Posts for tag: dental implants
The dental implant is the closest thing in modern dentistry to a natural tooth. This is because an implant replaces more than the visible crown — it also replaces the root, thanks to a metal post imbedded in the bone.
But what if you have a metal allergy — are you out of luck replacing a tooth with an implant? Before answering this question, let's take a closer look at metal allergies.
An allergy is an overreaction of the body's immune system to a particular foreign substance. This response can be as inconsequential as a minor rash or as life-threatening as a shutdown of the body's organ systems. You can be allergic to anything, including metals.
Usually, these allergies are to specific kinds of metals. For example, about 17% of women and 3% of men are allergic to nickel, while smaller percentages are allergic to cobalt or chromium. Most allergic reactions to metal occur from external contact with jewelry or similar metal items that create rashes or other anomalies on the skin. On a more serious note, an allergy to metal in a body replacement part could result in the body rejecting it.
Metals have also played an important role in dental care, particularly dental amalgam used for tooth fillings. Dental amalgam is a mixture of a precious metal like gold or silver with other metals like copper, tin and, in small amounts, mercury. While dental amalgam has been used safely for decades, there have been rare cases of inflammation or rashes.
This brings us to dental implants and the most common metal used in them, titanium. The commercial version of this metal is highly prized in medical and dental applications because it has a special affinity with bone. Bone cells readily grow and adhere to the metal, which strengthens the bond between the implant and the jawbone.
Even if you have a rare allergy to certain metals, it's even rarer that would include titanium. In one particular study of 1,500 implant patients less than 1% reported any reaction at all.
If you're concerned, you can undergo testing to see if you react to titanium. More than likely, though, you'll be able to join the millions of other patients who have successfully restored their smiles with dental implants.
If you would like more information on dental implants as a tooth replacement option, 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 “Metal Allergies to Dental implants.”
If you've lost a tooth, you have a number of options for replacing it. Perhaps the best choice in terms of lifelikeness and durability is a dental implant.
All implants have the same basic architecture: a titanium metal post imbedded in the jawbone to replace the root; and an abutment, a metal collar that links the post with a lifelike porcelain crown. But implants can vary in how the crown attaches to the abutment and post — either cemented to the abutment or screwed through the abutment to the post.
Either method will permanently secure the crown to the implant. But there are advantages and disadvantages for each.
A screw-retained crown may better facilitate any future repair that might be needed. For a skilled dentist it's a simple matter of removing the screw and then the crown from the abutment. There's less risk of damage to the implant during repairs or crown replacement. Many dentists also prefer screws for crowns placed at the same time they're installing the implant post (a procedure called immediate loading).
The screw access hole, however, could pose a cosmetic problem. Although we can cover it over with tooth-colored filling, it may still be noticeable and unattractive especially for a tooth visible when you smile (in the smile zone). There's also the possibility the porcelain around the access hole could chip.
By contrast, cemented crowns have a smooth, unbroken surface and are aesthetically ideal for smile zone teeth. But the cement could interact poorly with gum and bone tissue in some patients, causing inflammation and possible bone loss.
And unlike screw-retained crowns, cemented crowns are difficult to remove for implant repair. We may have to drill through the crown to access the screw between the abutment and the post, and then repair it cosmetically if we use the same crown. Again, the final result may not be quite as visually appealing.
In the end, it will depend on the implant's location, how your body reacts to the cement or your dentist's preference. In either case, though, you'll have a tooth replacement that's functional, life-like and able to endure 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.”
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.
In the realm of restorative dentistry, dental implants are king. A dental implant can replace a tooth with a permanent, life-like restoration with a solid reputation for durability.
Implants are also known for one other quality — variety. Not all implants are alike, and they have varied applications for use. Available in various shapes and sizes, they can be used for a single tooth or as part of a multiple tooth bridge or overdenture. And while their basic architecture is the same, you also have two options for how the permanent crown (the visible tooth portion) attaches to the implant: screwed or cemented.
A screw attachment can securely fasten a crown to an implant without the need for cement; it also allows for easy removal for repair or replacement should the crown become damaged or worn. On the other hand, it could pose a cosmetic problem — even though the access hole for the screw may be covered with a tooth-colored filling, it could still be distinguishable from the rest of the crown. There’s also a slight risk of the crown chipping around the access hole.
A crown cemented to the implant won’t have this cosmetic issue with an access hole, and will look just like a natural tooth. But unlike a screwed crown, removing a cemented crown can be more difficult. The cement may also cause gum inflammation and potential bone loss in sensitive patients.
The condition of your mouth, the type of implant you’re receiving and other circumstances will all factor into determining which method is best for you. If we’re “immediately loading” the crown (meaning we’re affixing a temporary crown to the implant immediately after placement in the jaw), then the screw method may be more advantageous. Aesthetically speaking, though, a cemented crown may be a better option in terms of final smile appearance.
But whichever method is used, you’ll still benefit from what implants do best — help you regain the function lost from a missing tooth and change your smile for the better.
If you would like more information on your options with 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.”
Dental implants are considered today’s premier method for restoring missing teeth. Obtaining an implant, though, is often a long process and the implants themselves must be surgically placed within the jaw bone. Nothing to worry about, though: implant surgery is a minor to moderate procedure akin to a surgical tooth extraction.
Still like any surgery, this procedure does involve cutting into the soft tissues of the gums and could allow oral bacteria to enter the bloodstream. While most bacteria in the mouth are harmless (and even beneficial) a few strains can cause disease. For some people, especially those with certain heart conditions or joint replacements, this could potentially cause serious issues in other parts of their body that might be highly susceptible to infection.
To guard against this, it’s been a long-standing practice in dentistry to prescribe antibiotics to certain high risk patients before a procedure. Although this departs from the normal use of antibiotics for already occurring infections, due to the circumstances this has been deemed an acceptable measure to prevent disease.
In the past, the categories of patients for which preventive antibiotics were appropriate had been more extensive. In recent years, though, both the American Dental Association and the American Heart Association have adjusted their recommendations. Today, your dental provider may recommend antibiotic pre-treatment if you have a prosthetic (artificial) heart valve, a history of infective endocarditis (inflammation of the inner linings of the heart), a heart transplant or certain congenital heart conditions.
While physicians may still recommend premedication with antibiotics for patients with joint replacements, it’s not as blanket a standard as it might once have been. It’s now only recommended for certain cases, such as patients who’ve received a prosthetic joint within the last two years.
There’s still an ongoing debate about the effectiveness of antibiotic pre-medication. However, there’s evidence medicating before procedures with antibiotics can be beneficial in avoiding infection. If you fall into one of the categories just mentioned or are concerned about infection, feel free to discuss with your dentist if using antibiotics before your implant surgery is wise move for you.
If you would like more information on antibiotic treatment before oral surgery, 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 “Implants & Antibiotics: Lowering Risk of Implant Failure.”