Posts for category: Dental Procedures
You may be familiar with a dental implant used to replace a single tooth — but implant technology can do much more. Implants can also support other restorations including total teeth replacement on a jaw.
The reason they're so versatile is because implants replace the tooth root as well as the visible crown. We use a metal post, usually made of titanium, which we surgically implant in the jawbone as a root substitute. Because of a special affinity with titanium, bone around the implant grows and adheres to it and creates a durable bond.
With a single tooth replacement (the implant's original purpose when they were introduced in the 1980s) we attach a life-like porcelain crown to the individual titanium post. But with their continuing development we've adapted implants for other applications, like using a few strategically-placed implants as a stable platform for removable dentures or fixed bridges.
We're now able to use implants to support a full prosthetic (false) dental arch. Though similar in appearance to a removable denture, this particular prosthesis is permanently joined to the supporting implants with retaining screws.
Of course, the application requires careful pre-planning, which includes making sure you have enough healthy bone to support the implants. We'll also need to determine how many implants you'll need (usually four to six for this application) and create a surgical guide to place them in the best location for supporting the prosthesis. A dental technician will then create the prosthesis to match your jaw ridge contours and facial structure.
Using implants this way has a benefit other types of restorations can't provide: they may help stop future bone loss. The jawbone life cycle depends on stimulation from the attached tooth as you bite and chew — stimulation that ends when you lose the tooth. Traditional dentures and other restorations can't replicate that stimulation. Implants, on the other hand, directly encourage bone growth and can stop gradual bone loss.
If you need some form of total teeth replacement, consider one supported by implants. You may find they'll provide an excellent long-term solution to both function and appearance.
Although dental implants are best known as single tooth replacements, they can actually play a role in multiple or complete tooth loss (edentulism) restorations. While replacing multiple teeth with individual implants is quite expensive, there’s another way to incorporate them in a restoration at much less cost — as supports for bridges.
In this case, only a few strategically placed implants are needed to support restorations of multiple crowns fused together into a single unit. Implant-based bridges consist of two main types: the first type is a fixed bridge, which is permanently attached to the implants and can’t be removed by the patient. It’s often the preferred treatment for patients who’ve lost most or all of their teeth but have not yet experienced significant bone loss in the jaw.
This choice, however, may not be the best option for patients with significant bone loss. In these cases, there’s a second type of fixed bridge: an implant-supported fixed denture. This type of fixed denture provides support for the lost bone support of the lips and cheeks. If a fixed bridge is not possible due to finances or inadequate bone support to place 4 to 6 implants, a removable denture (also known as an overdenture) that’s supported and held in place by implants is the next best alternative. Unlike a fixed bridge, an overdenture can be removed by the patient for cleaning purposes, and will require less investment than a fixed bridge.
For people with bone loss, the overdenture does more than restore chewing and speech function. Because bone loss can diminish support of the facial structures — actually shorten the distance between the chin and the tip of the nose — an overdenture provides additional bulk to support these structures to improve appearance. Depending on what the patient needs for facial support, overdentures for the upper jaw can be designed as “full palates,” meaning the denture plastic completely covers the upper jaw palate, or open in which the plastic doesn’t completely cover the palate.
Besides the condition of your teeth, gums and bone, your own personal preferences and financial ability will also play a role in which option is best for you. After considering all these factors, we can recommend which of these types of implant-based restorations will fit your needs. With either bridge, fixed or removable, you’ll certainly benefit from the improvement to both your mouth function and your smile.
If you would like more information on implant-supported bridges, 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 “Fixed vs. Removable.”
Dental implants are by far the best way to replace missing teeth. But they do more than improve your smile: they can restore your ability to eat, chew and talk properly, especially if the teeth replaced are in the back of your mouth. What’s more, they can improve the entire look of your face by restoring facial height and cheek support lost because of the missing teeth.
There is, however, one obstacle to overcome before receiving dental implants — a lack of sufficient bone at the implant site. Bone loss usually occurs when teeth have been missing for some time. This is because when we chew the forces generated by the teeth stimulate continual bone growth to make up for older bone that has dissolved (resorbed). This stimulation doesn’t occur after teeth are lost, which slows the rate of bone growth. Over time the amount of healthy bone diminishes.
Without enough bone for support, implants can’t be placed properly. Fortunately, some of the bone can be regenerated through techniques that place bone grafting material at the site to stimulate and serve as a scaffold for new bone.Â The new bone will eventually replace the graft.
For missing upper back teeth with bone loss, we can take advantage of facial anatomy to grow the bone needed for implants. This area of the face is where the maxillary sinuses, air spaces lined with a tissue membrane, are located on either side just above the upper jaw. After determining their exact size and location through detailed x-ray imaging, we can surgically access the area inside the mouth just above the missing teeth.
