Dental Implants | Ridge Augmentation

What are Dental Implants? Dental implants allow people who have lost teeth to enjoy the function, appearance and permanence that their natural teeth once provided. Dental Implants can be used to replace a single tooth, a partial, a bridge, or full dentures.  Understanding the basic principles of Implant Dentistry can make your decision about whether or not a dental implant is right for you much simpler.  Being a well-informed patient can make your first visit for a dental implant consultation much more productive because you will know how to ask the right questions to help prepare you to make the best decision possible.

	General Considerations
	A dental implant is a man-made replacement for a tooth root, which is essentially a tiny titanium post that will fill the role played by a natural tooth root.
	Because of the very unique design of dental implants, they become securely attached to your jawbone through a process called "osseointegration".
	After a waiting period allowing the bone to heal around the implant, final restorations are screwed or cemented onto the implant or an implant component.
	The final restoration is made utilizing procedures that are very similar to traditional crown, bridge and denture dentistry.
	With Michigan Dental Implants, it is possible to replace a single tooth, multiple teeth or an entire arch of teeth.
	For patients who are faced with losing all of their teeth, implant dentistry provides a tooth-replacement option that is much more stable and permanent than removable dentures or partials.
	Implant Composition
	Implants are constructed from titanium, a lightweight, soft, noncorroding metal.
	The surface of the titanium forms a natural ceramic coating when exposed to oxygen which enables bone cells to attach to it.
	Since bone cells react better to titanium surfaces that are rough, most implants are put through a process by the manufacturer which roughens the surface.
	Surface treatment, such as a hydroxyapatite coating, work to increase the bone/implant contact.  Hydroxyapatite is a material that acts as a component of bone necessary for the implant to fuse to the jaw bone.  The fusion process is called osseointegration.
	Under clinical observation, an osseointegrated implant will feel solid.  No mobility will be present.
	When an implant fails to osseointegrate, slight mobility will be present.  In such cases, the bone surface is separated from the implant surface by a thin, fibrous membrane which may be visible with careful x-ray analysis.
	A waiting period is required for successful osseointegration to occur because a complex series of events must occur.

A Closer Look at Osseointegration

The term osseointegration describes the attachment of bone to the surface of an implant.  The surface of an osseointegrated implant shows bone attached, under microscopic examination, but not in a continuous fashion.  There are actually "islands" of direct contact between the jawbone and the implant separated by marrow spaces.  Only 40%-50% of the implant surface is in direct contact with the bone.  To enhance bone healing, implants are sometimes coated with a calcium derivative found naturally occurring in human teeth and bones (hydroxyapatite) to jump start the osseointegration process.    The events leading to osseointegration begin at the time of implant placement with the formation of a blood clot between the bone and the implant.  This early event begins within the first few minutes after implant placement.  Surgical trauma causes bone cells on the surface to die and an inflammatory event begins.  Additionally, a fibrous mesh attaches to the implant. Within weeks, bone cells begin to grow back onto the fibrous mesh, reaching the implant surface.  As these bone cells repopulate the tiny gap between the bone and the implant, they help to fabricate the components necessary for bone mineralization.  Implants are often threaded.  In order to enhance implant placement and stability, thread shape and pitch are carefully calculated to transfer biting force to the surrounding bone.  This biting force transfer also helps kick start bone growth and osseointegration.

A 3-Unit Bridge or Dental Implant

Implant Supported Overdentures

Each and every patient deserves a magnificent smile.  Due to the incredible advances in aesthetic dentistry, there's no need for anyone to settle for less.  With dental implants, missing teeth can now be easily, comfortably and most importantly, permanently replaced. A 3-Unit Bridge or Dental Implant - Which is Right For You? Traditionally, a bridge has been the standard of care for replacing a missing tooth.  Constructed of metal sub-frames and tooth-colored porcelain, bridges are fabricated to approximately match the natural shade of your existing teeth. A bridge uses the teeth on either side of the missing tooth as support for the artificial tooth that replaces the missing natural tooth.  the goal of a bridge is to restore chewing function wile achieving an acceptable aesthetic outcome. Unfortunately, since the jawbone under the replacement tooth is no longer being stimulated by being involved in the chewing function, bone is often resorbed into the body.  This process creates a slowly-growing gap between the replacement tooth and the gums. Key-Features:  Bridges are slightly less expensive than a dental implant and often achieve acceptable cosmetic outcomes.  Chewing function is also restored. Drawbacks- Bridges require healthy adjacent teeth to be ground down, potentially increasing the risk to those teeth.  Bone resorption usually occurs, resulting in a compromised cosmetic outcome over time.  Bridges have a life span of only 5 - 7 years traditionally and may contain metal. Single Tooth Implant - The State of the Art Solution Dental implants can provide a more advanced replacement option for replacing a missing tooth than a traditional bridge, while preserving adjacent teeth.  Dental implants do not require adjacent teeth to be ground down or modified in any way.  The implant also provides the added benefit of creating stimulation to the underlying bone.  Restoration with all-ceramic components can produce a beautiful, natural looking, translucent replacement tooth that looks almost identical to the tooth that is being replaced! Key Features:  The adjacent teeth remain untouched - no grinding down required - leaving those teeth completely uncompromised.  The underlying bone integrity is also preserved because stimulation is restored.  Dental implants help to maintain long-lasting, cosmetically pleasing results because titanium is strong and naturally accepted by the body which leads to a high level of osseointegration. When deciding between a dental implant and a 3-unit bridge, it is important to be educated about all of the benefits associated with choosing dental implants.  When you lose a tooth, your jawbone can shrink, aging your appearance prematurely.  Implants help to prevent this premature aging. Like natural teeth, your newly restored dental implant will be very strong, stable and incredibly secure so you can comfortably eat all your favorite foods.  Dental implants are a long-lasting solution - often surviving for a lifetime.  Perhaps most importantly, your beautiful new teeth can give you back the confidence you may have lost when you lost your tooth.  Dental implants can absolutely transform your daily life leading to a happier, healthier new you!

