Dental implants for tooth replacement

Base Info

Dental implants for tooth replacement

by: Dr. Gina Sohn | .
. | .
published: March 10, 2014

Your teeth are designed to last a lifetime but sometimes they don’t.

Replacing missing teeth is important to your general health and to the health of your other teeth. Not only do you lose chewing ability when a tooth is lost, but unreplaced teeth can cause other teeth to be lost, tipped or crowded and create subsequent problems. Also, there are obvious problems of poor appearance and loss of self esteem caused by one or more missing teeth especially on the front teeth.

There are options for replacing missing teeth ; Bridges, dentures and implants.

Dental implants should always be considered as the first option to replace a failing or missing tooth. Replacement of missing teeth with implants has been used for more than 50 years and as recognized as an effective treatment choice. Treatment prognosis is considered more predictable than traditional bridgeworks and removable dentures.
Implants may be the right choice for anyone missing teeth due to injury, disease or decay. They are especially practical for patients who can no longer wear removable dentures.

Implant patients are of all age and it can be determined if you are a good candidate after a careful evaluation of your dental and medical history.
It is important for patients to have enough bone to support the implants. If you do not have enough bone, there are many safe and effective ways to correct bone deficiency and grow certain amount of bone.

Treatment time can vary greatly depending on your needs.

Classical Two Step Procedure

First Surgery
The implant site is prepared. The selected size of implant is placed. Gum tissue is sutured over the implant. The implant takes 3-4 months to fuse with bone.

Second surgery
The implant is uncovered and the appropriate abutment is attached to the implant. A mold of the abutment is taken and sent to the lab for the fabrication of the implant crown. For certain types of implants, second surgery to uncover the implant is not required.

Immediate Implant Placement
When the tooth has to be extracted, and the implant is a choice of treatment for the substitution of the tooth, immediate placement of implant into extracted site is recommended.

When implants are placed into the socket immediately after extraction, osseointegration process of implants speeds up as our body naturally fills the gap between the extraction socket and the implant with bone.

After extraction, we would wait 3-6 months for the extraction socket to be filled with bone, and then proceed with the implant surgery. The immediate placement of implants eliminates this waiting period. However, if the tooth is infected, immediate dental implant placement is not advisable.

Same day Implants and Teeth
In this technique, a failed tooth is removed, an implant Is placed and a temporary crown is immediately placed to avoid the “toothless look” that some patients are afraid of.

This procedure is not for everyone, though.

In order to do this procedure, certain criteria have to be met. There has to be adequate bone, a large enough implant needs to be placed, and the implant once placed has to show sufficient initial stability. And more importantly, the temporary crown has to be adjusted so that no forces are placed on it during teeth function in all directions. Meeting these criteria allows the bone to grow around the implant and a permanent crown can be placed after 9-12 weeks.

The success of dental implants depends on whether there is a sufficient volume of healthy bone at the recipient site at the time of implant placement. After tooth extraction, the alveolar ridge will commonly decrease in volume and change morphologically. If bone resorption is significant enough, then placement of an implant may become extremely challenging.
Today, we have the ability to grow bone where needed. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and aesthetic appearance.

Recent advances in bone grafting materials and techniques allow us to place implants in sites that were considered compromised in the past. The graft material can be either an autograft (your own bone), an allograft (bone from other human beings; disease free immune frees), a xenograft (from other species), an alloplast (Synthetic bone), or combination thereof.

Sinus Lift
The maxillary sinuses are behind your cheeks and on top of the upper teeth. These are air-filled spaces that everyone has. Often the roots of the natural upper teeth extend up into the maxillary sinuses. With age and tooth loss, the upper jawbone shrinks and the sinus enlarges. When these upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. This often makes a patient a poor implant candidate. Dental implants need bone to hold them in place. In order to increase bone height, the base of sinus is elevated and filled with bone graft material. And it’s called a sinus lift.

When Is The Right Time To Place Dental Implants In Teenagers
This is an important question and the current wisdom is not to have implants placed until jaw and facial growth are complete.

Although it varies from person to person, growth of the jaws in most cases is not complete until late teens. Consequently and most importantly, as the jaws continue to grow, the teeth will accommodate and move with jaw growth, but implants will not.

Of course, we are faced with the dilemma of waiting for the optimal time to place dental implants so that they will succeed on the one hand, and respecting the psychological needs of a teenager missing front teeth on the other. There are many other good interim options for temporarily replacing the teeth for a few years, both aesthetically and comfortably until implants can be placed. For example, temporary "fixed-in" options like bonded bridges can be attached to the adjacent teeth with little if any irreversible change to them. You should consult your dentist about them.

For these reasons, and since implants are a relatively permanent and best current solution to the problem of tooth replacement, it is better to wait until growth of the jaws and face is complete.

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