Posts for tag: dental implants
Losing permanent teeth is never good — unlike primary teeth, no natural replacements wait in the wings. But the good news is you have a number of options for replacing them with life-like prosthetic (false) teeth.
Today's premier choice is dental implants, preferred by dentists and patients alike for their durability and life-likeness. But because of their cost when replacing multiple teeth, many people opt for traditional dentures. And now dentures are easier to wear and maintain thanks to new, advanced materials and designs.
Still, there's one major area where implants have the definite edge over dentures — long-term bone health. Older bone cells die and dissolve (resorb), replaced then by newly formed cells. Teeth help perpetuate this cycle through the forces generated when we chew that travel through the roots to stimulate the formation of new bone.
But because this stimulation through a tooth ends when it's lost, new bone beneath the empty socket may not keep up with the resorption rate of older bone. As a result, you could lose as much as a quarter of normal bone width in just the first year after losing a tooth.
This bone loss will continue to accumulate even if you wear dentures, which can't replicate the bone growth stimulation of natural teeth. What's more, the constant pressure on the bony ridge of the gums can accelerate bone loss. Eventually, the firm, comfortable fit you first had with your dentures will become looser and less comfortable with the shrinking bone volume.
Implants, on the other hand, can stop bone loss and may even reverse it. This is because the titanium metal of an implant has a special affinity with bone cells that readily grow and adhere to it. This creates the anchorage responsible for the implant's durability, but it's also healthy for the bone.
Of course, this doesn't have to be a binary choice between the two restorations thanks to a new hybrid advancement that combines implants with dentures. We can install as few as two implants to support a removable denture. You'll enjoy greater stability, fit and durability with your dentures, while also improving bone health through the implants.
So before you decide on a dental restoration, be sure to discuss with us your implant options. Your oral health and appearance could benefit immensely.
If you would like more information on dental restoration, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”
You've seen ads for “Teeth in One Day” that promise immediate implant placement at the same time you have the problem tooth removed. But this presumes the gums and underlying bone are healthy and able to support and protect the implant. If that's not the case, it may be ill-advised to place an implant on the same day.
Even with immediate placement, there will be a small degree of bone and gum opening or space around the implant after it's placed into the socket. This can often be remedied by placing a bone graft and sometimes a gum graft when we install the implant. It's also possible for natural healing to gradually fill in the space, but we'll need to monitor the site carefully for several weeks.
On the other hand, if we detect significant bone loss (or strongly suspect it will occur), immediate placement may not be an option — there's not enough bone or it's too weak to support an implant. In this case, it's necessary to wait on placement and focus on improving the bone health and quantity, beginning when we remove the old tooth and place a bone graft.
After completing the extraction, we typically place a bone graft in the empty socket. The graft will become a “scaffold” for new bone cells to grow upon. We may then allow about two to four months for new bone to partially replenish the area and then place the implant. The bone will continue to regenerate as it grows and attaches to the titanium implant to create a solid attachment.
If the site, however, still appears fragile even after partial bone growth, we may opt to wait another two to four months before attempting placement. From a long-term perspective, this is the best scenario for ensuring a durable foundation for the implant. It also allows for a socket severely compromised by disease to heal more thoroughly.
To determine which of these placement scenarios is best for you, we'll first need to conduct a thorough dental examination. From there we'll be in a better position to discuss the right implant timeline for your situation. Our main goal is to ensure we can securely place your implant in just the right position to achieve the most successful and attractive result.
If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Implant Timelines for Replacing Missing Teeth.”
Although dental disease prevention has made great strides over the last century, tooth decay and periodontal (gum) disease continue to pose a major health threat. People who’ve lost all of their teeth (edentulism) or most of them suffer the most with adverse effects on their overall health, function and appearance.
Removable dentures have been the traditional and most affordable means to treat edentulism. But even with material and construction advances in recent years, dentures can still lose their fit over time as the bone in the jaw shrinks. This happens because the bone no longer has the stimulus of natural teeth and older cells can’t be replenished at a healthy rate; the continuing compression of traditional dentures on the jaw’s bony ridges compounds the problem.
As the bone shrinks the dentures become loose and uncomfortable to wear. Among other results, this poor fit can drastically affect how you eat: studies of denture wearers have found a decrease in their diet’s nutritional value because they’re eating fewer vegetables or fibrous, “chewy” foods and more foods with refined carbohydrates and fats that are easier to eat but less nutritious.
