Max Dental

Replacing a Single tooth

If you are missing a single tooth, one implant and a crown can replace it. A dental implant replaces both the lost natural tooth and its root.

What are the advantages of a single-tooth dental implant over a bridge?

A dental implant provides several advantages over other tooth replacement options. In addition to looking and functioning like a natural tooth, a dental implant replaces a single tooth without sacrificing the health of neighboring teeth. The other common treatment for the loss of a single tooth, a tooth-supported fixed bridge, requires that adjacent teeth be ground down to support the cemented bridge.

In the long term, a single implant can be more aesthetic and easier to keep clean than a bridge. The area can be flossed normally without having to thread it under the components of a bridge.

Procedure:

During the diagnostic phase, impressions of your teeth are taken, with the resulting models mounted on an articulator, a device that simulates your occlusion (bite), to make certain an implant is the best option to replace the missing tooth. A CT scan is taken to study the site of the proposed implant. The area is evaluated to make certain there is adequate width and length of bone in the area for the implant, and that there are no nerves or other anatomic structures that might be involved with implant placement. A consultation to discuss the Doctors findings, clarify the implant procedure, and answer any questions you might have will follow. A surgical guide is created to make certain the implant is placed precisely, in the most optimal position. Thereafter, topical (gel) anesthetic is applied, and local anesthetic is gently placed into the area. The implant, which is made of surgical grade titanium and looks like a screw, is placed into the jaw bone in the site of the missing tooth, using digital (immediate) radiographs to be certain of precise placement. Over the next three to six months of healing, the implant and the bone are allowed to integrate (bond together) to form an anchor for your artificial tooth. During this time, a temporary tooth replacement can be worn over the implant site.

A second step of the procedure is necessary to uncover the implant and attach an extension. This small metal posts (an abutment), completes the foundation on which your new tooth will be placed. Your gums will be allowed to heal several weeks following this procedure.

Finally, a replacement tooth called a crown will be created by your restorative dentist and attached to the abutment. After a short time, you will experience restored confidence in your smile and your ability to chew and speak.

Replacing a several or multiple teeth

Multiple implants, or implant-supported bridges, can replace several missing teeth. Dental implants will replace both your lost natural teeth and at least some of the roots.

Dental implants provide several advantages over other teeth replacement options. In addition to looking and functioning like natural teeth, implant supported bridges replace teeth without involving adjacent natural teeth. Other common treatment for the loss of several teeth, such as fixed bridges or removable partial dentures, is dependent on support from adjacent teeth. Additionally, many patients find removable partial dentures to be uncomfortable, because they are not “permanent” replacements for missing teeth. In addition, because implant-supported bridges will replace some or all of your missing tooth roots, bone in the area is preserved. With a fixed bridge or removable partial denture, some of the bone that previously surrounded the tooth roots may begin to resorb (deteriorate). Because dental implants integrate with your jawbone, they maintain the level of bone in the area.

In the long term, implants are aesthetic, functional and comfortable replacements for missing natural teeth.

Procedure:

During the diagnostic phase, impressions of your teeth are taken, with the resulting models mounted on an articulator, a device that simulates your occlusion (bite), to make certain an implant is the best option to replace the missing tooth. A CT scan is taken to study the site of the proposed implant. The area is evaluated to make certain there is adequate width and length of bone in the area for the implant, and that there are no nerves or other anatomic structures that might be involved with implant placement. A consultation to discuss the Doctors findings, clarify the implant procedure, and answer any questions you might have will follow. A surgical guide is created to make certain the implant is placed precisely, in the most optimal position. Thereafter, topical (gel) anesthetic is applied, and local anesthetic is gently placed into the area. The implants, which are made of surgical grade titanium and look like a screw, are placed into the jaw bone in the site of the missing teeth, using digital (immediate) radiographs to be certain of precise placement. Over the next three to six months of healing, the implants and the bone are allowed to integrate (bond together) to form an anchor for your artificial teeth. During this time, temporary tooth replacements can be worn over the implant site.

A second step of the procedure is necessary to uncover the implants and attach extensions. These small metal posts (abutments), complete the foundation on which your new teeth will be placed. Your gums will be allowed to heal several weeks following this procedure.

Finally, replacement teeth called crowns or implant- supported bridges (whichever is most appropriate in your particular clinical situation) will be created by your restorative dentist and attached to the abutments. After a short time, you will experience restored confidence in your smile and your ability to chew and speak.

Sinus Lift Procedure

The maxillary sinuses are empty spaces on top of the upper back teeth. Some of the roots of the natural upper teeth extend into or close to the maxillary sinuses. When these upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. Dental implants need adequate amounts of bone to hold them in place. When the sinus wall is very thin, it is impossible to place dental implants in this bone.

