18Sep

In implant dentistry, devices are used to replace missing teeth. They are made of titanium, an inert metal that bonds with the bone, forming a very tight union called osseointegration. The modern system of dental implants, the endosseous system, is extremely successful and has a 90% to 95% success rate.

The dental implant itself replaces the root of the tooth. It is usually in the shape of a screw or a cylinder. The implant connects to a component (the abutment) that joins the implant to the replacement tooth (the crown).

Dental implants are ideal replacements for teeth. When healthy teeth have to be prepared for crowns or bridges, healthy tooth structure needs to be removed. But if only one tooth is missing, the dental implant can simply replace it without having to sacrifice the adjacent teeth.

Dental implants can also be used to replace many missing teeth. Multiple teeth can be replaced with
implant dentistry and can avoid the need for a removable denture. Removable dentures can be hard to get used to. They may have clasps that can be unsightly and put additional stress on the existing teeth. Full dentures may be difficult to wear and may interfere with eating and speaking. People who wear dentures for a long time may have additional loss of the bone that supports the denture. This bone loss can be accelerated by osteoporosis, and eventually dentures may be very difficult to wear if not impossible. Poor-fitting dentures can interfere with proper nutrition and quality of life.

Generally, one implant is needed to replace each missing tooth. In some situations, several implants need to be joined together into a bridge. This adds greater strength to the implant restoration. If there is not enough bone available to replace a whole set of teeth, implants may be used as anchors for dentures. When dentures are supported by implants they can be much more stable and the implants help prevent the deterioration of the bone that supports the denture.

The endosseous system of implant dentistry has been used for over 30 years. They can look and feel like natural teeth, adding comfort and improving the smile of people of all ages.

By Laura Minsk, DMD

18Sep

Compared to previous generations when tooth loss was common, modern dentistry has made it possible for people to keep their teeth healthy and attractive for their entire lives. But for people who have experienced tooth loss, a full or partial denture has been the answer.

But dentures have drawbacks. Food gets caught under the denture with resulting sore gums. Or a denture can loosen and cause embarrassment.

Today, dental implants can replace missing teeth. Although the concept of a tooth implant is not new, advances in technology have improved the treatment process and the longevity of implants.

Modern day dental implants are made of pure titanium and are surgically inserted in the jawbone. The tooth implant is covered with gum tissue and allowed to heal for three to six months. During this time, the titanium meshes with the bone (osseointegration), becoming part of the jawbone itself. After the gums are healed, the implants are uncovered and permanent tooth replacements are attached to the implants.

Dental implants can be used for single tooth replacements, support for a permanent bridge, or as attachments to anchor a full denture securely to the jaw.

If you think a tooth implant could help you or someone you know chew more comfortably, speak more clearly, or look better, call your dental office for more details.

By Laura Minsk, DMD

18Sep

When the concept of dental implants and the mechanisms in which they work were introduced to mainstream dentistry during the late 1970’s, the advent of dental implants opened up an excitingly new chapter in dentistry.

Through the 1980’s, the news of the successful procedure of dental implant surgery spread at an explosive rate. It took approximately ten years of repeated long-term success for the procedure to gain validity.

By the early 1990’s dentists readily accepted implant dentistry as an adequate and routine substitute for missing teeth in all areas of the mouth.

Restoring dental implants has undergone a paradigm shift from simply validating that dental implants work to recreating missing teeth with a chameleon-like effect. Even though implants can be restored with a very high degree of success, one of the most difficult and critical areas in the mouth to achieve great esthetic results is in the upper front jaw — specifically when replacing a single upper central incisor tooth.

Single-tooth implant dentistry present dentists with unique challenges. When a single central incisor tooth is removed due to periodontal disease, tooth decay, trauma, or nerve failure, the body responds by shrinking the bone and gum tissue in place of the missing tooth. The body no longer needs the supporting bone structure; therefore, the bone is decreased and the gum tissue shrinks because of bone resorption.

