DENTAL IMPLANTS

Implants

When a tooth or several teeth are missing, a dental implant with a crown or bridge is an excellent treatment for replacing it.
Depending on the situation, placing an implant involves several phases, and treatment times can vary widely. First, we determine if an implant is right for you. We discuss your health history and treatment goals and perform a comprehensive examination to check the health of your gums and jawbone. We determine if you need any additional procedures, such as bone grafting or gum surgery.
Although each case will be different, placing an implant generally involves two phases: surgically placing the implant and restoring the implant with a crown or bridge.

Placing the Implant

For the surgical placement of the implant, your mouth is thoroughly numbed. An opening is made in your gums, and then a channel is shaped in the bone to receive the implant. Next, the body of the implant is placed into the prepared channel. Sometimes a cover is placed onto the implant and the gums are stitched closed. This method is called a two-stage procedure. In other cases that allow a single-stage procedure, an extension is attached to the implant at the time of surgery.

Healing may take several months as the implant becomes fused securely to the bone. During this time, a temporary crown or bridge may be placed. If the first phase included closing the gums over the implant, the second phase starts with surgical re-exposure of the implant. Another incision is made in your gums, and a small extension is placed to bring the implant above the gumline. You will then have a series of appointments to create the final restoration. Though some of the steps might be different in your case, they usually include removing any temporary crown or bridge, and taking impressions of your mouth.

The lab uses the impressions to make an accurate model of your teeth, including the implant. They use the model to create a crown or bridge that precisely fits the implant and your bite. When your final crown or bridge is ready, we check the fit and your bite and then secure the crown or bridge to the implant.

Implant Placement Post-op Instructions

After implants have been placed, it’s important to follow these recommendations to ensure their long-term success.

General Care

Control minor bleeding by applying moderate pressure with gauze pads or a clean, moist tea bag wrapped in a gauze pad. Call our office right away if you have heavy or increased bleeding, if you have pain or swelling that increases or continues beyond two or three days, or if you have a reaction to the medication. Limit your activities for the first three to five days to help reduce bleeding. If you usually wear a removable denture, partial denture or night appliance, you will be given specific instructions about wearing it while your implants heal.

Tobacco Use

Do not use tobacco products of any kind for at least 24 hours, and avoid tobacco as much as possible for several months. Tobacco slows healing and increases the risk that your body will reject the implants. It’s the leading cause of implant failure.

Chewing and Eating

Avoid chewing until the numbness has worn off completely. If we placed a temporary restoration, avoid chewing for 30 minutes to allow the temporary cement to set. For the first 24 hours, drink lots of liquids and eat soft, nutritious foods, chewing on the opposite side of your mouth. After the first 24 hours, you may begin to return to your usual diet, but continue to chew on the opposite side. At your next scheduled appointment, we will evaluate your situation to determine how soon you may begin chewing on the implant.

Brushing and Flossing

For the first 14 days, gently wipe the implant site with gauze or a cotton swab. After the 14 days, brush the area gently with a soft toothbrush. Don’t floss the site for four weeks. We will evaluate the healing and adjust your brushing and flossing as necessary. If we have recommended a mouth rinse, use it as directed.

Medication and Discomfort

If antibiotics or other medicines are prescribed, continue to take them as directed, even if all symptoms and signs of infection are gone. To control discomfort, take pain medication before the anesthetic has worn off or as recommended. It’s normal to experience some discomfort for several days after surgery. To reduce discomfort or swelling for the first 24 hours following surgery, use ice packs, 20 minutes on and 20 minutes off, on the outside of your jaw. After the first 24 hours, you may apply moist heat to reduce discomfort.

Immediate Implant Placement Procedure

When a tooth must be extracted, we can sometimes place an implant in the socket immediately after the tooth has been removed. Although each case will be different, placing the implant immediately after an extraction generally involves two phases, placing the implant in the socket and securing a restoration, such as a crown or bridge, onto the implant.

The Benefits of Immediate Placement

An immediately placed implant has several advantages. Extraction and implant placement can occur during the same procedure. The implant stops the bone loss that normally occurs when a tooth is lost, and it prevents the surrounding teeth from shifting into the space. And unlike replacing a tooth with a traditional bridge, there is no need to reduce the size of neighboring teeth. The implant with its restoration looks and feels like your natural teeth when you chew and talk.

