For a predictable outcome, a dental implant should be placed as soon as the bone and gum tissues following a tooth extraction have healed. But what happens if the tooth has been missing for months or years? You might then run the risk of not having enough bone to properly place an implant.
This can happen because of a disruption in the growth cycle of living bone tissue. As older bone cells dissolve (resorption), new bone develops to take its place. This is a dynamic process, as the amount and exact location of the new growth is in response to changes in the mouth, particularly from forces generated by the teeth as we chew. If, however, this stimulation transmitted to the bone no longer occurs because the tooth is missing, the bone will tend to dissolve over time.
In fact, within the first year after a tooth loss the associated bone can lose as much as a quarter of its normal width. This is why we typically place bone grafting material in an empty socket at the same time as we extract the tooth. This encourages bone growth during the healing period in anticipation of installing a dental implant or a fixed bridge. If, however, the bone has diminished to less than required for a dental implant, we must then use techniques to encourage new bone growth to support a future implant.
One such technique for restoring bone in the back of the upper jaw is to surgically access the area through the maxillary sinus (a membrane-lined air space within the bone structure of the face) positioned just over the jawbone to place grafting material. During surgery performed usually with local anesthesia, the surgeon accesses the sinus cavity, lifts the tissue membrane up from the sinus floor and applies the grafting material on top of the bone. Eventually, the new bone growth will replace the grafting material.
If successful, the new bone growth will be sufficient to support an implant. Thanks to this renewed growth, you’ll soon be able to enjoy better function and a transformed smile provided by your new implant.
If you would like more information on forming new bone for implants through sinus 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 “Sinus Surgery.”
When the dentist starts talking to you about dental implants, you may have a lot of questions. One of those questions may be about the many different ways that dental implants can be done. Dr. Jason Botts in Cordova wants you to be informed about the different types of dental implants available.
What are Dental Implants?
Dental implants are a permanent alternative to dentures for missing teeth. Dental implants use a metal frame or post that is placed into the jawbone. The post or frame behaves like a root to your replacement teeth. Once the implant is placed, the implant will fuse to your jawbone in a process called osseointegration. Osseointegration can take several months, but this is what will make your dental implants so strong and secure, giving you the look and feel of natural teeth.
Types of Dental Implants
Modern dental implants not only help you maintain your normal chewing ability and speech patterns after you have lost a tooth or teeth — they also keep you looking younger. How do they do this? Read on.
Do lost teeth cause tooth-supporting bone to “melt” away? Yes. Of course, the bone does not actually melt. Bone is a living tissue, and under normal conditions it constantly dissolves and rebuilds. Stimulation by the small stresses from the contact of upper and lower teeth — something that normally happens hundreds of times each day — keeps these two forces in balance. When a tooth is missing, the bone that normally surrounds and supports the tooth (called alveolar bone) no longer receives the stimulation that causes it to rebuild, and it begins to diminish over time.
What happens if you don't replace missing teeth? The first year after a tooth is lost, the width of the bone that once surrounded the tooth decreases by 25 percent. Over the years, gradually increasing bone loss results in sunken cheeks and lips, making you look older. Gum tissue also decreases, affecting your ability to chew and speak.
What happens if you lose all your teeth? For people who have lost all their teeth, called edentulous, the effects are severe. After the alveolar bone is lost, the bone beneath it, called basal bone, also begins to be resorbed, eventually causing the lower part of the face to partially collapse.
Do partial or full dentures prevent bone loss? Unfortunately, just the contrary is true. A removable denture pressing on a person's gum increases bone loss because the pressures from biting are not transferred into the internal structure of the bone but instead are compressive, which damages the bone over time. This is why dentures begin to fit poorly after they have been worn for a while. This problem can be reduced by anchoring dentures with strategically placed dental implants.
What is a dental implant? A dental implant is a tooth-root replacement that is made of titanium. This metal is able to osseointegrate, or fuse with the bone. For a single tooth replacement, a crown that looks and functions like natural tooth is attached to the titanium implant. As mentioned above, implants can also be used to anchor dentures.