There is an alternative, though, that might slow bone loss and provide a better long-term fit: an overdenture supported by dental implants. With this appliance, a few implants are strategically installed in the upper or lower jaw. Matched attachments securely fasten the denture to the implants. In this case, the implants not the jaw ridge and gums support the denture thereby preserving the bone.
If you’re healthy enough to undergo a tooth extraction, you should be able to handle implant surgery, a minor procedure usually performed with local anesthesia and with little to no discomfort afterward. It may even be possible to retrofit your current denture to work with the implants, but that will need to be determined during the planning stages.
Although more expensive than a traditional denture, overdentures are much more affordable than fixed restorations stabilized with implants. The difference, though, is the increase in your quality of life — for better nutrition, physical health and social confidence.
If you would like more information on treatment for teeth loss, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Implant Overdentures for the Lower Jaw.”
Placing a dental implant within the jawbone requires a surgical procedure. For most people it’s a relatively minor affair, but for some with certain health conditions it might be otherwise. Because of their condition they might have an increased risk for a bacterial infection afterward that could interfere with the implant’s integration with the bone and lead to possible failure.
To lower this risk, dentists for many years have routinely prescribed an antibiotic for patients considered at high-risk for infection to take before their implant surgery. But there’s been a lively debate among health practitioners about the true necessity for this practice and whether it’s worth the possible side effects that can accompany taking antibiotics.
While the practice still continues, current guidelines now recommend it for fewer health conditions. The American Dental Association (ADA) together with the American Heart Association (AHA) now recommend antibiotics only for surgical patients who have prosthetic heart valves, a history of infective endocarditis, a heart transplant or certain congenital heart conditions.
But patients with prosthetic joint replacements, who were once included in the recommendation for pre-surgical antibiotics, are no longer in that category. Even so, some orthopedic surgeons continue to recommend it for their joint replacement patients out of concern that a post-surgical infection could adversely affect their replaced joints.
But while these areas of disagreement about pre-surgical antibiotics still continue, a consensus may be emerging about a possible “sweet spot” in administering the therapy. Evidence from recent studies indicates just a small dose of antibiotics administered an hour before surgery may be sufficient to reduce the risk of infection-related implant failure with only minimal risk of side effects from the drug.
Because pre-surgical antibiotic therapy can be a complicated matter, it’s best that you discuss with both the physician caring for your health condition and your dentist about whether you should undergo this option to reduce the infection risk with your own implant surgery. Still, if all the factors surrounding your health indicate it, this antibiotic therapy might help you avoid losing an implant to infection.
If you would like more information on antibiotics before implant surgery, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Implants & Antibiotics: Lowering Risk of Implant Failure.”
Dental implants are popular with both patients and dentists for their durability and likeness to natural teeth. That natural look, though, can be difficult to attain, especially in what’s known as the “smile zone” — the area of the mouth where teeth are most visible when you smile.
Our biggest concern is the upper front teeth, where the gums are most visible, especially if you smile widely. It takes considerable skill, experience and artistry to position implants in this area so that they appear to naturally emerge from the gums and blend well with other teeth.
To obtain that natural look, we must first assess whether or not there’s enough bone present, which tends to dissolve (resorb) when a tooth is missing, to sufficiently anchor the implant in the right position. There also needs to be sufficient bone around adjacent teeth to support the tiny triangles of gum tissue between teeth called papillae. Without the papillae an unattractive black hole may result between the implant and an adjacent tooth or implant.
Another factor we must consider is the type of gum tissue you have. Everyone generally inherits one of two types of tissue from their parents: thin or thick. The type you have can influence the way the implant appears to emerge from the gums. If you have thick gums, they’re easier to work with and can cover more of the implant. Thinner tissues aren’t quite as easy and are less forgiving if an implant isn’t placed as precisely as possible.
In recent years, improvements in implant design have sought to provide greater stability around bone and gum tissues to offset some of the issues we’ve mentioned. A variation on the design of the top of the implant (where the crown is attached) changes the direction of growth for gum tissues from a horizontal orientation to a vertical one, which can help with the final appearance.
The first step, if you’re considering dental implants for a tooth in the smile zone, is to visit us for a complete examination to see if any of these factors may have an impact on your situation. We can then advise you on the best course of action to achieve the most attractive smile possible.
If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Implant Aesthetics.”