Posts for tag: dental implants
Among dental restorations, implants are the closest prosthetic we have to real teeth. They not only replace the visible crown, but the titanium post imbedded in the jawbone adequately substitutes for the tooth root. Because of their unique design, implants are not only life-like, they’re highly durable and could potentially last for decades.
But while their success rate is remarkably high (more than 95% exceed the ten-year mark), they can fail. Ironically, one possible cause for implant failure is periodontal (gum) disease. Although an implant’s materials are themselves impervious to disease, the tissues and underlying bone that support the implant aren’t. If these natural tissues become infected, the secure hold the implant has can weaken and fail.
A gum infection usually begins with dental plaque, a thin biofilm of bacteria and food particles that builds up on tooth surfaces. Certain strains of bacteria within plaque can infect the gums. One particular form of the disease known as peri-implantitis starts as an initial infection and ensuing inflammation of gum tissues around an implant. The disease can quickly spread down to the bone and destroy the integration between the bone and the implant that helps keep the implant in place.
That’s why it’s important for you to keep the implant and the tissues around it clean of plaque, just as you would the rest of your natural teeth. This requires daily brushing and flossing around the implant and other teeth, and visiting your dentist regularly for more thorough dental cleanings.
You should also be alert to any signs of disease, especially around implants: gum redness, swelling, bleeding or pus formation. Because of the rapidity with which peri-implantitis can spread, you should see your dentist as soon as possible if you notice any of these signs.
Preventing gum disease, and treating it promptly if it occurs, is a key part of implant longevity. Preserving your overall dental health will help make sure your implant doesn’t become a loss statistic.
You’ve invested quite a bit in your new dental implants. And it truly is an investment: because of implants’ potential longevity, their long-term costs could actually be lower than other restorations whose upfront costs might be less.
But to better ensure their longevity, you’ll need to keep your implants and the natural tissues supporting them clean of bacterial plaque, a sticky biofilm that can cause periodontal (gum) disease. Although the implant itself is unaffected by disease, the natural tissues around it can be. An infection could ultimately weaken the bone supporting the implant and lead to its failure.
Such an infection involving implants could advance rapidly because they don’t have the natural defenses of the original teeth. Our natural teeth are connected to the jaw through the periodontal ligament, a collagen network that attaches to both the teeth and the bone through tiny tissue fibers. This connection also provides access to antibodies produced by the body to fight infection.
By contrast, we place implants directly into the jawbone. While this creates a very secure attachment, the implant won’t have the same connection as teeth with the body’s immune system. That means any infection that develops in surrounding tissues can spread much more rapidly—and so must be dealt with promptly.
Treating this particular form of gum disease (known as peri-implantitis) is similar to infections with natural teeth and gums, with one important difference involving the tools we use to remove plaque from them. While natural teeth can handle metal scalers and curettes, these can create microscopic scratches in the porcelain and metal surfaces of an implant and create havens for further bacterial growth. Instead, we use instruments made of plastic or resin that won’t scratch, as well as ultrasonic equipment to vibrate plaque loose.
To avoid an infection, it’s important that you brush your implants and surrounding tissues just like you would your natural teeth (be sure you use a soft-bristled brush). And keep up regular dental visits for thorough cleanings and checkups to stay ahead of any developing gum infection. Maintaining your dentures will help ensure they continue to brighten your smile for a long time.
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 “Dental Implant Maintenance: Implant Teeth Must be Cleaned Differently.”
For generations, dentures have helped people avoid the dire consequences of total teeth loss. Now, implant technology is making them even better.
Composed of life-like prosthetic teeth fixed within a plastic or resin gum-colored base, dentures are manufactured to fit an individual patient’s mouth for maximum fit, comfort and performance. But dentures also have a critical drawback—they can’t stop bone loss in the jaw.
Bone is constantly regenerating as older cells dissolve and then are replaced by newer cells. In the jawbone, the forces generated when we chew travel through the teeth to the bone and help stimulate this new cell growth. When teeth are missing, though, the bone doesn’t receive this stimulus and may not regenerate at a healthy rate, resulting in gradual bone loss.
Dentures can’t transmit this chewing stimulus to the bone. In fact, the pressure they produce as they rest on top of the gums may actually accelerate bone loss. Over time then, a denture’s once secure and comfortable fit becomes loose.
