Dental Implants: Replacing Your Upper Teeth

What are your choices when you lose all of your teeth in the upper arch due to periodontal disease, fracture or deep decay? Tooth replacement options include implant-supported tooth replacement or complete lower dentures.

Dental Implants are the most progressive and natural option in tooth replacement. State-of-the-art technology provides predictable, comfortable, and esthetic results allowing high quality eating, speaking and smiling. An increased confidence accompanies an improved quality of life. Currently most dental implant systems available are designed around the concepts developed several years ago by researcher Dr. P.I. Bränemark click here to read "Dental Implants: An Historical Look at Tooth Replacement"). These implant systems are placed into the jawbone, allowed to integrate with living bone, and then used to anchor tooth replacements. Most are screw-shaped with internal openings that allow teeth to be attached. Most systems are made with a roughened titanium surface to increase implant surface area and improve bone integration, and increase chances for success in bone with poor density. This implant surface is growing in popularity as research shows improved success rates. Some dentists use an implant surface coated with chemicals as research shows this can improve the speed and quantity of connection of the implant to bone.


Implant-Supported Options For Replacing Entire Arch Of Upper Teeth

  1. Six or more implants to support a removable but implant supported denture: can be worn at all times except when cleaning the appliance. It is rigidly supported but can be removed by the patient.
  2. Four implants to support a denture with some soft tissue support: this appliance is removed daily by the patient for cleaning and sleeping. The implants act as anchors to stabilize the denture and prevent movement, allowing for a higher quality diet.
  3. Several implants to support porcelain fixed bridgework: the most lifelike design, it also requires the most careful pretreatment planning between dentist, surgeon and laboratory. The number of implants needed depends upon the number of teeth to be replaced. Additionally, available bone and opposing bite may affect the number and size of implants placed.

Benefits Of Implant Dentistry

  1. Implants are the most natural option.
  2. Plaque control around implants is similar to natural teeth.
  3. Implants do not decay.
  4. Implants are not sensitive to temperature changes.
  5. Implants help to preserve, strengthen and prevent atrophy or shrinkage of bone.
  6. Implants can be used to support a variety of tooth replacement options.
  7. Implants have high success rates.
  8. Implant-supported tooth replacements are stable and allow for chewing apples and other substantial foods.
  9. In the unlikely event an implant must be removed, bone loss is minimal and similar to that of an extracted tooth.
  10. Teeth on implants can be unscrewed and modified if changes occur to neighboring teeth.

Challenges to Implant Dentistry

  1. Surgery is required to place the implant into the jawbone.
  2. Implant dentistry requires more time.
  3. Often, a second procedure is required to expose the integrated implant.
  4. Not all implants work, although most systems have success rates over 95%.
  5. Implants are usually more expensive than other options for the short term.

Implant Treatment: The Process

  1. Review the patient's medical & dental history.
  2. Comprehensive oral, dental, and bite examination.
  3. Complete set of dental x-rays.
  4. Consult with the patient.
  5. Consult with the surgeon.
  6. Fabricate an acrylic implant template to guide the proper placement of the implants.
  7. A CT scan formatted for implant examination is frequently used.
  8. Implants are placed into the lower jawbone.
  9. Two to four months of healing are needed to allow the implants to heal directly against the bone. The integration of the implants is required for successful long-term function.
  10. The implants may require a second procedure to be exposed from under the gums.
  11. After a short healing period, the restorative dentist can register impressions of the implants.
  12. The laboratory manufactures the tooth replacements to fit on the implants. Precision components are used for stability and health for the implants.
  13. The dentist delivers the tooth replacements.
  14. Proper oral hygiene and regular hygiene visits should be performed to preserve health around teeth and implants.

Who Is Not A Good Candidate For Implants?

Patients with poor wound healing, poor resistance to infections and poorly controlled diabetes should find alternatives to dental implants. Patients also need enough bone to provide stable support to the implants and withstand chewing. Patients may be more easily treated with alternative dental options, such as dentures (see below) in select situations.

COMPLETE DENTURES have been around for centuries to replace missing teeth. While George Washington was famous for his wooden teeth, modern dentures are made of acrylic, porcelain or advanced composite materials. Most dentures have a pink acrylic base with teeth set in them to bite properly against the upper teeth.


Challenges

Dentures generally work well in the upper arch, but are commonly a source of frustration for lower denture wearers. Often the long-term absence of teeth results in atrophy or shrinkage of bone due to lack of stimulation. This shrinkage of bone can be further complicated by high muscle attachments along the tongue or cheek surfaces of the gums, which can dislodge the fit of the denture. As the bone continues to shrink, the denture becomes looser and can then move around, creating sore spots on the underlying gums. Chewing food can be a challenge and frequently patients may be forced to live on a soft diet. Medical research has shown that the aging population in our country is challenged by poor diets resulting from tooth loss, with a resulting lower quality of life and higher chance of illness.