Let's face it, nothing can set our mood for the day like looking in the mirror and feeling really good about our appearance. A healthy sense of self-confidence and a belief that we really do look our best can dramatically affect our self-image and quality of life.
Missing teeth can change all of the above for the worse, by affecting not only your self-confidence, but also how you live:
According to consumer reports online, about 19 million American adults have no teeth and another 113 million are missing at least 1 tooth. Traditional solutions for missing teeth include bridges, removable partial dentures, or full dentures.
The primary purpose of your jawbone is to support your teeth. With tooth loss, your body assumes that there is no need for bone either! Slowly but surely, the upper and lower jawbone can shrink (a process called resorption). Eventually, enough shrinkage will occur so that even the best dentures will not fit properly. Bone loss also causes changes in your facial features that can make you look older sooner by causing:
So…Are there any good choices? As a matter of fact-Yes! Dental Implants provide the most natural feeling tooth replacement alternative.
Because each surgery is different and each patient has a different pain threshold, this is a difficult question to answer. Most patients report less pain with a dental implant placement than a simple tooth extraction. Most surgeries are performed with simple local anesthetic; however, sedation methods are an option to insure patients are predictably comfortable during the procedure.
Study models of the jaw are made from impressions of the mouth. A surgical guide is then made from the mold. Special x-rays of the jaw are also taken- both an individual x-ray (periapical) and an x-ray of the entire mouth (panoramic). In many cases a CAT scan (Computer-Assisted Tomography) of the jaw is taken to see if there is enough quality bone in which to place the implant.
WITH THE AID OF COMPUTER AIDED TECHNOLOGY AND THE RIGHT CONDITIONS MANY DENTURE WEARERS CAN HAVE PHASE 2 AND PHASE 3 COMPLETED IN ONE DAY. THE PATIENT WILL NEED TO HAVE A GOOD FITTING DENTURE, A CAT SCAN, AND THROUGH STATE-OF-THE- ART TECHNOLOGY WILL LEAVE THAT DAY WITH IMPLANT PROSTHESIS.
Although dental implants are designed to last a lifetime, the earliest traditional implant is only about 30 years old. The overall dental health of the patient, the condition of the bone structure of the jaw, and regular follow-up care by your dentist all play an important part in how long implants last. Generally, implants in front lower jaw show a success rate after 5 years of over 95%. There is a higher failure rate in the posterior of the upper jaw, as the bone is less dense in this area of mouth and availability of bone is affected by sinus cavities.
The cost of dental implants varies depending on the number of missing teeth, whether or not a bone graft is required, the number of implants that need to be placed, and the type of prosthetic device to be used in the final restoration.
As a general dentist, Dr. Zieba has completed a one year implant fellowship at Southern Illinois University completely dedicated to placement and restoration of implants. In many cases the entire process will take place in our office. However, many cases need a team approach and with Dr. Zieba having broad knowledge on both the surgical and restorative side of implants you can rest assured you are being referred because of Dr. Zieba's confidence in another team member's skill.
Implant Dentistry is not a recognized specialty of the American Dental Association and as such there is no specific training to advertise this service.
Below is a composite of various situations that Implant Dentistry can be utilized for in order to address the demands of today's dental patient. Having experience performing the surgical and restorative components of the scenarios below, Dr. Zieba has provided some of his own insights into the benefits and concerns of these different options.
Dentures and Implant Dentistry is not a recognized specialty by the American Dental Association and as such there is no specific training to advertise this service.
Single tooth implant will allow you to avoid unnecessary preparation of adjacent teeth for fixed partial denture (bridge). Given that insurance companies' statistics show the average lifetime of bridge is between 7-10 years, a bridge can often lead to other dental procedures down the road. If there is not another tooth behind the missing tooth, then the options are removable partial denture or an implant. An implant is the best option especially if there are no other missing spaces to fill in an arch. Implants in the anterior zone require careful analysis of the bone and tissue available. The ultimate goal is to not only preserve the adjacent tooth structure, but make an implant crown look and function like a natural tooth. If there is considerable loss of bone height, a natural appearance may be very difficult to achieve. Careful consideration must be given to what the patient's expectations are and to what can be accomplished with an implant in an aesthetic area. Often, an implant may require bone grafts to provide bone width suitable for implant.
