Posts for tag: dental implants
Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.
In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.
Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.
Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.
If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.
The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.
Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.
While celebrating all that a new year brings, take a moment to remember the New Year's Day birthday of a true American patriot: the legendary Paul Revere. Ironically, he became a legend some 80 years after his midnight trek to warn colonists of approaching British troops, thanks to Henry Wadsworth Longfellow's 1861 poem “Paul Revere's Ride.” He was much better known to his fellow Bostonians as a prosperous silversmith, engraver—and “artificial teeth” maker.
That's right. Among his many business endeavors, Revere's résumé also included dental prosthetics, specifically custom dentures made of ivory. For the time, his work was state-of-the-art technology that far surpassed older tooth replacement methods.
But when we compare Revere's foray into the dental arts and today's restorations, his high quality 18th Century dentures were the proverbial “horse and buggy,” while modern denture technology seems like “supersonic transport.” Not only are today's dentures made of superior materials that are more “toothlike” in appearance, the means to create them using digital technology gives wearers a more secure and comfortable fit.
The modern denture—an appliance that replaces multiple or all lost teeth—is composed of a polymer base, usually acrylic that is colored to resemble gum tissue. Attached to this base are the prosthetic (“false”) teeth that replace those lost along the jaw. These new teeth are usually made of a durable dental material like porcelain that looks and functions like real teeth.
The basic design of today's denture hasn't changed much in the last century. What has changed is our ability to create dentures that follow an individual jaw contours much more precisely. Using the latest digital technology, we're able to obtain highly accurate impressions of the mouth to guide the manufacturing process. Fit is critically important for how dentures feel and function in the mouth. If they are too loose, they become uncomfortable and limit which foods you can eat.
If that weren't enough, recent advancements with dental implants have taken dentures to an entirely new level, beyond anything imaginable in Revere's day. We're now able to create dentures that connect or are permanently affixed to implants set within the jaw, which makes them more stable and secure. An implant-supported denture also helps prevent bone loss, a weakness of traditional dentures, causing them to loosen over time.
As amazing as they are, we wouldn't have the modern version of dentures without craftsmen like Paul Revere who helped advance the cause of dental restoration. So, lift a glass of holiday cheer this season to this hero of the American Revolution—and of American dentistry.
Dental implants are popular with both patients and dentists for their durability and likeness to natural teeth. That natural look, though, can be difficult to attain, especially in what’s known as the “smile zone” — the area of the mouth where teeth are most visible when you smile.
Our biggest concern is the upper front teeth, where the gums are most visible, especially if you smile widely. It takes considerable skill, experience and artistry to position implants in this area so that they appear to naturally emerge from the gums and blend well with other teeth.
To obtain that natural look, we must first assess whether or not there’s enough bone present, which tends to dissolve (resorb) when a tooth is missing, to sufficiently anchor the implant in the right position. There also needs to be sufficient bone around adjacent teeth to support the tiny triangles of gum tissue between teeth called papillae. Without the papillae an unattractive black hole may result between the implant and an adjacent tooth or implant.
Another factor we must consider is the type of gum tissue you have. Everyone generally inherits one of two types of tissue from their parents: thin or thick. The type you have can influence the way the implant appears to emerge from the gums. If you have thick gums, they’re easier to work with and can cover more of the implant. Thinner tissues aren’t quite as easy and are less forgiving if an implant isn’t placed as precisely as possible.
In recent years, improvements in implant design have sought to provide greater stability around bone and gum tissues to offset some of the issues we’ve mentioned. A variation on the design of the top of the implant (where the crown is attached) changes the direction of growth for gum tissues from a horizontal orientation to a vertical one, which can help with the final appearance.
The first step, if you’re considering dental implants for a tooth in the smile zone, is to visit us for a complete examination to see if any of these factors may have an impact on your situation. We can then advise you on the best course of action to achieve the most attractive smile possible.
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 “Implant Aesthetics.”
Dental implants are considered the best tooth replacement option available. An implant replaces the root of a tooth and allows for the replacement of the crown via attachments or abutments. They not only look like a real tooth, they function like one too.
Implants, though, for some are a significant investment and may be well beyond a person's financial means if they've experienced a sudden tooth loss. For that reason, many opt for a less expensive tooth replacement option like a removable partial denture.
Later when they can afford it, a person might consider an implant. But this could pose a complication. When a tooth is missing for some time, the underlying bone doesn't rejuvenate normally because it no longer receives stimulation from the tooth. Over time, the amount of bone may diminish. Restorations like dentures can't stop this bone loss and actually aggravates it.
For proper positioning, an implant requires a certain amount of bone volume. So, it's quite possible when the time comes to replace the old restoration with an implant that there may not be enough bone available.
We may be able to overcome this bone loss with bone grafting and regeneration. A specialist such as a periodontist or oral surgeon accesses the area surgically and inserts bone graft material, usually processed material that's completely safe. Properly placed, the bone graft serves as a scaffold that, along with growth stimulators, encourages bone cells to grow.
When the bone grafting has healed enough, we're then able to place the implant. Once imbedded in the bone, one of the implant's unique qualities comes into play. The imbedded post is made of the metal titanium, which is not only bio-compatible with body tissues, it also has an affinity with bone. Bone cells will easily grow and adhere to the implant surface. This further boosts bone growth in the area and strengthens the implant's hold.
These extra procedures to build back lost bone do add to the cost and time for installing an implant. But if you're ready for a more permanent restoration for a missing tooth — not to mention better bone health — the extra time and money will be well worth it.
If you have a problem tooth we’ve recommended removing, those “Tooth in one day” ads—a tooth removed and an implant placed at the same time—might start to pique your interest. But there are a few factors we must consider first to determine if this procedure is right for you. Depending on your mouth’s health conditions, you may need to wait a little while between tooth extraction and implantation.
Here are 3 timing scenarios for receiving your implant after tooth removal, depending on your oral health.
Immediately. The “tooth in one day” scenario can be much to your liking, but it could also be tricky in achieving the best results. For one, the implant may fit too loosely—the bone around the socket might first need to heal and fill in or undergo grafting to stimulate regeneration. In other words, immediate implant placement usually requires enough supporting bone and an intact socket. Bone grafting around the implant is usually needed as well.
After gum healing. Sufficient gum coverage is also necessary for a successful outcome even if the bone appears adequate. To guard against gum shrinkage that could unattractively expose too much of the implant, we may need to delay implant placement for about 4 to 8 weeks to allow sufficient gum healing and sealing of the extraction wound. Allowing the gums to heal can help ensure there’s enough gum tissue to cover and protect the implant once it’s placed.
After bone healing. As we’ve implied, implants need an adequate amount of supporting bone for best results. When there isn’t enough, we might place a bone graft (often immediately after tooth extraction) that will serve as a scaffold for new bone to grow upon. Depending on the degree of bone loss, we may wait until some of the bone has regenerated (about 2 to 4 months) and then allow the natural process of bone cells growing and adhering to the implant (osseointegration) to complete the needed bone growth. If bone loss is extensive, we may need to wait until full healing in 4 to 6 months to encourage the most stable outcome.
If you would like more information on the process of obtaining 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 “Implant Timelines for Replacing Missing Teeth.”