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Archive for February, 2010

When you first enquire about dental implants it is often in response to an awareness of ongoing dental problems or the recent loss of teeth. Each of these problems will need to be diagnosed and treated in a logical manner, often placing implants in order to establish healthier conditions. Although it is tempting to focus on the more glamorous aspects of teeth supported by dental implants, basic dental health, which includes the treatment of gum disease, repair of decay and the elimination of abscesses will be just as important for the long-term success of your treatment. If you are aware of bad breath, loose teeth, or have noticed excessive bleeding, particularly when your teeth are cleaned professionally, you may have gum problems. Periodontal (gum) disease is a major cause of bone loss and with reduced bone, dental implant treatment can be more complicated.

See the following case studies for an example:

Case Study – Branemark Implants

After suffering from gum disease at the age of 45 our client lost all her teeth and she was not ready to wear dentures for the rest of her life. …

Case Study – Teeth replacement

Fighting a loosing battle to gum disease, all of this patient teeth were mobile and there were visible signs of bone loss. Dr. Kaman, who placed over 13,000 dental implants …

So far we have covered the building blocks that are part of routine implant placement. This has included the initial examination and diagnosis, sedation during surgery and what to expect after the implants have been placed. However, for some people, bone loss after the removal or loss of teeth leaves them without enough to secure an implant.

Sinus augmentation – In the upper jaw above the back teeth, it is possible to increase the height of bone available by creating new bone in the sinus. This procedure is called a ‘sinus augmentation’. A skilled surgeon can deliver very predictable results in this location and without the general success of this technique many patients would be unable to have dental implants in a part of the mouth where teeth are so commonly missing.

Onlay grafting – There are many ways in which bone can be added to, however one simple concept is to take a piece of bone from somewhere else and secure it as an ‘onlay graft’ to a deficient area. The new piece of bone will slowly join to the underlying region and when healed and mature, an implant can be placed in a more favourable position.

See the following case studies for an example:

Case Study – Dental Implants

When Nicola Lewin contacted us her upper and lower jaws were badly affected by gum disease, her teeth were loose and the x-ray showed excessive bone loss. Our experienced dental team …

Case Study – Teeth replacement

Fighting a loosing battle to gum disease, all of this patient teeth were mobile and there were visible signs of bone loss. Dr. Kaman, who placed over 13,000 dental implants …

Most patients will be very familiar with the dental anaesthetics used for routine dentistry and will know how effective they are. Implants are placed using the same anaesthesia. Depending upon the complexity of your case, the operation might take anything from 30 minutes for a single implant, to several hours for complex bone grafting and multiple implant placements. Since the surgery normally involves exposing the bone in the area where the implant and/or bone graft is to be placed you can expect some minor swelling and occasionally bruising afterwards.

For most patients, any of the simple painkillers you might take for a headache will be all that is needed for a few days. If you experience more discomfort than this, contact your treatment provider who can prescribe a stronger medication. During the first few days you should report any unexpected levels of pain or swelling so that it can be assessed. If in doubt always ask for advice, as early detection of a problem will often lead to a simpler solution. You may also be asked to take a course of antibiotics and to follow some simple procedures such as rinsing with salt water or an antiseptic mouth rinse. It is important that you carry out these instructions.

See the following case studies for an example:

Case Study – Missing molars and discolouration

Having lived with discoloured and missing teeth our client longed for a fuller, more even and whiter smile which was achieved with a combination of dental implants and dental crowns.

Upper Jaw – In the upper jaw, provided the implants stay within the bone that once supported your own teeth there are really no important risk areas. If you have missing upper back teeth then the shape and location of the maxillary sinus (the region above the roots) can be shown to you. The maxillary sinuses can be seen on most x-rays and are therefore readily avoided.

Lower Jaw – In the lower jaw the most important anatomical structure to be avoided is the ‘inferior dental nerve’. This nerve runs from the area behind the wisdom teeth, passes under the molars and emerges onto the skin of the face in the region where your premolar teeth are or used to be. This is why a normal dental anaesthetic produces a numb lip even when the needle was placed right at the back of the mouth. If this nerve is disturbed or damaged during the placement of dental implants it can lead to temporary or even permanent numbness of the lip on the affected side. This is a rare but important complication.

If an implant does not achieve or cannot maintain a rigid fixation with the surrounding bone it will eventually become loose and no longer be able to support replacement teeth. Commonly the failing implant causes no discomfort and if there are enough remaining, it may not be necessary to replace it at all. Failures may not always be so easy to deal with and if you embark upon this type of treatment you have to be prepared to deal with this possibility. Most treatment providers will want to achieve failure rates much less than 5%, however in practice this could mean that 1 in 20 of the implants placed might not survive in long-term function. It is a good idea to discuss how your treatment plan might be affected by the loss of an implant.

For most implant-supported teeth you will be able to clean around each supporting implant by brushing and flossing in just the same way that you would around natural teeth and tooth-supported bridges. In some areas special floss, interdental toothbrushes and other cleaning aids may be needed to maintain good oral hygiene. Cleaning is not at all difficult, provided that you do not have impaired use of your hands. It is reasonable to expect some of the daily hygiene procedures to be a little more complex than around your original teeth – equally expect to spend more time than you may have done in the past if you wish to maintain optimum implant health.

See the following case studies for an example:

Case Study – Dental implants and fixed bridges

Our client decided to visit us for a London consultation when her front tooth broke off by the gum line and there was urgent need for a full mouth rehabilitation. Her …

Case Study – Front crowns and dental implants

Longing for brighter and more pleasing smile our client decided to travel to Budapest for a smile makeover. Replacing the molar teeth and the old and multicolour crowns, a fully revitalised …

During the period after the new teeth are fitted, the success of each treatment stage will be the main factor determining how the implants are performing. Once the implants and surrounding soft tissues are seen to be healthy and the new teeth comfortable and correctly adjusted, it is the quality of your home care and willingness to present for regular maintenance reviews that will have most influence on how long they will last

When poorly cared for, implants will develop a covering of hard and soft deposits (calculus and plaque) which is very similar to that found on neglected natural teeth. Untreated, these deposits can lead to gum infection, bleeding, soreness and general discomfort, just as can occur around natural teeth. It could probably be said that implants much like teeth will last for as long as you can keep them clean. Well maintained implants placed into adequate bone can be expected to last for many years and probably for your lifetime. However, just as you would expect conventional crowns, bridges and fillings to need occasional repairs or replacements during their lifetime, your implant-supported teeth may also have similar maintenance requirements over theirs.

See the following case studies for an example:

Case Study – Camlog Implants

Louise was suffering from recurring abscesses for years and was in and out of a dental chair. Her NHS dentist couldn’t offer her any treatment apart from extractions and dentures, …

Case Study – Full mouth reconstruction

Unhappy with his worn down and discoloured teeth our client opted for a full mouth makeover with long lasting metal free zircon crowns.
Treatment: Ultrasonic polish & clean
24 Zircon metal …

Case Study – Dental implants and fixed bridges

Our client decided to visit us for a London consultation when her front tooth broke off by the gum line and there was urgent need for a full mouth rehabilitation. Her …