The procedure to develop an implant site with adequate bone is called a sinus graft or sinus augmentation. Specialist enters the sinus in the area of missing upper back teeth. A portion of the sinus membrane is then lifted gently upward, and donor bone is inserted into the floor of the sinus. (Keep in mind that the floor of the sinus is the roof of the upper jaw). After several months of healing, the bone becomes part of your jaw, and dental implants can be inserted and stabilized in this new sinus bone.

The sinus graft makes it possible for many patients to have dental implants when years ago there was no other option other than wearing removable dentures.

Ridge Augmentation

Ridge deformities in previous extraction areas of the upper and lower jaw can create areas with inadequate bone and tissue thickness for placement of either an esthetic, functional bridge or dental implant restorations. The defects may have been caused by trauma, developmental defects, periodontal disease, severe osseous (bone) loss from a previous extraction or dental infection, or having worn partial or complete dentures.

Ridge augmentation procedures have been shown to greatly enhance the cleansability and appearance of non-implant restorations. They provide the opportunity to develop a site where implants can be successfully placed without compromising long-term successful stability or esthetics. Untreated ridge defects often times have inadequate dimension for implant placement.

Procedure:

Topical (gel) anesthetic is applied, and local anesthetic is gently placed into the area. Soft tissue ridge augmentation is performed in non-implant sites to enhance the cleansability and esthetics of the final restoration. During this procedure, an incision is made to expose the recipient site. A soft tissue graft is then obtained either from a suitable site in your mouth and/or a soft tissue substitute and inserted into the area. The tissue graft is secured with dissolvable sutures.

Extraction Site preservation

The bone surrounding your teeth is a special type of bone (alveolar ridge bone) that exists solely to support your teeth. As soon as a tooth is removed, this bone begins to degenerate, causing the extraction site (the ridge) to “shrink” The overlying gum tissue also diminishes as the ridge flattens. This occurs in two dimensions. The first is the loss of horizontal width, creating a narrower remaining ridge than when the tooth was present. The second is the loss of vertical height, making the ridge less “tall”. This process accelerates in areas where you wear a partial or complete denture.

You have many options to prevent this, and it is important that you consider them BEFORE any teeth are extracted. Most of these procedures are best performed at the time the tooth is removed.

Whenever a tooth is to be extracted, socket site preservation is recommended to maintain as much of your underlying jawbone as possible to optimize the future restoration. You will have several choices for replacing the newly missing teeth. All of the restorative replacements rely on the ridge having adequate bone support and contour for the best function and esthetics. The possible options include:

Dental implants: These are root-shaped “anchors” onto which replacement teeth are secured. The more bone support there is for the implants, the stronger the implant replacements and the better the esthetics of the replacement. In some cases, the bone can degenerate to a point where implants can no longer be placed without having more complex bone grafting procedures to create the necessary support. Max Dental Doctors would always prefer to preserve ridge dimension rather than having to rebuild the ridge, because preventing bone loss is much easier, and less expensive, than recreating the bone later.

Fixed bridge: This is a restoration that has crowns (caps) placed on the teeth adjacent to the missing tooth. The replacement tooth (the pontic) spans across the space. If the bone is deficient, there will be an unsightly space under the pontic that may trap food and compromise esthetics.

Other replacement alternatives include removable partial dentures or full dentures. These often are more comfortable the greater the supporting bone present, because there is added support against dislodgement.

There are two important aspects of retaining adequate ridge dimension. Non-traumatic extraction techniques are essential in preserving as much bone as possible, a consideration that will also reduce post-extraction discomfort. Molars are divided into component sections to reduce the forces necessary for their removal and to place less pressure on the surrounding socket bony walls.

In addition to non-traumatic extractions, the second aspect in preventing the collapse of the socket is the placement of bone grafting material into the socket at the time of the extraction.

After the tooth is extracted, the socket will have bone incrementally added and covered with an absorbable membrane. Early on, the grafting material will support the socket dimension; in time, your own bone will replace it. With the ridge dimension secured, the area potentially will be an excellent site for dental implant-supported replacement teeth. In some cases, additional bone grafting may be necessary prior to implant placement, especially if the extraction site is near the upper sinuses.

Although the bone created by socket grafting supports and preserves the socket, it will not do so indefinitely. Placing dental implants approximately six months after the socket grafting will provide the best long-lasting support for preserving the dimension of the ridge, allowing you to function as before the extraction. Otherwise the graft may resorb (diminish) over time.

When a patient is seen for an extraction, Doctors emphasis is always on preserving every millimeter of socket bone to preserve ridge dimension, not on merely removing the tooth.