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Posts for tag: dental implants

By Dr. Mark C. Pothitakis
January 02, 2022
Category: Dental Procedures
Tags: dental implants  
AnImplantCouldFailifSupportingStructuresBecomeDiseased

From an appearance standpoint, it might be difficult to tell a new dental implant and crown from a natural tooth. There is, however, one big difference between an implant and crown from a real tooth, one which could impact an implant's longevity: how each attach to the jaw.

A natural tooth is held in place by a tough, but elastic gum tissue called the periodontal ligament. The ligament lies between the tooth and the bone, extending out tiny fibers that attach to both. This holds the teeth firmly in place, while also allowing the tooth to gradually move in response to mouth changes. It also facilitates the delivery of infection-fighting agents to protect the teeth and gums against disease.

By contrast, an implant is imbedded in a prepared channel shaped into the jaw bone. Over time, bone cells grow and adhere to the titanium surface, which serves to fully secure the implant to the jaw. The periodontal ligament doesn't attach to the implant, so it relies solely for stability on its attachment to the bone.

Thus, although highly durable, implants don't share the properties real teeth have because of their connection with the periodontal ligament. They don't move dynamically like real teeth; and more importantly, they lack some of the disease-fighting resources available to natural teeth.

So, what difference would the latter make? Implants aren't composed of organic material, and are therefore unaffected by bacterial infection. The problem, though, is that the gums and bone supporting the implant are susceptible to disease. And, because an implant lacks the defenses of a real tooth that the periodontal ligament provides, an infection within these tissues could quickly undermine their support and cause the implant to fail.

To avoid this and protect the longevity of your implant, it's important that you practice daily oral hygiene. You should brush and floss your implant to clear away disease-causing plaque from the surrounding tissues just as you do natural teeth.

Your dental provider will also include cleaning around your implants during your regular visits, albeit with different tools that are more protective of the implant and crown surfaces. During these visits they'll also closely inspect the tissues around the implant for any signs of infection and initiate prompt treatment if necessary.

If you would like more information on taking care of your 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 Implant Maintenance.”

AddressingTheseFactorsHelpsEnsureaSatisfyingExperienceWithImplants

Patients and dentists alike love dental implants. For one, they're unique among other dental restorations because they replace the tooth root as well as the visible crown. It's actually their role as a root replacement that makes them so durable and lifelike.

But it still falls to the dentist to create as natural an appearance as possible through proper implant placement. It requires extensive technical skill and artistry to surgically place an implant in the precise location inside the jawbone to gain the best outcome. It's even more critical when the tooth is a highly visible one within the "smile zone"—the teeth others see when we smile.

With a patient's smile appearance on the line, it's important that we carefully consider a number of factors that can impact implant success and address them as needed in our treatment plan.

The gums. The gums are to the teeth as a frame is to a masterpiece painting. If the gums don't correctly cover the new implant, the final outcome won't look natural. Positioning the implant precisely helps ensure the gums look attractive. It may also be necessary to augment the gums, such as grafting surgery to encourage growth of lost gum tissue, to achieve the most lifelike result.

The socket. For simple extractions (as opposed to surgical removals), a dentist deftly manipulates the ligament holding the tooth in place to loosen and remove it. It's important to do this carefully—if the tooth's bony socket becomes damaged in the process (or because of other trauma), it can complicate implant placement in the future.

The supporting bone. Likewise, the bone in which the implant is imbedded must be reasonably healthy and of adequate volume. Besides not providing enough support, inadequate bone also makes it difficult to place an implant for the most attractive result. Bone grafting at the time of extraction minimizes bone shrinkage. If bone shrinkage had occurred, the Inadequate bone may require grafting, particularly if there is a lag time between extraction and implantation. In extreme cases, though, a patient may need to choose a different restoration.

The usual process for implants—planning, surgical placement and the healing period after surgery—can take time. Paying attention to these and other factors will help ensure that time and the effort put into this process has a satisfying outcome—an attractive, natural and long lasting smile.

If you would like more information on 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 “Immediate Dental Implants.”

By Dr. Mark C. Pothitakis
October 19, 2021
Category: Dental Procedures
Tags: dental implants  
ImplantsCanProvideEffectiveOptionsforTotalToothReplacement

Losing all your teeth can dramatically impact your life for the worst. Fortunately, we can give you your "teeth" back. The most common way, at least until a few decades ago, is with custom dentures, which reasonably restore life-like appearance and dental function. But it does have one major drawback—it can't stop bone loss.

Loss of bone in the jaws often occurs with missing teeth. Normally, the bone continuously generates newer cells to replace older ones that have died. Chewing stimulates this growth as the force generated travels up through the teeth to the bone. But when teeth go missing, new bone growth slows, eventually causing the bone's volume and density to decrease.

Dentures can't reactivate this lost stimulation, and so bone loss may continue. Dentures even accelerate this loss as the compressive forces applied to the bony ridge are detrimental. This often leads to a "loosening" of a denture's fit that can make them uncomfortable and less secure to wear.

