Posts for tag: dental implants
For a predictable outcome, a dental implant should be placed as soon as the bone and gum tissues following a tooth extraction have healed. But what happens if the tooth has been missing for months or years? You might then run the risk of not having enough bone to properly place an implant.
This can happen because of a disruption in the growth cycle of living bone tissue. As older bone cells dissolve (resorption), new bone develops to take its place. This is a dynamic process, as the amount and exact location of the new growth is in response to changes in the mouth, particularly from forces generated by the teeth as we chew. If, however, this stimulation transmitted to the bone no longer occurs because the tooth is missing, the bone will tend to dissolve over time.
In fact, within the first year after a tooth loss the associated bone can lose as much as a quarter of its normal width. This is why we typically place bone grafting material in an empty socket at the same time as we extract the tooth. This encourages bone growth during the healing period in anticipation of installing a dental implant or a fixed bridge. If, however, the bone has diminished to less than required for a dental implant, we must then use techniques to encourage new bone growth to support a future implant.
One such technique for restoring bone in the back of the upper jaw is to surgically access the area through the maxillary sinus (a membrane-lined air space within the bone structure of the face) positioned just over the jawbone to place grafting material. During surgery performed usually with local anesthesia, the surgeon accesses the sinus cavity, lifts the tissue membrane up from the sinus floor and applies the grafting material on top of the bone. Eventually, the new bone growth will replace the grafting material.
If successful, the new bone growth will be sufficient to support an implant. Thanks to this renewed growth, you’ll soon be able to enjoy better function and a transformed smile provided by your new implant.
If you would like more information on forming new bone for implants 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.”
If you’ve been reviewing tooth replacement options, you probably already know the superior benefits of dental implants: their durability, functionality and life-like quality could provide you with years, even decades of satisfying service.
If you take this option, however, you should be prepared for a slightly longer process than a couple of office visits. From concept to permanent crown placement, it will require several months of preparation, expertise and teamwork. The more you know about this process, the better prepared you’ll be to handle it.
After careful preparation, which may include extracting the tooth being replaced, the process begins in earnest with the surgical placement of the implant’s titanium post into the jawbone. The surgeon uses a guide based on your bite and mouth structure to precisely implant the post in a pre-planned location: this ensures that the permanent crown will be affixed in the right location for best appearance and functionality.
While a temporary crown can sometimes be attached immediately after implantation, the permanent crown must wait until the bone grows and attaches around the titanium post (osseointegration). Once this has occurred, usually over several months, the implant can fully support the permanent crown and its function.
This last element, the permanent crown, is in many ways a work of art. Taking into consideration the patient’s facial features and shape, the type of tooth replaced and the tooth coloring natural to the patient which is transmitted this information to the dental technician who will manufacture the crown. The goal is to produce a life-like replica that will look natural and perform well.
It may seem quite involved, but all these stages are necessary for a successful outcome. Although dental implants take careful attention and time, the outcome is worth it. In the end you’ll not only recover lost function, you’ll also have a new, transformed smile.
If you would like more information on the procedures for placing dental implants, 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 “Dental Implants: Evaluating Your Professional Options for Care.”
FAQs About This New and Miraculous Procedure
How can sinus surgery contribute to the replacement of missing back teeth with dental implants?
Dental implants must be anchored the in bone to be successful. Maxillary sinus surgery can help regenerate bone that has been lost and is critically needed to anchor dental implants.
What are the maxillary air sinuses?
Inside the upper jaw, or “maxilla,” are structures known as the maxillary air sinuses, one on either side of the upper jaw. Each sinus is an air-filled space lined by a membrane. Upper back teeth are normally encased in the bone of the maxilla, below the sinuses.
Why is it important to replace missing back teeth?
Replacing back teeth restores the ability to eat, chew, and talk properly. The back teeth also provide facial and cheek support.
Why use dental implants?
Dental implants are the state-of-the-art method for replacing missing teeth.
Why does bone loss occur?
Unless special precautions are taken to prevent it, when teeth are lost, the bone supporting them is also lost.
If there is insufficient bone to anchor dental implants, what are the alternatives?
If all the back teeth are lost and dental implants cannot be placed, removable upper dentures may be the only alternative.
How do you determine whether a sinus surgical procedure is necessary?
The size, shape, and remaining bone of the maxillary sinuses influence whether you can have dental implants with or without a sinus surgical procedure.
How does surgery grow bone?
A small window is created in the sinus wall above where implants need to be placed. The sinus membrane is lifted and the space thus created filled with bone grafting and biologically active bone generating materials. The window is then closed and simply heals.
How is the surgery done?
