Posts for tag: dental implant
If you've been dealing with a tooth that needs to be removed—or it's already missing—you may be looking to replace it with a dental implant. And it's a great choice: No other restoration can provide the appearance and function of a real tooth like an implant.
You and your smile are ready for it. The question is, though, are your gums and underlying bone ready? These dental structures play a critical role in an implant's stability and eventual appearance. A problem with them may make placing an implant difficult if not impossible.
An implant requires around 2.0 millimeters of bone thickness surrounding the implant surface for adequate support and to minimize the chances of gum recession. But tooth loss often leads to bone loss that can drop its thickness below this threshold. This can make placing an implant problematic.
Fortunately, though, we may be able to address the lack of sufficient bone through bone grafting. By placing grafting material within the empty socket, we create a scaffold for new bone cells to grow upon. Over time this subsequent growth may be enough to maintain an adequate thickness of bone for an implant to be placed.
The gums may also pose a problem if they've shrunk back or receded from their normal positions, as often happens because of gum disease (which may also have precipitated the tooth loss). Again, grafting procedures can help ensure there's adequate gum coverage for the implant. And healthier gums may also help protect the underlying bone from loss.
There are several techniques for placing gum tissue grafts, depending on how much recession has taken place. One procedure in particular is often used in conjunction with implant placement. A small layer of synthetic collagen material or gum tissue referred to as pa dermal apron is included with the implant when its placed. Settling into the bone socket, this apron helps thicken the gum tissues, as well as preserve the underlying bone.
During your preliminary exams, we'll assess your bone and gum health to determine if we should take any steps like these to improve them. It may add some time to the implant process, but the end result will be well worth it.
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 “Immediate Dental Implants.”
Besides their life-likeness, implants are also prized for their high success rate. More than ninety-five percent of implants continue to function effectively after ten years.
Implants’ advanced technology explains some of their reliability and longevity—they’re as close to natural teeth as we’re now able to achieve. But their impressive success rate also owes to the detailed protocols that dentists follow to install them. One critical part of these protocols is ensuring a patient has enough bone in their jaw to support and precisely situate the implant for the best functional and aesthetic outcome.
Unfortunately, there are situations where a patient doesn’t have enough bone to achieve a satisfactory result. This often happens if there’s been months or years between losing the tooth and considering an implant. The reason why relates to the nature of bone as living tissue.
Like other cellular tissues in the body, bone has a life cycle: Older, worn-out cells die and are absorbed by the body, and new cells form to replace them. The growth cycle in the jaw receives stimulation from the forces generated when we chew, which travel up through the teeth to the bone.
However, this stimulation stops after tooth loss for the related area of bone, which can slow new bone growth. Over time, the volume and density of the bone around a missing tooth gradually decreases, enough eventually to make an implant impractical.
Insufficient bone volume, though, doesn’t necessarily mean an implant is out of the question. We may be able to address the problem by attempting to regenerate the bone through grafting. This is a procedure in which we insert graft material into the affected area of the jawbone. The graft then becomes a scaffold upon which bone cells can grow. After several months, we may have enough regenerated bone to support an implant.
If there’s been too much bone loss, we may still need to consider another form of restoration. But if we can successfully build up the bone around your missing tooth, this premier restoration for replacing lost teeth could become a reality for you.
Millions of microorganisms call your mouth home—and while most are friendly, some are not. An invasive procedure like implant surgery can disrupt the mouth's soft tissues and allow disease-causing bacteria to enter the bloodstream.
This isn't necessarily a major concern if your immune system is sound—your body will move quickly to quash any developing infection. But if your body's defense is weak or compromised by other health conditions, an ensuing infection could cause you problems. In the case of a dental implant, a localized infection around it could lead to its failure.
The bone normally grows and adheres to the surface of an implant soon after it's placed, giving it the added strength and durability for which implants are best known. A bacterial infection, though, could impede bone integration and weaken the implant's hold within the jaw.
One way to avoid this is by treating patients at high risk for infection with an antibiotic before the procedure. In one recent study, researchers concluded that patients receiving a 2-gram dose of amoxicillin an hour before implant surgery helped reduce the risk of future implant failure.
But before taking this route, the dentist must first decide whether antibiotic pre-treatment might be more detrimental than beneficial to an individual patient. Antibiotics can cause side effects in certain people ranging from diarrhea to allergic reactions. Healthcare providers must also be prudent with administering antibiotics for the good of society in general—overuse can potentially give rise to antibiotic-resistant bacteria.
A number of healthcare associations highly recommend antibiotic pre-treatment for any dental patient with prosthetic heart valves, a history of infective endocarditis, a heart transplant and similar heart conditions. They also recognize patients with conditions like prosthetic joints, weakened immune systems, diabetics or other serious health problems could also benefit from antibiotic pre-treatment, but leave it to the physician's discretion on whether or not it's appropriate for an individual patient.
If you're planning to undergo implant surgery or a similar procedure and are concerned about infection, speak with your dentist about whether you would qualify and benefit from antibiotic pre-treatment. If appropriate, taking an antibiotic beforehand could minimize your infection risk.
If you would like more information on pre-surgical antibiotic treatment, 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.”
If you know anyone with a dental implant, you may know it can be a long process in getting one. Several weeks or months can pass between removing the old tooth and placing the implant, and then several more weeks before affixing the permanent crown.
But with recent advances in implant technology, some patients don't have to wait as long for a new implant and crown. In fact, one procedure commonly known as "tooth in one day," allows patients to walk in with a problem tooth and out the same day with a new "one."
Not every implant patient, however, can undergo this accelerated procedure. If you're considering implants, the state of your bone health will determine whether or not you can.
Implants need a certain amount of available bone for proper placement. But bone loss, a common consequence of missing teeth or dental disease, can reduce bone volume to less than what's needed to place an implant. The patient may first need to undergo grafting to regenerate the bone or choose another restorative option.
If your supporting bone is sound, your dentist might then proceed with the implant. But you will still have to wait a while for your new crown. The implant needs to integrate with the bone to improve its hold. This integration process can take anywhere from a minimum of six weeks to more commonly twelve weeks. After the attachment is mature, the dentist may need to undo the gum covering before taking impressions for the formation of the new crown.
But it is possible to have a tooth or teeth in a day. For a single tooth, your dentist may be able to immediately attach a crown right after implant surgery if the implant is very stable. Even so, this crown will need to be temporary, slightly shorter than a permanent crown so that it won't make contact with other teeth and put too much pressure on the new implant. After further healing from bone integration, impressions will be taken so that you'll receive your permanent crown shortly.
Immediate crown placement can allow you to have the cosmetic and limited functional benefit of a new tooth right from the start. If multiple implants are placed in one arch in a day, it's possible to have immediate teeth if enough implants are attached together with a temporary restoration.
This is different from a single implant replacing a single tooth and does create confusion for patients when they read about teeth in a day. Regardless, no final tooth crown can be placed at the time of an implant—only a temporary restoration.
If you would like more information on your options for 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 “Same-Day Tooth Replacement with Dental Implants.”