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Dental Implants

Your Third Set of Teeth

By Dr. Edwin S. Rosenberg

(Continued)

Innovations

Immediate implant placement: More recently and in the right circumstances it has become possible to remove teeth and immediately place dental implants into the sockets. The preconditions include that there is sufficient healthy bone left into which to place an implant following tooth removal, and that the socket can accommodate an implant of approximately the same size as the tooth root removed.

Immediate implant loading: Immediate “loading” refers to the ability to not only place an implant into a socket but also to place a crown on the implant simultaneously. This procedure engenders more risk and skill and can only be carried out if the situation is appropriate. One of the keys to success of this technique is to make sure that the crown of the tooth is completely free of movement. If it is not the implant will not integrate or fuse successfully to the bone. This is more difficult to achieve for single tooth replacement than it is for multiple teeth; they can be splinted or joined together, much like pickets in a fence, thereby guaranteeing rigidity.

Technical Challenges

Implants are more challenging for dental clinicians to achieve acceptable aesthetic results in highly visible areas like the front of the mouth, particularly in people who show not only teeth but the gum tissues as well. In such cases the whole tooth/gum tissue complex must be recreated including the “papillae” (the pink gum tissues that fill the triangular spaces between the teeth in health). It is here that knowledge and experience really come to the forefront with correct prior assessment and diagnosis of the situation being paramount together with knowledge of what can be achieved. Other challenges include creating or generating bone and/or gum tissues where insufficiency exists. Both of these can be accomplished in today's world quite predictably with a variety of grafting, regenerative and plastic surgical techniques.

Implant Success — When and When Not to Use Implants

A collaborative team approach is necessary to correctly assess your situation and plan the right personalized treatment options for you. While implants are highly successful in the right place, they may not be for everyone or every situation. In the right situation implant success rates in the high nineties have been consistently shown by vigorous research. Even in areas of poor bone quality and amount, success albeit slightly more limited, is quite common.

There are many other types of highly successful dental tooth replacement systems, like fixed or removable bridgework. Sometimes implants can be used in combination with, or to support fixed or removable bridgework.

Implant success is critically dependant upon:

  • Careful assessment, diagnosis, and understanding of the site where implant replacement is sought and how the site relates to the function of the rest of the teeth
  • The judgment, clinical experience and collaborative efforts of the implant team — dentist, surgeon and technician

Once integrated and functional, implant supported crowns — complete tooth replacements can last a lifetime.



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