Lansing's Dental Discussion

Posts for tag: dental implant

By Holly Scott-Hetchler DDS
April 21, 2022
Category: Dental Procedures
Tags: dental implant  
WhatsInvolvedinGettingaDentalImplant

Although the term "surgery" is broad enough to drive a proverbial truck through, we can roughly categorize procedures as either major or minor. Installing an implant is decidedly in the minor column.

Akin to having a tooth extraction, implant surgery can be done painlessly in a dentist's office with very little discomfort afterward. If you're considering a dental implant, going through this surgical procedure shouldn't worry you.

Still, it's hard not to feel a little nervous about any type of surgery, even one as minor as getting an implant. That's where shining a little more light in the way of information can help dissolve any lingering anxiety. Here, then, is an overview of dental implant surgery from start to finish.

First, a little planning. Preparation beforehand helps eliminate any potential snags during surgery. During earlier visits, your dentist will completely map out the procedure with x-rays or CT scanning of your jaws to locate any obstacles, followed by the preparation of a surgical guide placed in the mouth to direct drilling.

Numbing the pain. The dentist begins the surgery by completely deadening the area with local anesthesia. This is usually done with an anesthetic swab of the surface gums to numb the needle prick, which is then used to deliver the remaining anesthetic to the deeper tissues and bone.

Creating the channel. After ensuring the area is fully anesthetized, the dentist will expose the bone by making small incisions in the gums. Then, using the surgical guide, they'll drill a small hole, incrementally enlarging it until it matches the size of the implant post.

Installing the implant. After drilling, the dentist removes the implant from its sterile packaging and directly places it into the prepared channel. The dentist then ensures the implant positioning is correct, often checking with additional x-rays. They'll then suture the gums back into place to protect the implant.

You may initially have a few days of mild discomfort, usually manageable with over-the-counter pain relievers. Over the next few weeks new bone cells will form and adhere to the implant to create a durable bond. You'll then be ready for the attachment of a life-like crown.

Surgery is one step in a long process. But it's an important step—and with the resulting smile outcome, well worth it.

If you would like more information on 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 “Dental Implant Surgery.”

By Holly Scott-Hetchler DDS
January 01, 2022
Category: Dental Procedures
Tags: dental implant  
ShouldYouTakeanAntibioticBeforeImplantSurgery

Although getting an implant requires surgery, it's usually a minor affair. Chances are good that after just a few days recuperation you'll be back completely to your normal activities.

But like many other minor surgeries, an implant procedure does pose a slight risk of post-op infection. That's especially so with any dental procedure like implant surgery, since the mouth harbors numerous strains of bacteria that could escape into the bloodstream. For most people, though, a post-op infection doesn't pose a major problem since their immune system kicks in immediately to defeat it.

But some patients with less than robust immune systems or other health problems can have serious complications from an infection. Among other things, infected tissues around an implant may not heal properly, putting the implant at significant risk for failure.

If you have a condition that makes a post-op infection problematic, your dentist or physician may recommend you take an antibiotic before your procedure. Known as prophylactic (preventive) antibiotic treatment, it's intended to give a weakened immune system a head-start on any potential infection after a procedure.

Using antibiotics in this way has been a practice for several decades, and at one time were recommended for a wide list of conditions. That's changed in recent years, though, as evidence from numerous studies seems to show the risk to benefit ratio isn't significant enough to warrant its use in all but a handful of conditions.

Both the American Dental Association and the American Heart Association recommend prophylactic antibiotics for patients with prosthetic heart valves, past infective endocarditis, a heart transplant and some congenital heart conditions. Some orthopedists may also recommend it for patients with prosthetic joints.

Even if you don't fall into these particular categories, prophylactic antibiotics may still be beneficial if you have a compromised immune system or suffer from a disease like diabetes or lung disease. Whether or not a prophylactic antibiotic is a prudent step given your health status is a discussion you should have with both your physician and your dentist.

If they feel it's warranted, it can be done safely in recommended doses. If your health isn't as robust as it could be, the practice could give you a little added insurance toward a successful implant outcome.

If you would like more information about dental implant surgery, 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 “Implants & Antibiotics.”

By Holly Scott-Hetchler DDS
January 06, 2021
Category: Dental Procedures
Tags: dental implant  
AToothinaDayImplantCouldGiveYouaPerfectSmileFromDayOne

Getting a new implant tooth in only one day sounds too good to be true. But it's true—up to a point. Whether or not you can undergo an immediate crown replacement (attaching a crown to an implant right after surgery) will depend mostly on the underlying bone.

Traditionally, an implant crown isn't attached until several weeks after surgery to allow bone cells to grow and adhere to an implant's titanium surface (osseointegration). The gums are sutured back in place to protect the metal implant until it develops a durable hold within the bone. But this also leaves you with a noticeable missing tooth gap during the integration period.

A “tooth in a day” procedure gives you a full smile right after implant surgery. There is one catch, though—this first crown will be temporary and it won't be able to receive biting pressure.

Until the bone and implant fully integrate, attaching a full-sized permanent crown can damage the implant. To avoid this, the initial crown is slightly shorter than the future permanent crown. This prevents it from contacting solidly with teeth on the other jaw while biting or chewing, which can generate enough force to potentially damage the implant.

