Posts for tag: dental implants
Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.
In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.
Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.
Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.
If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.
The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.
Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.
Dental implant technology has advanced at such an astounding rate in recent years that you can now walk into a dentist's office with a problem tooth and out the same day with a new one. Unfortunately, not all dental situations allow for this possibility.
For example, you might be considering an implant many years after losing a tooth. But there's a potential problem: there might not be enough supporting bone. While an implant might still be possible, inadequate bone complicates the matter.
Because implants are essentially tooth root replacements, they require a certain amount of bone for stability and the best attractive outcome. As a general rule, implants need to be surrounded by at least 1.5-2.0 millimeters of healthy bone to support an implant. But you might not have enough if your tooth has been missing for awhile, regardless if you have or haven't worn dentures or other restorations.
That's because bone has a life cycle in which older cells die and newer ones form to take their place. As we chew or bite, the force generated travels up through the teeth to the bone to stimulate this new growth. Without a tooth the bone doesn't receive this stimulus, which can slow the growth rate. Over time the affected bone can lose its volume and density.
If we find you've experienced loss to the point your bone won't support an implant, that doesn't automatically mean this popular restoration is out of the picture. But it will require us first performing a procedure known as augmentation or bone grafting to help rejuvenate some of the lost bone.
With grafting, we place processed bone grafting material in the jaw through a minor surgical procedure to form a scaffold for new bone to grow upon. After several months this can result in several millimeters of new growth maintaining the width of the underlying bone, which in turn may be able to support an implant.
Bone grafting is quite common, often performed at the same time as tooth extraction if there's going to be a time lag before installing an implant. Even if performed later, though, it can successfully rejuvenate lost bone and make it possible for you to take advantage of durable, life-like implants.
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 “Dental Implants after Previous Tooth Loss.”
Generations have depended on dentures to effectively and affordably replace lost teeth. But they do have a major weakness: They contribute to jawbone loss that creates not only mouth and facial problems, but can also ruin a denture’s fit.
Bone loss is a normal consequence of losing teeth. The biting forces normally generated when we chew stimulate new bone to replace older bone. When a tooth is missing, however, so is that chewing stimulation. This can slow bone replacement growth and gradually decrease the density and volume of affected bone.
While dentures can restore dental appearance and function, they can’t restore this growth stimulation. What’s worse, the pressure of the dentures against the gum-covered jaw ridge they rest upon may irritate the underlying bone and accelerate loss.
But there is a solution to the problem of denture-related bone loss: an implant-supported denture. Rather than obtaining its major support from the gum ridges, this new type of denture is secured by strategically-placed implants that connect with it.
Besides the enhanced support they can provide to a denture restoration, implants can also deter bone loss. This is because of the special affinity bone cells have with an implant’s imbedded titanium post. The gradual growth of bone on and around the implant surface not only boosts the implant’s strength and durability, it can also improve bone health.
There are two types of implant-supported dentures. One is a removable appliance that connects with implants installed in the jaw (three or more for the upper jaw or as few as two in the lower). It may also be possible to retrofit existing dentures to connect with implants.
The other type is a fixed appliance a dentist permanently installs by screwing it into anywhere from four and six implants. The fixed implant-supported denture is closer to the feel of real teeth (you’ll brush and floss normally), but it’s usually more costly than the removable implant-supported denture.
While more expensive than traditional ones, implant-supported dentures still cost less than other restorations like individual implant tooth replacements. They may also help deter bone loss, which may lead to a longer lasting fit with the dentures. Visit your dentist for an evaluation of your dental condition to see if you’re a good candidate for this advanced form of dental restoration.
If you would like more information on implant-supported dentures, 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 “Overdentures & Fixed Dentures.”
If you’re considering different options for tooth replacement, dental implants are likely high on your list. Implants have a proven reputation for both durability and life-like appearance that can restore mouth function and revitalize your smile.
There is one aspect concerning implants, however, which gives people pause — the surgical procedure required to place the implants in the jawbone. If you’re leery about undergoing this procedure we can put your mind at ease — for most patients implant surgery is a minor, pain-free process with little discomfort afterward.
While there are variations in style, implants generally have two major components: a titanium post that’s implanted into the jawbone and a permanent life-like crown that’s affixed 6 to 12 weeks after implant surgery. Titanium is the metal of choice because of its affinity with bone cells; over time bone will grow to and attach itself around the implant, a process known as osseo-integration. The metal post is normally spiral in shape, allowing it more surface area for bone to adhere to.
In the beginning of the procedure we administer local anesthesia to fully numb the area before proceeding. After accessing the bone through tiny incisions in the gum tissue, we create a small channel in the exposed bone. A surgical guide may be used to prepare the precise location for the implant with a series of drilling sequences that increases the channel until it matches the implant size. While this takes place, you should only feel a mild vibration and a little pressure from the drill.
The implants are then removed from their sterile packaging and placed immediately into the prepared site. The gum tissues are then sutured into place with self-absorbing sutures. Most people have only mild discomfort after the surgery that can be managed with a prescription-strength non-steroidal anti-inflammatory drug like ibuprofen. We may also prescribe antibiotics and other care instructions to ensure successful gum tissue healing.
With proper planning and precise implant placement by skilled hands, implant surgery is an easy and uneventful procedure. And, with your new crowns in place, your new, beautiful smile will make the experience a distant memory.
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 “Dental Implant Surgery.”
Restoring a smile with implants involves more than the surgical procedure itself. We must also take into consideration the quality of the bone they’re placed into and the gums that will surround them — the “canvas” that showcases your new beautiful smile.
Bone — not only at the missing tooth site but supporting neighboring teeth as well — is the foundation for a successful implant. Without an adequate amount of bone, we can’t place an implant to achieve a final life-like appearance. Inadequate bone can be a problem if the tooth has been missing for awhile — without the stimulation of biting forces from the tooth, the bone can shrink gradually over time. Periodontal (gum) disease and other dental conditions can also cause bone loss.
The health of your gums — as well as the tissue type you’ve inherited from your parents, thin or thick — can also determine how natural the implant crown looks as it emerges from them. If they’ve receded due to gum disease they may not regenerate sufficiently, making your teeth longer-looking or leaving the triangular bit of gum tissue between the teeth, the papillae, noticeably missing. If you’ve inherited thin tissue gums, you’re also more susceptible to gum recession and there’s less margin for error during implant surgery.
There are some things we can do to minimize these problems. Tooth removal to make room for the new implant needs to be done carefully with as little tissue trauma as possible; it’s also helpful to place grafting material in the empty socket immediately after extraction, especially if there’s going to be a time gap before implant placement. If bone loss has already occurred, we can also use similar grafting techniques to rebuild the bone.
Likewise we need to take special care during implant surgery when dealing with thin or diseased gums. With the latter, it’s usually necessary to bring the gum disease under control and allow the gums to heal first. In extreme cases, cosmetic gum surgery may also help restore lost tissues and create a more natural look between the gums and the implant crown.
Creating a natural appearance with implants is a blend of technical skill and artistic insight. Keeping the balance between all these factors will produce a smile you’ll be proud to show.
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 “Matching Teeth & Implants.”