Does an implant prevent bone loss? Yes. When dental implants fuse to the jaw bone, they stabilize the bone. They also provide tooth-to-tooth stimulation that was formerly supplied by the natural tooth.
How long do dental implants last? Dental implants have been shown to last at least 10 years. For most people, implants will last the rest of their lives.
Contact us today to schedule an appointment to discuss your questions about tooth loss and dental implants. You can also learn more by reading the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”
One of the many reasons for dental implant popularity is their reliability — studies have shown 95% of implants still function well after ten years. Still, on rare occasions an implant will fail. We can minimize this risk by taking precautions before, during and after installation.
Long-term success begins with careful planning before surgery. We thoroughly examine your teeth and jaws, using x-rays or CT scanning to map out the exact location of nerves, sinus cavities and other anatomical structures. Along with your medical history, this data will help us develop a precise guide to use during implant surgery.
We’ll also assess bone quality at the intended implant site. The implant needs an adequate amount of bone for support — without it the implant will not be able to withstand the biting force of normal chewing. It may be possible in some cases to use bone grafting or similar techniques to stimulate growth at the site, but sometimes other restoration options may need to be considered.
The surgery can also impact future reliability. By precisely following the surgical guide developed during the planning stage, the oral surgeon can increase the chances of success. Still, there may be an unseen variable in play — a pre-existing or post-operative infection, for example, that interferes with the integration of the implant with the bone. By carefully monitoring the healing process, we can detect if this has taken place; if so, the implant is removed, the area cleansed and the implant (or a wider implant) re-installed.
Even if all goes well with the implantation, there’s still a chance of future failure due to gum disease. Caused mainly by bacterial plaque, gum disease infects and inflames the supporting tissues around the teeth; in the case of implants it could eventually infect and weaken the surrounding bone, a condition known as peri-implantitis. This calls for aggressive treatment, including plaque and infected tissue removal, and possible surgery to repair the bone’s attachment to the implant. Without treatment, the implant could eventually detach from the weakened bone.
Maintaining your implants with good oral hygiene and regular dental checkups is the best insurance for long-term reliability. Taking care of them as you would natural teeth will help ensure a long, happy life for your “third set” of teeth.
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.”
In a recent study, 92% of dental implants were found to have survived the twenty-year mark — an impressive track record for any dental restoration.
Still, implants do fail, although rarely. Of those failures, tobacco smokers experience them twice as often as non-smokers. The incidence of early failure (within the first few months after implantation) is even higher for smokers.
Early implant failure typically happens because the titanium implant and the surrounding bone fail to integrate properly. Titanium has a natural affinity with bone — the surrounding bone will attach and grow to the titanium in the weeks after surgery, forming a strong bond. An infection around the implant site, however, can inhibit this integration and result in a weaker attachment between bone and implant. This weakness increases the chance the implant will be lost once it encounters the normal biting forces in the mouth.
Smokers have a higher risk of this kind of infection because of the way tobacco smoke alters the environment of the mouth. Inhaled smoke burns the mouth’s top skin layers and creates a thick layer of skin called keratosis in its place. Smoke also damages salivary glands so that they don’t produce enough saliva to neutralize the acid from food that’s left in the mouth after eating. This creates an environment conducive to the growth of infection-causing bacteria. At the same time, the nicotine in tobacco can constrict the mouth’s blood vessels inhibiting blood flow. The body’s abilities to heal and fight infection are adversely affected by this reduced blood flow.
The best way for a smoker to reduce this early failure risk is to quit smoking altogether a few weeks before you undergo implant surgery. If you’re unable to quit, then you should stop smoking a week before your implant surgery and continue to abstain from smoking for two weeks after. It’s also important for you to maintain good brushing and flossing habits, and semi-annual dental cleanings and checkups.
Although smoking only slightly raises the chances of implant failure, the habit should be factored into your decision to undergo implant surgery. Quitting smoking, on the other hand, can improve your chances of a successful outcome with your implants — and benefit your life and health as well.