BONE GRAFTING

DENTAL IMPLANTS

A dental implant is a bio-inert titanium replacement of the root portion of a natural tooth.  A natural tooth consists of a root and a crown. When you lose a tooth, the root portion is replaced by an implant, which in turn supports and holds the crown portion of your missing tooth. CT imaging is performed in-office to provide additional knowledge and precision to  treatment plans.  CT guidance  can provide surgical guides necessary place implants with millimeter accuracy. This ensures pertinent anatomical structures are not violated, and surgical placement of bone and implants are optimal and physiologic for the restoring dentist.  The implant is placed by the Oral surgeon and is anchored within your jaw bone.  When it heals there by bonding with your bone, it is ready to support the crown portion of the artificial tooth.  Dental implant placement and restoration is a team effort between an oral surgeon and a restorative dentist.  At ROMS we perform the initial tooth extractions, implant placement surgery, and bone grafting if necessary.  The restorative dentist (your dentist) makes and fits the permanent prosthesis. Your dentist will also make any temporary prosthesis needed during the implant process.  There are various options for replacing missing teeth, placing implants and restoring occlusion.  Your dentist and oral surgeon will discuss your individual treatment needs with you. 

We are now also able to place single stage implants. These implants do not require a second procedure to uncover them, but do require a minimum of six weeks of healing time before artificial teeth (crowns) are placed on them. Sometimes implants  can be placed at the same time as the tooth extraction – further minimizing the number of surgical procedures.  Do ask Dr.Hudson if you are a candidate for this option.

REPLACING MISSING TEETH USING IMPLANTS

Your teeth affect your whole body. When they’re healthy, you are healthier too. A missing tooth can affect your bite, speech and food choices. Missing teeth also stress the other remaining teeth as they have to compensate for their missing counterparts.  There are several choices to replace your missing teeth.  Although replacing missing teeth using implants is now the standard of care, every case is different and your dentist and oral surgeon will help you decide if you are an ideal candidate for implant restorations.

 If you have a single tooth or a couple of teeth that need extraction, see below for an immediate temporary restoration to wear while your implant heals.

 

Dental implants are the most comfortable and permanent solution. They form a strong foundation for teeth and keep the jaw healthy and strong. Implants support individual replacement teeth or secure specialized dentures in place. Unlike bridges, no healthy teeth are damaged. Unlike most bridges, implants can last a lifetime. Implant-supported replacement teeth can be attractive, stable, and comfortable for almost any patient.
 
SHOULD I SELECT DENTAL IMPLANTS OVER MORE TRADITIONAL TYPES OF RESTORATIONS?

 

In several cases it is: A dental bridge sacrifices the structure of surrounding  teeth to bridge the span of the missing tooth/teeth. If you wear a denture,removing it or a “partial” denture at night may be inconvenient. Dentures that are supported and secured by implants enhance confidence and minimize embarrassing situations in social settings.

IMPLANT SURGERY? What you should expect...

 

The procedure to place a dental implant takes about an hour.  It might take longer depending on how complicated your case is and how many implants you need. You will be give a fair estimate of time and cost at your consultation appointment.  Prior to surgery, you may receive antibiotics ,intravenous sedation or nitrous oxide (laughing gas). These options are also discussed with you at your consultation appointment. A local anesthetic will be administered to numb the area where the dental implant will be placed.  The surgeon then makes a small incision in the gum tissue to expose the underlying bone, creates space using special instruments, and gently inserts the titanium implant. The top of this implant is often visible through the gum. Sometimes it is better in the early stages of healing to have the implant covered by the gum tissue.  The surgical procedure might vary depending on your individual anatomy, treatment needs.

See the diagrams below for a fair overview of a simple implant case:

 
 AFTER DENTAL IMPLANT SURGERY

 

The length of healing time varies from person to person, depending upon several factors like the quality and quantity of bone. In some cases, implants may be restored immediately after they are placed. The surgeon will advise you on follow-up care and timing. At ROMS we advise a follow up appointment in one week to monitor healing and suture removal.  About three months after the initial surgical appointment the surgeon places an abutment (support post) or a healing cap onto the dental implant at a brief follow-up visit. This allows gum tissue to mature and provides access to the implant.

