When you have missing teeth, an alternative solution to dentures is dental implants. While dentures are removable, dental implants provide permanent new teeth to restore your mouth’s function and appearance. Dental implants tend to offer a successful and lasting solution to the loss of some or all of your teeth.
Under proper conditions, such as diligent patient maintenance, implants can last a lifetime. Dental implants are intimately connected with the gum tissues and underlying bone in the mouth. Since periodontist’s are the dental experts who specialize in precisely these areas, we are ideal members of your dental implant team. Not only do we have experience working with other dental professionals, we also have the special knowledge, training, and facilities that you need to have teeth that look and feel just like your own.
We and your general dentist will consult with you to determine where and how your implant should be placed. Depending on your specific condition and the type of implant chosen, a treatment plan will be tailored to meet your needs.
What are the advantages of a single-tooth implant over a bridge?
A dental implant provides several advantages over other tooth replacement options. In addition to looking and functioning like a natural tooth, a dental implant replaces a single tooth without sacrificing the health of neighboring teeth. The other common treatment for the loss of a single tooth, a tooth-supported fixed bridge, requires that adjacent teeth be ground down to support the cemented bridge.
Because a dental implant will replace your tooth root, the bone is better preserved. With a bridge, some of the bone that previously surrounded the tooth begins to resorb (deteriorate). Dental implants integrate with your jawbone, helping to keep the bone healthy and intact. In the long term, a single implant can be more esthetic and easier to keep clean than a bridge. Gums can recede around a bridge, leaving a visible defect when the metal base or collar of the bridge becomes exposed. Resorbed bone beneath the bridge can lead to an unattractive smile. Occasionally the cement holding the bridge in place can wash out, allowing bacteria to decay the teeth that anchor the bridge.
Dental implants are also an option if you are missing multiple or even all of your teeth. Restorations such as an implant-supported bridges or full dentures can be fabricated to replace the missing teeth. These types of restorations are more comfortable and stable than conventional dentures, allowing you to retain a more natural biting and chewing capacity.
How will the implant be placed?
First, the implant, which looks like a screw or cylinder, is placed into your jaw. Over the next 3-6 months, the implant and the bone are allowed to bond together or osseointegrate to form an anchor for your artificial tooth. During this time, a temporary tooth replacement option can be worn over the implant site.
Sometimes, a second surgical procedure is necessary to uncover the implant and attach an extension. This small metal post, called a healing abutment, completes the foundation on which your new tooth will be placed. Your gums will be allowed to heal for a couple of weeks following this procedure.
Most often however implant placement does not require this second surgery and the implant and healing abutment is placed at one time and protrudes slightly through your gums. We will advise you on which procedure is best for you.
Finally, a replacement tooth called a crown will be created for you by your general dentist and attached to the final abutment. After a short time, you will experience restored confidence in your smile and your ability to chew and speak. Dental implants are so natural-looking and feeling, you may forget you ever lost a tooth.
Insufficient Bone
A key to implant success is the quantity and quality of the bone where the implant is to be placed. Deformities in the upper or lower jaw can leave you with inadequate bone in which to place dental implants. This defect may have been caused by periodontal disease, wearing dentures, developmental defects, injury or trauma. Not only does this deformity cause problems in placing the implant, it can also cause an unattractive indentation in the jaw line near the missing teeth that may be difficult to clean and maintain.
To correct the problem, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or bone substitute to build up the ridge. We can tell you about your options for graft materials, which can help to regenerate lost bone and tissue.
Finally, the incision is closed and healing is allowed to take place. Depending on your individual needs, the bone usually will be allowed to develop for about 3-6 months before implants can be placed. In some cases, the implant can be placed at the same time the ridge is modified.
Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come. Ridge modification can enhance your restorative success both esthetically and functionally.
Sinus Lifts (Augmentation)
The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus or air space in your skull. If you’ve lost bone in that area due to reasons such as periodontal disease or tooth loss, you may be left without enough bone to place implants.
Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants. Several techniques can be used to raise the sinus and allow for new bone to form. In one common technique, called a lateral window, an incision is made to expose the bone. Then a small circle is cut into the bone. This bony piece is lifted into the sinus cavity, much like a trap door, and the space underneath is filled with bone graft material. We can explain your options for graft materials, which can regenerate lost bone and tissue.
Finally, the incision is closed and healing is allowed to take place. Depending on your individual needs, the bone usually will be allowed to develop for about three to six months before implants can be placed. After the implants are placed, an additional healing period is required. In some cases, the implant can be placed at the same time the sinus is augmented.
The second technique used to lift the sinus is called an “osteotome” sinus lift. This type of sinus lift is performed when there is enough bone to place a stable implant but 1-3mm of lifting is needed in order to prevent puncturing the sinus membrane. A hole is drilled and implant site prepared in the area where the implant is to be placed without going into the sinus membrane. Before inserting the implant, bone is placed into the hole and an instrument used to place gentle pressure on the bone which acts like a hydraulic jack to lift the bone, which in turn lifts the membrane. This is repeated several times with the implant itself used as the final instrument to lift the bone and membrane when placed. Sinus lifts (augmentation) have been shown to greatly increase your chances for successful implants that can last for years to come.
Sinus augmentation has been shown to greatly increase your chances for successful implants that can last for years to come. Many patients experience minimal discomfort during this procedure.