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Dental implants have revolutionized dentistry and transformed the lives of many people. Implants can restore a front tooth or even the entire smile of someone who has previously lost their teeth. Implants can be thought of as artificial roots that never decay and have a 95% success rate. Root form implants replace missing teeth without compromising or affecting neighboring teeth. Unlike the alternatives like fixed bridge-work or removable partial dentures, implants are stable.
A Single Implant to Replace a Missing Tooth
When a tooth has been missing for a period of time, yet sufficient bone is present to place the implant, this is an optimal case surgically. Prior to the placement, you will meet with the doctor for a consultation. On the day of placement, a small incision (unless you opt for flapless surgery) is made to reveal the underlying bone. The bone then is shaped to accept the implant. Finally, sutures are placed, closing the tissue. The whole process, including pre-op preparation and post-op instructions, takes about an hour. The amount of healing time required before placement of the crown depends on a variety of factors but most commonly is 1 to 3 months. After healing, you receive an abutment and crown.
A Single Implant to Replace a Tooth Being Lost
Often a tooth is removed because it is infected or so badly broken that it is not able to be saved. When it is extracted, the implant can be placed directly into the socket that same day. This is referred to as immediate placement. An immediate placement is the best choice for implant placement because it preserves the maximum amount of bone. It also eliminates the need to wait for healing which might otherwise necessitate going without a tooth for six months or more. In the case when a front tooth is not present, most patients opt for some sort or temporization. But, if it is a lower tooth, particularly a lower back tooth, many patients prefer not to fill in the space while they wait.
Multiple Implants to Replace Multiple Missing Teeth
The old gold-standard for replacing missing teeth was a fixed bridge. But, sometimes, one of the teeth supporting a fixed bridge can fail. In this case, a large space remains, leaving a person unable to chew on that side of the mouth. In this situation, two or more implants may be placed. Although each tooth can be replaced individually by an implant, often people will opt for an implant supported bridge because it is less expensive. A bridge is defined as multiple crowns that are linked together.
In the case when multiple implants are placed, it is very common to utilize a surgical guide in order to precisely place the implants. Using a guide, often negates the need for grafting, decreases surgical time and further reduces discomfort that some may have from the procedure. Typically, there is very little discomfort associated with one, or multiple implants.
Complete Upper or Lower Tooth Replacement
Implant Supported Bridges and/or Individual Crowns: The ultimate solution for those who have lost their teeth are implant supported bridges and/or crowns. Implant supported crowns and bridges offer the distinct advantage of preserving the maximum amount of bone, offering the best natural esthetics.
Prettau Screw Retained Zirconia Bridge
Prettau screw-retained bridge is the premium solution for complete tooth replacement. Prettau is an all-ceramic fixed bridge that has completely natural looking teeth and is supported by four, or more, implants. The bridge is attached directly to the implants with screws and is completely secure. It cannot be removed other than by your dentist.
On the day of surgery, any remaining teeth are removed, prior to the seating of an acrylic temporary/transitional denture which will be worn until each of the implants has stabilized. Eventually, the transitional denture is replaced by the all-ceramic fixed bridge.
Teeth-in-a-Day or All-On-4 Screw-Retained Hybrids
Screw retained dentures have become known as “Teeth-in-a-Day” because of many corporate dental chains that spends heavily on advertising. In reality, there is relatively little difference between a locator denture and the “All-on-4” or “Teeth-in-a-Day” solution. The main difference is that the latter solution is screwed into place as opposed to being removable. Some patients prefer the peace of mind of having their dentures screwed-in rather than removable. But, the disadvantage is that they are more difficult to clean and maintain over time. Both locator overdentures and screw-retained hybrids are extremely stable. But, most patients prefer the feature of a prosthesis that is firmly and permanently affixed.
Overdentures with Locator Attachments
Implant supported dentures are a radical upgrade for patients struggling with dentures. As any dentist, or any denture wearer will explain, dentures are a suitable solution for missing teeth, but they are a poor substitute when compared to actual teeth. The most economical, long term solution for people struggling with their denture is a locator supported denture. A detailed description of this solution can be viewed here. The process of getting locators is relatively simple. Implants are placed, and then one end of the locator attachment is screwed into the implant. The other end is placed into the denture. When the denture is placed in the mouth, the two ends snap together, resulting in a surprisingly stable solution. In fact, most patients are able to remove the plastic from the palate of the denture. As a result, the overall comfort and improved ability to taste food again results. Most patients report that their dentures feel stable and secure. Locators work best when four implants are placed per arch. Although, in the lower jaw, even two implants can be a great improvement.
