Dental implants have emerged as the premier replacement option for lost teeth. Their life-like appearance, durability and versatility have made them extremely popular with patients.
Implants aren’t a quick fix, though: in most cases the process takes months to complete. Here’s a chronological overview of what you can expect if you decide on dental implants.
Stage 1: Planning. The process begins at least a few weeks before the actual implantation with an examination to determine what’s best for your individual case. Implant materials and designs are quite numerous, enabling us to precisely match individual tooth types, shapes, lengths and color. We then use x-rays or CT scanning to identify the best locations for the implants — careful planning here increases the chances that implantation will go smoothly and the final outcome will be aesthetically pleasing.
Stage 2: Implantation. Once we’ve finished planning, it’s time to surgically insert the titanium implants into the pre-determined locations in the jawbone identified during Stage 1. While this procedure is relatively minor and routine, the surgeon still operates with precision and care to ensure the best functional and aesthetic outcome.
Stage 3: Integration. In most cases after implantation, we’ll need to wait for a few weeks before attaching the final crowns. Because bone has an affinity for titanium, it will grow and adhere to the implant during this waiting period, anchoring it securely into the bone that will increase its long-term durability. We attach temporary teeth made of acrylic plastic (along with giving you some precautions on biting and chewing) to help you function normally during the waiting period.
Stage 4: A Transformed Smile! Once integration has been achieved and the gum tissues fully healed, we can then attach the permanent crowns. These crowns are typically made of strong, durable materials that will fit the healed gum tissues more precisely than your temporary crowns. Depending on the type of implant used, the crowns are either cemented or screwed into place onto the implant.
The process of dental implantation involves a lot of time, effort and precision. In the end, though, it’s well worth it — the joy of new teeth that will function well for years and look great too!
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 “New Teeth in One Day.”
Once you receive your dental implants, you can have peace-of-mind in knowing that you have chosen a successful tooth replacement option, with long-term success rates of well over 95%. Your implant will look, feel and function just like the natural teeth that it has replaced.
However, despite the natural appearance, when you visit us for a regular cleaning, you may notice that we are using special instruments to clean around the implant. Cleaning around implants differs from the maintenance of your natural teeth for two reasons:
Cleaning implants is just as important as cleaning natural teeth, because both depend on healthy surrounding tissues for support. Just as bacterial biofilm (plaque) collects on your natural teeth, it can also collect on your implant. That is why it is very important to brush and floss thoroughly on a daily basis at home. Without daily biofilm removal, the gums surrounding your implant can become infected, leading to bone loss and eventually loss of the implant.
Your regular dental cleanings will also play an important role in keeping dental implants infection-free, and we will select the right instruments for a professional cleaning. We will ensure that these instruments will not damage the crown, abutment, or the implant itself. If implants are scratched, they can attract and harbor bacteria. That's why the instruments we use, called scalers and curettes, are most often made of plastics and resins. Natural teeth don't scratch in the same way, and therefore metal instruments need to be used to clean them.
A number of power instruments have nylon or plastic sheaths or tips to minimize implant damage. They clean by using high-frequency vibration, which may be necessary if large quantities of debris have accumulated on your implant. We use these on a low power setting with a lot of water irrigation, and sometimes antibacterial solutions, to clean and flush material.
When it comes to keeping your implants infection-free, keep in mind that the most successful formula will be consistent oral hygiene at home mixed with regular dental cleanings.
If you would like more information about maintaining your dental implants, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Dental Implant Maintenance.”
You may be considering dental implants for a lot of reasons: durability, functionality and imperviousness to decay. But perhaps the winning reason is how they will make you look — their life-like quality can restore a smile marred by missing or disfigured teeth. Achieving that result, though, requires your dental team to determine beforehand the state of your bone and gums, and treat any conditions that would interfere with the final result.
The first area to look at is the amount of bone available to support the implant. An adequate amount is necessary not only to stabilize the implant, but to also ensure proper placement needed to achieve the best “smile” result. Your specialist, then, will take steps to protect available bone during procedures, or even aid in building up the bone structure by inserting grafting materials that encourage new bone growth.
The degree of bone volume in adjacent natural teeth is also important because it can greatly affect the health of the papillae. This is the triangular-shaped gum tissue that occurs between each tooth that gives normal teeth their arched appearance. Insufficient bone in these areas could cause the papillae not to regenerate properly around the implant site, which creates unsightly dark spaces in the gum tissue known as “black hole disease.”
