1 post tagged “prosthodontists”

 DENTAL IMPLANTS

For some people, dental implants offer a smile that looks and feels very natural. Surgically placed below the gums over a series of appointments, implants ankylosed (anchored) to the jawbone and work as a base for the teeth to be replaced, and for bridges or dentures. In the past there were only fixed or removable bridges for the replacement of one or more teeth missing.

While with fixed bridges your teeth need to be grinded or prepared for final placement of the bridge; and with a removable bridge, people have to remove it on a daily basis, leaving the empty space, once the bridge is removed.

Implants in the other hand, offer stability because they osseointegrate to your bone. Integration of the implants into your jaw also helps your replacement teeth feel more natural and some people find the secured fit, more comfortable than conventional substitutes.

Am I an implant candidate?

Most of the people that have had a tooth extracted could be a candidate for dental implant placement. Age is not as important as having healthy gums and adequate bone to support the implant. A thorough evaluation by your prosthodontist (specialist on implant restorations) or your restorative dentist will help to determine, whether you are a good candidate for dental implants. Dental implants can provide artificial teeth that look natural and feel secure (see pictures).

Dental implants can also be used to attach full or partial dentures. Implants, however, are not an option for everyone. Because implants require surgery, patients must be in good health, have healthy gums, have adequate bone to support the implant and be committed to meticulous oral hygiene and regular dental visits. Do not discard this type of treatment until you have an evaluation. 

What is involved in placing implants?

First, surgery is performed to place a titanium implant. Surgery can take from one hour to several hours depending on the number of implants to be placed, and from two to six months may be required for the bone to grow around the anchor and firmly hold it in place. Once the implant has osseonintegrated to the bone an uncovering phase proceed. This is a short appointment to get you ready for the restorative phase.

After the gums have had several weeks to heal, the restorative phase is started, removing the healing abutment, an accurate final impression is taken to copy the position of the implant. With this impression, pictures, study models, x-rays, and bite registration the case is sent to the dental laboratory for fabrication of the final abutment and final crown for the implant. Once the lab finishes the fabrication of the implant restoration, patient is brought back to the office for the final appoinment and insertion of the implant restoration.

Implant surgery can be done in a dental office under local anesthesia. Usually pain medications and, when necessary, antibiotics are prescribed. Your Periodontist or Oral and Maxillofacial surgeon  will give you instructions on diet and oral hygiene.

The primary consideration for the suitability of dental implants for a particular patient is the amount and condition of the bone in the area where the implant is to be placed. With the loss of a tooth, the area of the jaw without the tooth naturally undergoes resorption, or a thinning, of the bone in that area.

The less bone available in which to place the implant, the greater chance of the implant not "taking" in the region. A common type of implant, called root form implants due to their similarity in shape to a tooth root, actually undergo a bonding with the surrounding bone called Osseo integration. Without enough healthy bone at the implant site, this process cannot occur and the implant will fail.

There are solutions commonly used for highly resorbed bone in the area where the implant is to occur. The first is bone grafting. This involves undergoing a procedure that moves bone from one place in the body to another to enlarge the bone structure at the implant site.

Often bone can be moved from one place in the mouth to another. Sometimes a graft from a donor or artificial bone can be used if bone from the patient is not available. Grafting healing period usually is from four to six months before the implant procedure, to allow the graft a chance to heal before it is disturbed with the implant process.

In an ideal single tooth missing case where no grafting is necessary, an implant is placed, a two to six months period of healing is given to the implant area; and then the final implant restoration is begun that might take from one to month and a half for final insertion of the restoration.

Implant Benefits:

Within the dental implants benefits we have the following:

More healthy and beautiful: we know that when a natural tooth is extracted, the bone reabsorb, with an implant placement we prevent the bone to reabsorb and avoid the patient face to look older.

More Confident: when dental implants are placed, the patient does not have to worry about moving dentures; giving a secure feeling while speaking.

More Comfort: this is one of the most important elements in dental implants, you will not have a denture moving from side to side during mastication; giving you better function and efficiency while eating.

Natural Tooth Preservation: with dental implants your dentist will not have to work or grind your natural teeth. For example if  you are missing one tooth, with a fixed bridge your dentist will have to prepare or grind the two teeth next to the empty space. With a dental implant there is no reason to work on your natural teeth. Which one would you choose?  

Complete removable denture with no palate:   If you are missing all your natural teeth on the upper jaw (maxilla); placing four implants as a minimum let us fabricate a complete removable denture with no palate, giving this more pleasure and better taste while eating.

 Immediate provisional tooth placement:

There are some cases when the patient’s health, bone and all surgical requirements are met during the dental implant surgical placement; that a provisional tooth can be placed the same day of the surgery giving the patient the option to have a fixed (not removable) tooth restoration avoiding to wear removable dentures. This option is mostly done in the esthetic zone.  Always ask your dentist for this option before having an implant placed in the upper or lower anterior area.

Definitely implants cost more than conventional dentistry, but never look it in the short term perspective, always the long term perspective; at the end your natural teeth were the ones that were not grinded or prepared for conventional dentistry. Dental implants, the solution is here.

The author has private practice limited to prosthodontics, restorative, cosmetic and implant dentistry in Hato Rey, Puerto Rico. For further information you may contact Dr. Rivera-Zayas al 787-773-0123 or by email: baldrichdental@yahoo.com.