Mini-implants with Locator Attachments
Of all of the options to stabilize dentures, narrow diameter or mini-implants should be thought of as a basic or an economy option- albeit a great one! Mini-implants work just like Locator Overdentures (see above), however the diameter of the supporting implants are more narrow, they are skinny. With mini’s, you get the same great snap-on feel, however mini implants have a higher incidence of failure, because the support is not as strong. Mini-implants are a super denture stabilizing solution but because of their value pricing and higher rate of failure, we do not offer our no-questions-asked limited warranty. Mini-implants are an exceptional value to stabilize a new or existing denture. We recommend 6 mini’s on top and 4 mini’s on the bottom for maximum success.
Metal-free (Zirconia) Implants
For patients looking for a metal free option for tooth replacement, ceramic implants are the answer. There are no known allergies to ceramic and it is considered the most hypoallergenic, biologically compatible solution available. It results in improved healing because it is so tissue-friendly, while also being the most natural esthetically. To learn more about ceramic implants, click here, to visit the biologic dentistry section of our site.
People with the following situations:
Placing an implant is a relatively easy process. First, careful review of a patients’ medical history occurs, a 3D X-ray is taken, and a thorough examination is performed to determine whether a person is a candidate. If a person is a good candidate, then the risks and benefits associated with the procedure are discussed. If not, the site can typically be grafted in order to regrow sufficient bone so as to place an implant in the future.
On the day of placement, the implant(s) is (are) inserted into the bone (often with the aid of a surgical guide) and then allowed to heal for a period of 1 to 3 months until stable. Throughout this time, the body heals and the implant becomes fully integrated, or fused, into the bone. Once an implant has integrated, the final restoration (crown) or removable prosthesis (denture) is placed on top of the implant.
Does it hurt to get an implant? Most patients who have had implants placed report the procedure as easy and relatively pain-free. In cases when no tooth extraction is involved, a situation where there are no nerve endings within the bone, the procedure is painless.
How long will I have to go without a tooth? When a tooth is lost, there are many different reasons. Accordingly, a tooth may be immediately temporized or worst case, it may take up to six months before a new tooth can be received. Accordingly, many people opt to wear a temporary. Temporaries or provisionals come in various forms, the most common include flippers, Essix (Invisalign-type) retainers and bonded provisionals.
Can I sleep through the procedure? Many people are understandably anxious about implants, but most implant placements are very easy surgeries. Even so, many of our patients would prefer to “be in another place.” One way to relieve anxiety is to take an oral sedative, such as Valium or other shorter acting drug, which provides an overall sense of calm.
Implant: The implant body itself is a medical-grade titanium (or ceramic) screw/anchor inserted into the jaw, taking the place of a missing root. Although there are many types of implants today, the most common are bone-level, root form implants.
Crown: The implant supported crown, or tooth, is either cemented on top of the abutment (see below) in the mouth or it is attached to the abutment outside of the mouth. Then, together, the crown and abutment are screwed into place on top of the implant.
Abutment: The abutment is a connection between the crown, or tooth, and the implant that connects by a screw. There are two common types of connections: stock and custom abutments. A stock abutment is the most common type and is least expensive. But, because of its one-size-fits-all solution, it has certain limitations. The custom abutment, on the other hand, is superior as it best replicates the form of natural teeth, providing superior retention along with trapping less food.
Locator Attachment: In a case when an implant is not replacing a tooth, but rather supporting a denture or partial denture, a locator attachment is used. A locator abutment allows a denture to snap into place on top of the denture in order to increase stability.
Bone graft: When teeth are lost, bone begins to shrink. Often extensive bone loss can result in the impossibility of an implant being placed without a bone graft. Traditionally, bone grafts were taken from a donor site, such as a hip or another part of the jaw It would then be ground and replaced in that same person. However, today, donor bone is harvested and then processed to produce a material that is safe, economic and comfortable.
3-D CBCT: Precise placement of dental implants is critical for long term success and esthetic outcomes. A CBCT scan is a 3 dimensional x-ray that allows the doctor to determine whether or not a potential site is viable for an implant (or if the site may first require grafting). Also, it allows the practitioner to safely place an implant, avoiding vital structures, which include the lower alveolar nerve, the maxillary sinus and other teeth.
Surgical Guide: A surgical guide is used to place an implant in a precise location, thus achieving a safe, specific and predictable outcome. This is made possible by utilizing information from a CBCT scan (see above) along with the physical structures of a patient. Surgical guides are also useful to expedite implant procedures, particularly when multiple teeth are involved. Guides enable “flawless,” minimally invasive and almost entirely painless procedures.