Dental Implants

with Dr Nick

Nearly 70% of middle aged Americans are missing at least 1 tooth due to an accident, decay, or gum disease. The teeth are designed to work together to help us chew, smile and speak. When one or more teeth are lost the system begins to be unbalanced and begins to break down. Teeth shift to partially fill gaps left by missing teeth, teeth become worn unevenly because of overuse, the jaw joint and muscles can also become affected.

There are 3 components to a dental implant. The implant is a titanium screw that is placed in the jaw bone. The implant has a special surface treatment that allows the bone to grow around and into the implant surface. This natural remodeling process solidifies the implant into the bone and allows it to function similarly to a natural tooth root.  The second component is the abutment, which is a connection between the implant and the crown. The abutment is customized to properly align the implant crown with the other teeth. The final component is the crown which is similar to a regular cap or crown that a dentist would place on a natural tooth.

The crown and abutment are screwed into the implant. The most common compilation with regard to implants is a loosened screw. The crown will feel loose, but won’t come off. This can be disconcerting to the patient, but we are able to tighten the screw down or replace the screw very easily. The second most common complication is soreness of the opposing teeth. Implants, unlike natural teeth are connected directly into the bone and don’t have a soft ligament around them. Consequently, if the bite isn’t adjusted properly or if the teeth shift the bite can be heavy on the teeth opposing the implant. Once we have completed an implant restoration we recommend that each patient have a custom night guard made to protect their teeth and the implant as well as to prevent movement of the teeth.

 

 

More About Dental Implants

Dental Implants and Alternatives Dental Implant Timeline Parts of a Dental Implant
Advanced Implant Planning Precise Implant Placement Questions about Dental Implants
 

Dental Implants and Alternatives

Dental Implants

 

Dental Implants, as we know them today, originated in the 1950’s. Since that time incremental advances have given us a reliable, predictable, long lasting solution for tooth replacement. Dental implants can be used to replace a single tooth, multiple teeth, or an entire set of teeth. They are the most natural in appearance, feel, and function to our natural teeth.

What’s Involved?

  1. Placement of the implant: The dentist surgically places the implant into the jawbone. There may be some swelling and or tenderness after the surgery, so pain medication is usually prescribed. Your dentist may recommend a soft diet during the healing process.
  2. The healing process: What makes an implant so strong is that the bone actually grows around it and holds it in place. This process takes time. Usually patients must wait about 4 months before replacement teeth can be fixed to the implant.
  3. Replacing your missing tooth or teeth: The dentist will make a custom crown or bridge to fit over your implants. The new teeth are porcelain and have the look, feel, and function of natural teeth.

 

Fixed Bridge

 

Fixed Bridges are another option for replacing teeth. A bridge is made in the same way as a dental crown and are not removable. However, a bridge has a minimum of 3 crowns that are made in a single piece. Bridges require a remaining tooth on either side of the space where a tooth was lost. Much of the enamel surface of the teeth on either side of the gap is removed to accommodate the bridge. Also, because each of the crowns are constructed in a single piece you can’t floss without threading the floss under the bridge.

 

BridgeGraphicHow is a bridge placed?

  1. Bridge Preparation: Enamel is removed from the teeth on either side of the gap to allow space for the crown to fit over the teeth. A mold is made of the prepared teeth and sent to a lab. A temporary bridge is fabricated to allow for normal chewing until the final bridge comes back from the laboratory.
  2. Bridge Seating: The final bridge is cemented to the teeth on either side of the gap. Once installed, it can be difficult to distinguish the bridged teeth from the natural ones. However, the bridge requires special care because it is harder to clean and as a result the supporting teeth are at increased risk of decay.

 

Removable Partial Denture

 

Removable Partial Denture are the third option for replacing missing teeth.  As the name implies they are removable and must be removed and cleaned after each meal and during sleep. If a person is missing multiple teeth a removable partial denture can be a very economical way to replace them. The removable partial denture is the only option that rests on the tissue. As a result sores can develop. Where teeth are losts the bone atrophies and the pressure of a removable partial denture can accelerate this loss of bone. Compared with nothing though, a removable partial denture will maintain the position and health of the remaining teeth and restore the function of the missing teeth.

 

RemovalblePartialHow is a removable partial denture made?

  1. Small groves are made in some of the remaining teeth to help hold in the removable partial denture. A mold is taken and sent to the laboratory.
  2. A wax mock up is made and tried it. This step allows for any adjustments in the fit or position of the acrylic teeth.
  3. A final removable partial denture is fabricated with white acrylic teeth and pink acrylic to match the color of the gums a metal framework supports the acrylic and attaches the removable partial denture to the remaining teeth.