We must next consider the quality and health of your gum tissue. Patients whose gum tissue tends to be thin face difficulties during cosmetic surgical procedures; their thinner tissues are also more prone for objects behind them to be visible, including metal or other crown materials.
Our aim is an implant crown emerging from the surrounding gum tissue just as a natural tooth would. To achieve this requires knowing first what we have to work with regarding your bone and gums, and to address any issues that are problematic. One aid in this process is to affix a temporary “prototype” crown on the implant to wear while the permanent crown is manufactured. This allows you to “test-drive” the new look, and make adjustments in the final product regarding color and materials.
Accounting for all these factors — and then making adjustments along the way — will help ensure the final crown meets your expectations for function and appearance.
If you would like more information on the fabrication of implant crowns, 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.”
Normally, teeth erupt and grow in a symmetrical alignment: on the top palate, for example, the two central incisors take center stage; on either side are the lateral incisors, and then beside these the canines (cuspids).
But what happens when teeth don’t grow in? The result can be a smile that just doesn’t quite look right; more importantly, normal function is impaired because the person can’t grasp and chew food correctly.
These missing teeth are the result of a congenital (“from birth”) defect. It’s estimated that almost a quarter of all people are missing one or more wisdom teeth, and more than 5% are missing one or more second premolars or upper lateral incisors.
In a normal arch (the upper or lower set of teeth), each tooth type performs a particular role during eating. A missing tooth causes the remaining teeth to compensate, but beyond their capacity. The remaining teeth also tend to move to fill in any gaps left by the missing teeth, as when the eye teeth move toward the central incisors in the absence of the lateral incisors. This puts them out of position, so they can’t cover (“occlude”) their counterparts on the other arch and grasp food properly.
To improve the smile and restore proper chewing function it’s necessary to first move these “out of position” teeth to their correct position through orthodontics. We would then fill the gaps that result with life-like restorations (preferably dental implants with crowns) that resemble the type of tooth that should be there.
The restoration needs to be timed carefully, especially for young patients whose jaw structure has not fully developed. If implants are installed before the jaw’s full maturity (usually late teens or early twenties), the implant crowns may not appear to be the right length as the jawbone continues to grow. Since bone growth depends on the normal pressures exerted by the teeth, there may also be insufficient bone mass in the gap area to support a dental implant. Growing bone with bone-grafting material may be necessary before installing implants.
The total process could take many months or even years, depending on age and other conditions. In the end, though, the results can be astounding — better function and a vibrant, new smile.
If you would like more information on developmental problems with teeth, 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 “When Permanent Teeth Don’t Grow.”
There’s no doubt dental implants are an effective choice for restoring both the form and function of missing teeth. But although they aren’t susceptible to tooth decay as with natural teeth, the bone and gum tissues that surround them are. Implants, therefore, require the same cleaning and maintenance as natural teeth.
A dental implant is actually a root replacement, a titanium post surgically imbedded in the jawbone. Because titanium is osteophilic (“bone-loving”), bone will naturally grow around it, making the implant more secure over time. Atop the implant is an abutment to which an artificial crown, the visible portion of the implant, is attached. The abutment is surrounded and supported by connective fibers within the gum tissue that hold the tissue against the implant surface.
This attachment differs significantly from natural teeth’s attachment to the jawbone, which attach to a tooth’s root through the periodontal ligament. The tiny fibers of the ligament hold teeth in place; its elasticity allows for tiny adjustments in a tooth’s position in response to changes in other teeth and bone. The ligament is also rich in blood supply that enriches the area with nutrients and provides resources to fight and resist infection.
An implant doesn’t have this same degree of defense against infection. Without proper hygiene, a layer of bacterial plaque known as biofilm can develop on the crown surface of both natural teeth and restorations. In addition, an infectious condition specific to implants known as peri-implantitis can set in the gum tissues surrounding the implant. This can lead to bone loss (sometimes very rapid) and eventual loss of the implant.
Although your daily hygiene won’t require special toothbrushes or other devices for implant cleaning, your professional cleanings will. The metal instruments (known as curettes) used to clean natural teeth could damage implant surfaces. The hygienist will use devices made of plastic or resin rather than metal, and nylon or plastic sheaths or tips on ultrasonic equipment that are specially designed for implant cleaning.
While maintaining dental implants requires diligence on both your part and ours, implants remain an effective, long-term choice for dental restoration. In fact, some studies indicate upwards of 95% success rate. Proper hygiene will greatly increase your chances for many years of service from your implants.
If you would like more information on properly maintaining your 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 Maintenance.”