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Frequently
Asked Questions
What are dental implants?
Are implants for everyone?
What are some tooth replacement options?
What does dental implant treatment involve?
Does placement of the implant in the maxilla
differ from placement in the mandible?
What if a patient has a deformed jaw?
What is Platelet Rich Plasma and what are some
of the benefits of this treatment?
What of the Edentulous Maxilla?
What does implant-supported overdenture treatment
involve?
What is involved in implant-supported fixed
complete bridge/denture treatment?
What of patients who are missing multiple teeth?
What is involved in implant-supported bridge
treatment?
What of patients who are missing a single tooth?
What is involved in implant-supported crown
treatment?
Dental implants offer a more natural, longer
lasting alternative to loose or ill-fitting dentures and missing
or broken teeth, which can negatively impact overall dentition,
as well as facial contouring.
What are dental implants?
A dental implant is a prosthetic tooth root, which is surgically
inserted into the jawbone and designed to hold a prosthetic
tooth or bridge securely in place. As a result of this unique
placement method, dental implants help prevent bone loss and
gum recession. Also, unlike traditional bridgework, which
requires that the surface of neighboring healthy teeth be
ground in order to fasten the bridge, dental implants are
completely independent and do not need the support of any
adjacent teeth. The result is a natural looking, and feeling,
prosthetic tooth, and because surrounding healthy teeth are
not altered in any way to accommodate the dental implant,
better oral health is achieved.
Dental implants allow the wearer to speak and eat naturally,
and in a comfortable manner. The procedure offers a very high
success rate, and is often the most natural looking and feeling
option available in tooth replacement.
Are implants for everyone?
To determine whether or not a patient is a good surgical candidate
to receive a dental implant(s) certain criteria must be met.
These include:
· Good physical, as well as oral, health.
· Sufficient bone tissue to support the fastening of
the implant to the jawbone.
· Healthy gums, which are free of any periodontal disease.
The nature of the dental implant requires that an oral surgeon
work closely with a patient’s periodontist to insure
the best dental implant option, fit, and look possible. Together
they will design a treatment plan specifically tailored to
a patient’s particular needs, and always with a beautiful,
natural smile as the final outcome.
What are some tooth replacement options?
When considering the implant alternative, it is important
to remember that both a tooth and root are being replaced.
Whether a patient is in need of single, multiple, or total
dental replacement, an implant, or “implant-supported”
bridge is the best choice. Simply put, the implant is inserted
and acts as a dental root, while a crown or prosthesis lends
the look of a natural tooth to the existing dentition.
Once upon a time, the only method for replacing a missing tooth
was to apply a “tooth-supported” fixed bridge. While
seemingly adequate, the disadvantages far outweigh any immediate
benefit. The tooth-supported fixed bridge procedure requires
adjacent healthy teeth to be ground down in order to support and
hold the bridge in place with adhesives and cement; thus compromising
the condition of otherwise healthy teeth. Over time, as the cement
begins to wear away, the potential for decay is multiplied. Also
at stake, is the bone surrounding the now missing dental root.
This bone is at an increased risk for resorption and deterioration,
which will affect overall dentition, and a person’s smile.
Gums are more apt to recede, thereby exposing the metal base
or collar of the bridge.
What does dental implant treatment involve?
Once a patient has been found to be a good implant candidate,
the first step is the surgical insertion of the implant(s)
itself into the jaw. The implant(s), which resembles a screw
or cylinder, is allowed to heal for several months as surrounding
bone grows around it to form a secure bond, and strong anchor,
for the prosthetic tooth or implant-supported bridge or denture.
During this process, it is strongly recommended that the patient
wear a temporary crown(s) to keep adjacent teeth from shifting.
After a few months, when sufficient bone growth has occurred,
the implant is then surgically uncovered and an abutment is placed
in the site. This abutment is a small metal post, which serves
as an extension for eventually holding the new prosthetic tooth
in place.
Finally, the gums are allowed to heal for several more weeks before the crown,
or “implant-supported” bridge, is placed and the
patient achieves the full natural look that only dental implants
can give. It is that simple!
Does placement of the implant in the maxilla
differ from placement in the mandible?
Occasionally, the maxilla rear jaw presents some difficulty
for successful implantation due to the lack of sufficient
bone thickness and its close proximity to the sinus. Loss
of bone in this area may result from such things as injury,
tooth loss, or periodontal disease. In these cases, sinus
augmentation may prove necessary and will greatly improve
the functionality of dental implants, while reducing the risk
of complications associated with low bone density.
