Implants

IMPLANTS

Dental Implants are one of the possible solutions to tooth or teeth replacement. It consists of a titanium fixture that is placed into the bone after which a crown, bridge or denture is attached to it.

The concept of implanting metal or prosthetic roots into the jaws to support teeth is not new. Archeologists have uncovered attempts at dental implants in mummies found in ancient Egypt.

Replacing a Single Tooth

If you are missing a single tooth, one implant and a crown can replace it.

Replacing Several Teeth

If you are missing several teeth, implant-supported bridges can replace them.

Replacing All of Your Teeth

If you are missing all of your teeth, an implant-supported full bridge or full denture can replace them.

Bone Grafting

In certain cases, bone grafting procedures have to be carried out to ensure that the implant has sufficient bone coverage and stability. Bone grafting can be done before implant or during implant placement. Your dentist will access each individual case and advise you accordingly.

Sinus Augmentation

A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditonally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants.

Dr. Per-Ingvar Branemark is credited with the discovery and development of the technique of osseointegration. Osseointegration is defined as a chemical and mechanical bonding of a titanium implant (essentially a titanium screw or fixture) to the surrounding bone. These implants act as artificial roots, or anchors, for the replacement of missing teeth. Implants give replacement teeth a more stable base and improve the use one can get out of bridgework and dentures.

Dental implant treatment is performed with a team. The team consists of a restorative dentist who will ultimately fabricate the prosthesis or teeth that are to be replaced; and an experienced surgeon who will place the dental implants in the jaw bone. Careful evaluation of the patient and meticulous planning is essential in providing predictable and satisfactory results.

The treatment consists of 3 phases

The first phase of treatment is the placement of the implants by the surgical specialist.

The second phase of the implant treatment is performed after an appropriate period of healing. Bone heals slowly. A period of approximately 3-6 months is required for the process of osseointegration to be complete. The second phase of treatment consists of the placement of abutments or small metal posts to the implanted fixtures.

The third phase of treatment consists of the restorative phase. In this phase the new replacement teeth are fabricated and placed on the implants and abutments.

Dentures

DENTURES

A denture is a removable replacement for missing teeth and adjacent tissues. It is made of acrylic resin, sometimes in combination with various metals.

There are basically 2 types of dentures – Full / Complete Dentures or Partial Dentures.

Full/Complete Dentures

Full/Complete Dentures are removable prosthesis that replaces the whole set of teeth on the upper and lower arch. It uses the remaining surrounding soft and hard tissues of the oval cavity for support.

In certain cases if the support is insufficient, dental implants may be indicated to help support the full/complete denture.

Partial Dentures

Partial Dentures are removable prosthesis that replaces one or more teeth on the upper and lower arch. It is supported by one or more remaining teeth left on the arch as well as the surrounding soft tissues. The dentist will come up with the design of the partial denture after a thorough assessment of the condition of the remaining teeth as well as the surrounding soft tissue.

Candidates for complete dentures have lost most or all of their teeth. A partial denture is suitable for those who have some natural teeth remaining. A denture improves chewing ability and speech, and provides support for facial muscles. It will greatly enhance the facial appearance and smile.Complete or full dentures are made when all of your natural teeth are missing. You can have a full denture on your upper or lower jaw, or both.

Complete dentures are called “conventional” or “immediate” according to when they are made and when they are inserted into the mouth. Immediate dentures are inserted immediately after the removal of the remaining teeth. To make this possible, the dentist takes measurements and makes the models of the patient`s jaws during a preliminary visit.

An advantage of immediate dentures is that the wearer does not have to be without teeth during the healing period. However, bones and gums can shrink over time, especially during the period of healing in the first six months after the removal of teeth. When gums shrink, immediate dentures may require rebasing or relining to fit properly. A conventional denture can then be made once the tissues have healed. Healing may take at least 6-8 weeks. An over denture is a removable denture that fits over a small number of remaining natural teeth or implants. The natural teeth must be prepared to provide stability and support for the denture.

Partial dentures are often a solution when several teeth are missing.

Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases, which are connected by metal framework. Removable partial dentures attach to your natural teeth with metal clasps or devices called precision attachments. Precision attachments are generally more esthetic than metal clasps and are nearly invisible. Crowns on your natural teeth may improve the fit of a removable partial denture and they are usually required with attachments. Dentures with precision attachments generally cost more than those with metal clasps.

