Posts for tag: dental implants
Among dental restorations, implants are the closest prosthetic we have to real teeth. They not only replace the visible crown, but the titanium post imbedded in the jawbone adequately substitutes for the tooth root. Because of their unique design, implants are not only life-like, they’re highly durable and could potentially last for decades.
But while their success rate is remarkably high (more than 95% exceed the ten-year mark), they can fail. Ironically, one possible cause for implant failure is periodontal (gum) disease. Although an implant’s materials are themselves impervious to disease, the tissues and underlying bone that support the implant aren’t. If these natural tissues become infected, the secure hold the implant has can weaken and fail.
A gum infection usually begins with dental plaque, a thin biofilm of bacteria and food particles that builds up on tooth surfaces. Certain strains of bacteria within plaque can infect the gums. One particular form of the disease known as peri-implantitis starts as an initial infection and ensuing inflammation of gum tissues around an implant. The disease can quickly spread down to the bone and destroy the integration between the bone and the implant that helps keep the implant in place.
That’s why it’s important for you to keep the implant and the tissues around it clean of plaque, just as you would the rest of your natural teeth. This requires daily brushing and flossing around the implant and other teeth, and visiting your dentist regularly for more thorough dental cleanings.
You should also be alert to any signs of disease, especially around implants: gum redness, swelling, bleeding or pus formation. Because of the rapidity with which peri-implantitis can spread, you should see your dentist as soon as possible if you notice any of these signs.
Preventing gum disease, and treating it promptly if it occurs, is a key part of implant longevity. Preserving your overall dental health will help make sure your implant doesn’t become a loss statistic.
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.”
Losing a tooth from disease or accident can be traumatic. The good news, though, is that it can be replaced with a life-like replica that restores your smile. One of the most popular and durable solutions is a dental implant, which replaces not only the root of the tooth but the crown as well.
But there's a possible wrinkle with implants — for accurate placement there must be a sufficient amount of bone around it. This could be a problem if you've been missing the tooth for sometime: without the stimulus provided by a tooth as you chew, older bone cells aren't replaced at an adequate rate. The bone volume gradually diminishes, as up to 25% of its normal width can be lost during the first year after tooth loss. A traumatic injury can damage underlying bone to an even greater extent.
There is a possible solution, but it will require the services of other specialists, particularly a periodontist trained in gum and bone structure. The first step is a complete examination of the mouth to gauge the true extent of any bone loss. While x-rays play a crucial role, a CT scan in particular provides a three-dimensional view of the jaw and more detail on any bone loss.
With a more accurate bone loss picture, we can then set about actually creating new bone through grafting procedures. One such technique is called a ridge augmentation: after opening the gum tissues, we place the bone graft within a barrier membrane to protect it. Over time the bone will grow replacing both the grafting material and membrane structure.
Once we have enough regenerated bone, we can then perform dental implant surgery. There are two options: a “one-stage” procedure in which a temporary crown is placed on the implant immediately after surgery; or a “two-stage” in which we place the gum tissue over the implant to protect it as it heals and bone grows and attaches to it. In cases of pre-surgical bone grafting, it's usually best to go with the two-stage procedure for maximum protection while the bone strengthens around it.
Necessary preparation of the bone for a future dental implant takes time. But the extra effort will pay off with a new smile you'll be proud to display.
There’s a lot to like about replacing a missing tooth with a dental implant. This state-of-the-art restoration is by far the most durable and life-like option available. And unlike other replacement options implants stimulate bone growth, a major concern after tooth loss.
For that reason we encourage getting an implant as soon as possible — for adults, that is. We don’t recommend implants for younger patients because even a teenager’s jaws haven’t yet reached full maturity. Because it attaches to the jaw differently, an implant can’t move with the growing jaw as real teeth do. It would eventually look as if it were sinking into the jaw below the gum line or being left behind as the rest of the jaw grows.
It’s best, then, to postpone placing an implant until the jaw fully matures, usually in a patient’s early twenties. In the meantime, there are some things we can do to prepare for a future implant while also restoring the tooth with a temporary replacement.
As previously mentioned, our biggest concern is bone health. Like other living tissue, bone has a growth cycle of older cells dissolving and newer ones forming in their place. The teeth transmit the pressure produced when we chew to the bone to stimulate this growth. With the absence of a tooth, the adjacent bone no longer receives this stimulation — the growth cycle slows and may eventually lead to bone loss.
We can help this situation by placing a bone graft in the missing tooth socket at the time of extraction. The graft serves as a scaffold that’s eventually taken over and replaced by new bone growth. We can also try to control how fast the graft is replaced by using grafting material that’s slowly removed and lasts longer — often a preferable situation if an implant is years away.
As for appearance, we can create a custom partial denture or even a type of bridge that bonds a prosthetic tooth to neighboring teeth without significantly altering them. If the patient undergoes orthodontic treatment it’s also possible to add prosthetic teeth to an orthodontic appliance.
Eventually, we’ll be able to provide the permanent solution of a dental implant. With careful planning and measures to preserve bone health, there’s a good chance the outcome will be worth the wait.
If you would like more information on treatments for lost teeth in children and teenagers, 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 for Teenagers.”
You’ve decided to obtain dental implants for your missing teeth. It’s a good choice — they provide the closest restoration to the function and appearance of natural teeth. You will, however, need to undergo a surgical procedure to imbed the implants’ threaded titanium posts into supporting bone.
It’s understandable if you’re a little apprehensive about undergoing surgery. We’re here, though, to set your mind at ease: implantation is a relatively minor procedure carefully planned in advance. Most patients experience no discomfort during the procedure and very little afterward.
We begin by completely numbing the surgical site with a local anesthetic. If you have a high level of anxiety, we can also administer a sedative or similar medication to help you relax. We then access the underlying bone through a series of incisions that create a flap in the gum tissue that we’ll later suture closed.
It’s quite common to have prepared a surgical guide or template beforehand. The template placed in the mouth marks the exact site for a small channel (or hole) we create in the bone. We then incrementally increase the size of the hole by drilling until it matches precisely the implant’s size and shape. This takes time to avoid overheating and damaging the bone.
We then remove the implant from its sterile packaging and insert it into the opening. We’ll also take x-rays to ensure correct positioning, which is critical for achieving an attractive result. We then suture the gum flap in place using stitches that will eventually dissolve. The implant will then integrate with the bone for a few weeks to create a strong, durable hold before we continue with the restoration.
Most patients can manage any post-surgical discomfort with mild anti-inflammatory pain relievers like aspirin or ibuprofen, although we can prescribe something stronger if you need it. We may also prescribe a mouthrinse with an anti-bacterial agent like chlorhexidine for you to use while the gums are healing to reduce the risk of infection.
Implant surgery is part of a long process that will eventually result in regaining the function of your lost teeth. What’s more, undergoing this minor procedure will also help you regain something just as important — a beautiful smile.
If you would like more information on dental implant 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 “Dental Implant Surgery.”