The sinus cavity is an area where bone growth can occur by placing a bone graft between the floor of the sinus and the sinus membrane. Sometimes bone growth enhancers are used to stimulate and speed up regeneration. The procedure can usually be performed with local anesthesia (much like a routine tooth filling), with only mild discomfort afterward for a few days managed by an anti-inflammatory drug like ibuprofen and a decongestant for sinus swelling.
After six to seven months, we re-evaluate the area to see if sufficient bone has returned for implant surgery. If so, you will be well on your way to achieving a new look and better function through dental implants.
If you would like more information on building new bone through sinus surgery, 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 “Sinus Surgery.”
Which would you rather have — the flu or a root canal procedure? Nearly 80 percent of people recently surveyed by the American Association of Endodontists wisely chose the root canal. If this takes you by surprise, then let us bring you up to date on root canal treatment today. It’s nothing like the experience that once made it the butt of jokes and a benchmark against which other “undesirable” experiences were measured.
The term “root canal” actually has two meanings. It is part of the pulp-filled chamber at the center of every tooth containing nerves and blood vessels that keeps teeth vital (alive). It’s also the endodontic (endoÂ = inside; dont = tooth) procedure that treats inflammation and infection in this tissue. Common causes of pulp problems are traumatic damage (for example a crack, chip, or root fracture), deep decay, or gum disease.
The first sign of a problem is typically pain — ranging from acute and intense pangs when biting down, to lingering discomfort after consuming hot or cold foods, to a chronic dull ache and pressure, or tenderness and swelling in nearby gums. The primary pain may abate as the nerves in the pulp die, but the infection will continue, compromising the affected tooth, jeopardizing the health of the surrounding tissues, and often triggering secondary pain.
Pain-Relieving, Tooth-Saving Treatment
Endodontic treatment, by contrast, is no more uncomfortable than having a cavity filled. The tooth and surrounding area are numbed with a local anesthetic before the procedure begins. In order to access the diseased pulp, a small opening is made in the biting surface of the tooth. Tiny instruments are used to remove the pulp, clean and disinfect the root canal(s) and pulp chamber, and prepare the empty tooth interior to receive a biocompatible filling material to prevent bacteria from returning. A permanent crown may be placed over the tooth at that time, or a second visit may be needed. A crown (cap) is important to the tooth's long-term strength and functionality.
For a day or two following treatment you may experience temporary sensitivity, which often responds to an over-the-counter medication like ibuprofen. Occasionally, prescription medications, including antibiotics, may be needed.
All in all, doesn’t saving a tooth sound easier and more constructive than coming down with the flu?
If you would like more information about root canal treatment please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine article “A Step-By-Step Guide To Root Canal Treatment.”
Tooth decay and periodontal (gum) disease pose the most common dangers to dental health. But there are some rare conditions that can also place teeth at risk to be on the lookout for during regular dental checkups.
One such condition is root resorption in an adult tooth, in which the root itself or its surface breaks down and is absorbed by the body. Resorption occurs naturally in a primary (“baby”) tooth so it can loosen and give way for an incoming permanent tooth. Â Resorption still occurs in a limited form with young permanent teeth but should eventually stop.
Sometimes, though, it doesn’t, either from the inside of the tooth out (internal resorption) or more often from the outside in, usually around the neck-like (or “cervical”) portion of the tooth. This more common occurrence, External Cervical Resorption (ECR), can first appear as pink spots on the enamel and then progress into cavity-like areas. If not found and treated promptly, damage can occur quickly and lead to tooth loss.
We don’t fully understand the exact nature and causes for ECR, but we have identified risk factors for its development. Excessive orthodontic force on the teeth or any other trauma can cause damage to the periodontal ligament (which holds teeth in place with the jaw bone). Teeth grinding habits and some dental procedures like internal tooth whitening can also be risk factors.That being said, though, the vast majority of people who experience these issues don’t develop ECR.
Although the causes aren’t fully understood, we can still treat it: the key to success is early detection. You probably won’t notice early signs of ECR, but we can often detect spots from routine x-rays. We can then remove the tissue cells within the lesions causing the damage and restore the area with a tooth-colored filling material. If ECR has extended near the tooth’s interior pulp layer, then a root canal treatment may be needed.
Needless to say, the more extensive ECR occurs in the roots, the less likely the tooth can be saved and may need to be extracted. It’s important, therefore, to maintain regular dental checkups (at least twice a year) to increase your chances of catching a developing problem early.
If you would like more information on root resorption in adult 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 “Root Resorption: An Unusual Phenomenon.”