Posts for tag: dental implants
Even with modern prevention and treatment advances, losing teeth in later life is still a sad but common part of human experience. Just as generations have before, many today rely on dentures to regain their lost dental function and smile.
But although effective, dentures have their weaknesses. The most serious: they can't prevent jawbone deterioration, a common problem associated with tooth loss.
Bone health depends on chewing forces applied to the teeth to stimulate replacement growth for older bone cells. When teeth are gone, so is this stimulation. Dentures can't replicate the stimulus and may even accelerate bone loss because they can irritate the bone under the gums as they rest upon them for support.
But there's a recent advance in denture technology that may help slow or even stop potential bone loss. The advance incorporates implants with dentures to create two hybrid alternatives that may be more secure and healthier for the supporting bone.
The first is known as an overdenture, a removable appliance similar to a traditional denture. But instead of deriving its support from the gums alone, the overdenture attaches to three to four implants (or only two, if on the lower jaw) that have been permanently set into the jawbone. This not only increases stability, but the implants made of bone-friendly titanium attract and foster increased bone growth around them. This can help slow or even stop the cycle of bone loss with missing teeth.
The second type is a fixed denture. In this version, four to six implants are implanted around the jaw arch. The denture is then secured in place to these implants with screws. It's a little more secure than the overdenture, but it's also more expensive and requires good quality bone at the implant sites.
If you've already experienced significant bone loss you may first need bone grafting to build up the implant sites for these options, or choose traditional dentures instead. But if you're a good candidate for an implant-supported denture, you may find it provides better support and less risk of continuing bone loss than traditional dentures.
If you would like more information on implant-supported dental restorations, 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.”
We've been using bridges to replace missing teeth for decades. Now, recently-developed implant-supported bridges are even more dependable, promising greater durability and less interference with remaining natural teeth.
But just like other restorations, you'll need to keep implant bridges clean to ensure their longevity. Although both the bridge and implants are impervious to disease, the supporting gums and bone aren't. If they become infected, they can break down and your restoration will fail.
Cleaning an implant-supported bridge includes flossing around each of the implants to remove dental plaque, a thin film of food particles and bacteria most responsible for dental disease. To perform this task, you'll have to pass the floss between the bridge and gums to access the sides of each implant.
To help make it easier, you can use a tool like a floss threader, a thin, shaft-like device with a loop on one end and a needle-like point on the other. You'll first thread about 18" of floss through the end and then pass the threader between the bridge and gums with the sharp end toward the tongue.
With the threader completely through, you'll then wrap the floss around your fingers as with regular flossing and move the floss up and down each side of the implants you can access. You'll then pull the floss out, reload the threader and move to the next section, repeating this process until you've flossed each side of each implant.
You can also use pre-cut floss with a stiffened end to thread between the bridge and gums or an interproximal brush with a thin bristled head that can reach underneath the bridge. And you might consider using an oral irrigator, a pump device that sprays a stream of pressurized water to remove and flush away plaque around implants.
To round out your hygiene efforts, be sure you visit your dentist at least twice a year for dental cleanings. Your dentist can also advise you and give you training on keeping your implants clear of disease-causing plaque. Cleaning around your implants will help ensure your restoration will last.
If you would like more information on caring for your dental restoration, 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 “Oral Hygiene for Fixed Bridgework.”
Placing a dental implant within the jawbone requires a surgical procedure. For most people it’s a relatively minor affair, but for some with certain health conditions it might be otherwise. Because of their condition they might have an increased risk for a bacterial infection afterward that could interfere with the implant’s integration with the bone and lead to possible failure.
To lower this risk, dentists for many years have routinely prescribed an antibiotic for patients considered at high-risk for infection to take before their implant surgery. But there’s been a lively debate among health practitioners about the true necessity for this practice and whether it’s worth the possible side effects that can accompany taking antibiotics.
While the practice still continues, current guidelines now recommend it for fewer health conditions. The American Dental Association (ADA) together with the American Heart Association (AHA) now recommend antibiotics only for surgical patients who have prosthetic heart valves, a history of infective endocarditis, a heart transplant or certain congenital heart conditions.
But patients with prosthetic joint replacements, who were once included in the recommendation for pre-surgical antibiotics, are no longer in that category. Even so, some orthopedic surgeons continue to recommend it for their joint replacement patients out of concern that a post-surgical infection could adversely affect their replaced joints.