Sinus augmentation is used to increase bone density in the
sinus floor. A small incision is made in the bone at the designated
implant site. The bone is then lifted into the sinus cavity.
A bone grafting material is applied to the resulting depression,
providing a strong basis for the placement of an implant(s).
Occasionally, the implant is placed at the time of the surgery.
Otherwise, a healing a period of four to twelve months may be
necessary before the implant surgery can be completed.
What if a patient has a deformed jaw?
Dental implants rely on healthy bone for the support of the
prosthetic tooth. Deformities in the jaw from such things
as the use of traditional dentures, periodontal disease, developmental
defects, injury, or trauma, may result in indentation of the
jaw line near the implant site, and insufficient bone mass
to which the dental implant can adhere. In these cases, ridge
modification may prove necessary and will greatly improve
the functionality of dental implants, while reducing the risk
of complications associated with low bone density.
However, a patient suffering from jaw deformity need not be
automatically disqualified as a potential dental implant candidate.
Corrective procedures consisting of lifting the gum away from
the bone ridge and filling the deformed area with bone grafting
material or bone substitute, are available and can create a suitable
environment for the placement of a dental implant(s).
Upon completion of a ridge modification procedure, the bone will be allowed
to heal for four to twelve months before a dental implant(s)
can be placed. Occasionally, implant placement occurs at the
time of ridge modification. Whether placement occurs at the
time of surgery, or at a future date, is determined on a per
patient basis.
What is Platelet Rich Plasma and what
are some of the benefits of this treatment?
Platelet Rich Plasma (PRP) is a blood product consisting of
platelets and plasma derived from the patient’s own blood
at the time of surgery. Although platelets enable blood to
clot, they also contain large amounts of natural growth factors.
These growth factors play an important role in tissue regeneration
and healing. Platelets initiate bone regeneration and repair,
encourage the development of new blood vessels, and accelerate
the body’s own natural healing process.
Benefits of PRP include the minimization of bleeding and bruising,
decreased inflammation and swelling, enhanced wound repair, accelerated
bone growth, and the reduction of overall healing time. Since
PRP is obtained from a patient’s own blood, there is no risk
to the patient of contracting a blood-born disease. Although
the use of PRP varies from procedure to procedure, PRP is generally
applied topically to the wound site. PRP may also be applied
to bone grafts and soft tissue graphs in order to stabilize the
grafting material, thus fixing the bone graft and accelerating
bone growth.
The many benefits outlined above, particularly the regenerative capabilities
of PRP in the production of bone, make PRP an excellent choice
for many oral surgical procedures, especially dental implant
surgery.
What of the Edentulous Maxilla?
Patients with total tooth loss in the maxilla or upper jaw,
face several challenges with regard to the use of a traditional
denture. Thanks to innovations in the field of dentistry,
there are now more restorative options than ever before available
to help those patients. The next few pages will outline some
common problems associated with Edentulous Maxilla and the
methods available to help rectify this condition. This information
is designed to help the patient better understand his/her
dental treatment options.
Option 1: The Complete Denture
A complete denture is a non-fixed, prosthetic set of teeth made
of acrylic and porcelain. Because it can be removed, it is often
unstable and prone to falling or slipping out of place when the
wearer is speaking. Some patients have psychological objections
to wearing a fully removable appliance, while others experience
difficulty with functioning/chewing ability, poor or affected
speech, and decreased taste sensitivity. Dentures have been known
to fracture, and when natural teeth remain in the mandible or
lower jaw, the denture is more likely to feel loose and less secure.
As a result, patients who wear dentures often find it necessary
to have the denture refitted from time to time.
Of course, many denture patients never experience any of these
problems, and enjoy the dentures as a less costly, and shorter
treatment time, alternative to tooth replacement than other restorative
methods.
Option 2: The Implant-Supported Overdenture
The implant-supported overdenture, while similar to the traditional
complete denture, is held in place by four or more dental implants
surgically inserted into the maxilla or upper jaw. In some cases
the palatal coverage is completely eliminated. Like traditional
dentures, the implant-supported denture is removable. However,
the implant-supported denture is affixed onto a metal bar attached
to the dental implants. This stabilizes the implant providing
a mechanism for keeping the denture in place and improving function.
One of the many advantages of this option is that the removable
denture enables better daily cleaning of the denture and support
bar. It allows the dentist to alter the profile and facial contours
to the patient’s satisfaction. Also, because the implants
lend more overall stability to the denture, the bite force is
greatly increased.