This option allows a patient to avoid a removable partial denture or a large spanning fixed partial denture (bridge) to fill missing spaces. Ideally, an implant is placed for each tooth replaced; however, when appropriate, spaces can be spanned with an implant bridge. This patient benefits from avoiding the difficulties of wearing a removable partial denture and the forces that ensue on supporting teeth of either a removable or fixed partial denture.
The two-implant overdenture is the most economical route to enjoy benefits of implant dentures. The preferred method is to use this option only for the lower jaw. With minimal hardware involved, it has simple repairs and low maintenance costs. My favorite attachment for this denture is locator attachments. These attachments are similar to buttons on a coat. However, depending on the locator used we can control the amount of force by which the denture is held into place. The patient who chooses the two-implant locator denture must be aware that some movement is still to be expected in the denture. I compare the retention to having the best denture adhesive on the market, holding the denture in place at all times. In some European countries this option has become the minimal standard of care for someone who has lost all their lower teeth.
The use of 4 implants allows for very strong stability in all directions, yet the minimal hardware involved allows for less expense than other implant denture options. With the use of 4 locator attachments connected to implants, patients find the denture extremely retentive. Again, maintenance cost of this denture is minimal. In addition, Implants are very accessible for the patient, making hygiene very simple. I would prefer to use this type of restoration in the lower jaw as I would prefer stabilization with an implant bar in the upper.
The removable bar overdenture provides the benefits of cross arch stabilization of implants. This means that the forces of chewing are shared amongst all the implants together, rather than each implant alone. This reduces the chances of implant failure due to overload or extreme forces. The retention in this type of case is expected to be slightly stronger than then 4 locator supported denture and chewing forces are nearly as strong as natural teeth. This type of restoration requires more effort in implant hygiene with cleaning under the implant bar. There is more expense in fabrication due to greater hardware and lab support involved. I would prefer to use a bar in stabilizing implants in the upper arch, as bone is not as dense and often quality is not as good consistently throughout the upper arch. A number of attachments can be used on bar. I prefer to place locators on the ends of the bar with soft material in denture to grip the bar and offer additional friction for retention. There are a number of systems I have used that make quality overdenture systems; however, I have found some make regular dental maintenance easier than others, and consequently, a lower cost down the road for the patient.
This is a completely implant supported denture with no support from tissue. I would prefer to have 5 implants on lower and minimally 6 on upper for this type of restoration. Unlike the above options, the patient is unable to remove this type of denture. This would be the closest to having natural teeth with equivalent biting force. This type of denture can not be placed on everyone. Careful consideration for bone heights, lip support, and other factors must occur for aesthetics and speaking. In addition, the shape of the jaw must be carefully analyzed in this patient as considerable forces will be generated on supporting implants. These patients must take additional efforts to maintain cleanliness of restoration and implants. Furthermore, this restoration would be expected to have more repairs as the chewing forces generated are much stronger than a traditional denture endures. With the technology available today, in many cases the implants can be placed and patient can leave with this type of fixed implant restoration in one day.
This is the most complex of implant restorations. This patient will benefit from having the complete implant supported prosthesis while still being able to remove the denture and more easily clean the implants. This implant denture consists of a milled bar with corresponding secondary bar in the finished prosthesis. These two systems are precision milled together and when in place are held in by friction and small swivels on each side of restoration. This patient has options for needed lip support that may exclude them from the completely fixed option. Due to this level of technology the investment in this denture is the largest of all implant options, but offers many benefits of lip support, incredible biting force, while still being able to maintain good implant hygiene.