Placing the Implant

First we make sure the area is completely numb, and then we remove the tooth. We reshape the extraction site and place the body of the implant into the prepared socket. In many cases, we add bone grafting material to the socket to help the jawbone heal tightly around the implant. A healing cap or an extension is attached to the implant. We then close the gums. Over the next several months, the implant will become fused securely to the bone. During this time, we may place a temporary replacement tooth.

Restoring the Implant

The next phase includes a series of appointments to create your final restoration. Though some of the steps might be different in your case, they usually include removing the temporary and making impressions of your mouth. The lab uses the impressions to make an accurate model of your mouth, including the implant. They use the model to create a restoration that precisely fits the implant and your bite. When your beautiful new restoration is ready, we check the fit and your bite and then secure it to the implant.

Diagnosing Bone Loss

Diagnosing Bone Loss

One of the keys to the success of your implant is healthy jawbone. When bone in the jaw has been lost, it may not have enough height and width to securely hold an implant. Diagnosing the health of your jawbone is an important step in planning for stable, secure implants and maintaining a beautiful smile.

Causes of Bone Loss

Bone in the jaw can be lost for a number of reasons. These can include:

  • Periodontal disease destroys the jawbone around the affected teeth.
  • Development of a cyst or abscess creates a hole in the jawbone.
  • Removal or accidental loss of teeth sometimes can injure jawbone.
  • Missing teeth do not stimulate the jawbone through chewing, causing the jawbone to shrink.
Diagnosis and Treatment

To determine whether your jaw has enough healthy bone to secure an implant, we do a thorough examination. First, we typically take x-rays, which can show us the height of the bone. In some cases, we may need additional, specialized x-rays, such as a CT (computerized tomography) scan, to provide more detail about your jawbone and the location of nerves and blood vessels in the jaw. Then we perform a visual exam to look at the shape of the jawbone, and we may use a periodontal probe to check the height of bone around any neighboring teeth. Sometimes, we may also find defects in the jawbone while we are performing implant surgery. If we discover that you have lost bone in your jaw, we will discuss the variety of techniques we can use to replace it.

Bone Augmentation Procedure for Implants

Augmentation Replaces Missing Bone

When your jawbone has receded or lost its shape, we can often augment it to replace missing bone and help new bone to grow. Depending on where and why bone loss has occurred, we select the appropriate procedure, which can include:

  • Sinus graft or lift.
  • Bone grafting.
  • Ridge preservation.

Sinus grafts and lifts thicken the wall of bone that forms the upper jawbone and the floor of the sinus. Bone grafting replaces the height and width of the jaw where bone tissues have receded. Ridge preservation fills the empty socket of an extracted tooth.

The Procedure

For all three procedures, we first prepare the replacement material, which may be your own bone or bone from another source. Then we make sure the area is thoroughly numb. In a sinus graft, we open a small window into the sinus area above the missing tooth, and then we place bone grafting material on the floor of the sinus. In a bone grafting procedure, we gently open the gums and place grafting material onto the areas where the jawbone has receded. With ridge preservation techniques, we fill the empty socket with bone material after a tooth has been removed.

Depending on the situation, we may also apply platelet-rich plasma to the site. This material is made from a small sample of your own blood, and it enhances bone growth and speeds healing. We may also place a special membrane over the graft to prevent unwanted tissue from growing into the graft site. The last step is to close the grafting site. Although situations vary, we may need to wait several months after the procedure for the bone to heal before moving on to the next step of your dental treatment.

The Benefits of Bone Augmentation

A bone augmentation procedure has several benefits. It can recreate a healthy jawbone, provide a solid anchor for dental implants, form an attractively shaped foundation for the gums, and help preserve your healthy smile.

The Benefits of an Implant

An implant has several benefits. Like the roots of natural teeth, it stimulates the jawbone when you chew. This preserves the jawbone and keeps it healthy. An implant is strong, comfortable, and secure. When the restoration is in place, the implant looks and feels much like natural teeth.
An implant can support a variety of restorations, such as a single crown, multi-unit bridges, and full-arch dentures.
The implant stops the bone loss that occurs when a tooth is lost, and it prevents the surrounding teeth from shifting into the space. Unlike replacing the tooth with a traditional bridge, there is no need to reduce the size of neighboring teeth. The crown, bridge or denture with an implant also looks and feels like your natural teeth when you chew or talk, and can be brushed and flossed.
With proper homecare and regular checkups, your implant can be a long-term solution for a natural-looking smile.
Some restorations, like a single crown and most bridges, are not removable. Others, like many full-arch dentures, can be removed for sleeping and cleaning. Depending on your specific replacement needs, your dentist, prosthodontist, periodontist, or oral surgeon will discuss with you what options are best for your situation to restore your beautiful smile.

