board Consultation
After Pre-treatment records have been studied and a preliminary treatment plan is prepared, a consultation will be scheduled for you. During this appointment the treatment plan will be discussed with you and one or more of the dental specialists. After evaluation by the WRAMC Implant Board, a vote of the team members is taken in order to select the patients who will receive treatment. Limited resources and treatment time are appropriately dedicated to patients who will most benefit from implant placement.

TREATMENT SEQUENCING AND TIMING
Reconstruction of your bite with dental implants may take up to two years. This number represents an average case without complications. Delays caused by missed appointments, broken appliances, and poor patient cooperation may result in untimely delays and a compromise in the final results. Treatment generally consists of two (2) phases: Surgical and Restorative
PHASE 1: THE SURGICAL PHASE
The surgical phase may be done either in the clinic or the operating room, depending upon the patient's physical status and the extent of treatment required. It may be necessary to harvest bone from various parts of the oral cavity, and sometimes the body, to augment the existing bone in order for the dental implants to be successful. If bone grafting is required, a healing period of between four to six months is often required BEFORE implants may be placed in the grafted bone.
After the implants are placed, they must be left undisturbed under the gum tissues for a healing period of two to six months. During this time, it is usually possible for a provisional (interim) dental prosthesis to be worn to provide for esthetic requirements. It may be necessary to leave existing dentures out for prolonged periods of time to maximize healing of the implants. After this period of initial healing, a second surgical procedure is performed to uncover the implants and attach an abutment, or ǃ?postǃ? which protrudes from the gum tissue. This abutment is the structure to which your new dental prosthesis is attached
IS THERE ANY DISCOMFORT INVOLVED?
Just as with any surgery, there can be some discomfort; however, anesthetic and patient sedation are used to eliminate any discomfort at the time of the procedure. Your surgeon will prescribe medications to ease any discomfort that may occur. Special care will be taken to stay in contact with you after the surgery to be sure that you remain comfortable.
PHASE 2: THE RESTORATIVE PHASE
After the abutment is connected to the implant, the Restorative phase of treatment begins. This phase may last from six to eighteen months, depending upon the complexity of your case. After the restorative treatment is completed, the recall phase begins. Periodic examinations will be scheduled. During these sessions, oral hygiene will be evaluated and the prosthesis will be inspected for signs of wear or deterioration.
COMPLETION OF TREATMENT POLICY
FOR ALL IMPLANT PATIENTS
ACTIVE DUTY:
Maintenance and follow-up care for Dental Implants is available for all active duty patients.
OTHER THAN ACTIVE DUTY:
All patients who are ǃ?other than active dutyǃ? (OTAD) are accepted as teaching cases at the discretion of the WRAMC Dental Implant Board. If accepted for treatment as a teaching case, the patient must secure Phase 2 (Restorative) support for implant restoration by a civilian dentist. The patient must provide a letter of intent signed by the supporting civilian restorative dentist prior to evaluation by the Implant Board or any of its members.