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Posts for tag: dental implants

By C. Roger Macias Jr., DDS
January 14, 2022
Category: Dental Procedures
3WaystoCorrectaSmileWithMissingIncisors

In the classic holiday film, It's a Wonderful Life, George Bailey sees what life would be like if he'd never been born. In a variation on the theme, imagine your life if your teeth had never formed.

That's actually a reality for some—they're born without teeth, albeit usually only one or two. But even then, they're often more susceptible to problems with their bite, speech development and nutrition.

And if their missing teeth affects their appearance, their self-image could also take a hit. In particular, the maxillary lateral incisors on either side of the central incisors (those in the very front) can create an odd smile if missing.

Fortunately, we can correct the problem of missing lateral incisors with three possible solutions. The first is canine substitution, involving the pair of pointed teeth next in line to the missing incisors. In effect, we use orthodontic appliances like braces to move them toward the frontmost teeth and close the missing teeth gap.

It's a minimally invasive way to improve smile appearance. But because of their size and sharp edges, it's often necessary to alter the canines, perhaps even crown them. Some people may also need gum surgery to "blend" the gums with the repositioned teeth.

A second method is a fixed bridge, a series of fused crowns. Those in the middle replace the missing teeth, while those on the ends are bonded to the natural teeth on either side of the gap to support the bridge.

Bridges can function well for many years, but it does require permanently altering the supporting teeth for crowning. An alternative Maryland or bonded bridge doesn't require this alteration, but it's also less durable than a traditional bridge.

Finally, we could replace the missing teeth with dental implants, a titanium post imbedded into the jawbone with an attached life-like crown. An implant tooth can last for decades, and don't require alterations to other teeth. However, they're not suitable for younger patients who are still undergoing jaw development—a temporary restoration may thus be in order until the jaw matures.

Being born without certain teeth is something you can't do anything about. But you can change how it affects your appearance and life with one of these options for a new smile.

If you would like more information on correcting a smile with missing teeth, 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 “When Permanent Teeth Don't Grow.”

By C. Roger Macias Jr., DDS
January 04, 2022
Category: Dental Procedures
Tags: dental implants  
3EmergingTechnologiesThatImproveDentalImplants

Historically speaking, implants are a recent blip on the centuries-long march of dental progress. But few innovations in dentistry can match the impact of implants in its short history on dental function and appearance.

Dental implant therapy has already established itself as a restoration game-changer. But it also continues to improve, thanks to a number of emerging technologies. As a result, implant restorations are far more secure and life-like than ever before.

Here are 3 examples of state-of-the-art technologies that continue to improve this premier dental restoration.

CT/CBCT scanning. Functional and attractive implants depend on precise placement. But various anatomical structures like nerves or sinuses often interfere with placement, so it's important to locate these potential obstructions during the planning phase. To do so, we're increasingly turning to computed tomography (CT). This form of x-ray diagnostics is the assembly of hundreds of images of a jaw location into a three-dimensional model. This gives us a much better view of what lies beneath the gums.

Digital-enhanced planning. Implant success also depends on careful planning. And, it isn't a one-sided affair: The patient's input is just as important as the dentist's expertise. To aid in that process, many dentists are using digital technology to produce a virtual image of a patient's current dental state and what their teeth may look like after dental implants. This type of imaging also allows consideration of a variety of options, including different sized implants and positions, before finalizing the final surgical plan.

Custom surgical guides. To transfer the final plan details to the actual implant procedure, we often create a physical surgical guide placed in the mouth that marks the precise locations for drilling. We can now produce these guides with 3-D printing, a process that uses computer software to produce or "print" a physical object. In this case, the 3-D printer creates a more accurate surgical guide based on the exact contours of a patient's dental arch that's more precise than conventional guides.

Obtaining a dental implant is a highly refined process. And, with the aid of other advances in dental technology, it continues to provide increasing value to patients.

If you would like more information on restoring teeth 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 Technology Aids Dental Implant Therapy.”

By C. Roger Macias Jr., DDS
December 05, 2021
Category: Dental Procedures
Tags: dental implants  
DoYouHaveEnoughSupportingBoneforanImplant

Upgrades can be exciting—moving on to a larger house, the latest smartphone, or maybe a new car. And, the same can apply with tooth replacements: Maybe you're ready now to upgrade your existing restoration to a dental implant, the most advanced tooth replacement method now available.

But you might encounter a speed bump in your plans: whether or not you have enough bone available for an implant. Here's why your bone may not be adequate.

Like any other cellular tissue, bone has a life cycle: older cells die and newer cells form to take their place. This process stays on track because of the forces generated when we chew, which stimulates new growth.

But that stimulus disappears when a tooth goes missing. This slows the bone growth cycle to the point that bone volume can gradually dwindle. You could in fact lose up to a quarter of bone width in just the first year after losing a tooth.

