Implants and BridgesCan anyone have implants?
Candidates need to have healthy gums and adequate bone to support the implant, and they must commit to keeping these structures healthy. Meticulous oral hygiene and regular dental visits are critical to the long-term success of dental implants.
Because implant placement involves more than one oral surgery, candidates must be in overall good health.
Certain chronic diseases like diabetes, osteoporosis or chronic sinus problems may interfere with proper healing and could prevent the bone from attaching to the implant. Long-term medication use and certain behaviors, like smoking, also may affect the stability of the implant over time.
What are implants made of?
The implant itself is made of metal - usually titanium as it has proven to be very compatible with bone and other tissues. The surfaces of some implants are treated with a substance that helps them adhere to the bone.
Just like conventional crowns, bridges or dentures, the replacement teeth mounted on the implants are made of porcelain, porcelain and metal, or polymer resin.
Are there different types of implants?
With proper patient selection, the ADA considers two kinds of implants safe:
- endosteal
- subperiosteal
Like tooth roots, endosteal implants extend into the jawbone. A sufficient amount of bone is required to support this type of implant.
After placement, the gum tissue may be stitched over the implant for a period from three to six months. During this time the bone attaches to the implant in a process called osseointegration. A second surgery would be needed to attach a post to the implant. Artificial teeth then can be attached to the posts individually, or grouped on a bridge or denture.
A subperiosteal implant can be used if there is not enough bone present to support an endosteal implant. The subperiosteal implant is a metal frame that fits on the jawbone beneath the gums. As the gums heal, the implant becomes fixed to the jaw. Posts, which are attached to the frame, protrude through the gums. As with the endosteal implant, artificial teeth then are mounted to the posts.
Is there any way to build up the bone in my jaw to support implants?
Some studies suggest that implant placement can be successful in augmented bone. Bone substitutes, either synthetic or natural, can be placed under the gums. Over a period of about six to 12 weeks, these materials can stimulate new bone growth.
Would I need to see a specialist to have implants placed?
Implant placement is not one of the dental specialties recognized by the ADA. Implants can be placed by general dentists or specialists, like oral and maxillofacial surgeons, prosthodontists or periodontists. Any dentist who places implants, however, should have special training in the procedure.
When seeking a dentist qualified to place implants, you should ask:
- How much training the dentist has in this procedure.
- How many implant patients he or she has treated.
- How long the dentist has been working with implants.
What else should I know about implants?
As with any medical or dental procedure, implant placement is not always successful. You and your dentist should discuss complications related to healing factors that could influence long-term retention of the implant.
Placing the implant and allowing the bone to fuse with the implant will take some time. The entire procedure can take place over a few months and usually involves more than one surgical appointment. Your dentist may be able to make a temporary bridge or denture that you can use during this healing period. Placement and adjustment of the artificial teeth also may require more than one fitting.
Implant placement also can be costly, and some insurance carriers do not cover this procedure. When considering implants, you should check with your insurer to determine how much of the cost will be covered under your plan.
How can I tell If implants are the right choice for me?
Talk to your dentist. He or she is familiar with your oral health and history, and will help you determine whether dental implants are an option for you.
As part of a thorough evaluation, your dentist will check the condition of your mouth, the supporting bone in your jaws and the way your upper and lower teeth fit together. The dentist may gather additional information by taking dental X-rays or making models of your teeth. This information will help determine whether you are a good candidate for dental implants.
Nothing can take the place of a healthy set of teeth, but when disease or an accident ends in tooth loss, it's good to know you have some options in restoring your smile.
For some people, dental implants offer a feel and look very similar to their own teeth.
What are implants?
Implants are metal posts or frames that are surgically placed beneath your gums. After placement, the implants fuse to the bone of your jaw and act as artificial tooth roots. Replacement teeth, singularly or grouped on a bridge or denture, are then mounted to the implant.
What are the benefits of implants?
One key advantage of implants is that they fuse to the jawbone, offering stable support to artificial teeth. Dentures, bridges or individual teeth mounted to the implants won't slip or shift in your mouth - an especially important benefit when eating and speaking.