In order to achieve a natural appearance to the final restoration, restorative dentists must attempt to replace what nature he as taken away. An unnatural appearance will be the result if the tooth is replaced without considering augmenting or “plumping up” the support structures. It would be like placing a great painting in the wrong frame, thus having a diminished outcome.

Achieving Esthetic Implant Dentistry with Crowns

Certain steps are necessary to achieve a successful outcome, especially in the most demanding implant cases, like replacing a single upper front tooth. Before the decision to place an implant is made, patients should know the sequential steps.

The process starts with a thorough exam. Clinically, dentists should examine the affected area and the entire mouth. A comprehensive exam of the bone and soft tissues must be performed along with taking specific X-rays and possibly detailed bone scans to identify any potential complications.

An analysis of your smile should also be performed. Do your teeth and gums show when you smile? Does your upper lip drape over your teeth? If the patient has a high lip line that shows teeth and gums, the need for bone and soft tissue grafting may be necessary.

By discussing several of the aspects necessary for implant treatment, you can be more aware of the possibilities, as well as the limitations, associated with implant dentistry. Armed with various soft and hard tissue grafting techniques, ceramic material advancements, and better dental implant components, dentists are able to satisfy even the most esthetically-minded patients.

By Benjamin O. Watkins, III, DDS

18Sep

The art and science of implant dentistry has advanced rapidly during recent years and new techniques and materials have greatly improved our ability to replace missing tissues with functional and natural-looking artificial prostheses called dentures implants. However, it must be remembered from the outset that no prosthesis or artificial substitute will ever function as well as the original living tissues. Research has shown that the chewing efficiency of experienced denture patients is, at best, less than 20% as efficient as the average chewing efficiency of patients with natural teeth.

Why Is the Lower Complete Denture So Hard to Wear?

Both upper and lower dentures are retained in the mouth by an intimately close fit of the plastic denture base to the gums. The intimately close fit is achieved by a combination of muscle control and suction. Mastering the function of the lower denture is more difficult than learning to use an upper complete denture. By comparison, the lower denture has less stable tissue with which to rest on than the upper denture. The lower denture stays in place largely due to the ability of the denture wearer to control their tongue well enough to hold the denture down while they speak and chew. Therefore, lack of tongue coordination in a lower complete denture wearer can severely affect the patient’s ability to wear a lower complete denture.

Bone Loss and Complete Dentures

For various reasons, teeth have to be removed. After tooth removal, the residual bone that is used to support the teeth will then shrink away quite rapidly over the first year because the body knows that the residual bone is no longer needed. The greatest amount of shrinkage occurs during the first year after tooth removal. Research has shown that wearing dentures will accelerate jawbone shrinkage. As the shrinkage of the jawbone support progresses over time, new dentures will need to be fabricated in approximately six to ten years. Because each denture wearer is unique, sometimes the internal surface of the denture needs to be readapted to the gum tissues. This procedure is called a reline.

Lower Complete Dentures and Denture Implants

Some patients are never able to adapt to functioning day-to-day with their complete dentures. Many of these patients do not have adequate bone to stabilize a lower denture. Others never develop enough muscle coordination to learn to chew with their dentures. For many years, dentistry had nothing more to offer patients other than a denture adhesive. Today, such problems can often be managed through the use of implant dentistry. Even with as few as two dental implants, the retention and stability of a lower denture can be greatly increased with denture implants. In fact, the chewing efficiency can also be greatly increased. Some patients have estimated that they regained up to 70% of their original chewing capacity. Overall, patients feel more confident when they are in public because they no longer fear that their dentures will slip or cause them embarrassment with denture implants.