Another tooth replacement option is the implant-supported overdenture.   An implant-supported overdenture requires that implants are placed into the jaw. The implants bond to the jawbone forming an anchor. Full bridges or dentures are created to attach to the implants, literally locking the teeth replacement into place. In a 2005 study that printed in the Journal of Periodontology, researchers found that the cumulative survival rate of implant-placed overdentures was 95.4 percent for 10 years. The success rate for the maxilla (upper jaw) implant supporting overdentures was 87.3 percent and the mandible (lower jaw) was 99.5 percent.  There are some questions that you must ask yourself and your dentist when considering this course of treatment.  -Do you complain of soreness, instability or decreased function with your current denture? -Is your dissatisfaction or desire for additional function a result of your original appliance's design or inadequate retention? -Have you been informed of the benefits of implant-supported overdentures: increased prosthesis retention, increased chewing ability, improved nutritional status and reduction of future bone loss? -Do you have adequate interocclusal space in the anterior segment to accommodate the prosthetic attachments on the implants?  Posts extend about 3-4mm above the tissue level.  Attachments add an additional 1-2mm of height.  The retentive device occupies 3-5mm of space. -Is there adequate lower jawbone height for implant placement?  In patients who have recently lost their teeth, the lower jawbone may actually need to be reduced to provide adequate interocclusal space for the implants and the prosthesis.  Often, ridge height reduction is necessary to have enough bone width.  Optimally, a 13 mm implant is used in the front of the lower jawbone.  The lower residual ridge can be assessed for height with a panoramic x-ray. -Is the current denture adequate in height and width to retain implant overdenture attachments?  The height and width of the appliance must be adequate, the borders properly extended and the occlusion balanced.               Systemic Influences May Affect Michigan Dental Implant Prognosis      Certain systemic influences may interfere with osseointegration and adversely affect implant prognosis.  As a patient's systemic condition changes for the worse, negative influences on local etiology and the physiologic response of the surrounding soft tissues and bone are not unusual.  Smoking and many medications also affect oral flora, soft tissue and bone metabolism.      Common systemic diseases such as diabetes and osteoporosis have been demonstrated to affect the bone-to-implant contact.  It is well known that medications such as calcium channel blockers and immunosuppressants may have a profound effect on the inflammatory response of the peri-implant environment.         Bisphosphonate drugs used to treat a variety of bone metabolism disorders can also lead to bisphosphonate-related osteochemonecrosis of the jaws following tooth extractions.  As with any patient, a regular, updated medical history is of critical importance.       Finally, home care of implants must be excellent.  There must be an absolute patient commitment to keeping the implants and the rest of the mouth clean.  That includes regular maintenance visits to identify any problems before they can cause implant loss.  Excessive alcohol consumption and a poor diet can also affect implant success.

 

Two Main Categories of Dental Implants
Dental Implants can be divided into two main categories: root form implants or periosteal and blade implants
Root Form Dental Implants
The most widely used implants today are root-form implants.  While they may resemble a cylinder or a screw, the screw type root form implant is the most common.  These implants are manufactured in varying lengths and diameters so that  most clinical situations can be accommodated.  Most root-form implants have an attachment that is utilized in the final restoration process, i.e., a place for the crown to attach to the dental implant.  These replacement crowns can attach to the dental implants in one of two ways: with an internal connection or an external connection. External Connection The attachment rises approximately 1 mm above the implant when there is an external connection.  The shape of the attachment may be a hexagon ora a castle-like design depending on the type of root-form dental implant used and will have a screw hole in the center of the attachment for the abutment or crown.  In cases where the abutment contains the scrwe in one piece, the implant attachment is non-engaging.  For example, the head of the dental implant may be a hexagon but the abutmen is round allowing rotation into place. Internal Connection If there is an internal connection, the attachment lies inside the implant and the shape of that internal space varies.  Abutments might be threaded and screw retained into the dental implant or, in systems known as "internal friction systems", abutments may be retained only by friction against the inner walls of the dental implant.  Abutments might be shaped like a tooth prepared for a crown (for cemented restorations), or they may have a built-in hole for a screw (screw retained restorations).  The implant platform may be flat or have beveled edges, although the beveled-edge type is becoming the most popular type of dental implant. One-Stage vs Two-Stage Implants Another major division of root-form dental implants is between one-stage and two-stage implants.  On the day of surgery, a one-stage implant is exposed to the oral cavity immediately following placement while two-stage implants are covered by gingiva after surgical placement.

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