But while these areas of disagreement about pre-surgical antibiotics still continue, a consensus may be emerging about a possible “sweet spot” in administering the therapy. Evidence from recent studies indicates just a small dose of antibiotics administered an hour before surgery may be sufficient to reduce the risk of infection-related implant failure with only minimal risk of side effects from the drug.
Because pre-surgical antibiotic therapy can be a complicated matter, it’s best that you discuss with both the physician caring for your health condition and your dentist about whether you should undergo this option to reduce the infection risk with your own implant surgery. Still, if all the factors surrounding your health indicate it, this antibiotic therapy might help you avoid losing an implant to infection.
If you would like more information on antibiotics before implant surgery, 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.”
Every year dentists place over 5 million dental implants for lost teeth, often removing the problem tooth and installing the implant at the same time. But getting a “tooth in a day” depends on a number of health factors, especially whether or not there’s adequate bone available for the implant. Otherwise, the implant’s placement accuracy and success could be compromised.
Bone loss can be a similar problem when a tooth has been missing for a long period of time. If this describes your situation, you may have already lost substantial bone in your jaw. To understand why, we need to know a little about bone’s growth cycle.
When bone cells reach the end of their useful life, they’re absorbed into the body by a process called resorption. New cells then form to take the older cells’ place in a continuous cycle that keeps the bone healthy and strong. Forces generated when we chew travel through the teeth to the bone and help stimulate this growth. But when a tooth is missing, the bone doesn’t receive this stimulus. As a result, the bone may not replace itself at a healthy rate and diminish over time.
In extreme cases, we may need to consider some other dental restoration other than an implant. But if the bone loss isn’t too severe, we may be able to help increase it through bone grafting. We insert safe bone grafting material prepared in a lab directly into the jaw through a minor surgical procedure. The graft then acts like a scaffold for bone cells to form and grow upon. In a few months enough new bone may have formed to support an implant.
Bone grafting can also be used if you’re having a tooth removed to preserve the bone even if you’re not yet ready to obtain an implant. By placing a bone graft immediately after extraction, it’s possible to retain the bone for up to ten years—enough time to decide on your options for permanent restoration.
Whatever your situation, it’s important that you visit us as soon as possible for a complete examination. Afterward we can assess your options and hopefully come up with a treatment strategy that will eventually include smile-transforming dental implants.
Although dental implants are best known as single tooth replacements, they can actually play a role in multiple or complete tooth loss (edentulism) restorations. While replacing multiple teeth with individual implants is quite expensive, there’s another way to incorporate them in a restoration at much less cost — as supports for bridges.
In this case, only a few strategically placed implants are needed to support restorations of multiple crowns fused together into a single unit. Implant-based bridges consist of two main types: the first type is a fixed bridge, which is permanently attached to the implants and can’t be removed by the patient. It’s often the preferred treatment for patients who’ve lost most or all of their teeth but have not yet experienced significant bone loss in the jaw.
This choice, however, may not be the best option for patients with significant bone loss. In these cases, there’s a second type of fixed bridge: an implant-supported fixed denture. This type of fixed denture provides support for the lost bone support of the lips and cheeks. If a fixed bridge is not possible due to finances or inadequate bone support to place 4 to 6 implants, a removable denture (also known as an overdenture) that’s supported and held in place by implants is the next best alternative. Unlike a fixed bridge, an overdenture can be removed by the patient for cleaning purposes, and will require less investment than a fixed bridge.
For people with bone loss, the overdenture does more than restore chewing and speech function. Because bone loss can diminish support of the facial structures — actually shorten the distance between the chin and the tip of the nose — an overdenture provides additional bulk to support these structures to improve appearance. Depending on what the patient needs for facial support, overdentures for the upper jaw can be designed as “full palates,” meaning the denture plastic completely covers the upper jaw palate, or open in which the plastic doesn’t completely cover the palate.
Besides the condition of your teeth, gums and bone, your own personal preferences and financial ability will also play a role in which option is best for you. After considering all these factors, we can recommend which of these types of implant-based restorations will fit your needs. With either bridge, fixed or removable, you’ll certainly benefit from the improvement to both your mouth function and your smile.
If you would like more information on implant-supported bridges, 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 “Fixed vs. Removable.”