The disadvantage to this option is that the treatment time
is longer, requiring two surgical procedures, as opposed to the
traditional denture. Similarly, implant screws can fracture,
loosen, and sometimes fail. The denture or prosthetic teeth may
also fracture as well.
What does implant-supported overdenture
treatment involve?
A treatment-planning phase is conducted and completed by the
restorative dentist and oral surgeon prior to implant placement.
The total number of implants, implant positioning and final
prosthesis design are determined at this time. During the
first surgical treatment, the implants are placed in the maxilla
or upper jaw. The upper denture is not placed for a period
of up to two weeks while the gum tissue is healing. The oral
surgeon then recommends a four to six month waiting period
while bone growth around the implant occurs.
Once sufficient bone growth has taken place in the site, the
oral surgeon uncovers the implants and places the abutment,
which will emerge from the gum tissue. After a short healing
period, the restorative dentist begins fabrication of the
overdenture and bar. This fabrication includes the preliminary
impression, the final impression, the wax try-in, the bar
try-in, and finally, the insertion of the denture. Once all
adjustments have been made the patient schedules routine maintenance
and reevaluation appointments.
For those patients suffering from bone and gum tissue loss,
and augmentation or building-up of the bone or tissue must be
performed prior to, or at the same time as, implant placement.
Augmentation allows patients who would otherwise not be considered
suitable implant candidates to enjoy the benefit of dental implant
surgery. In augmentation, the site is built up by using a hard
or soft material. This is done primarily to ensure the greatest
possible success rate of the implant.
Option 3: The Implant-Supported Fixed Complete Bridge/Denture
This form of restoration is fixed and non-removable, and supported
by multiple implants placed in the maxilla or upper jaw. The
implant-supported fixed complete bridge/denture is constructed
of metal, denture acrylic, and denture teeth, or metal and porcelain.
The advantage of this type of restoration is that it is more
stable, and although fixed in place, can be removed by a dentist.
Also, over time, this type of restoration has been shown to stabilize
bone height. Unfortunately, occasional implant failure or loosening,
as well as prosthesis fracturing, while highly unlikely, has been
known to occur. Some patients experience difficulty performing
daily maintenance around the fixed bridge/denture due to its shape.
For some patients, the shape of the fixed bridge/denture is
sometimes responsible for difficulty when speaking. However,
many patients find that through practice and a bit of adjustment,
their speech returns to normal within a short period of time.
What is involved in implant-supported
fixed complete bridge/denture treatment?
A treatment-planning phase, much like that of the implant
supported overdenture, is conducted and completed by the restorative
dentist and oral surgeon prior to implant placement. Similarly,
two surgical procedures are required. These procedures must
be coordinated with the restorative dentist who will fabricate
the prosthetic teeth. The final result is a prosthesis fastened
by multiple implants. Although removable by a dentist, this
method offers maximum stability and overall performance.
NOTE: The success of the three options outlined above depends as much
on a routine schedule of oral hygiene and maintenance with
the patient’s restorative dentist and oral surgeon, as
it does on the actual surgery itself. All teeth, whether natural
or prosthetic, require good regular care.
What of patients who are missing multiple
teeth?
Patients who have lost multiple teeth face a number of dental
challenges. First, there is the aesthetic concern, especially
when there are teeth missing in the anterior regions. A patient
who is missing teeth in the posterior regions might experience
difficulty masticating. Finally, a jaw that is missing any
teeth is susceptible to shifting and moving of other teeth.
Fortunately for these patients, there are several treatment
options available to help correct this condition.
Option 1: The Removable Partial Denture (RPD)
A removable partial denture is a set of replacement prosthetic
teeth and gums made of metal and acrylic. The patient who chooses
this option will enjoy a relatively short treatment time period
and comparatively lower cost. The removable partial denture adequately
replaces missing teeth and gum tissue, while stabilizing the bite
and preventing shifting or movement among other already existing
teeth.
However, there are several disadvantages associated with the
removable partial denture, which should be considered very carefully
before selecting this treatment option. Most of these result
from the “removability” of the appliance. For example,
the patient who wears a removable partial denture is likely to
find the appliance bulky, experience difficulty speaking, and
in some cases, note that their sense of taste has been altered.
The patient who wears a removable partial denture is at a greater
risk for tooth decay, gum tissue irritation, and bone problems.
Finally, the removable partial denture is not always fully concealed
when a patient smiles, potentially exposing metal or wires to
anyone in the company of the patient.