 

Dental Implant Timeline


 

Guided Implant Placement

If you’ve ever built or remodeled a house you can appreciate the value of thorough planning. Replacing a tooth requires similar planning. The foundation, supports, neighboring structures, and local environment all need to be taken into consideration. A tool that we now have to help in these steps of planning is a 3D xray machine.

 

Printing in three dimensions has recently become accessible to designers, inventors and hobbyists. 3D scanning is actually the real first step in any project. The ability to three dimensionally scan a failing tooth can help determine the cause of the failure. We can also assess the foundational bone and surrounding teeth.

 

Starting with a 3D scan we can design and then print an implant placement guide.  The guide is a precise physical blueprint. It direct the placement of the implant to make sure that the new tooth will be in the right place to function and look its best.

 

Frequently Asked Questions about Dental Implants

How long does it take to place a dental implant? Am I a good candidate for dental implants? I am diabetic, can I get dental implants? How successful are dental implants?
Is the procedure painful? How long will it take to fix teeth over the implant? Will I be able to chew well after I have dental implants? How many implants will I need?
How many visits does it take to get my teeth fixed? What is the materials for the artificial teeth? What happens if an implant fails? How do I maintain my dental implants?

How long does it take to place a dental implant?

Dental implant placement is a minor surgical procedure like a tooth extraction and takes approximately 1 hour including time for anesthetic and postoperative instructions.

Am I a good candidate for dental implants?

Anyone who is missing one or more teeth due to injury, disease or decay may be a candidate for dental implants. If teeth have been missing for many years the bone will atrophy and may cause unique challenges. In most of these cases however, implants are still an option. Some medical conditions may interfere with the healing process (e.g., connective tissue disorders, steroid therapy, bone infections, uncontrolled diabetes, and cigarette smoking). We carefully evaluate each patient for potential risks and benefits of using dental implants. We also work closely with your medical doctor to make sure you are a good candidate for dental implants.

I am diabetic, can I get dental implants?

If your diabetes is under control or can be bought under good control, dental implants can be an option. However, uncontrolled diabetes will interfere with your body’s natural ability to heal. then it is important to discuss with your physician and bring it under good control before placing dental implants.

How successful are dental implants?

For more than three decades, dental implants have been used successfully. The average success rate is over 95% at 15 years. Even in a successful case there can be minor complications. About 20% of dental implants will have a minor complication. The most common is loosening of the screw that holds the crown onto the implant. This can be alarming, but is easy to fix by returning to your dentist to have the screw tightened. In some cases we cement the crown onto the dental implant. This cement can lose its bond and the crown will come off. Again, the crown can easily be recemented by your dentist. Implants can get gum disease just like natural teeth. Good oral hygiene is an important factor in insuring long lasting results from your implants. The most common cause of tooth loss is gum disease. The same is true for dental implants. Your dentist recommends using a waterpik or shower flosser each day to maintain the health of the gums around your implant.

Is the procedure painful?

Local anesthesia is used during the surgical procedure to eliminate any pain. We also prescribe medication both before and after the surgery to accelerate healing and prevent discomfort. We also offer conscious sedation for the procedure.

How long will it take to fix teeth over the implant?

We recommend a healing period of approximately 4 to 6 months before the teeth were fixed over dental implant. A follow up appointment will be scheduled 4 months following implant placement. The implant will be evaluated and in most cases restored at that time. In the meantime we can make a temporary removable tooth to wear until the teeth can be fixed over the implant.

Will I be able to chew well after I have dental implants?

After the implants have the teeth fixed on top they feel, function and look like natural teeth. There are no food restrictions. You can eat anything hard, sticky, or chewy or crunchy.

How many implants will I need?

For a single or just a couple of missing teeth one implant is needed per missing tooth. If for example all of your lower teeth need to be replaced 3 to 7 implants are needed.

How many visits does it take to get my teeth fixed?

Including implant placement, we schedule a minimum of 3 visits to replace a single or couple of teeth. Each of these visits are 30 minutes to 1 hour. If a denture is going to be retained using implants we schedule about 5 visits.

What is the materials for the artificial teeth?

The artificial teeth are made of ceramic or zirconia ceramic which are not only very hard materials but also look very natural like tooth enamel. They are made using CAD CAM technology and as custom made per patient.

What happens if an implant fails?

The failed implant is removed and a new implant can, in most cases, can be placed in the same or a nearby position. As with the initial implant placement, in some cases, grafting or sinus augmentation can be necessary. The time and effort for this procedure is similar to placing a new dental implant.

How do I maintain my dental implants?

Care for a dental implant is nearly the same as for natural teeth. In addition to your normal brushing and flossing we recommend using a waterpik or shower flosser to flush out any debris that might collect around your teeth or the dental implant. Good oral hygiene is an important factor in insuring long lasting results from your implants. The most common cause of tooth loss is gum disease. The same is true for dental implants.

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