Today, however, patients with total tooth loss have another option that could alleviate the problem of bone loss—dental implants. Since their inception forty years ago, implants have become the preferred method of both dentists and patients for tooth replacement.

Implants consist of a titanium metal post that's surgically imbedded into the jawbone. Bone cells are attracted to this particular metal, readily multiplying and adhering to the implant's titanium surface. Because of this, an implant can slow or even stop bone loss.

Most people are familiar with the single tooth implant with an attached lifelike crown. Although this use of implants could be used to restore total tooth loss, it can be quite costly replacing over two dozen teeth individually.

But implants could still be part of the answer for someone with complete tooth loss, because they can also be used to support traditional restorations. A few implants strategically placed around the jaw can support either a removable denture or a fixed bridge.

Besides being a cost-effective way to add support to these traditional tooth replacements, the inclusion of implants will likely decrease continuing bone loss. Most importantly, it can give you back your dental function—and your smile to boot.

If you would like more information on dental implant options, 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 “New Teeth in One Day.”

By Dr. Mark C. Pothitakis
September 09, 2021
Category: Dental Procedures
Tags: dental implants   crowns  
WhichImplantCrownAttachmentMethodisBestforYou

If you've decided on a dental implant to replace a missing tooth, you've made a great choice. Implants are a big favorite of both dentists and patients, not only for their life-likeness, but also their durability. Studies show that more than 95% of implants survive after ten years.

As you may know, single tooth implants are composed of two main parts: a metal post (usually titanium) imbedded in the jawbone; and a life-like crown affixed to the end of the post. But what you may not know is that there are two ways to attach the crown—either with screws or with dental cement.

Neither way is superior to the other—both have their own set of advantages and disadvantages. A cemented crown, for instance, usually looks more like a natural tooth than a screw-retained crown (more about that later) and dentists have more flexibility in making them look natural.

But cemented crowns require an additional piece of hardware called an abutment to better match it with the implant, something unnecessary with a screw-retained crown. Some people can also experience a reaction to the cement resulting in inflammation or even bone loss. And once installed, removing the crown later for repair or replacement is much more difficult than with a screw-retained crown.

Besides attaching directly to the implant, screw-retained crowns don't require cement and are more easily attached and removed. But the screw-hole can pose some aesthetic problems: Although it can be filled with a tooth-colored filling, the tooth's appearance isn't as ideal as a cemented crown.

So, which one is best for you? That will depend on the type and location of teeth being replaced, as well as your dentist's preferences. For instance, a more attractive cemented crown may be better for a visible front tooth, while a screw-retained crown might be a good choice for a back premolar or molar where appearance isn't as big a factor.

In the end, it's likely your dentist will discuss the pros and cons for each method as it pertains to your individual case. Whichever way your crown attaches, the end result will still be a life-like tooth that could last you for years to come.

If you would like more information on 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 “How Crowns Attach to Implants.”

YouCanHaveaSuccessfulImplantOutcomeifYourDiabetesisUnderControl

Around one in ten U.S. adults have diabetes, a metabolic disease that can disrupt other aspects of a person's health like wound healing and vision. It could also cause complications with dental implants, the premier replacement choice for missing teeth.

There are two basic types of diabetes. In type 1 diabetes, the pancreas stops producing insulin, a hormone needed to regulate the amount of sugar glucose in the bloodstream. With the more prevalent type 2 diabetes, the body either doesn't produce enough insulin or doesn't respond efficiently to the insulin produced.

Uncontrolled diabetes can contribute to several dangerous health conditions. In addition to vision impairment and poor wound healing, diabetics are at higher risk for other problems like kidney disease or nerve damage. Drastic swings in blood glucose levels can also cause coma or death.

Many diabetics, though, are able to manage their condition through diet, exercise, medications and regular medical care. Even so, they may still encounter problems with wound healing, which could complicate getting a dental implant.

An implant is composed of a titanium metal post imbedded into the jawbone. Because of its affinity with titanium, bone cells naturally grow and adhere to the implant's metal surface. Several weeks after implant surgery, enough bone growth occurs to fully secure the implant within the jaw.

But this integration process may be slower for diabetics because of sluggish wound healing. It's possible for integration to not fully occur in diabetic patients after implant surgery, increasing the risk of eventually losing the implant.

Fortunately, though, evidence indicates this not to be as great a concern as once thought. A number of recent group studies comparing diabetic and non-diabetic implant patients found little difference in outcomes—both groups had similar success rates (more than 95 percent).

The only exception, though, were diabetic patients with poor glucose control, who had much slower bone integration that posed a threat to a successful implant outcome. If you're in this situation, it's better if you're first able to better control your blood glucose levels before you undergo surgery.

So, while diabetes is something to factor into your implant decision, your chances remain good for a successful outcome. Just be sure you're doing everything you can to effectively manage your diabetes.

If you would like more information on diabetes and dental health, 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 & Diabetes.”