Replace Missing Teeth

Your teeth affect your whole body. When they’re healthy, you’re healthier too. A missing tooth can affect your bite, speech and eating choices. As you rely more on your remaining teeth, you increase the chance they will wear out prematurely, or be damaged or lost. You may also experience headaches and/or jaw pain.

Who would want their appearance and health to deteriorate? That’s the natural consequence of missing teeth – the jaw literally melts away. Generally, people will lose 25% of their supporting jawbone structure within the first year after tooth loss. Dental implants are more easily placed when teeth are first extracted because bone replacement becomes more complex as time passes. The great news? Implants act just like your natural teeth. They safeguard and preserve your bone structure, oral health, and appearance. Your dentist and the implant surgeon will provide you with options so that you can make the most informed decision concerning tooth replacement.

Dental Implants

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.

Why Select Dental Implants Over More Traditional Types Of Restorations?

There are several reasons: A dental bridge can sacrifice the structure of surrounding good teeth to bridge the space of the missing tooth/teeth. In addition, removing a denture or a “partial” at night may be inconvenient, not to mention dentures that slip can be uncomfortable and rather embarrassing.

Overview of Implant Placement
The Surgical Procedure

The number of appointments and time required, vary from patient to patient.
Prior to surgery, you may receive antibiotics and for greater comfort, intravenous sedation or nitrous oxide (laughing gas). These options are discussed with you at your consultation appointment. A local anesthetic will be administered to numb the area where the implant will be placed.

When you are comfortable, the surgeon makes a small incision in the gum tissue to reveal the 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 Healing Phase

Now the healing begins. The length of time varies from person to person, depending upon 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. After the initial phase of healing, the surgeon places an abutment (support post) or a healing cap onto the implant during a brief follow-up visit. This allows gum tissue to mature and provides access to the implant.
Occasionally, impressions are made at the time the implant is placed. This enables the crown to be 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.

It may be beneficial to perform a soft tissue graft to obtain stronger, more easily cleaned and natural appearing gum tissue in the area around the implant. This process involves moving a small amount of gum tissue from one part of your mouth to the area around the implant. Most often, it is a brief and relatively comfortable procedure.
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.

When Are Dental Implants Placed?

Implants are often placed several months after extraction. At times, an implant may be placed immediately after extraction of a tooth. This simplifies the process—you won’t have to wait for another appointment to place the implant. When infection or other problems with the bone are present, immediate implant placement is not the best treatment.

If your tooth has been missing for some time, the adjacent support bone is likely to grow thinner and shrink. This occurs because the root of the natural tooth has to be present to stimulate the bone. As much as one-third of your jaw’s thickness can be lost in the year following tooth extraction. If you are missing enough bone, you may benefit from having additional bone grafted into the area. This ensures the implant will be adequately supported when it is placed in the jaw.

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 Upper or 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 will still be movement of your lower denture, and sore spots will occur if any food particles, especially seeds, are caught under it. As with all removable replacement teeth, you still will need periodic appointments for denture adjustment.

1. Before

2. Implants Placed

3. Denture Attached

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.

1. Before

2. Implants Placed

3. Denture Attached

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.

1. Before

2. Implants Placed

3. Denture Attached

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 costly 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.

1. Before

2. Implants Placed

3. Denture Attached

What if I'm Missing All of My 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
Do I Have Enough Bone?

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.

1. Inadequate Bone

2. Graft Material Placed

3. Implants Placed

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.

1. Inadequate Bone

2. Graft Material and Implant Placed

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.

Oral & Maxillofacial Surgery Associates

20 Long Creek Drive
South Portland, Maine 04106

Monday – Thursday
8:00 am – 5:00 pm
Friday
8:00 am – 3:00 pm

T: 207-772-4063
F: 207-772-8641
Billing: 207-772-3027
[email protected]