Option 2: The Conventional Bridge
A conventional bridge is a prosthesis made of metal, or metal
and porcelain. The teeth surrounding the site are ground down
and the bridge is cemented onto these “prepared” teeth.
This form of restoration is fixed, and cannot be removed by the
patient. A conventional bridge is aesthetically pleasing, a good
alternative for the treatment of missing teeth, and offers adequate
support to prevent neighboring teeth from shifting or moving.
The disadvantage of this treatment option is that the crowned
teeth are at an increased risk for tooth decay, nerve damage,
gum tissue irritation, and bone problems which could lead to periodontal
disease. The restoration itself is susceptible to fracturing,
cracking, or becoming loose and unstable.
Option 3: The Implant-Supported Bridge
This form of restoration is fixed and non-removable, and supported
by multiple implants placed in the maxilla or upper jaw. The
implant-supported bridge/denture is constructed of metal, denture
acrylic, and denture teeth, or metal and porcelain. The advantage
of this type of restoration is that it is more stable, and although
fixed in place, can be removed by a dentist. Also, over time,
this type of restoration has been shown to stabilize bone height.
Unfortunately, occasional implant failure or loosening, as well
as prosthesis fracturing, while highly unlikely, has been known
to occur. Some patients experience difficulty performing daily
maintenance around the fixed bridge/denture due to its shape.
For some patients, the shape of the fixed bridge/denture is
sometimes responsible for difficulty when speaking. However,
many patients find that through practice and a bit of adjustment,
their speech returns to normal within a short period of time.
What is involved in implant-supported
bridge treatment?
A treatment-planning phase is conducted and completed by the
restorative dentist and oral surgeon prior to implant placement.
The total number of implants, implant positioning and final
prosthesis design are determined at this time. During the
first surgical treatment, the implants are placed in the maxilla
or upper jaw. The upper denture is not placed for a period
of up to two weeks while the gum tissue is healing. The oral
surgeon then recommends a four to six month waiting period
while bone growth around the implant occurs.
Once sufficient bone growth has taken place in the site, the
oral surgeon uncovers the implants and places the abutment, which
will emerge from the gum tissue. After a short healing period,
the restorative dentist begins fabrication of the overdenture
and bar. This fabrication includes the preliminary impression,
the final impression, the wax try-in, the bar try-in, and finally,
the insertion of the denture. Once all adjustments have been
made the patient schedules routine maintenance and reevaluation
appointments.
For those patients suffering from bone and gum tissue loss,
and augmentation or building-up of the bone or tissue must be
performed prior to, or at the same time as, implant placement.
Augmentation allows patients who would otherwise not be considered
suitable implant candidates to enjoy the benefit of dental implant
surgery. In augmentation, the site is built up by using a hard
or soft material. This is done primarily to ensure the greatest
possible success rate of the implant.
What of patients who are missing a single
tooth?
A patient missing a single tooth faces the same problems as
the patient missing multiple teeth. There are aesthetic concerns,
and problems with mastication. This patient also risks shifting
and movement of neighboring teeth, which eventually will affect
a patient’s overall dentition.
Fortunately for these patients, there are several treatment
options available to help correct this condition. Among them
are, a resin retained bridge, a conventional bridge, a removable
partial denture, and an implant-supported single crown.
Option 1: The Conventional Bridge
A conventional bridge is a prosthesis made of metal, or metal
and porcelain. The teeth surrounding the site are ground down
and the bridge is cemented onto these “prepared” teeth.
This form of restoration is fixed, and cannot be removed by the
patient. A conventional bridge is aesthetically pleasing, a good
alternative for the treatment of missing teeth, and offers adequate
support to prevent neighboring teeth from shifting or moving.
The patient who chooses this restoration option can expect to
enjoy a shorter treatment time, as well as a lower overall cost
than other alternative methods.
The disadvantages of this treatment option are that the crowned
teeth are at an increased risk for tooth decay, nerve damage,
gum tissue irritation, and bone problems which could lead to periodontal
disease. Also, many patients report difficulty performing basic
oral hygiene with a conventional bridge in place. The restoration
itself is susceptible to fracturing, cracking, or becoming loose
and unstable.
Option 2: A Resin-Retained Bridge or Maryland Bridge
A resin-retained partial denture is a metal and porcelain prosthetic
tooth. This method is usually limited to the anterior teeth only.
