Replacement Of Missing Teeth
When a tooth is removed, the root can be replaced as a titanium analog. This titanium root can be used to anchor a custom crown that will function like a new tooth. The titanium portion is underneath the gums, so it cannot be seen or felt. But the strength is far superior to the original root. The tooth is permanently attached to the titanium root and cannot be removed.
There are three components to an implant prosthesis: the fixture, the abutment and the crown.
The fixture (also referred to as the implant) is analogous to the tooth root. It is the foundation at the bone level, or the aforementioned titanium post that is placed into the jaw bone which forms the base that will eventually support the tooth. You will not be able to see the implant since it is submerged below the gums.
The crown is the visible portion of the tooth. It is the esthetic and functional component that will emerge from the gums. This portion of the prosthesis will be custom created by your dentist after the foundation (i.e. implant fixture) is fully healed and integrated with the bone. This process will occur between 3-6 months after the implant is placed.
The abutment is what connects the implant fixture to the crown. This component is also placed after the implant fixture is fully healed (again 3-6 months) and at the same time as the crown. Most of the time, the abutment is custom made by your dentist along with the crown. In certain circumstances, our surgeons will fabricate the abutment and your dentist will create the crown.
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The Pre surgical Planning
Placing dental implants requires a lot of planning and preparation prior to the surgery. A slight error in angulations or depth of placement could cause difficulties later in fabricating the crown. Our doctors utilize the newest techniques to ensure optimum results. Prior to the surgery, we will be taking additional 3-D radiographs specifically designed for implants and impressions, or molds, to duplicate your teeth in order to fabricate a surgical guiding stent. For more complex, full-arch reconstructions, a computer generated program will aid in placement and angulations of the implants so that any chance of complications will be minimized.
The Surgical Procedure
For most patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. The healing implants are re submerged beneath the gums, so there will be no teeth attached to the implants immediately after surgery. For the first three to six months following surgery, the implants are beneath the surface of the gums gradually bonding with the jawbone. You should be able to cautiously wear temporary dentures and eat a soft diet during this time. Majority of implant failures occur during this time, thus careful management of the wound is critical. After the surgery, most patients recover quickly within 2-3 days and experience minimal disruption in their daily routine.
After the implant has bonded to the jawbone, the second phase begins. Our doctors will uncover the implants and attach small cylinders that protrude through the gums and will act as a guide for the surrounding gums to heal around. These cylinders, called healing abutments, will be replaced when the permanent crowns are seated by your dentist.
When replacing a tooth in the visible esthetic areas, our surgeons will coordinate treatment with your restorative dentist regarding a temporary replacement during the healing period. We will make arrangements prior to your surgery visit to make sure you have an acceptable replacement for the missing tooth on a temporary basis while the implant heals.
Using the most recent advances in dental implant technology, there are select instances in which we are able to place implants at the same time as removal of the tooth, resulting in a fewer number of surgical procedures and quicker healing time. Your doctor has the experience and clinical acumen to determine whether he can predictably recommend this option for your case.
There are even situations where the implants can be placed at the same time as a tooth extraction and placing a temporary, non removable crown on the implant within 3-4 days further minimizing the number of surgical procedures. Advances in dental implant technology have made it possible, in select cases, to extract teeth and place implants with temporary crowns at one visit.
Implants are a team effort between an oral surgeon and a restorative dentist. While our doctors perform the actual implant surgery, initial tooth extractions, and bone grafting if necessary, your dentist fits and makes the permanent prosthesis. Your dentist will also make any temporary prosthesis needed during the implant process.
Types Of Available Prosthesis (Teeth)
A single implant is used to replace each missing tooth each prosthetic tooth attaches to its own implant.
A partial prosthesis (fixed bridge) can replace two or more teeth and may require only two or three implants. An implant supported bridge would utilize two or more anchor teeth that would support a gap to replace three, four or more missing teeth in a quadrant.
If all teeth are missing, a full arch reconstruction can be performed using multiple implants. Depending on the residual bone levels, full fixed arch reconstruction can be completed with four to six implants. In these cases, implants can be used to help anchor the dentures for improved fit (see below), or replace the denture altogether with a full set of teeth that are permanent and fixed. They can only be removed by your dentist.