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Posts for tag: dental implants

By John Kelmenson, D.D.S.
October 19, 2019
Category: Uncategorized
Tags: dental implants   crowns  
CementedorScrewedWhichImplantCrownAttachmentisBestforYou

In the realm of restorative dentistry, dental implants are king. A dental implant can replace a tooth with a permanent, life-like restoration with a solid reputation for durability.

Implants are also known for one other quality — variety. Not all implants are alike, and they have varied applications for use. Available in various shapes and sizes, they can be used for a single tooth or as part of a multiple tooth bridge or overdenture. And while their basic architecture is the same, you also have two options for how the permanent crown (the visible tooth portion) attaches to the implant: screwed or cemented.

A screw attachment can securely fasten a crown to an implant without the need for cement; it also allows for easy removal for repair or replacement should the crown become damaged or worn. On the other hand, it could pose a cosmetic problem — even though the access hole for the screw may be covered with a tooth-colored filling, it could still be distinguishable from the rest of the crown. There’s also a slight risk of the crown chipping around the access hole.

A crown cemented to the implant won’t have this cosmetic issue with an access hole, and will look just like a natural tooth. But unlike a screwed crown, removing a cemented crown can be more difficult. The cement may also cause gum inflammation and potential bone loss in sensitive patients.

The condition of your mouth, the type of implant you’re receiving and other circumstances will all factor into determining which method is best for you. If we’re “immediately loading” the crown (meaning we’re affixing a temporary crown to the implant immediately after placement in the jaw), then the screw method may be more advantageous. Aesthetically speaking, though, a cemented crown may be a better option in terms of final smile appearance.

But whichever method is used, you’ll still benefit from what implants do best — help you regain the function lost from a missing tooth and change your smile for the better.

If you would like more information on your options with dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Crowns Attach to Implants.”

By John Kelmenson, D.D.S.
September 29, 2019
Category: Dental Procedures
Tags: dental implants   smoking  
DentalImplantsandSmoking-CauseforConcern

You probably already know that using tobacco causes significant health risks: It increases your odds of getting various cancers and coronary diseases, to name just a few. Unfortunately, not everyone is able to kick the habit, even when they know they should. Tooth loss is another issue that can cause trouble for your health, in the form of bone loss, malnutrition, and social or psychological problems. Dental implants are a great way to replace missing teeth — but does smoking complicate the process of getting implants?

The short answer is yes, smoking can make implant placement a bit riskier — but in the big picture, it doesn’t mean you can’t (or shouldn’t) have this procedure done if it’s needed.

Smoking, as you know, has harmful effects in your mouth (even leaving aside the risk of oral cancer). The hot gases can burn the oral cavity and damage salivary glands. Nicotine in smoke reduces blood flow to the soft tissues, which can affect the immune response and slow the processes of healing. At the same time, smoking promotes the growth of disease-causing oral bacteria.

How does this affect dental implants? Essentially, smoking creates a higher risk that implants may not heal properly after they are placed, and makes them more likely to fail over time. Studies have shown that smokers have an implant failure rate that’s twice as great as non-smokers. Does this mean that if you smoke, you shouldn't consider implants to replace missing or failing teeth?

Not necessarily. On the whole, implants are the most successful method of replacing missing teeth. In fact, the overall long-term survival rate of implants for both smokers and non-smokers is well over 90 percent — meaning that only a small percentage don’t work as they should. This is where it’s important to get the expert opinion of an implant specialist, who can help you decide whether implants are right for your particular situation.

If you do smoke, is there anything you can do to better your odds for having a successful dental implant? Yes: quit now! (Implants are a good excuse to start a smoking-cessation program.) But if you can’t, at least stop smoking for one week before and two weeks after implant placement. And if that is not possible, at least go on a smoking diet: restrict the number of cigarettes you smoke by 50% (we know you can at least do that!) Try to follow good oral hygiene practices at all times, and see your dentist regularly for checkups and cleanings.

If you have questions about smoking and dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine article “Strategies to Stop Smoking.”

By John Kelmenson, D.D.S.
August 10, 2019
Category: Dental Procedures
Tags: dental implants   dentures  
Implant-SupportedDenturesCouldImproveYourBoneHealth

Generations have depended on dentures to effectively and affordably replace lost teeth. But they do have a major weakness: They contribute to jawbone loss that creates not only mouth and facial problems, but can also ruin a denture’s fit.

Bone loss is a normal consequence of losing teeth. The biting forces normally generated when we chew stimulate new bone to replace older bone. When a tooth is missing, however, so is that chewing stimulation. This can slow bone replacement growth and gradually decrease the density and volume of affected bone.

While dentures can restore dental appearance and function, they can’t restore this growth stimulation. What’s worse, the pressure of the dentures against the gum-covered jaw ridge they rest upon may irritate the underlying bone and accelerate loss.

