Posts for tag: dental implants
Let’s say you’re traveling to Italy to surprise your girlfriend, who is competing in an alpine ski race… and when you lower the scarf that’s covering your face, you reveal to the assembled paparazzi that one of your front teeth is missing. What will you do about this dental dilemma?
Sound far-fetched? It recently happened to one of the most recognized figures in sports — Tiger Woods. There’s still some uncertainty about exactly how this tooth was taken out: Was it a collision with a cameraman, as Woods’ agent reported… or did Woods already have some problems with the tooth, as others have speculated? We still don’t know for sure, but the big question is: What happens next?
Fortunately, contemporary dentistry offers several good solutions for the problem of missing teeth. Which one is best? It depends on each individual’s particular situation.
Let’s say that the visible part of the tooth (the crown) has been damaged by a dental trauma (such as a collision or a blow to the face), but the tooth still has healthy roots. In this case, it’s often possible to keep the roots and replace the tooth above the gum line with a crown restoration (also called a cap). Crowns are generally made to order in a dental lab, and are placed on a prepared tooth in a procedure that requires two office visits: one to prepare the tooth for restoration and to make a model of the mouth and the second to place the custom-manufactured crown and complete the restoration. However, in some cases, crowns can be made on special machinery right in the dental office, and placed during the same visit.
But what happens if the root isn’t viable — for example, if the tooth is deeply fractured, or completely knocked out and unable to be successfully re-implanted?
In that case, a dental implant is probably the best option for tooth replacement. An implant consists of a screw-like post of titanium metal that is inserted into the jawbone during a minor surgical procedure. Titanium has a unique property: It can fuse with living bone tissue, allowing it to act as a secure anchor for the replacement tooth system. The crown of the implant is similar to the one mentioned above, except that it’s made to attach to the titanium implant instead of the natural tooth.
Dental implants look, function and “feel” just like natural teeth — and with proper care, they can last a lifetime. Although they may be initially expensive, their quality and longevity makes them a good value over the long term. A less-costly alternative is traditional bridgework — but this method requires some dental work on the adjacent, healthy teeth; plus, it isn’t expected to last as long as an implant, and it may make the teeth more prone to problems down the road.
What will the acclaimed golfer do? No doubt Tiger’s dentist will help him make the right tooth-replacement decision.
If you have a gap in your grin — whatever the cause — contact us or schedule an appointment for a consultation, and find out which tooth-replacement system is right for you. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Crowns & Bridgework.”
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.”
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.
Accidents happen, especially to teenagers involved with sports or similar activities. In an instant they can lose one or more teeth and permanently alter their smile.
Fortunately we can restore a teenager’s lost teeth, but often not immediately as a permanent restoration with a dental implant requires maturity of their jaw structure. Our focus then turns to the age of the patient and the condition of the underlying bone. A future dental implant, your best choice for tooth replacement, depends on bone for support, but also the age of the patient as it relates to jaw development.
There are a couple of ways an accidental tooth loss can harm supporting bone: first and foremost, the impact of the accident itself can damage the bony socket. To find out for sure we may need to perform a cone beam scan, a type of x-ray that allows us to view the area three-dimensionally. If we do find damage, we can attempt to repair the socket through bone grafting.
Bone can also suffer from the long-term absence of a tooth. Bone has a growth cycle in which older cells dissolve and new ones form to take their place. The force generated by teeth when we eat or chew helps stimulate this growth. Without stimulation, as with a missing tooth, the bone may not grow at a healthy rate. In time, it could lose some of its volume and density and not be able to support an implant.
Installing an implant right after tooth loss could help avoid this situation. Bone has a natural affinity with the titanium post imbedded in the jaw and will naturally grow and adhere to it. But we can’t place an implant with a teenager. This is because the jaw is still developing so an implant would gradually become misaligned as the jaw grows. It’s best to install an implant later after full jaw development in early adulthood.
Today, we can place a bone graft in the empty socket right after tooth loss. The graft serves as a scaffold for bone cells to grow on and will help keep the bone volume at a healthy level until we can install an implant.
Timing is everything in restoring a teenager’s accidental tooth loss. But with coordination and care for the supporting bone, a teenager can eventually enter their adult years with their smile intact.
If you would like more information on restoring your teenager’s smile after tooth 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 “Dental Implants for Teenagers.”
Unlike other tooth replacement options, dental implants require a surgical procedure. But don't let your imagination run wild — the procedure is relatively minor and easy for most people to undergo.
Implants are unique among restorations because they replace a tooth's root. A metal titanium post, substituting for the root, must be surgically placed into the jawbone. While the procedure itself is simple and no more involved than a tooth extraction, it does require careful attention to detail before, during and afterward.
Our first step is to examine the target site with x-rays (often CT scanning) to pinpoint the best location for placement. This is critical because where we place the implant will have a huge bearing on how attractive and natural the implant finally appears. From this evaluation we frequently create a surgical guide.
Surgery begins with a local anesthesia to completely numb the site. You will feel no pain during the procedure and only minimal discomfort for a few days afterward. We then make small incisions in the gums to access the bone and create a small channel or hole.
Using the surgical guide, we then initiate a drilling sequence that gradually increases the size of the channel until it's the size and shape of the implant post. One thing we must do at this point is take our time: we use gentle pressure and water-cooling to avoid overheating and damaging the bone.
Once we're finished with drilling we remove the implant from its sterile packaging and imbed it directly into the prepared channel. It's then a matter of verifying the location with x-rays and then closing the gum tissue with self-absorbing sutures if necessary.
Most patients only need mild pain medication like aspirin or ibuprofen to manage discomfort afterwards. You won't even notice it in a week or less. After several weeks in which the bone grows and adheres to the implant (a process called osseointegration), you'll be ready for the final step, attaching the life-like porcelain crown to the implant.
Although the process can take several weeks to months, your discomfort should be minimal at any stage. In the end, your patience will be rewarded with a new, more attractive smile.
If you would like more information on the process of obtaining 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.”