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Dental Implants

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What Is A Dental Implant?

The best way to describe a dental implant is to compare it to a real tooth. A natural tooth consists of a root and a crown. The part of the tooth that you see and eat with is called the crown. Beneath the crown is the root, which anchors the tooth through the gum tissue to the jawbone. When you lose a tooth, you lose both the root and the crown. To replace a tooth, we first have to replace the root. Essentially, a dental implant is a new root. This titanium root is fitted into a socket that we create in your jaw, replacing the lost root of your natural tooth.

Dental implants come in various shapes and sizes and have different types of surfaces. The actual implant selection will depend on a variety of factors related to your specific treatment needs and the most appropriate one(s) will be used. Once an implant has been placed in the jaw, the bone around the implant will need to heal for up to six months, depending upon how hard the bone is. When this initial phase of healing is completed, a support post called an abutment will be placed on the implant itself and then a new crown will be placed on top. If all of your teeth are missing, a variety of treatment options are available to support the replacement teeth.

 

Why Should I Replace My Missing Teeth?

Usually, when you lose a tooth, it is best for your oral health to have it replaced. Missing teeth can affect your “bite” as well as your ability to speak and chew. Their loss can increase the burden on your remaining teeth and can cause muscle pain in your jaws and headaches. And of course, losing a tooth can affect your appearance.

The good news is that, most of the time, replacing a missing tooth is not an emergency. You have time to consider what replacement option is best for you and to make an informed decision. 

MIssing Teeth Can Lead to...

  • Bone Loss
  • Premature Aging
  • Teeth May Shift
  • Low Self Esteem
  • TMJ Disorder

dental Implant Benefits

  • No Damage To Other Teeth
  • Preserve Bone Structure
  • Avoid Premature Aging
  • Long Term Solution
  • Avoid Occlusion Issues

What Are My Tooth Replacement Options?

If you are missing one or more teeth and choose to have it or them replaced, several treatment options are available.

A ‘flipper’ is a removable plastic tooth that is inexpensive but fragile and temporary.

A cast partial denture also is removable but is precision cast in metal for longer service life. Wire clips help hold it in place.

A fixed bridge is cemented into place using crowns or “caps” on the teeth adjacent to the open space for support. Crown placement usually requires removing or reducing the outer layer of the tooth. In some cases, a ‘Maryland’ bridge, a fixed bridge that does not need crowns, is glued onto the back of the teeth adjacent to the space so that minimal tooth structure is removed.

Complete dentures or ‘plates’ are the traditional solution for people who have lost all their teeth in one or both jaws. The success of a complete denture depends upon the individual’s jaw size and shape, his or her oral habits, and his or her adaptability. Some people adapt well to dentures, while others are not able to adapt.

Dental implants can be used to provide support for the replacement of one tooth or all of an individual’s teeth. After years of research and clinical trials, we can now provide this option in addition to the traditional treatments just described. Implant-supported teeth can be cemented, screw-retained, or removable and can be made attractive, stable, and comfortable for almost any patient.

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Are Dental Implants An Option For Me?

If you are considering dental implants, your mouth will be examined thoroughly and your dental and medical history will be reviewed to ensure that dental implants are appropriate for you. 

Dental x-rays and, frequently, panoramic (or complete) x-rays of your jaws will be taken to evaluate your jawbone and to determine if it will accommodate implants. Occasionally, more detailed information is required and can be provided by special x-rays. They will help determine if additional tests or procedures are needed to place your implants properly.

 

HOW ARE DENTAL IMPLANTS PLACED?

Usually, the office procedure to place a dental implant takes about an hour for one implant and no more than two or three hours for multiple implants. The placement process consists of the following steps:


STEP ONE:

After you are comfortable, a small incision is made into the gum tissue, revealing the bone into which the implant will be placed.

STEP TWO:

Using special instruments, a space (socket) is created in the bone into which the implant will be placed.

STEP THREE:
The titanium implant is then inserted into the socket.
STEP FOUR:

Finally, if necessary, sutures will be used.

Once the implant is inserted, it is completed in one of a few ways: First, the gum tissue will be closed (or sutured) over the implant, allowing the implant to heal for up to six months. Then a second procedure, called “uncovering surgery,” will be performed after a local anesthetic has been used to numb the gum tissue. Next, the gum is moved out of the way, the implant located, and a healing cap placed into it. The gum tissue is then sutured around the healing cap. Generally, after two to four weeks, you will return to have the healing cap removed, the abutment (or support post) placed, and impressions made in order for the final crown (replacement tooth) to be fabricated. This is called a “two-stage” or “two-step” approach to implant placement.  A “single-stage” implant can also be placed directly through the gum tissue without the need for sutures.  Because only one surgical appointment is all that is needed, both patients and doctors often prefer this approach. However, it is not always the best method for placing implants.  It is also possible to place an implant at the time that a tooth is removed.  This is called an immediate implant and is used in situations when adequate bone is available.  We will use the most appropriate approach to meet your particular needs. 