 

Then impressions are made and the crown fabricated so that they are ready when the implants have healed. How long your mouth needs to heal is determined by a variety of factors. Follow-up care (one to four appointments) is usually needed to ensure that your mouth is healing well and to determine when you are ready for the restorative phase of your treatment.

Whether it’s one tooth or all of your teeth that are being replaced, your dentist will complete the restoration by fitting the replacement tooth (crown) to the dental implant.

HOW MANY IMPLANTS DO I NEED?

Most frequently, one implant per missing tooth is placed. Because many of the larger teeth in the back of your jaws have two or three roots, the most common approach is to replace missing back teeth with larger implants.

MISSING ALL LOWER TEETH

 

Although many patients have no problem wearing an upper denture, some people find it difficult to wear and eat with lower dentures. Several implant-supported replacement options are available if you are missing all of your lower teeth.

 

Ball Attachment Denture

 

One option is to have two implants placed in your lower jaw and a denture made that snaps onto these implants. This option allows your lower denture to be more stable while chewing than without implants. However, there might still be some movement of your lower denture, and sore spots might occur if any food particles, are caught under it. As with all removable replacement teeth, you  will need periodic appointments for denture adjustment.

 
Bar Attachment Denture

 

Another option involves placing four to six implants, depending on your jaw size or shape, into your lower jaw. After healing is complete, the implants are connected with a custom-made support bar. Your denture will be made with special internal retention clips that attach onto the support bar, enabling the denture to snap firmly into place. This is called an “overdenture.” The advantage of this option is that it is much more stable than the first option and allows very little denture movement. Your denture is still removable for easy cleaning and maintenance.

 
Screw Retained Denture

 

A third option involves placing five or more implants in your jaw and attaching a permanent denture. Your denture is held in place by screws or clasps that secure it to the support posts or bar. It doesn’t touch the gum tissue, which allows you to clean under the denture without removing it. This denture will replace all your missing lower teeth and will not be removed except at maintenance visits. Although cleaning under your denture without removing it is more time consuming and requires more dexterity, many patients who want a permanent denture prefer this option.

Individual Implants

 

The final option is to have all your teeth individually replaced so that they will appear to be growing out of your gum tissue and will most closely resemble the appearance of your natural teeth. This option usually requires eight or more implants. Separate abutments or support posts for each one of these implants will be made and crowns for each missing tooth will be placed. The teeth are often joined together for sinus grafting to replace bone height strength and support. Overall, this is the most expensive option, because it requires the most implants and individual replacement tooth fabrication. Your replacement options may also be limited by the current size and shape of your jawbone.

 MISSING ALL UPPER TEETH?

 

A similar range of treatment options is also available for your upper jaw. However, because the bone is not as hard as that in the lower jaw, people often need more implants to support their new replacement teeth. Depending upon the number of implants to be placed, it may be possible to eliminate the need for covering the roof of your mouth with a complete denture. This option allows you to fully taste your food and gives you a better sense of its temperature. Your denture will feel more natural. You will still have a removable denture, which makes cleaning the support bar and denture much easier.

Implant Retained Upper Denture

 

Depending upon the number of implants to be placed, it may be possible to eliminate the need for covering the roof of your mouth with a complete denture. This option allows you to fully taste your food and gives you a better sense of its temperature. Your denture will feel more natural. You will still have a removable denture, which makes cleaning the support bar and denture much easier.

Individual Upper Implants

 

If you want a restoration that is similar to your natural teeth and therefore not removable, you probably will need eight to ten individual implants placed. This is followed after healing by the placement of the abutments and new replacement crowns.