The surgical procedures are performed from inside the mouth in the area just above the missing back teeth. They are generally carried out under local anesthesia (small shots, just like for a filling), sometimes with the addition of sedation or anti-anxiety medication.
How do bone grafts work?
Bone grafts act as scaffolds that the body replaces with its own bone. The most well researched bone substitute grafting material is currently bovine (cow) bone. All grafting materials are approved by the Food and Drug Administration. They are specially treated to render them completely sterile, non-contagious, and free of rejection factors.
What can I expect after surgery?
Moderate swelling and discomfort after surgery generally lasts for a few days to a week, about the same as having an upper impacted wisdom tooth removed. Supportive treatment usually includes a course of antibiotics to prevent infection and prescription strength medication of the aspirin or ibuprofen type. A decongestant may also be prescribed, if necessary. Healing is generally uneventful.
Who performs this surgery?
Maxillary sinus augmentations are usually carried out by oral surgeons, periodontists, or appropriately trained general dentists. Proper assessment of your situation and diagnosis are critical pre-requisites to the right procedure.
If you are missing upper back teeth, contact us today to schedule an appointment and discuss maxillary sinus augmentation. You can also learn more about this procedure by reading the Dear Doctor magazine article “Sinus Surgery: Creating Bone for Dental Implants out of Thin Air.”
You may be considering dental implants for a lot of reasons: durability, functionality and imperviousness to decay. But perhaps the winning reason is how they will make you look — their life-like quality can restore a smile marred by missing or disfigured teeth. Achieving that result, though, requires your dental team to determine beforehand the state of your bone and gums, and treat any conditions that would interfere with the final result.
The first area to look at is the amount of bone available to support the implant. An adequate amount is necessary not only to stabilize the implant, but to also ensure proper placement needed to achieve the best “smile” result. Your specialist, then, will take steps to protect available bone during procedures, or even aid in building up the bone structure by inserting grafting materials that encourage new bone growth.
The degree of bone volume in adjacent natural teeth is also important because it can greatly affect the health of the papillae. This is the triangular-shaped gum tissue that occurs between each tooth that gives normal teeth their arched appearance. Insufficient bone in these areas could cause the papillae not to regenerate properly around the implant site, which creates unsightly dark spaces in the gum tissue known as “black hole disease.”
We must next consider the quality and health of your gum tissue. Patients whose gum tissue tends to be thin face difficulties during cosmetic surgical procedures; their thinner tissues are also more prone for objects behind them to be visible, including metal or other crown materials.
Our aim is an implant crown emerging from the surrounding gum tissue just as a natural tooth would. To achieve this requires knowing first what we have to work with regarding your bone and gums, and to address any issues that are problematic. One aid in this process is to affix a temporary “prototype” crown on the implant to wear while the permanent crown is manufactured. This allows you to “test-drive” the new look, and make adjustments in the final product regarding color and materials.
Accounting for all these factors — and then making adjustments along the way — will help ensure the final crown meets your expectations for function and appearance.
If you would like more information on the fabrication of implant crowns, 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 “Matching Teeth & Implants.”
Dental implants are a great choice for many people who need to permanently replace a missing tooth. Reliable and long-lasting, they offer a highly successful outcome, and can even help reduce long-term bone loss and damage to adjacent teeth. One of the best features of implants is that the titanium metal of which they're made actually becomes fused with your natural, living bone tissue.
But sometimes, an examination may show that where you have missing teeth, you may not have enough bone remaining to properly place an implant. Does this mean you're out of luck? Not necessarily!
Employing the refined techniques of bone grafting, regenerating bone tissue has become a standard procedure in periodontal and oral surgery. In many cases, it's possible to build up just the right amount of bone using a variety of grafting materials, in combination with other special techniques. This can enable patients who wouldn't otherwise be good candidates to enjoy the benefits of dental implants.
How does it work? Basically, by helping your body repair itself.
You may already know that bone is a living tissue, which can respond to its environment positively (by growing) or negatively (by resorbing or shrinking). When you've lost bone tissue, the trick is to get your body to grow more exactly where you want it. Once we know where — and how much — replacement bone is needed, we can place the proper amount of bone grafting material in that location. Then, in most cases, the body will use that material as a scaffold to regenerate its own bone.
Bone grafting is often done at the time of tooth removal as a preventive procedure or prior to the placement of an implant, to give the body time to re-grow enough of its own tissue. The procedure is generally carried out under local anesthesia, or with the aid of conscious sedation. Sometimes, if there is enough natural bone to stabilize it, it's even possible to place an implant and perform a bone graft at the same time.
So if you're considering dental implants, let us advise you on what's best for your particular situation. We have the knowledge and experience to help you make the right choices, and achieve the most successful outcome.
If you would like more information about bone grafting, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Can Dentists Rebuild Bone?”