Procedures

Today, the preferred method of tooth replacement is dental implant treatment. Dental implants replace missing tooth roots, and form a stable foundation for replacement teeth that look, feel, and function like your natural teeth. Dental implants also help preserve the remaining bone by providing the stimulation previously provided by the natural tooth roots.

There are numerous advantages of dental implant treatment over other treatment options. It is not necessary to grind down the adjacent teeth for a bridge, or secure a partial denture to adjacent teeth with clasps or hooks, which can cause tooth loosening. Implant-supported replacement teeth spare patients many of the disadvantages of traditional false teeth.

Implant Supported Crown

Dental implants are available in several different forms. The most common dental implants are called "root form implants." Root form implants are similar to teeth in that they mimic roots of teeth. They can be used to support individual teeth or to help anchor removable dentures. The implants are placed under the skin and into the bone at the first surgical appointment. This surgical appointment is performed in the dental office under local anesthetic, and when necessary, with oral sedation. The dental implants are allowed to heal for a period of two to four months. Sometime after this healing time, the implants must be exposed at a brief second surgical appointment prior to placing a post (abutment) inside. The post becomes the extension to which a crown is attached. The total process tends to take a period of four to six months

Tooth Supported Bridge Implants are made of a bio-compatible material called titanium, which cannot decay and does not need root canal therapy. An advantage of implants is that they stimulate bone growth, and thus, prevent future bone loss. Bone behaves similarly to muscle. When the muscle is stimulated and active, it will grow. If the muscle stops being active, it shrinks. The same events occur with bone; however if bone disappears, it can only be replaced with a bone graft.

Surgical placement of an implant fixture or post is the first step in your dental implant treatment.

A dental implant is surgically inserted into the jawbone and covered by the gum or by a special 'healing cap'. This procedure takes less than 1 hour and can be done with local anesthetic only. It is painless and produces little or no post-operative discomfort.

Top quality dental implants permanently integrate with your jawbone and do not need to be replaced or removed.

Implant Supported Bridges

ADA Video on Dental Implants

In order to determine the best treatment for each patient, an extensive number of diagnostic records must be taken. These include X-rays, models, photos, an examination and possibly a CT Scan or Icam. This information together with the patient's desires will determine the ideal treatment. It is impossible to give an exact estimate of time, fees or extent of treatment without a blueprint of the treatment plan. Occasionally, if a patient does not have a sufficient amount of bone to place an implant, a bone graft may be necessary prior to implant placement. The amount of available bone is determined through the use of the diagnostic records. Dr. Gonzalez will explain any additional procedures necessary prior to implant placement.

Traditional Removable Partial Denture If you have a budget concern, please discuss this with the doctor prior to his planning out your treatment. The doctor will design the best possible outcome for your desires and budget.

A dental implant designed to replace a single tooth is composed of three parts: the titanium implant that fuses with the jawbone; the abutment, which fits over the portion of the implant that protrudes from the gum line; and the crown, which is created by a prosthodontist or restorative dentist and fitted onto the abutment for a natural appearance.

Many people who are missing a single tooth opt for a fixed bridge; but a bridge may require the cutting down of healthy, adjacent teeth that may or may not need to be restored in the future. Then there is the additional cost of possibly having to replace the bridge once, twice or more over the course of a lifetime. Similarly, a removable partial denture may contribute to the loss of adjacent teeth. Studies show that within five to seven years there is a failure rate of up to 30% in teeth located next to a fixed bridge or removable partial denture.

Further, conventional dentures may contribute to the loss of bone in the area where teeth are missing. As illustration (a) indicates, the presence of natural teeth preserves the jawbone. When a tooth is missing, as in illustration (b), the bone may erode and weaken until it may be necessary for your oral and maxillofacial surgeon to graft bone to the area to strengthen it for placement of a dental implant. When a missing tooth is replaced by a dental implant, the fusion, or osseointegration, of the implant and bone provides stability, just as the natural tooth did.

If you are missing several teeth in the same area of your mouth, you may still enjoy the confidence and lifestyle benefits that come with dental implants. Your oral and maxillofacial surgeon will place two or more dental implants, depending on the number of teeth that are missing. Your replacement teeth will be attached to the implants to allow excellent function and prevent bone loss. The implants will serve as a stable support that tightly locks into your replacement teeth and dentures to prevent slipping and bone loss.

With an overall success rate of about 95% and almost 50 years of clinical research to back them up, dental implants are frequently the best treatment option for replacing missing teeth.

Fixed bridges may require the shaping or cutting down of adjacent healthy teeth

Bone is maintained by the presence of natural teeth or implants (a). Bone loss occurs with the loss of teeth (b).

Modern dental implants have been maintained in individual cases for more than twenty years. An implant, although made of metal, still requires continued care after placement. This includes patient home care and professional maintenance. The life of the implant varies with factors of patient health (diabetes, HIV, metabolic bone disease), patient habits (smoking, oral hygiene) and structural overload.

It is impossible to predict exactly how long an implant will last, therefore it is impossible to predict or guarantee success. If an implant fails it may be replaced, however the prosthesis (overdenture/crowns) will need to be remade. It is not uncommon to have success rates over 95% in the field of dental implants

Implant supported appliances can bring back normal function and a confident smile for people who are missing many or all of their teeth.