Considering a Single Tooth Implant

When a tooth is missing, a dental implant can be a great choice for replacing it. An implant is a small titanium post that replaces the roots of a missing tooth and supports a custom-made crown.

Problems Caused by a Missing Tooth

A missing tooth can cause a chain reaction of problems, including loss of bone in the jaw, shifting teeth, difficulty keeping teeth free of plaque and bacteria, grinding and clenching, and pain in the jaw joints. Teeth transmit chewing forces through their roots to the jawbone. This provides the stimulation bone needs to stay healthy, so when a tooth is missing, the jawbone around the area begins to shrink, along with the surrounding gums.

A missing tooth also changes the biting forces on teeth around the space. Neighboring teeth begin to shift, and the opposing tooth begins to extrude out of its socket.

These changes create places around the teeth that are hard to keep clean, so plaque and bacteria quickly accumulate. This accumulation can cause tooth decay and periodontal disease.

Changes in the bite also put improper chewing forces on the shifted teeth. This may lead to grinding and clenching, as well as painful problems with your jaw joint, the TMJ.

Diagnosis and Treatment

To determine if an implant is right for you, we do a thorough examination. The examination includes recording your medical history in which we discuss any condition that may interfere with healing. We perform a visual examination to check the health of your teeth and gums. To check the health of your jawbone, we take panographic x-rays and possibly CT (computerized tomography) scans. We take impressions and bite registrations to create an accurate model of your mouth.

When we have thoroughly studied these records, we will be able to discuss which implant treatment options may be best for you.

Benefits of an Implant

An implant fitted with a crown effectively replaces a missing tooth. The implant is held firmly in the jawbone, so it feels much like your natural teeth when you talk and chew. The crown is custom crafted to match or enhance your smile. A dental implant is a great way to keep your jawbone healthy, to stop neighboring teeth from shifting, and to maintain a stable bite.

Considering an Implant Bridge

When several neighboring teeth are missing, an implant-supported bridge is an excellent treatment for replacing them.

Although each case will be different, placing an implant-supported bridge generally involves two phases. The first phase is the surgical placement of the implants. The second phase is restoring the implants with the bridge.

The Benefits of Implants with a Bridge

Implants restored with a bridge have several advantages. The implant stops the bone loss that occurs when a tooth is lost, and the bridge prevents the surrounding teeth from shifting into the space. Unlike a traditional bridge, there is no need to reduce the size of neighboring teeth. A bridge retained by implants looks and feels like your natural teeth when you chew and talk.

With proper homecare and regular checkups, your implants can be a long-term solution for a natural-looking smile.

Placing the Implants

For the surgical placement of the implants, your mouth is thoroughly numbed. Small openings are made in your gums, and a channel is shaped in the bone to receive each implant. Next we place the bodies of the implants into the prepared channels. Sometimes covers are placed on the implants, and the gums are stitched closed. This method is called a two-stage procedure. In other cases that allow a single-­stage procedure, extensions are attached to the implants at the time of the surgery. Healing may take several months as the implants become fused securely to the bone. During this time, we may place a temporary replacement bridge.

Restoring the Implants with a Bridge

If the first phase included closing the gums over the implant, the second phase starts with surgical re-exposure of the implant. Small incisions are made in your gums, and an extension is placed on each implant to bring it above the gumline. Then we schedule a series of appointments to create your final bridge.

Though some of the steps might be different in your case, they usually include removing a temporary bridge and taking impressions of your mouth. The lab uses the impressions to make an accurate model of your mouth, including the implants. They use the model to create a bridge that fits the implants and your bite. Depending on the circumstances, we may have you try in the bridge framework, or we have you try in the final bridge. When everything is right, we secure your beautiful new bridge to the implants.

Considering Implants for Full Arch

When all of the teeth in an arch are missing, implants can be an excellent choice for replacing them. Implants are small titanium posts that replace the roots of missing teeth and support removable dentures or a full-arch bridge.

