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Although a dental implant will probably be the best option for her, she may not be ready to have a dental implant placed just yet because of her age and incomplete gowth. But that doesnt mean we should ignore some very important considerations. Yes, a dental implant will probably be her best option in terms of replacing a tooth in the most natural, least invasive way. This is beacuse an implant tooth replacement does not require the dentist to cut healthy natural teeth adjacent to the tooth that is being replaced as a conventional bridge would. Also, if the bone and gum after a tooth removal is left to heal on its own without the use of a bone and tissue preservation protocol, it usually begins to shrink or atrophy. The consequences could be cosmetic in that the missing tooth space when replaced may require an unsightly longer artificial tooth. Bone requires function to maintain itself. In the mouth this can only be accomplished with a health tooth root or a dental implant. The atrophy, if allowed to take place, could also lead to a more complex and more expensive bone grafting surgery in the future. So my advice is to have a consultation to evaluate for the following among other things: 1. Bone preservation/augmentation procedure. 2.Temporary tooth for cosmetic and space maintenance that would help transition the case until she is old enough for the implant (when she stops growing). 3. An Orthodontic consult to determine whether there is a general need for braces as well as specifically looking at the spacing remaining in the area of the missing tooth ( since teeth can be moved orthodontically but implants can’t). Finally, consider that implants may not be as expensive as you think when you compare them to the cost of reversing the negative changes that could take place if a good treatment plan is not developed.
August 12, 2010
August 5, 2010
I am 76 years old and have osteoporosis. This has never interfered with any dental procedures that I have had, but now I need several dental implants. Could there be a problem with getting the implants to embed in the bone of the jaw in my case?
The risk of having a problem could be greater than that of a patient who does not have osteoporosis but that doesn’t necessarily mean you cannot have dental implants. Of most importance is to know whether or not you are taking bisphosphonates. Second, we need to learn more about your specific circumstances regarding the osteoporosis. Third, we need to evaluate your specific dental needs as well as expectations you have regarding the implants. Assuming that you have been cleared for treatment, the surface of the implants should be highly advanced for bone integration. Most modern surface are but this must be confirmed. One of the things we do is “wet” the implant surface in the patients own growth factors (isolated from the blood plasma) just seconds before placing it to aid in the bone to surface integration. Because most of the load or force occurs in the top third of the implant once integrated, wider is better. The length of the implant will influence the initial stabilization and healing period. Immediate or early loading of the implants should be avoided and more time than usual should be given for healing and integration before the teeth are attached. Once the teeth are attached, it would be beneficial to “tie” or splint the implants together with the prosthesis or by connecting the crowns to help dissipate the chewing forces
August 2, 2010
I am getting an implant to replace two teeth that have had a removable bridge. Do you do anything to the teeth adjacent to the bridge to build them up?
That depends on whether there is a need to strengthen what holds the teeth in place or change the tooth itself. During a proper evaluation we would evaluate for mobility patterns (you may not realize your teeth are starting to loosen), bone support around the remaining teeth, pathology such as root canal type infections that may show up only on x-rays and make sure that the natural teeth and the implants work together in providing the best possible function. The forces on the “new bite” have to be designed in a very specific way and this could vary depending on the circumstances of the patient. Where the tooth is positioned in the arch dermines, in part, what role it should play in overall chewing as well as appearance. Sometimes the surrounding teeth do have to be built up in order to achieve this proper bite and also create a more youthful appearance if something called the “vertical dimension” of the face has been changed (iefacial collapse). If all that is nessary is the treatment of gum disease then a simple non-invasive laser option called LANAP can reverse the damage to the bone that supports the teeth. I hope this helps!
August 1, 2010
I have to have some teeth taken out and I have decided on dental implants to replace them. I do not want to have both procedures on the same day. Would it be bad to wait a month for the implants? I mean bad in that there might be some bone loss during this period, or scar tissue could form that might make it harder to seat the implant.
Placing implants at the time of tooth removal could be the very best treatment decision for patient and doctor. However, I do understand that you may not feel comfortable with this idea. Waiting four weeks should not be a problem and scar tissue is not a problem either. Typically four weeks is not enough time for significant bone loss to take place. There is always the risk of an unforseen delay in implant placement for whatever reason. In your case I would strongly consider a bone preservation procedure at the time of tooth removal if you feel your appointment plan could change or you dont want to risk unforseen needs to graft at the time of implant placement. Because some areas of the bone remaining after a removal could be unexpectedly thinner or weaker, these areas could “disappear” shortly thereafter and make it difficult or in extreme cases impossible and even dangerous to proceed with implant placement without having to add more involved, more expensive grafting procedures and possibly delay the time of tooth replacement. Bone preservation can be accomplished with natural growth factors that can be obtained from your plasma in minutes where all you expirience is a small blood sample just like you would at your physicians office. This technique is known as PRGF. Other more traditional techniques involve the use of human or cow bone mineral.
If I get a dental implant, will that help restore bone that has been lost? I know that I have to have a bone graft first, but after the implant, does that new bone grow more bone and fill in the area to make it stronger? I am worried about bone loss affecting surrounding teeth in the future.
A dental implant will not create more bone volume (size) but it will make the bone that IS there much stronger and more dense unlike a bridge or a removable partial denture which can actually contribute to more bone loss. In situations where bone grafting is absolutely necessary, keep in mind that all bone grafts and techniques are not the same and they could vary from case to case. Also the health of the teeth ,the gingiva and bone surrounding them that will be next to the dental implants must be evaluated in the early stages of planning the case. The best way to not risk bone loss is to prevent it and plan against it with a comprehensive evaluation including a periodontal examination in addition to the implant consult.