How are dentures made?

The denture process takes about one month and five appointments: the initial diagnosis is made; an impression and a wax bite are made to determine vertical dimensions and proper jaw position; a “try-in” is placed to assure proper color, shape and fit; and the patient`s final denture is placed,following any minor adjustments.

First, an impression of your jaw is made using special materials. In addition, measurements are made to show how your jaws relate to one another and how much space is between them (bite relationship). The color or shade of your natural teeth will also be determined. The impression, bite and shade are given to the dental laboratory so a denture can be custom-made for your mouth.

The dental laboratory makes a mold or model of your jaw, places the teeth in a wax base, and carves the wax to the exact form wanted in the finished denture. Usually a “wax try-in” of the denture will be done at the dentist`s office so any adjustments can be done before the denture is completed.

Getting used to your denture

For the first few weeks, a new denture may feel awkward or bulky. However, your mouth will eventually become accustomed to wearing it. Inserting and removing the denture will require some practice. Your denture should easily fit into place. Never force the partial denture into position by biting down. This could bend or break the clasps.

At first, you may be asked to wear your denture all the time. Although this may be temporarily uncomfortable, it is the quickest way to identify those denture parts that may need adjustment. If the denture puts too much pressure on a particular area, that spot will become sore. Your denture can be adjusted to fit more comfortably. After making adjustments, you may need to take the denture out of your mouth before going to bed and replace it in the morning.

Start out by eating soft foods that are cut into small pieces. Chew on both sides of the mouth to keep even pressure on the denture. Avoid sticky or hard foods, including gum. You may want to avoid chewing gum while you adjust to the denture.

Care of your denture

It’s best to stand over a folded towel or a sink of water when handling your denture, just in case you accidentally drop it. Brush the denture (preferably with a denture brush) daily to remove food deposits and plaque, and keep it from becoming permanently stained. Avoid using a brush with hard bristles, which can damage the denture. Pay special attention to cleaning teeth that fit under the denture`s metal clasps. Plaque that becomes trapped under the clasps will increase the risk of tooth decay.

Hand soap or mild dishwashing liquid to clean dentures is also acceptable. Other types of household cleaners and many toothpastes are too abrasive and should not be used for cleaning dentures. A denture could lose its proper shape if it is not kept moist. At night, the denture should be placed in soaking solution or water. However, if the appliance has metal attachments, they could be tarnished if placed in soaking solution. Even with full dentures, you still need to take good care of your mouth. Every morning, brush your gums, tongue and palate with a soft-bristled brush before you put in your dentures. This removes plaque and stimulates circulation in the mouth. Selecting a balanced diet for proper nutrition is also important for maintaining a healthy mouth.

Adjustments

Over time, adjusting the denture may be necessary. As you age, your mouth naturally changes, which can affect the fit of the denture. Your bone and gum ridges can recede or shrink, resulting in a loose-fitting denture. Loose dentures can cause various problems, including sores or infections. Dentures that do not fit properly can be adjusted.

If your denture no longer fits properly, if it breaks, cracks or chips, or if one of the teeth becomes loose, see your dentist immediately. Complicated repairs may require that the denture be sent to a special dental laboratory.

Over time, dentures will need to be relined, re-based, or re-made due to normal wear. Dentures may need to be replaced if they become loose and the teeth show signs of significant wear.

Common concerns

Eating will take a little practice. Start with soft foods cut into small pieces. Chew slowly using both sides of your mouth at the same time to prevent the dentures from tipping. As you become accustomed to chewing, add other foods until you return to your normal diet.

Continue to chew food using both sides of the mouth at the same time. Be cautious with hot or hard foods and sharp-edged bones or shells. Some people worry about how dentures will affect their speech. Consider how your speech is affected when you have a number of your natural teeth missing.

Pronouncing certain words may require practice. Reading out loud and repeating troublesome words will help. If your dentures “click” while you`re talking, speak more slowly. You may find that your dentures occasionally slip when you laugh, cough or smile. Reposition the dentures by gently biting down and swallowing. If a speaking problem persists, consult your dentist.

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