The bridge is cemented to the inside of the teeth adjacent to
the site. Like the conventional bridge, a resin-retained bridge
is fixed and cannot be removed by the patient. Yet this method,
which has a very short treatment time, requires less preparation
of surrounding teeth, and is therefore less compromising to healthy
teeth than a conventional bridge. The resin-retained bridge is
a good alternative for the treatment of a missing tooth. This
method stabilizes the bite, while helping to prevent shifting
or movement among opposing teeth.
The disadvantages of this treatment option include loosening
or “de-bonding”, sensitivity, and fracture of the restoration.
The resin-retained bridge is not always fully concealed when
a patient smiles, thereby potentially exposing the metal to anyone
in the company of the patient. The longevity of this method also
varies, so much so, that many dentists consider it a temporary
restoration, recommending the treatment for mostly younger patients.
Option 3: The Removable Partial Denture (RPD)
A removable partial denture is a replacement prosthetic tooth
and gum made of metal and acrylic. The patient who chooses this
option will enjoy a relatively short treatment time period and
low cost. The removable partial denture adequately replaces missing
teeth and gum tissue, while stabilizing the bite and preventing
shifting or movement among other already existing teeth. Also,
additional teeth can be added to the appliance at a later time.
However, there are several disadvantages associated with the
removable partial denture, which should be considered very carefully
before selecting this treatment option. Most of these result
from the “removability” of the appliance. For example,
the patient who wears a removable partial denture is likely to
find it bulky, and experience difficulty when speaking or masticating.
This patient is at a greater risk for tooth decay, gum tissue
irritation, and bone problems. It may be necessary to crown or
contour neighboring healthy teeth in order to insert and remove
the partial denture. Finally, the removable partial denture is
not always fully concealed when a patient smiles, potentially
exposing its metal to anyone in the company of the patient.
Option 4: The Implant-Supported Crown
The implant-supported crown is a prosthetic tooth fixed in place
by a single implant. However, it can be designed to be retrievable
by a dentist for repair or updating when necessary. This treatment
option offers the patient many advantages. For example, because
it is not necessary to prepare or shape neighboring teeth, healthy
teeth are not compromised in any way. The spaces between the
teeth remain clear of any restoration material making them easy
to access and clean on a daily basis. Studies show that bone
preservation and stabilization occur around the implant shortly
after placement.
Although few disadvantages are associated with this treatment
option, the patient should consider that cemented crowns often
become loose, as do the screws in retrievable crowns. In very
rare cases, fracturing of the restoration, or failure of the implant
is possible. And while the implant-supported crown offers a natural-looking
restoration alternative, it does not replace missing tissue between
the teeth, which can affect overall appearance.
NOTE: Recent clinical studies show that more than 90% of all implants
placed over 30 years ago are still successfully functioning
today
What is involved in implant-supported
crown treatment?
A treatment-planning phase is conducted and completed by the
restorative dentist and oral surgeon prior to implant placement.
The total number of implants, implant positioning and final
prosthesis design are determined at this time. During the
first surgical treatment, the implants are placed in the maxilla
or upper jaw. The upper denture is not placed for a period
of up to two weeks while the gum tissue is healing. The oral
surgeon then recommends a four to six month waiting period
while bone growth around the implant occurs.
Once sufficient bone growth has taken place in the site, the
oral surgeon uncovers the implants and places the abutment, which
will emerge from the gum tissue. After a short healing period,
the restorative dentist begins fabrication of the overdenture
and bar. This fabrication includes the preliminary impression,
the final impression, the wax try-in, the bar try-in, and finally,
the insertion of the denture. Once all adjustments have been
made the patient schedules routine maintenance and reevaluation
appointments.
For those patients suffering from bone and gum tissue loss,
and augmentation or building-up of the bone or tissue must be
performed prior to, or at the same time as, implant placement.
Augmentation allows patients who would otherwise not be considered
suitable implant candidates to enjoy the benefit of dental implant
surgery. In augmentation, the site is built up by using a hard
or soft material. This is done primarily to ensure the greatest
possible success rate of the implant.
NOTE: The success of the three options outlined above
depends as much on a routine schedule of oral hygiene and
maintenance with the patient’s restorative dentist and
oral surgeon, as it does on the actual surgery itself. All
teeth, whether natural or prosthetic, require good regular
care.
Mission Statement
This practice is dedicated to conducting itself in an ethical
manner. Therefore, patient need, not profit, determines every
treatment plan prescribed by our surgeons. We are the humble
servants of our patients, and our goal is to provide them with
the best treatment and care available.
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