BONE GRAFTING FOR IMPLANTS
After tooth extraction, if the walls of the socket are very thick, they will usually fill naturally with bone in two to three months. However, when the walls of your socket are very thin (such as in your upper and lower front teeth), this type of healing will not be as predictable. In these situations, a bone graft is often placed at the time of tooth extraction to help your body fill in the empty socket with bone. This step will maintain the width and volume of bone you will need for implant placement several months later.

There may be inadequate bone for implant placement if your tooth was removed many years ago and your bony ridge is extremely thin. In this case, a bone graft can be placed next to the thin bone and allowed to heal for up to six months. After the graft has fused to your pre-existing bone, the ridge will be re-entered and the implant placed. Bone grafting is usually a relatively comfortable office procedure. Many different bone-grafting materials are available, including your own bone.

 

You may also need bone grafting if the sinus cavities in your upper jaw are very large, or very low, and extend into the tooth-bearing areas. This often occurs when teeth in the back of a person’s upper jaw have been removed many years before, and the amount of bone available for implant placement is limited. A “sinus grafting procedure” is then required. Most often, it is performed in the office with local anesthesia and perhaps sedation. During this procedure, the membrane that lines the sinus will be located and elevated. Bone will then be added to restore the bone height and ensure that dental implants of an adequate length can be placed. This procedure often can be performed at the time of implant placement.

IMPLANT SUPPORTED OVERDENTURE
 

An Implant Supported Overdenture is a contemporary restoration that has revolutionized the way surgeons and dentists think of replacing a full set of teeth. Standard dentures are unsecured prostheses with inherent limitations. Most often, dentures are painful, inconvenient and unstable. Such dentures can make chewing foods difficult, limiting the foods that you once enjoyed. Modern dentistry can help with implant supported dentures.

 

The Implant Supported Overdenture treatment concept replaces your missing teeth with a full dental bridge supported by dental implants. Fewer implants are needed and overall treatment time and cost is reduced. An Implant Supported Overdenture solution also ensures greater stability in the bone, reducing the need for bone graft surgery to increase bone volume. Implant-supported overdentures stay connected with bar and clip attachment methods or use a variety of abutment-based attachments (ball, magnets, and resilient stud attachments such as Locators). The most appropriate attachment system for your individual needs relates to a variety of factors that is determined early in the treatment. Typically, a temporary set of teeth can be placed on the same day of surgery. The temporary teeth allow you to lead a normal life immediately after surgery. After a short healing period, your dentist will place the final bridge. Your quality of life is improved, and you can start enjoying your favorite foods again with renewed confidence.

 

IMPLANT SUPPORTED OVERDENTURES OFFER YOU MANY ADVANTAGES:

 

  • A cost effective solution. When compared to some other implant supported restoration methods, your new replacement teeth require fewer implants for each jaw. With fewer implants required, the cost is lowered.

  • Reduced need for bone grafting. The special angled placement of two of the implants ensures a secure and stable anchorage for the replaced arch, often making bone grafting unnecessary.

  • Faster treatment and healing time. Your replacement arch can be attached to your implants immediately after insertion.

 

Scientifically proven and documented. Implant Supported Overdentures have had good clinical outcomes from decade long studies with favorable results.

TEETH-IN-AN-HOUR/ ALL ON FOUR IMPLANTS
 

TEETH-IN-AN-HOUR/ ALL ON FOUR implant:  a revolutionary concept providing patients with fully functioning teeth on dental implants in a single procedure that takes about an hour. This technology was developed by Nobel Biocare and utilizes collaboration between both the restorative doctor and the oral surgeon. This merging of knowledge and experience achieves not only increased safety, but also a more precise implant placement. In addition, the fabrication of a final prosthesis is completed prior to the surgery. The computer-guided implant surgery is done in an arthroscopic fashion without requiring any flap reflection. This benefits the patient in that there is less postoperative discomfort, less swelling, and less bruising. Patients can often resume their normal activities the next day.

