The basis for modern dental implants is a biological process called osseointegration, in which materials such as titanium or zirconia form an intimate bond to the bone.

Planning the position and number of implants is key to the long-term health of the prosthetic since biomechanical forces created during chewing can be significant.

Since both can atrophy after tooth extraction, pre-prosthetic procedures such as sinus lifts or gingival grafts are sometimes required to recreate ideal bone and gingiva.

In the presence of healthy tissues, a well-integrated implant with appropriate biomechanical loads can have 5-year plus survival rates from 93 to 98 percent[2][3][4] and 10-to-15-year lifespans for the prosthetic teeth.

Modern dental implants work through a biologic process where bone fuses tightly to the surface of specific materials such as titanium and some ceramics.

An evolving field is the use of implants to retain obturators (removable prostheses used to fill a communication between the oral and maxillary or nasal cavities).

There is limited evidence that implant-supported single crowns perform better than tooth-supported fixed partial dentures (FPDs) on a long-term basis.

To enable this, the abutment is shaped as a small connector (a button, ball, bar or magnet) which can be connected to analogous adapters in the underside of the dental prosthesis.

Since implants do not have a periodontal ligament, and bone remodelling will not be stimulated when tension is applied, they are ideal anchor points in orthodontics.

Based on the findings of many studies, mini dental implants exhibit excellent survival rates in the short to medium term (3–5 years).

[21] A typical conventional implant consists of a titanium screw (resembling a tooth root) with a roughened or smooth surface.

The majority of dental implants are made of commercially pure titanium, which is available in four grades depending upon the amount of carbon, nitrogen, oxygen and iron contained.

Those with poor oral hygiene, heavy smokers and diabetics are all at greater risk for a variant of gum disease that affects implants called peri-implantitis, increasing the chance of long-term failures.

[30] The ultimate location of implants is based on both biologic (bone type, vital structures, health) and mechanical factors.

The use of CT scanning in complex cases also helps the surgeon identify and avoid vital structures such as the inferior alveolar nerve and the sinus.

The position paper recommends against placing implants in people who are taking high-dose or high-frequency intravenous therapy for cancer care.

[38] The approaches are: An increasingly common strategy to preserve bone and reduce treatment times includes the placement of a dental implant into a recent extraction site.

The dentist will work to restore the vertical dimension of occlusion, the esthetics of the smile, and the structural integrity of the teeth to evenly distribute the forces of the implants.

[58] The corollary is that single implants, even in solid bone, require a period of no-load to minimize the risk of initial failure.

The combination of conical fits and platform switching gives marginally better long term periodontal conditions compared to flat-top abutments.

Another variation on abutment/crown model is when the crown and abutment are one piece and the lag-screw traverses both to secure the one-piece structure to the internal thread on the implant.

[65][66][67] This disease begins as a reversible condition called peri-implant mucositis but can progress to peri-implantitis if left untreated, which can lead to implant failure.

Nearby anatomic structures, such as the inferior alveolar nerve, the maxillary sinus and blood vessels, can also be injured when the osteotomy is created or the implant placed.

The stability of the titanium screw implant in the patient's bone tissue post surgery may be non-invasively assessed using resonance frequency analysis.

More often, osseointegration failure occurs when a patient is either too unhealthy to receive the implant or engages in behavior that contraindicates proper dental hygiene including smoking or drug use.

The long-term complications that result from restoring teeth with implants relate directly to the risk factors of the patient and the technology.

There are the risks associated with appearance including a high smile line, poor gingival quality and missing papillae, difficulty in matching the form of natural teeth that may have unequal points of contact or uncommon shapes, bone that is missing, atrophied or otherwise shaped in an unsuitable manner, unrealistic expectations of the patient or poor oral hygiene.

[81][82] Wilson Popenoe and his wife in 1931, at a site in Honduras dating back to 600 AD, found the lower mandible of a young Mayan woman, with three missing incisors replaced by pieces of sea shells, shaped to resemble teeth.

Brånemark carried out further studies into this phenomenon, using both animal and human subjects, which all confirmed this unique property of titanium.

He began working in the mouth as it was more accessible for continued observations and there was a high rate of missing teeth in the general population offered more subjects for widespread study.