And, you'll need adequate bone to provide your implants with sufficient strength and stability, as well as the best possible appearance alongside your other teeth. If you don't have enough bone, we must either enhance its current volume or opt for a different restoration.

Fortunately, we may be able to do the former through bone augmentation or grafting. With this method, we place a graft of bone tissue in the area we wish to regenerate. The graft becomes a scaffold upon which new bone cells build upon. It's possible for grafting to produce up to 5 mm in additional width and 3 mm in height to supporting bone.

We can also use this method to prevent bone loss by placing a graft immediately following a tooth extraction. Some studies show the graft can help preserve bone up to 10 years, giving patients time to consider or prepare for a dental implant.

 There are circumstances, though, where bone loss has been too extensive to make up enough ground to place an implant. If so, there are other effective and life-like restorations to replace missing teeth. But there's still a good chance augmentation can restore the bone you need for a new smile with dental implants.

If you would like more information on dental implant restorations, 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 After Previous Tooth Loss.”

By C. Roger Macias Jr., DDS
September 16, 2021
Category: Dental Procedures
Tags: dental implants  
DentalImplantsCouldHelpPreserveBoneAfterToothLoss

Losing teeth can make it more difficult to eat, not to mention the effect it can have on your smile. But that could be just the beginning of your problems. Missing teeth can contribute to extensive bone loss within your jaws and face. Here's why.

Bone is like any other living tissue—cells develop, function and eventually die, and new cells take their place. Forces generated during chewing stimulate this new growth, helping the jawbone maintain its normal volume and density.

But you lose this stimulus when you lose teeth. This can cause a slowdown in bone cell regrowth that can eventually diminish bone volume. And it can happen relatively quickly: you could lose a quarter or more of jawbone width around a missing tooth within a year.

As this loss continues, especially in cases of multiple missing teeth, the bone can eventually erode to its base level. This loss of dental function can make chewing more difficult, place more pressure on the remaining teeth and adversely affect facial appearance. It could also prevent an implant restoration to replace missing teeth.

Dentures and other forms of dental restoration can replace missing teeth, but not the chewing stimulus. Dentures in particular will accelerate bone loss, because they can irritate the bony gum ridges they rest upon.

Dental implants, on the other hand, can slow or even stop bone loss. Implants consist of a metal post, typically made of titanium, imbedded into the jawbone at the site of the missing tooth with a life-like crown attached. Titanium also has a strong affinity with bone so that bone cells naturally grow and adhere to the implant's surface. This can produce enough growth to slow, stop or even reverse bone loss.

This effect may also work when implants are combined with other restorations, including dentures. These enhanced dentures no longer rest on the gums, but connect to implants. This adds support and takes the pressure off of the bony ridge, as well as contributes to better bone health.

If you've lost a tooth, it's important to either replace it promptly or have a bone graft installed to help forestall any bone loss in the interim. And when it's time to replace those missing teeth, dental implants could provide you not only a life-like solution, but a way to protect your bone health.

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 “The Hidden Consequences of Losing Teeth.”

DiabetesCanMakeGettinganImplantDifficultButNotImpossible

Over 26 million Americans have diabetes, a systemic condition that interferes with maintaining safe levels of blood sugar in the bloodstream. Over time, diabetes can begin to interfere with other bodily processes, including wound healing—which could affect dental care, and dental implants in particular.

Diabetes affects how the body regulates glucose, a basic sugar derived from food digestion that's the primary source of energy for cell development and function. Our bodies, though, must maintain glucose levels within a certain range — too high or too low could have adverse effects on our health. The body does this with the help of a hormone called insulin that's produced as needed by the pancreas to constantly regulate blood glucose levels.

There are two types of diabetes that interfere with the function of insulin in different ways. With Type I diabetes the pancreas stops producing insulin, forcing the patient to obtain the hormone externally through daily injections or medication. With Type II diabetes, the most common form among diabetics, the body doesn't produce enough insulin or doesn't respond adequately to the insulin that's present.

As mentioned, one of the consequences of diabetes is slow wound healing. This can have a profound effect on the body in general, but it can also potentially cause problems with dental implants. That's because implants once placed need time to integrate with the bone to achieve a strong hold. Slow wound healing caused by diabetes can slow this integration process between implant and bone, which can affect the entire implantation process.

The potential for those kinds of problems is greater if a patient's diabetes isn't under control. Patients who are effectively managing their diabetes with proper diet, exercise and medication have less trouble with wound healing, and so less chance of healing problems with implants.

All in all, though, it appears diabetics as a group have as much success with implants as the general population (above 95 percent). But it can be a smoother process if you're doing everything you can to keep your diabetes under control.

If you would like more information on managing dental care with diabetes, please contact us or schedule an appointment for a consultation.



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