 

The process begins when a CAT scan is taken of the patient’s jaw bone. This CAT scan allows for the generation of a three-dimensional model of the jaw bone that can then be used with virtual reality software to plan the implant placement without the presence of the patient. The results are a more accurate implant placement and less chair time for the patient.

 FAQ
TEETH WHILE THE IMPLANTS HEAL?

 

Many options are available, and they are tailored to your specific requirements. If you need a replacement tooth while the implants are healing, temporary removable teeth or a temporary bridge can be made. If all of your teeth are missing, we can usually modify your present complete denture or make you a new temporary denture. If you would prefer non-removable teeth during the healing phase, temporary transitional implants usually can be placed along with the permanent implants, and temporary teeth may be made and inserted the same day. Depending on your particular situation, some implants can be placed and “loaded” immediately. This means a temporary or permanent replacement tooth can be placed on, or shortly after, the day the implant is placed.

 

Flipper

 

A fragile, temporary and inexpensive solution is a removable plastic tooth with a plastic retainer, often called a “flipper”.  This restoration is only temporary and is worn till your implant is ready to be restored with a final restoration/crown.

HOW LONG WILL THE IMPLANTS LAST?

 

Implants usually last a long time. When patients are missing all of their teeth, long-term studies (more than 30 years) show an 80 to 90 percent success rate. For patients missing one or several teeth, recent studies show a success rate of greater than 95 percent, which compares favorably with other areas in the body that receive implant replacement (such as hips or knees). However, if one of your dental implants either doesn’t heal properly or loosens after a period of time, you may need to have it removed. After the site heals (or on occasion at the time of removal), another implant usually can be placed.

 

WHEN ARE THE REPLACEMENT TEETH ATTACHED TO THE IMPLANT?

 

The replacement teeth are usually attached to the implant when adequate healing has occurred and your jaw bone is firmly fused to the implant. Depending on a variety of factors, it may be possible to begin this phase of your treatment immediately or shortly after implant placement. We will review the most appropriate treatment sequence and timing for your particular situation.

 

The number of appointments and the amount of time required for each appointment is different for each patient. No two cases are exactly the same and regardless of the number of teeth replaced, the work must be completed with great precision and attention to detail.  Between appointments, we will need time to complete the necessary lab work to make your replacement teeth. It is most beneficial that you keep all of your scheduled appointments.

 

In general, once your implants are placed, you can expect your tooth replacement treatment to be completed anywhere from 1 to 12 months. 

 
POTENTIAL COMPLICATIONS AFTER DENTAL IMPLANT SURGERY?

 

Although it is natural to be concerned about the pain that may be caused by these procedures, most patients do not experience severe or significant post-operative pain. Pain medication and antibiotics will be prescribed for you to make your recovery as easy as possible. Occasionally, some people develop post-operative infections that require additional antibiotic treatment. Even though great care is taken to place the implant precisely, occasionally adjacent teeth are injured in the placement process. In addition, there is a chance that the nerve in the lower jaw, which provides sensation to your lower lip and chin, may be affected. If you are missing quite a lot of bone, it might be difficult to place an implant without infringing on the nerve space. Although we take great care to avoid this nerve, occasionally it is irritated during the procedure, resulting in tingling, numbness or a complete lack of sensation in your lip, chin or tongue. Usually these altered sensations will resolve within time, but they can be permanent and/or painful. If you notify us of post-operative numbness as soon as possible, it will allow us to manage your care in the most appropriate way.

 
 
 
Cleaning my new teeth:

 

As with natural teeth, it is important that you clean implant-supported restorations regularly with toothbrushes, floss and any other recommended aids. You should also visit your dentist several times each year for hygiene and maintenance. As with regular dentures and other tooth replacements, your implants and their associated components are subject to wear and tear and eventually will need repair, including clip replacement, relines, screw tightening, and other adjustments.

 
WILL ONE DOCTOR DO EVERYTHING?