Keep in mind, an implant-supported bridge or a full-arch appliance requires less implant fixtures for support than a number of teeth it is replacing. For instance, only six dental implants are required to support a full-arch appliance spanning twelve teeth.

Additionally, if you require an implant supported denture, mini dental implants may offer a great low-cost alternative to conventional surgical treatment with full-size dental implants.

Mini-implants (also called, transitional implants) may help patients who are experiencing problems with their existing dentures. If your dentures are shifting in position and irritating your gums you could secure them with mini-implants. Mini-implants are not a substitute to more expensive regular implants.

Many patients who have selected dental implants describe a quality of life that is much more comfortable and secure than the lifestyle endured by those with fixed bridges or removable dentures. Dentures often make a person feel and look older than they are, cause embarrassment in social situations when they slip and click, and restrict the everyday pleasure of eating comfortably.

When they count the benefits they enjoy as a result of their dental implants, patients say their implants eliminate the day-to-day frustrations and discomfort of ill-fitting dentures. They allow people to enjoy a healthy and varied diet without the restrictions many denture wearers face. With a sense of renewed self-confidence, many people rediscover the excitement of an active lifestyle shared with family and friends and the chance to speak clearly and comfortably with co-workers. For all these reasons, people with dental implants often say they feel better... they look better... they live better.

Dental Implants are a Team Effort

Dental implants combine the best of modern science and technology, including a team approach spanning several disciplines.

A successful implant requires that all parties involved — the patient; the restorative dentist, who makes the crown for the implant; and the oral and maxillofacial surgeon, who surgically places the implant, follow a careful plan of treatment. All members of the implant team stay in close contact with each other to make sure everyone clearly understands what needs to be done to meet the patient's expectations.

The team is organized as soon as the decision for placing a dental implant is reached. Following an evaluation that includes a comprehensive examination, x-rays and a consultation with the patient and members of the implant team, the oral and maxillofacial surgeon surgically places the posts, or implants, in the patient's jaw.

When the implants have stabilized in the jaw, the restorative dentist prepares an impression of the upper and lower jaws. This impression is used to make the model from which the dentures or crowns are created. The teamwork continues long after the implant and crown have been placed. Follow-up examinations with the oral and maxillofacial surgeon and restorative dentist are critical, and progress is carefully charted. Both the oral and maxillofacial surgeon and the restorative dentist continue to work together to provide the highest level of aftercare.

Implants can be used to replace one missing tooth so that the replacement looks and feels natural (a). Also, two or more implants can serve as a stable support for the replacement of many teeth (b).

Whether you are a young, middle-aged or older adult; whether you need to replace one tooth, several teeth, or all your teeth, there is a dental implant solution for you. With the exception of growing children, dental implants are the solution of choice for people of all ages, even those with the following health concerns:

Existing Medical Conditions. If you can have routine dental treatment, you can generally have an implant placed. While precautions are advisable for certain conditions, patients with such chronic diseases as high blood pressure and diabetes are usually successful candidates for dental implant treatment.

Gum Disease or Problem Teeth. Almost all implants placed in patients who have lost their teeth to periodontal disease or decay have been successful.

Currently Wearing Partials or Dentures. Implants can replace removable bridges or dentures, or they can be used to stabilize and secure the denture, making it much more comfortable.

Smokers. Although smoking lowers the success rate of implants, it doesn't eliminate the possibility of getting them.

Bone Loss. Bone loss is not uncommon for people who have lost teeth or had periodontal disease. Oral and maxillofacial surgeons are trained and experienced in grafting bone to safely and permanently secure the implant.

Implant tooth replacement in children is usually deferred until their jaw growth is complete. There are, however, some instances when a dental implant may be appropriate, such as when it is part of the child's orthodontic treatment plan. Your family dentist or orthodontist can guide you in this instance.

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 traditionally 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 bone grafting can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants.

The sinus is essentially a hole in the bone. Since this is an empty space, there is no bone to support an implant. If there is an inadequate amount of bone below the level of the sinus to support an implant, bone can be grown within the sinus to increase the amount of supporting bone. This is achieved with the use of a Sinus Augmentation.

Sinus Augmentations are achieved by raising the floor of the sinus. A bone graft material is then placed below the sinus floor to allow new bone to grow. The new bone that grows provides additional support for the implant(s). Sometimes implants can be placed at the same time as a sinus augmentation. Other times bone has to grow in the sinus before the implant(s) can be placed. This is generally determined by the amount of bone present below the floor of the sinus. Sinus Augmentation has been shown to greatly increase the success of implants in the upper back areas of the jaw.

Insufficient Bone Below Sinus

Implant After Sinus Augmentation

Pre-Treatment

Day of Implant Placement and Sinus Augmentation

6 mo after Implant Placement + Sinus Augmentation

Deformities in the upper or lower jaw can leave you with inadequate bone in which to place dental implants. To correct the problem, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or bone substitute to build up the ridge. Ridge grafting modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come.