Clinical Treatments

Dental Implants

Dental implants are replacement tooth roots. Implants provide a strong foundation for fixed (permanent) or removable replacement teeth that are made to match your natural teeth.

What Are the Advantages of Dental Implants?

There are many advantages to dental implants, including:

• Improved appearance. Dental implants look and feel like your own teeth. And because they are designed to fuse with bone, they become permanent.
• Improved speech. With poor-fitting dentures, the teeth can slip within the mouth causing you to mumble or slur your words. Dental implants allow you to speak without the worry that teeth might slip.
• Improved comfort. Because they become part of you, implants eliminate the discomfort of removable dentures.
• Easier eating. Sliding dentures can make chewing difficult. Dental implants function like your own teeth, allowing you to eat your favorite foods with confidence and without pain.
• Improved self-esteem. Dental implants can give you back your smile and help you feel better about yourself.
• Improved oral health. Dental implants don’t require reducing other teeth, as a tooth-supported bridge does. Because nearby teeth are not altered to support the implant, more of your own teeth are left intact, improving long-term oral health. Individual implants also allow easier access between teeth, improving oral hygiene.
• Durability. Implants are very durable and will last many years. With good care, many implants last a lifetime.
• Convenience. Removable dentures are just that; removable. Dental implants eliminate the embarrassing inconvenience of removing dentures, as well as the need for messy adhesives to keep them in place.

How Successful Are Dental Implants?

Success rates of dental implants vary, depending on where in the jaw the implants are placed but, in general, dental implants have a success rate of up to 98%. With proper care (see below), implants can last a lifetime.

Can Anyone Get Dental Implants?

In most cases, anyone healthy enough to undergo a routine dental extraction or oral surgery can be considered for a dental implant. Patients should have healthy gums and enough bone to hold the implant. They also must be committed to good oral hygiene and regular dental visits. Heavy smokers, people suffering from uncontrolled chronic disorders — such as diabetes or heart disease — or patients who have had radiation therapy to the head/neck area need to be evaluated on an individual basis.

What Is Involved in Getting a Dental Implant?

The first step in the dental implant process is the development of an individualized treatment plan. The plan addresses your specific needs and is prepared by a team of professionals who are specially trained and experienced in oral surgery and restorative dentistry. This team approach provides coordinated care based on the implant option that is best for you.

Next, the tooth root implant, which is a small post made of titanium, is placed into the bone socket of the missing tooth. As the jawbone heals, it grows around the implanted metal post, anchoring it securely in the jaw. The healing process can take from six to 12 weeks.

Once the implant has bonded to the jawbone, a small connector post — called an abutment — is attached to the post to securely hold the new tooth. To make the new tooth or teeth, your dentist makes impressions of your teeth, and creates a model of your bite (which captures all of your teeth, their type, and arrangement). The new tooth or teeth is based on this model. A replacement tooth, called a crown, is then attached to the abutment.

Instead of one or more individual crowns, some patients may have attachments placed on the implant that retain and support a removable denture. Your dentist also will match the color of the new teeth to your natural teeth. Because the implant is secured within the jawbone, the replacement teeth look, feel, and function just like your own natural teeth.

How Painful Are Dental Implants?

Most people who have received dental implants say that there is very little discomfort involved in the procedure. Local anesthesia can be used during the procedure, and most patients report that implants involve less pain than a tooth extraction.

After the dental implant, mild soreness can be treated with over-the-counter painmedications, such as Tylenol or Motrin.

How Do I Care for Dental Implants?

Dental implants require the same care as real teeth, including brushing, flossing, and regular dental check-ups.

Crowns

A dental crown is a tooth-shaped “cap” that is placed over a tooth – to cover the tooth to restore its shape and size, strength, and improve its appearance. The crowns, when cemented into place, fully encase the entire visible portion of a tooth that lies at and above the gum line.

What Types of Crowns Are Available?

Permanent crowns can be made from stainless steel, all metal (such as gold or another alloy), porcelain-fused-to-metal, all resin, or all ceramic.

• Stainless steel crowns are prefabricated crowns that are used on permanent teeth primarily as a temporary measure. The crown protects the tooth or filling while a permanent crown is made from another material. For children, a stainless steel crown is commonly used to fit over a primary tooth that’s been prepared to fit it. The crown covers the entire tooth and protects it from further decay. When the primary tooth comes out to make room for the permanent tooth, the crown comes out naturally with it. In general, stainless steel crowns are used for children’s teeth because they don’t require multiple dental visits to put in place and so are more cost- effective than custom-made crowns and prophylactic dental care needed to protect a tooth without a crown.
• Metals used in crowns include gold alloy, other alloys (for example, palladium), or a base-metal alloy (for example, nickel or chromium). Compared with other crown types, less tooth structure needs to be removed with metal crowns, and tooth wear to opposing teeth is kept to a minimum. Metal crowns withstand biting and chewing forces well and probably last the longest in terms of wear down. Also, metal crowns rarely chip or break. The metallic color is the main drawback. Metal crowns are a good choice for out-of-sight molars.
• Porcelain-fused-to-metal dental crowns can be color matched to your adjacent teeth (unlike the metallic crowns). However, more wearing to the opposing teeth occurs with this crown type compared with metal or resin crowns. The crown’s porcelain portion can also chip or break off. Next to all-ceramic crowns, porcelain-fused-to-metal crowns look most like normal teeth. However, sometimes the metal underlying the crown’s porcelain can show through as a dark line, especially at the gum line and even more so if your gums recede. These crowns can be a good choice for front or back teeth.
• All-resin dental crowns are less expensive than other crown types. However, they wear down over time and are more prone to fractures than porcelain-fused-to-metal crowns.
• All-ceramic or all-porcelain dental crowns provide better natural color match than any other crown type and may be more suitable for people with metalallergies. However, they are not as strong as porcelain-fused-to-metal crowns and they wear down opposing teeth a little more than metal or resin crowns. All-ceramic crowns are a good choice for front teeth.
• Temporary versus permanent. Temporary crowns can be made in your dentist’s office, whereas permanent crowns are made in a dental laboratory. Temporary crowns are made of acrylic or stainless steel and can be used as a temporary restoration until a permanent crown is constructed by a lab.

What Steps Are Involved in Preparing a Tooth for a Crown?
Preparing a tooth for a crown usually requires two visits to the dentist — the first step involves examining and preparing the tooth, the second visit involves placement of the permanent crown.

What Are “Onlays” and “3/4 Crowns?”
Onlays and 3/4 crowns are variations on the technique of dental crowns. The difference between these crowns and the crowns discussed previously is their coverage of the underlying tooth. The “traditional” crown covers the entire tooth; onlays and 3/4 crowns cover the underlying tooth to a lesser extent.

How Long Do Dental Crowns Last?
On average, dental crowns last between five and 15 years. The life span of a crown depends on the amount of “wear and tear” the crown is exposed to, how well you follow good oral hygiene practices, and your personal mouth-related habits (you should avoid such habits as grinding or clenching your teeth, chewing ice, biting fingernails, and using your teeth to open packaging).