Millions of people throughout the world now have a better quality of life because of dental implants. Dental implants are the only tooth replacement option that preserves bone and doesn’t compromise the health of adjacent teeth — and they can potentially last a lifetime. Implants are today’s preferred choice for restoring your natural smile with replacements that look, feel and function like natural teeth.
In Part One of our series we discussed the problems that follow tooth loss — the loss of alveolar (tooth-supporting) bone, changes to the face and jaws — and the subsequent impact on personal and social well-being. Maintaining alveolar bone is necessary for proper tooth replacement with dental implants, which are state of the art dentistry. We also considered other tooth replacement alternatives and why implants, long term, are the most cost effective.
In Part Two, we’ll discuss the most suitable dental health professionals for both placing implants and fabricating the teeth that attach to them. We’ll also give advice on where to go — and why, as well as when and how to make these important choices.
Crown Manufacture and Placement
After the successful osseointegration (osseo – bone, integrate – join or fuse with) of the implant(s) to the jawbone your general dentist or prosthodontist (crown and bridge specialist), together with a skilled laboratory technician, will make a crown to fit on top of the implant that will precisely mimic a normal tooth both in form and function. Even this is not a simple task. It requires accurate record-taking and the transfer of this information to the dental laboratory for “abutment” fabrication (the part that fits into the implant and holds the crown in place). The crown of the tooth is then made of porcelain-like materials that look and function exactly like natural teeth. Implant success rates are extremely high and give patients many years of function and satisfaction.
Technical Challenges — Aesthetic Areas and “Teeth In A Day”
Achieving acceptable aesthetic results with implants is most challenging in highly visible areas like the front of the mouth, particularly in people who show not only teeth but the gum tissues as well. In these cases the whole tooth/gum tissue complex must be recreated including the papillae, the pink gum tissues that fill the triangular spaces between healthy teeth. It’s at this point where knowledge and experience really come to the forefront.
There is a lot of advertising about “teeth in a day” where implant results can seemingly be achieved in a lot less time. In the right circumstances where multiple implants replace missing teeth, and where crowns (the portion of the teeth you see in the mouth) can be attached to them in such a way as to prevent any movement, “teeth in a day” is a possibility. This is accomplished by “splinting” the crowns to multiple implants — a precise fitting splint that keeps them movement free. However, this still requires multiple appointments for proper assessment, diagnosis and treatment-planning prior to “teeth in a day.” It also requires experience, great precision and care.
In some instances implants can be placed directly into extraction sockets and occasionally temporary crowns placed simultaneously. This also includes single tooth replacement, but stabilizing an implant in this situation is even more precarious and critical for success.
Our advice can be distilled to this: successful dental implant treatment can’t be accomplished overnight and shouldn’t be hurried. Anyone who is serious about dental implant treatment should first secure the services of well-trained and experienced dental professionals. Embracing this prudent route will greatly enhance the chances of a successful outcome.
Insufficient Bone — “Regeneration” In Our Generation
Sufficient bone volume for implant placement is vitally important to proper tooth placement resulting in both the most natural-looking and properly functioning tooth. Today there is general scientific agreement supporting the concept that when a tooth is removed a bone graft placed into the extraction site will minimize inevitable melting away of bone or “resorption.” Maintaining “bone volume” following removal of a tooth will facilitate implant placement in the best possible position.
Understanding the principles of wound healing now allows for regeneration of bone to occur using a variety of techniques. Most include opening the gingival (gum) tissues to expose the bone and then augmenting the existing or remaining bone by adding bone grafting materials to it. Healing of the bone can be enhanced by the utilization of membranes which cover the grafts and act like little subterranean band-aids to “guide bone regeneration.” Along with other biologically active molecules (found normally in the body) these techniques promote and enhance healing. In addition, excellent techniques exist for replacing and adding gingival gum tissues.
These surgical procedures are generally carried out by a periodontist or oral surgeon skilled and experienced in these techniques, especially in advanced situations. When creating new bone for implant placement, particularly in the upper jaw where sinuses are involved and bone grafting is necessary, these procedures are more predictably carried out in the hands of a specialist or a general dentist who has taken special and advanced training.