But there is a solution to the problem of denture-related bone loss: an implant-supported denture. Rather than obtaining its major support from the gum ridges, this new type of denture is secured by strategically-placed implants that connect with it.

Besides the enhanced support they can provide to a denture restoration, implants can also deter bone loss. This is because of the special affinity bone cells have with an implant’s imbedded titanium post. The gradual growth of bone on and around the implant surface not only boosts the implant’s strength and durability, it can also improve bone health.

There are two types of implant-supported dentures. One is a removable appliance that connects with implants installed in the jaw (three or more for the upper jaw or as few as two in the lower). It may also be possible to retrofit existing dentures to connect with implants.

The other type is a fixed appliance a dentist permanently installs by screwing it into anywhere from four and six implants. The fixed implant-supported denture is closer to the feel of real teeth (you’ll brush and floss normally), but it’s usually more costly than the removable implant-supported denture.

While more expensive than traditional ones, implant-supported dentures still cost less than other restorations like individual implant tooth replacements. They may also help deter bone loss, which may lead to a longer lasting fit with the dentures. Visit your dentist for an evaluation of your dental condition to see if you’re a good candidate for this advanced form of dental restoration.

If you would like more information on implant-supported dentures, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Overdentures & Fixed Dentures.”

MoreThananewSmile-DentalImplantsHelpStopBoneLossasWell

Since their introduction over three decades ago, dental implants have evolved into dentistry’s premier tooth replacement choice. While their primary purpose is to replace missing teeth and rejuvenate a patient’s smile, they’re also regarded for another important benefit: they can slow or stop bone loss accelerated by the loss of teeth.

Like all living tissue, bone has a life cycle. Older bone dissolves and is absorbed by the body, a process called resorption. New bone forms and grows to replace the resorbed bone in response to stimuli occurring within the body. In the jaw, this stimulation comes from the forces the teeth receive when we bite or chew.

When a tooth is lost, however, it no longer transmits these force stimuli to the adjacent bone. This results over time in less new growth to replace resorbed bone, and the overall bone mass shrinks. In fact, about a quarter of the normal bone width will diminish in the first year alone after tooth loss. Other serious problems follow, like gum recession or chewing and speaking difficulties. A person’s appearance may also suffer, because as resorption continues unchecked, the underlying foundational bone will continue to shrink. As more teeth are lost, a decrease in the distance between the nose and chin may result causing the lower third of the face to become smaller in size.

Dental implants can interrupt this process by encouraging bone growth around the implant. Implants are made of “osseophilic” titanium, meaning the metal has a natural affinity with bone. After implantation, bone cells will begin to grow and attach to the titanium post. The enhanced growth stabilizes bone loss by providing stimulation to the bone as teeth once did, thereby maintaining bone levels and minimizing potential effects on the patient’s appearance.

Ironically, too much bone loss could make the installation of implants more difficult, since they require a minimum level of bone mass for anchorage. Receiving an implant as soon as is practical once a tooth is lost will minimize the chances of that occurring — and a better chance of improving bone health overall.

If you would like more information on how dental implants improve bone health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”

YouShouldBrushandFlossAroundYourImplanttoEnsureitsLongevity

With a 95%-plus success rate, dental implants are an effective and durable replacement for lost teeth. But we can't place them and forget them: if you don't clean and maintain them they could fail as a result of disease.

The inorganic materials that make up the implant aren't in danger of infection. But the living gums and bone that surround and support the implant are at risk. In fact, there's a particular periodontal (gum) disease involving implants called peri-implantitis (“peri” – around; implant “itis” – inflammation).

Peri-implantitis begins when the gum tissues around the implant become infected and inflamed. This happens most commonly because plaque, a thin film of bacteria and food particles, builds up on implant surfaces. Another less frequent cause is a buildup of excess cement used to bond the crown to the implant. We need to remove the built-up plaque or the excess cement during your dental visit.

If the infection isn't treated or you don't keep up effective, daily hygiene practices, the infection can grow and extend deeper into the tissues and finally the bone. This can destroy the all-important integration of bone and metal titanium post that has created the implant's strong hold. When that support becomes compromised the implant can lose its attachment and, if untreated, eventually fail.

It's important to keep an eye out for any indications you may have a gum infection around an implant. Look for redness, swelling, bleeding or pus formation. If the implant feels loose, this may mean that extensive bone loss has already occurred. If you encounter any of these signs, see us immediately for an examination.

The best approach, though, is to prevent peri-implantitis in the first place. So, brush and floss daily around your implant as you do your natural teeth. And be sure you keep up regular dental cleanings and checkups.

With proper care and maintenance you can avoid problems with disease that could affect your implant. Healthy gums and bone will ensure your implant will last for many decades to come.

If you would like more information on preventing disease involving your dental implants, please contact us or schedule an appointment for a consultation.