Posts for tag: dental implants
For whatever reason, you’ve put off replacing a missing tooth for awhile. Now you want to fill that empty gap in your smile with a dental implant restoration.
But if your tooth’s been missing for a long time, there could be a problem with space. This is because the teeth on either side of the space may have gradually drifted into it, leaving no room for the implant. You could need orthodontic work first to return these teeth to their proper position.
We could use braces, metal orthodontic devices with wires threaded through brackets bonded to the teeth that are then anchored, usually to back teeth. The orthodontist uses elastics or springs as well as possibly incrementally tightening of the wire against the anchors. These techniques create pressure or tension on the teeth for the desired direction of movement. The teeth’s natural mechanism for movement does the rest.
But while effective, braces can be quite noticeable, an embarrassing thought for many adults having to wear them over several months of treatment. But there may be an alternative: clear aligners, a succession of slightly different plastic trays usually worn in two-week intervals. Sequentially wearing each tray gradually moves the teeth to their desired positions.
Though not appropriate for all bite situations, clear aligners have a number of benefits when they can be used. They’re nearly invisible to others and can be removed for hygiene tasks or rare special occasions. What’s more, the orthodontist may attach a temporary prosthetic (false) tooth to the trays to camouflage the missing space during treatment.
There’s one other issue you may have to deal with: if your tooth loss was related to periodontal (gum) disease, the gums and underlying bone may be in poor condition. In fact, substantial bone loss could rule out an implant altogether. But we may be able to remedy both gum and bone deficiencies through grafting or plastic surgery. It may be possible to regenerate enough bone to support the implant; and surgically repairing your gums will help ensure the implant appears natural.
If you have problems like these, don’t give up on your restoration goal just yet. With some orthodontic and dental work ahead of time, we may still be able to make implants a reality for you.
Dental implants are best known as restorations for single missing teeth. But there’s more to them than that—they can also be used to support and secure removable dentures or fixed bridges.
That’s because a dental implant is actually a root replacement. A threaded titanium post is inserted directly into the jawbone where, over time, bone cells grow and adhere to it. This accumulated bone growth gives the implant its signature durability and contributes to its long-term success rate (95%-plus after ten years). It can support a single attached crown, or serve as an attachment point for a dental bridge or a connector for a removable denture.
The method and design of implants differentiates it from other restoration options. And there’s one other difference—implants require a minor surgical procedure to insert them into the jawbone.
While this might give you pause, implant surgery is no more complicated than a surgical tooth extraction. In most cases we can perform the procedure using local anesthesia (you’ll be awake the entire time) coupled with sedatives (if you have bouts of anxiety) to help you relax.
We first access the bone through small incisions in the gums and then create a small channel or hole in it. A surgical guide that fits over the teeth may be used to help pinpoint the exact location for the implant.
We then use a drilling sequence to progressively increase the size of the channel until it matches the implant size and shape. We’re then ready to insert the implant, which we remove at this time from its sterile packaging. We may then take a few x-rays to ensure the implant is in the right position, followed by closing the gums with sutures.
There may be a little discomfort for that day, but most patients can manage it with over-the-counter pain relievers like aspirin or ibuprofen. It’s what goes on over the next few weeks that’s of prime importance as the bone grows and adheres to the implant. Once they’re fully integrated, we’re ready to move to the next step of affixing your crown, bridge or denture to gain what you’ve waited so long for—your new implant-supported smile.
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 “Dental Implant Surgery: What to Expect Before, During and After.”
Losing a tooth from disease or accident can be traumatic. The good news, though, is that it can be replaced with a life-like replica that restores your smile. One of the most popular and durable solutions is a dental implant, which replaces not only the root of the tooth but the crown as well.
But there's a possible wrinkle with implants — for accurate placement there must be a sufficient amount of bone around it. This could be a problem if you've been missing the tooth for sometime: without the stimulus provided by a tooth as you chew, older bone cells aren't replaced at an adequate rate. The bone volume gradually diminishes, as up to 25% of its normal width can be lost during the first year after tooth loss. A traumatic injury can damage underlying bone to an even greater extent.
There is a possible solution, but it will require the services of other specialists, particularly a periodontist trained in gum and bone structure. The first step is a complete examination of the mouth to gauge the true extent of any bone loss. While x-rays play a crucial role, a CT scan in particular provides a three-dimensional view of the jaw and more detail on any bone loss.
With a more accurate bone loss picture, we can then set about actually creating new bone through grafting procedures. One such technique is called a ridge augmentation: after opening the gum tissues, we place the bone graft within a barrier membrane to protect it. Over time the bone will grow replacing both the grafting material and membrane structure.
Once we have enough regenerated bone, we can then perform dental implant surgery. There are two options: a “one-stage” procedure in which a temporary crown is placed on the implant immediately after surgery; or a “two-stage” in which we place the gum tissue over the implant to protect it as it heals and bone grows and attaches to it. In cases of pre-surgical bone grafting, it's usually best to go with the two-stage procedure for maximum protection while the bone strengthens around it.
Necessary preparation of the bone for a future dental implant takes time. But the extra effort will pay off with a new smile you'll be proud to display.
Dental implants are considered today’s premier method for restoring missing teeth. Obtaining an implant, though, is often a long process and the implants themselves must be surgically placed within the jaw bone. Nothing to worry about, though: implant surgery is a minor to moderate procedure akin to a surgical tooth extraction.
Still like any surgery, this procedure does involve cutting into the soft tissues of the gums and could allow oral bacteria to enter the bloodstream. While most bacteria in the mouth are harmless (and even beneficial) a few strains can cause disease. For some people, especially those with certain heart conditions or joint replacements, this could potentially cause serious issues in other parts of their body that might be highly susceptible to infection.
To guard against this, it’s been a long-standing practice in dentistry to prescribe antibiotics to certain high risk patients before a procedure. Although this departs from the normal use of antibiotics for already occurring infections, due to the circumstances this has been deemed an acceptable measure to prevent disease.
In the past, the categories of patients for which preventive antibiotics were appropriate had been more extensive. In recent years, though, both the American Dental Association and the American Heart Association have adjusted their recommendations. Today, your dental provider may recommend antibiotic pre-treatment if you have a prosthetic (artificial) heart valve, a history of infective endocarditis (inflammation of the inner linings of the heart), a heart transplant or certain congenital heart conditions.
While physicians may still recommend premedication with antibiotics for patients with joint replacements, it’s not as blanket a standard as it might once have been. It’s now only recommended for certain cases, such as patients who’ve received a prosthetic joint within the last two years.
There’s still an ongoing debate about the effectiveness of antibiotic pre-medication. However, there’s evidence medicating before procedures with antibiotics can be beneficial in avoiding infection. If you fall into one of the categories just mentioned or are concerned about infection, feel free to discuss with your dentist if using antibiotics before your implant surgery is wise move for you.
If you would like more information on antibiotic treatment before oral 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.”
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.”