 

Usually, an oral surgeon places the implant(s) and performs other necessary surgical procedures – your general dentist provides the temporary and permanent replacement teeth. Both doctors are involved in planning your dental treatment.  Also, depending upon a variety of factors, different dental specialists may help with your dental care.

HOW MUCH DOES DENTAL IMPLANT TREATMENT COST?

 

Before treatment begins, every effort will be made to give you an accurate estimate of all the expenses involved in placing the implants and making your replacement teeth. In many cases, there is an initial charge for the diagnostic work-up, including study models, x-rays, and the fabrication of a surgical template to ensure the best possible result. In addition you will be charged for the abutment or support post(s), plus the crown, dentures, or anything else that will be placed over the implants, including temporary restorations. Periodic maintenance such as hygiene visits, tissue conditioners, denture relines and other repairs will also incur additional charges.

 

When different doctors are involved in your treatment, you will be charged separately for their services. We will try to assist you in estimating what your actual payments will be after we evaluate your insurance coverage or other third party payments. Also, you should consider your personal financial investment in each treatment option as some insurance companies provide limited or no coverage.

 

Each patient is unique, and it is not possible for us to discuss every option and every contingency for treatment outcome. This website is intended to help you understand the general treatment options available to you. If your specific treatment options are not clear, please contact us. We will be happy to answer any questions you have about your dental care.

CONSIDERING THE COST OF DENTAL IMPLANTS

 

Dental implants have been available for several decades. However, for most patients, they are still a relatively new concept. When considering the cost of dental implants and comparing quotes, there are several important points that should be kept in mind.

 

LONGEVITY

 

When comparing the cost of dental implants to other tooth replacement methods such as dentures and bridges, it is important to take into consideration the longevity offered by dental implants that is not always afforded by other, more traditional methods.

 

While dentures and bridges are initially less expensive, their affordability can be short-lived. Because these older methods require repair and replacement every 5-10 years, they are often more expensive over time. By contrast, dental implants, when properly placed and cared for, can last a lifetime.

 

JAW BONE HEALTH

 

Over time, when a tooth is missing, the jaw bone deteriorates. So while a denture or bridge may seem to function similarly to a tooth, underneath the surface damage is being done to the jaw bone and ultimately to the structure of the face. This can result in the distortion of the shape of a person’s face, leading to additional cosmetic costs down the road.

 

On the other hand, dental implants are made of titanium, which actually integrates with the jaw bone, strengthening it and stimulating bone growth. This preserves the natural strength and quality of the mouth, lessening problems in the future.

 

QUALITY OF LIFE

 

Dental implants can be seen as a long-term investment not only in terms of money, but also in terms of quality of life. A dental implant is the closest thing to a natural tooth. In addition to allowing the patient to eat the same healthy foods he or she has always enjoyed, it also eliminates the day-to-day hassles and possible embarrassment that are frequently caused by dentures.

 

COMPARING DENTAL IMPLANT QUOTES

 

There are several steps (and often multiple professionals) involved in the placement of a dental implant. When comparing quotes, it’s important to factor in the cost of each of these steps:

 

  • Exams/office visits

  • Tooth/root extraction

  • Bone Grafting

  • Placement of the titanium root (the “dental implant”)

  • Placement of the crown

  • X-rays, pre/post operative care

FINANCING FOR DENTAL IMPLANTS

 

First, check with your dental insurance carrier to see what portion, if any, of dental implants they cover.

 

There are health care credit companies that offer no-interest and low-interest loans for medical procedures including dental implants.

 

Dental Implants are an investment in your health as well as your appearance. A full set of teeth makes eating a pleasure again, making it easier to eat a balanced, healthy diet. A full set of teeth also preserves the contours of the face, keeping you from looking old before your time.

 

SCHEDULE YOUR CONSULTATION

 

The only way to receive an accurate price quote is to call us and come in for a consultation, and we can give you a specific price for your case.

Dental implants: are the most technologically advanced and longest lasting tooth replacement option available today. Restore your confidence and …
LOVE WEARING YOUR SMILE AGAIN!