By Benjamin O. Watkins, III, DDS

18Sep

Implant dentistry is a safe, predictable method for replacing missing teeth. “Immediate dental implants” or the placement of tooth implants at the time of extraction is a great method of implant placement. This method can be considered when a single upper front tooth is traumatized, when one or two teeth have advanced decay, or when the remaining roots are too short to support a crown. The purpose of this method of tooth replacement is to maintain as much bone volume as possible. This means preserving bone height and width. The benefits to the patient after restoration of dental implants are a beautiful, natural-looking tooth without cutting down healthy adjacent teeth and being able to eat in comfort without the fear of having the tooth loosen or fall out.

An implant dentist can easily determine if a person is a candidate for the immediate dental implants method of replacing missing teeth. They will examine the teeth adjacent to the involved tooth for periodontal disease and take a traditional dental X-ray. Impressions of the teeth will aid in determining one’s prognosis. Additional X-rays may be necessary to determine the exact bone width and height, as well as the root position.

Implant placement is performed with local anesthesia. The remaining root is removed and the gum tissue is gently displaced from the surrounding tissue. The dental implant site is prepared with small drills. Special equipment is used to gently place the tooth implant into the prepared site, after which the gums are replaced over the implant with sutures. A temporary tooth replacement is placed in the space where the tooth was removed. Post-operative discomfort is minimal. The sutures are removed in a week, and oral hygiene is resumed.

In the upper jaw, bone grows and adheres to the tooth implant within five to six months, while the immediate dental implants in the lower jaw require three to four months for proper bone formation. After healing, there is a series of visits when an implant dentist will make a tooth that will be attached to the implant. Within a few weeks after receiving the implant-supported crown, patients consider the restoration as their own tooth, rather than an implant.

Implants require good oral hygiene, dental maintenance, and periodic evaluation by a dentist. For further information regarding placement of tooth implants at the time of extraction, look in PubMed, searching the following key words: placement of implants at time of extraction, dental implants, immediate implants.

By William Becker, DDS

18Sep

The endosseous system of dental implants, currently the most popular system used in dentistry today, has been utilized to replace missing teeth for over thirty years. Dental implants are very successful. Dental implants are made of titanium, an inert metal that bonds with the bone and forms a very tight union. Dental implants have a 90% to 95% success rate and once placed and restored, can last for an indefinite amount of time.

Although rare, dental implant complications do occur. If the bond between the dental implant and the bone breaks, or the dental implant itself breaks, it may have to be removed. If so, it may be possible to replace the failed dental implant, either at the same time or after doing a bone grafting procedure.

There are two main reasons for dental implant complications are:

  1. Infection of the implant surface can result in disintegration of the bond between the implant and the bone. Eventually, the dental implant may have to be removed. To avoid infection at the time of dental implant placement, sterile operating techniques are recommended and most implant surgeons prescribe antibiotics after surgical implant placement.
    The oral bacteria that causes periodontal disease can also affect implants. Around implants, this infection is called peri-implantitis. Just as with the natural teeth, meticulous oral hygiene that includes brushing and flossing, combined with periodic professional cleanings are critical to prevent peri-implantitis.
  2. Excessive loading: If the forces on the dental implants are too strong or not in the right direction, the implant components can break or the bond between the implant and the bone can disintegrate. The bite on an dental implant has to be properly designed.

There are certain risk factors that may increase the risk of dental implant complications. Smoking, for example, halves the success rate of dental implants and is the number one risk factor for dental implant complications.

Also, persons that have a diminished healing ability such as people with uncontrolled diabetes may have an increased risk for dental implant complications. To reduce the risk of dental implant complications, and to prevent serious health complications from surgery, a thorough medical evaluation is required before dental implant treatment.

To reduce the risk of dental implant complications, make sure that the dentist that places the dental implants and the one that restores the dental crown on the dental implant have plenty of experience with dental implant procedures.

The success of dental implant treatment is dependent on the expertise of the dental team and the patient’s ability to control plaque. With proper dental implant design and follow-up maintenance, you could enjoy the benefits of dental implant treatment for a lifetime.

By Laura Minsk, DMD