Problems Caused by Missing Teeth

Missing teeth can cause several dental problems, including loss of bone in the jaw, loose and uncomfortable dentures, and a compromised appearance.

Jawbone needs the stimulation of chewing to maintain its strength and shape, so when teeth are missing, the bone around the area begins to shrink.

This shrinkage continues over time; so if you wear a denture, it will become looser and less comfortable. In fact, the lower jawbone can shrink so much that the nerves end up closer to the surface of the bone, making it painful to bite down.

In addition, as the jawbone shrinks, the space between your chin and nose decreases, flattening your lips and creating wrinkles around your mouth.

Diagnosis and Treatment

To determine if implants are right for you, we do a thorough examination. The examination includes recording your medical history so we can discuss any condition that may interfere with healing. We perform a visual examination to check the health of your teeth and gums. To check the health of your jawbone, we take panographic x-rays and possibly CT (computerized tomography) scans. We also take impressions and bite registrations to create an accurate model of your mouth.

When we have thoroughly studied these records, we will be able to discuss which implant treatment options may be best for you.

Benefits of Implants

A dental implant that supports a full arch bridge or dentures effectively replaces missing teeth. The implant is placed firmly in the jawbone, and it holds the denture or bridge securely in your mouth. This makes it feel much like your natural teeth when you talk and chew.

An implant also supports the denture by holding your jaws in their correct positions and helps you maintain a more youthful look. In addition, the artificial teeth are custom-crafted to match or enhance your smile. A dental implant is a great way to stabilize your jawbone, keep it healthy, and maintain a stable bite and beautiful smile.

Alternatives to Implants for Full Loss of Teeth

Treatment Alternatives

When you are missing a full arch of teeth, you have several choices for replacing them:

  • Modify a current denture.
  • Wear a new conventional denture.
  • Wear an implant-retained denture.
  • Delay treatment.
Modifying a Current Denture

If you now wear a denture that does not fit well, we may be able to adjust or reline it so that it is more comfortable and functional. Sometimes we can create a better-fitting denture base, reusing the teeth in your current denture.

Wearing a Denture

If you have not worn a complete denture before, or if your old one needs replacing, we can create a new denture for you.

Dentures can look good and fit well at the start. However, when teeth are missing, the jawbone gradually shrinks, and in some cases, dentures can accelerate bone loss. This shrinkage changes your appearance. It also causes dentures to become loose, making it difficult to chew and talk and causing sores and tender spots to develop.

Wearing an Implant Denture

An implant denture (fixed denture) is different than a removable denture. An implant denture stays in the mouth, and a removable denture can be taken out of the mouth. Depending on your situation, an implant denture may not be the best choice for you, in which case you have two alternatives to consider: either modify an existing denture or have a new one created.

Delaying Treatment

If you are thinking about delaying treatment, you should know that the jawbone will continue to shrink due to the missing teeth. This means that delaying treatment now will make future treatment more complex.

Alternatives to Implants for Partial Loss of Teeth

Treatment Alternatives

When you’re missing one or more teeth, you have several choices for replacing them:

  • Wear a partial denture.
  • Wear a bridge.
  • Delay treatment.
  • Wear an implant-supported crown or bridge.
Wearing an Implant-supported Crown or Bridge

Unlike partial dentures and bridges, an implant replaces the roots of missing teeth, so it helps maintain the health and shape of the jawbone. An implant holds natural-looking crowns and bridges securely in the mouth without requiring clasps or reducing neighboring teeth. This enables you to talk and chew easily, and it preserves your beautiful smile.

Wearing a Partial Denture

A partial denture can replace one or more missing teeth. A partial is held in place by clasps or special attachments, and it is removable for sleeping and cleaning.

Wearing a Bridge

An implant denture (fixed denture) is different than a removable denture. An implant denture stays in the mouth, and a removable denture can be taken out of the mouth. Depending on your situation, an implant denture may not be the best choice for you, in which case you have two alternatives to consider: either modify an existing denture or have a new one created.

Delaying Treatment

If you are thinking about delaying treatment, you should know that without teeth and tooth roots, the jawbone in that area gradually shrinks. This weakens the jaw and changes your appearance. The longer you delay, the more the jawbone will shrink, making future treatment more complex. In addition, teeth need each other for support. Missing teeth can lead to a chain reaction of dental problems, including shifting teeth, increased risk for tooth decay and periodontal disease, and changes in the bite that can lead to painful problems with your jaw joints.



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