In the past, most patients with loose dentures have had them relined with new dental material to improve fit, or have new dentures created to conform to the changed contours of the jaws. But implant technology now offers another alternative.
Implants are in essence a tooth root replacement. Dentists surgically implant a titanium metal post directly into the jawbone that naturally attracts bone cells to grow and adhere to it over time (a process called osseointegration). This not only creates a secure and lasting hold, it can also stop or even reverse bone loss.
Most people know implants as single tooth replacements with a porcelain crown attached to the titanium post. But a few strategically placed implants can also support either removable or fixed dentures. Removable dentures (also called overdentures) usually need only 3 or 4 implants on the top jaw and 2 on the bottom jaw for support through built-in connectors in the dentures that attach to the implants. A fixed bridge may require 4-6 implants to which they are permanently attached.
There are pros and cons for each of these options and they’re both more expensive than traditional dentures. In the long run, though, implant-supported dentures could be more beneficial for your bone health and hold their fit longer.
There’s a lot to like about dental implants for replacing missing teeth. Not only are they life-like, but because they replace the root they also function much like a natural tooth. They also have another unique benefit: a track record for long-lasting durability. It’s estimated more than 95% of implants survive at least ten years, with a potential longevity of more than 40 years.
But even with this impressive record, we should still look at the few that didn’t and determine the reasons why they failed. We’ll soon find that a great number of those reasons will have to do with both oral and general health.
For example, implants rely on adequate bone structure for support. Over time bone cells grow and adhere to the implant’s titanium surface to create the durable hold responsible for their longevity. But if conditions like periodontal (gum) disease have damaged the bone, there might not be enough to support an implant.
We may be able to address this inadequacy at the outset with a bone graft to encourage growth, gaining enough perhaps to eventually support an implant. But if bone loss is too extensive, it may be necessary to opt for a different type of restoration.
Slower healing conditions caused by diseases like diabetes, osteoporosis or compromised immune systems can also impact implant success. If healing is impeded after placement surgery the implant may not integrate well with the bone. An infection that existed before surgery or resulted afterward could also have much the same effect.
Oral diseases, especially gum disease, can contribute to later implant failures. Although the implant’s materials won’t be affected by the infection, the surrounding gum tissues and bone can. An infection can quickly develop into a condition known as peri-implantitis that can weaken these supporting structures and cause the implant to loosen and give way. That’s why prompt treatment of gum disease is vital for an affected implant.
The bottom line: maintaining good oral and general health, or improving it, can help keep your implant out of the failure column. Perform daily brushing and flossing (even after you receive your implant) and see your dentist regularly to help stop dental disease. Don’t delay treatment for gum disease or other dental conditions. And seek medical care to bring any systemic diseases like diabetes under control.
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 “Dental Implants: A Tooth-Replacement Method that Rarely Fails.”
If you’re in the initial planning stages for a dental implant, you may already be encountering a number of options to consider. One that may come up is how the visible crown will attach to the metal implant imbedded in the bone.
Generally speaking, implants are composed of two parts: a metal post most often made of titanium placed into the bone that serves as the “root” for the new tooth; and a visible, life-like crown made of dental porcelain that attaches to an abutment on the titanium post. The crown can be attached in one of two ways: either with a small screw through the biting surface of the crown into a receiving hole in the abutment or cemented to it.
The major advantage of a screwed crown is that it allows for easy removal of the crown if needed. While the titanium post can often last a lifetime, porcelain crowns more often need repair or replacement since they receive the brunt of the biting forces in the mouth. A screw-attached crown is much easier to remove than a cemented one.
On the other hand, screwed crowns have a small access hole that must be restored with a tooth-colored filling to help the crown appear natural. This isn’t too great an issue with back teeth but does make achieving a natural appearance in the front more difficult. Cemented crowns look more like a natural tooth and are thus more flexible in achieving the desired appearance.
Besides the possibility the cement may cause gum inflammation or bone loss, the chief detraction from cemented crowns is the difficulty in removing them. Crowns are often damaged in this process so it’s highly likely it will have to be replaced rather than repaired. It’s possible to use weaker cement, but this raises the risk of the crown coming loose at some point from the abutment.
As we plan for your implant, we’ll discuss which type of attachment will work best for you, depending on the tooth to be replaced and other conditions with your oral health. The end result, though, should be the same — a new, natural-looking tooth that serves you well for many 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.”