This secure fit also helps replacement teeth feel more natural than conventional bridges or dentures. Some people may find the stability of implant-supported dentures to be more comfortable than removable dentures.
Implant-Supported Bridge
Bridges
What exactly is a bridge or fixed partial denture?
A bridge (also called a fixed partial denture) is a restoration that replaces or spans the space where one or more teeth have been lost. There are two types of bridges: fixed and removable. A fixed bridge is bonded or cemented into place. Only a dentist can remove it.
As its name describes, a removable bridge (more commonly known as a removable partial denture) readily can be taken out of the mouth for cleaning. Although removable bridges generally are less expensive, fixed bridges may feel more stable and comfortable.
Why do I need a bridge?
Your appearance, dental health and the proper functioning of your mouth are all important reasons for wearing a bridge. A bridge helps maintain the natural shape of your face and may help support your lips and cheeks. The loss of a back tooth may cause your mouth to sink and your face to look older.
More important, though, your dental health may suffer when teeth are not replaced. Teeth work together. When a tooth is lost, the nearby teeth may tilt toward the empty space, or the teeth in the opposite jaw may shift up or down toward the space. This can alter your bite and place unusual stress on both the teeth and tissues in your mouth.
In addition, due to the increased stress, the gum tissues and the bone that holds teeth in place can break down from the resulting gum disease. Teeth that have tipped are difficult to clean, making them more likely to decay. Chewing on only one side may cause stress in your mouth and jaw joints. As a result, even more teeth may eventually be lost.
Missing teeth also can affect the way you chew and speak. Chewing on only one side may cause stress in your mouth and jaw joints. You also need your teeth to speak properly, since they help you make many of the sounds needed in speech.
If you need extensive fixed bridge work, your dentist will provide treatment or refer you to a prosthodontist. A prosthodontist is a specialist trained in the restoration and replacement of teeth.
How is a bridge attached?
A fixed bridge is commonly cemented to the natural teeth next to the space left by the missing teeth. A false tooth (called a pontic) replaces the lost tooth. A pontic is attached to a crown (restoration that covers a tooth). Crowns, which are cemented on natural teeth, serve as abutments that provide support for the bridge.
Traditional Fixed Bridge
After adjustments are made, the bridge is cemented into place.
Are there different types of bridges?
Yes. For example, implants attach artificial teeth directly into the jaw or under the gum tissue. Because they require surgery, candidates for implants should have good general health and have adequate bone to support an implant.
Implant Bridge
In some instances, a resin-bonded bridge, frequently called a "Maryland Bridge," can be used to replace one or more missing teeth. Because the bridge is attached by a special procedure called bonding, it doesn't require the use of crowns or extensive tooth preparation. Your dentist can determine whether this treatment method is appropriate for you.
What materials are used?
Appearance and function are considered when selecting materials for bridges. Bridges are made from gold alloys, non-precious alloys, porcelain, or a combination of these materials. Porcelain often is bonded to either precious or non-precious metal. Your dentist will discuss which materials are best for you.
How do I take care of my bridge?
It is very important to keep your remaining teeth healthy. A bridge can lose its support if the surrounding teeth or the jawbone that holds it becomes damaged by dental disease. Brush twice a day with fluoride toothpaste, and clean between the teeth and under your bridge with floss or other interdental cleaners (specially shaped brushes as well as rubber, plastic or wooden items). While it is not a substitute for flossing, a useful tool to use in addition to floss is a water jet. These measures help remove a sticky film of bacteria called plaque. Plaque causes gum disease and dental decay.
When choosing a dental product, check to see if it displays the American Dental Association (ADA) Seal of Acceptance. This is your assurance that the company has demonstrated through testing of its product that the product has met the ADA's criteria for safety and effectiveness.
Be especially careful to clean the areas under, around and between the bridge and your natural teeth. Dental floss threaders and special brushes can help you reach these areas. It is also important to visit your dentist regularly.
Remember, the ultimate success or failure of a fixed bridge depends on its foundation. Help keep your gums and remaining teeth healthy. Your oral health and your appearance are worth the effort!