After the implant is placed, the area will need to heal for as long as three to six months. How long your mouth will need to heal will be determined by a variety of factors. Follow-up care (one to four appointments) is usually needed to ensure that your mouth is healing well and to determine when you are ready for the restorative phase of your treatment. 

On occasion, it may be necessary to perform a “soft tissue graft” to obtain stronger, more easily cleaned and natural appearing “gum” tissue in the area around the implant. This process involves moving a small amount of gum tissue from one part of your mouth to the area around the implant. Most often, it is a brief and relatively comfortable procedure.

When Are The Implants Placed?​

Approximately three months after the tooth is removed, the implant is placed where the missing tooth was located. Once a tooth is removed, if your socket walls of bone are intact and fairly thick, your body will grow new bone to replace or refill the empty socket. Your socket will usually be completely filled in with bone by the time you are ready for placement of your implant (about three months later). Occasionally, it is possible to take out the tooth and place the implant at the same time. This may involve a little more risk, but it simplifies the process—you won’t have to wait three months for the bone to refill the socket. Again, there are times when this is appropriate and other times (when infection or other problems with the bone are present) when immediate implant placement is not the best treatment.

Do I Have Enough Bone?

If your tooth was removed many years ago, then your bony ridge may be extremely thin and you may not have enough bone left for implant placement. In this case, a bone graft can be placed next to the thin bone and allowed to heal for three to nine months. After the graft has fused to your pre-existing bone, the ridge will be re-entered and the implant placed. Many different bone-grafting materials are available, including your own bone.

You also may need bone grafting if the sinus cavities in your upper jaw are very large or very low and extend into the tooth-bearing areas. This often occurs when teeth in the back of a person’s upper jaw have been removed many years before, and the amount of bone available for implant placement is thus limited. This condition requires what is called a “sinus grafting procedure.” Most often, it is performed in the office with local anesthesia and perhaps sedation. During this procedure, the membrane that lines the sinus will be located and elevated. Bone will then be added to restore the bone height and ensure that dental implants of an adequate length can be placed. This procedure often can be performed at the time of implant placement.

If after tooth extraction, the walls of the socket are very thick, they will usually fill with bone in three months. However, if the walls of your socket are very thin (such as in your upper and lower front teeth), then this type of healing will not be as predictable. After waiting three months for the bone to fill in, you may have only a very thin ridge of bone. Sometimes, a bone graft is placed at the time of tooth extraction to help your body fill in the socket with bone. This step will maintain the width or volume of bone you will need for implant placement. It is most commonly performed on thin-walled extraction sockets, especially in such visible areas as the front of the mouth.

What If I’m Missing All Of The Teeth In My Lower Jaw?

Dental Implants If you are missing all of the teeth in your lower jaw, you may consider a number of treatment options. Although many patients have no problem wearing an upper denture, some find it difficult to wear lower dentures.

The first option is to have two implants placed in your lower jaw and a denture made that snaps onto these implants. This option allows your lower denture to be more stable while chewing than without implants. This is a viable option if your jaw’s support ridge is big enough. There will still be movement of your lower denture, however, and you can still get sore spots if any food particles, especially seeds, are caught under it. As with all removable replacement teeth, you still will need periodic appointments for denture adjustment.

A second option involves placing four to six implants, depending on your jaw size or shape, into your lower jaw.  Your denture will be made with special retention clips inside that attach onto the support bar, allowing the denture to snap firmly into place. This is called an “overdenture.” The advantage of this option is that it is much more stable than the first option, allowing very little denture movement. Your denture still will be removable for easy cleaning and maintenance.

A third option involves placing five or more implants in your jaw and attaching a permanent denture. Your denture is held in place by screws or clasps that secure it to the support posts or bar. It doesn’t touch the gum tissue, which allows you to clean under the denture without removing it. This denture will replace all your missing lower teeth and will not be removed except at maintenance visits. Although cleaning under your denture without removing it is more time consuming and requires more dexterity, many patients who want a permanent denture prefer this option.

The final option is to have all your teeth individually replaced so that they will appear to be growing out of your gum tissue and will most closely resemble the appearance of your natural teeth. This option usually requires eight or more implants. Separate abutments or support posts for each one of these implants will be made and crowns for each missing tooth will be placed. The teeth are then frequently joined together for strength and support. Overall, this is the most costly option, because (among other reasons) it requires the most implants. In addition, your options may be limited by the current size and shape of your jawbone