Tuesday, April 8, 2014

Implants and Their Benefits


 One of the areas of dentistry where some of the greatest technological advances have taken place in the last 10 years has been in the field of implant dentistry. In the past when a tooth was lost there were two options on how to replace it. One was to replace the tooth with a removal partial denture that was both cumbersome and awkward in the mouth. It was also not very cosmetically appealing and often times the metal clasps would show. The second method was to place a bridge that was not removable but did require preparing or shaving down the adjacent teeth on either side of the missing tooth space. A false tooth was attached between the two anchor or abutment teeth. On our web site is a short video demonstrating how a bridge works. The problem with this technique is a two or more perfectly good tooth had to be shaved down, and once the bridge was permanently cemented into place there was no way to floss in between the teeth as you normally would. A special device called floss threader is used to thread the floss in between the false tooth and the anchor teeth.

Implants have been around for decades but in the last 20 years there has been much research and advancements made in the area of the biomechanics and biomaterials of dental implantology. Implants are typically made of special titanium that has a special coating on it that promotes the growth or integration of bone to the implant itself. It is through this mechanism that the bone attaches to the implant. When a tooth is lost there is a natural loss of bone that takes place in the area where the tooth once was. This can result in a poor cosmetic outcome or there may even be insufficient bone available to allow an implant to be placed. These days there are many choices the doctor has to perform bone grafts and provide additional needed bone if necessary. The bone used for bone grafting is typically a freeze-dried bone that has been rendered in such that it can be used on anybody without the worry of rejection or disease. Today when a tooth has to be removed a bone graft is often placed in the socket of the tooth after it has been extracted in order to preserve bone so that an implant can be later placed in the same area. Implants offer many advantages over removable partial dentures and prosthetic bridges, and have a very predictable outcome. They provide a superior cosmetic result, preserve bone where the tooth was lost, provide an easily cleansable area that can be easily flossed, and eliminate the need to unnecessarily prepare adjacent teeth.

The process of replacing a missing tooth with an implant retained prosthetic crown is very straightforward and predictable. Following the removal of the tooth the doctor must allow 3-4 months time to pass to allow for new bone to fill in where the old tooth root once existed. This is true whether a bone graft is placed or not. Sometimes an implant can be placed at the same time the tooth is removed. Once it is deemed that the bone has filled in sufficiently a small hole is drilled into the bone  and an implant is placed within the space and the surrounding  bone is allowed to grow and integrate with the implant. A small healing cap is placed on top of the implant during this healing phase, and this process typically takes 3-4 months. A short video of an implant placementcan be seen on our web site Since bone has no nerve endings in it there is surprisingly very minimal discomfort, if any, following the procedure. Most of our patients will take one ibuprofen when they leave our office and that will be the last pain relieving medication they need to take after that. There is also no swelling. After the 3-4 month period of bone growth has passed the healing cap that was covering the top of the implant is removed and an implant abutment is screwed into the implant and a crown is placed permanently over the abutment. This process can be seen on a short animated video on our web site. Once completed an implant will function and look just like a natural tooth. In order to maintain them properly implants do require very good oral hygiene and regular check ups.

About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.