Posts for tag: dental implant
Dental implants are far and away the most “tooth-like” restoration available today for missing teeth. Not only do they look real, they also mimic dental anatomy in replacing the tooth root.
To install an implant, though, requires a minor surgical procedure. And, as with any surgery, that includes a slight risk for a post-surgical infection. For most patients this isn't a major concern—but it can be for people with certain medical conditions.
One way to lessen the risk for implant patients whose health could be jeopardized by an infection is to prescribe a prophylactic (preventive) antibiotic before implant surgery. The American Dental Association (ADA) recommends the measure for patients with artificial heart valves, a history of infective endocarditis, a heart transplant and other heart-related issues.
In the past, their recommendation also extended to people with joint replacements. But in conjunction with the American Academy of Orthopedic Surgery (AAOS), the ADA downgraded this recommendation a few years ago and left it to the physician's discretion. Indeed, some orthopedic surgeons do recommend antibiotic therapy for patients before surgical procedures like implantation for up to two years after joint replacement.
These changes reflect the ongoing debate over the proper use of antibiotics. In essence, this particular argument is over risks vs. benefits: Are pre-surgical antibiotics worth the lower infection risk for patients at low to moderate risk in return for increased risk of allergic reactions and other side effects from the antibiotic? Another driver in this debate is the deep concern over the effect current antibiotic practices are having on the increasing problem of antibiotic-resistant bacteria.
As a result, dentists and physicians alike are reevaluating practices like prophylactic antibiotics before procedures, becoming more selective on who receives it and even the dosage levels. Some studies have shown, for example, that a low 2-gram dose of amoxicillin an hour before the procedure can be effective with much lower risks for side effects.
If you're considering dental implants and you have a medical condition you think could be impacted by the procedure, discuss the matter with your dentist and physician. It may be that pre-surgical antibiotics would be a prudent choice for you.
If you would like more information on getting 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 “Implants & Antibiotics.”
Besides their life-likeness, implants are also prized for their high success rate. More than ninety-five percent of implants continue to function effectively after ten years.
Implants’ advanced technology explains some of their reliability and longevity—they’re as close to natural teeth as we’re now able to achieve. But their impressive success rate also owes to the detailed protocols that dentists follow to install them. One critical part of these protocols is ensuring a patient has enough bone in their jaw to support and precisely situate the implant for the best functional and aesthetic outcome.
Unfortunately, there are situations where a patient doesn’t have enough bone to achieve a satisfactory result. This often happens if there’s been months or years between losing the tooth and considering an implant. The reason why relates to the nature of bone as living tissue.
Like other cellular tissues in the body, bone has a life cycle: Older, worn-out cells die and are absorbed by the body, and new cells form to replace them. The growth cycle in the jaw receives stimulation from the forces generated when we chew, which travel up through the teeth to the bone.
However, this stimulation stops after tooth loss for the related area of bone, which can slow new bone growth. Over time, the volume and density of the bone around a missing tooth gradually decreases, enough eventually to make an implant impractical.
Insufficient bone volume, though, doesn’t necessarily mean an implant is out of the question. We may be able to address the problem by attempting to regenerate the bone through grafting. This is a procedure in which we insert graft material into the affected area of the jawbone. The graft then becomes a scaffold upon which bone cells can grow. After several months, we may have enough regenerated bone to support an implant.
If there’s been too much bone loss, we may still need to consider another form of restoration. But if we can successfully build up the bone around your missing tooth, this premier restoration for replacing lost teeth could become a reality for you.
Losing a tooth can be traumatic, but a dental implant can dramatically turn that experience around. Providing functionality, life-like appearance and durability, implants stand out as the premier restoration for lost teeth.
For adults, that is. An older child or teenager with a missing tooth may need to wait a few more years for an implant. The reason: jaw development. A person's jaws, particular the upper jaw, continue to grow with most growth completed by early adulthood. Natural teeth with their periodontal attachments develop right alongside the jaw.
But because an implant attaches directly to the jawbone, its position is fixed: it won't change as the jaw grows and may gradually appear to sink below the gum line. That's why we wait to place an implant until most of jaw maturity has occurred after full jaw maturity. For females, we try to wait until 20 years of age and for males, usually 21 years of age. These are guidelines as some people mature faster and some slower, so a discussion with your dentist or surgeon is necessary to make an educated decision.
While we wait, we can install a temporary replacement for a child's or teenager's lost tooth, usually a partial denture or fixed modified ("Maryland") bridge. The latter affixes a prosthetic (false) tooth in the missing tooth space by attaching it to the back of natural teeth on either side with bonded dental material. It differs from a traditional bridge in that these supporting teeth aren't permanently altered and crowned to support the bridge.
During the time before implants we should understand that the area where the implant will be placed will undergo some bone deterioration, a common consequence of missing teeth. Forces generated as we chew travel through the teeth to stimulate renewing bone growth all along the jawbone. But with a lost tooth the chewing stimulation ceases at that part of the bone, slowing the growth rate and leading to gradual bone loss.
Fortunately, the titanium posts of dental implants stimulate bone growth as bone cells naturally grow and adhere to their surfaces. Before then, though, if the bone volume is diminished, we may need to graft bone material to stimulate bone growth that will enlarge the jaw bone enough for an implant to be placed.
It usually isn't a question of "if" but "when" we can provide your child with an implant for their missing tooth. In the meantime, we can prepare for that day with a temporary restoration.
If you would like more information on dental restorations for teenagers, 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 for Teenagers.”