If you undergo an immediate-load crown on your implant, you'll have to return later for the full-length permanent crown. In the meantime, though, you'll avoid the embarrassment of a missing tooth in your smile.

With that said, the target bone must be healthy and intact for you to undergo a “tooth in a day” procedure. That isn't always the case with missing teeth—over time, bone volume can gradually diminish. The subsequent loss can complicate implant placement, which must be exact to achieve the most natural outcome. If extensive bone loss exists, you may need grafting to build up enough bone to adequately support an implant.

Even if an implant can be placed, the bone may still be too weak to allow for immediate crown placement. In that case, the traditional procedure may be the best course to allow the bone and implant to fully bond.

To determine if you're a candidate for a “tooth in a day” implant procedure, you'll first need to have a thorough dental exam that includes an assessment of bone health. If it's sound, you may be able to have a full smile right after implant surgery.

If you would like more information on dental implant restorations, 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 “Same-Day Tooth Replacement With Dental Implants.”

By Holly Scott-Hetchler DDS
November 07, 2020
Category: Dental Procedures
Tags: dental implant  
DentalImplantsCouldHelpYouAvoidThisLong-TermEffectofLosingTeeth

What happens when you lose a tooth? In the short-run, it can certainly undermine your appearance and ability to efficiently chew and digest food. But a chain of events could also be set in motion that may cause the most harm to your appearance and health—and it all has to do with bone loss.

Our bones aren't just rigid structures providing a frame for our bodies. They're living tissue with other purposes like producing blood cells and regulating the endocrine system. Bone tissue is constantly replenishing itself as older cells die and newer ones take their place.

In the jawbone, the pressure generated by the teeth while biting and chewing travels through the roots to stimulate the growth of new bone. If a tooth goes missing, however, the bone around the tooth also loses this growth stimulus.

This can cause normal bone growth to slow so that dying bone cells aren't sufficiently replaced. The bone may then diminish at an alarming rate—a decrease in width of about 25% in the first year after a tooth loss and several millimeters in height after only a few years.

This bone loss can continue to advance, especially if multiple teeth are lost, until the jaw structure as a whole loses significant height. The bite may then collapse, forcing the front teeth to push forward. In this state, a person may not be able to adequately bite or chew food. It can also damage their appearance—their smile suffers, of course, but their entire face may also appear shrunken.

You may be able to avoid this scenario if you replace missing teeth with dental implants. In addition to their life-likeness and durability, implants can also stop or slow bone loss. This is because titanium, the principle metal used in an implant, has a strong affinity with bone: Bone cells readily grow and attach to the titanium surface and foster new growth.

But don't wait: Bone loss could eventually extend beyond what an implant can accommodate—you may then need grafting to build up the bone or consider a different type of restoration. So, speak with your dentist as soon as possible about an implant restoration for a lost tooth to help avoid significant bone loss.

If you would like more information on how tooth loss can affect your life, 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.”

By Holly Scott-Hetchler DDS
July 20, 2020
Category: Uncategorized
Tags: dental implant  
GettingImplantsCanBeaLongProcess-ButWorthit

Dental implants aren't simply prosthetic teeth, but rather an innovative system that restores both smile appearance and dental function. And while an implant can indeed replace a single tooth, they can do so much more. Integrated with removable dentures or a fixed bridge, they provide a secure solution to multiple missing teeth.

Implants essentially replace a missing tooth's root, the basis for their lifelikeness and functionality. As such, they're also the most sophisticated restoration used today, requiring a high degree of technical and aesthetic skill to place them properly. In reality, implantation is more a process than a procedure.

If you're considering implants, that process begins with a comprehensive dental exam. During the exam, we'll assess the exact condition of your oral and facial structures like the length of remaining teeth, your bite and jaw dimensions. We'll use this information to plan the type and placement of your implants. The exam may also reveal problems like bone loss that might postpone your implants or suggest another form of restoration.

Using digital technology, we then locate the exact positions for your implants on the jaw to ensure the best outcome. This often results in the creation of a surgical guide, a plastic template placed over the jaw that accurately pinpoints the locations for the drilling sequence during implant surgery.

In most cases once the implants are surgically installed, gum tissue may be sutured over the implant to protect it while it integrates with the bone. In some cases, though, a visible crown may be placed immediately, so the patient can enjoy a tooth-filled smile the same day. This immediate crown, though, is temporary and will be replaced with a more durable, permanent one in a few months.

During this interim, the titanium in the implant post will attract bone cell growth, which will build up on the implant surface. This increased bone contact will help secure the implant fully in the jaw, giving the implant its signature durability.

Once the integration is complete, the permanent crown is affixed to the implant (or implants in the case of a fixed or removable dental appliance). It may have been a long road, but you'll have the closest thing to real teeth.

If you would like more information on implant restorations, 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 “New Teeth in One Day.”

By Holly Scott-Hetchler DDS
January 12, 2020
Category: Dental Procedures
DoYouHaveAdequateBonetoSupportanImplant

Besides their life-likeness, implants are also prized for their high success rate. More than ninety-five percent of implants continue to function effectively after ten years.

Implants’ advanced technology explains some of their reliability and longevity—they’re as close to natural teeth as we’re now able to achieve. But their impressive success rate also owes to the detailed protocols that dentists follow to install them. One critical part of these protocols is ensuring a patient has enough bone in their jaw to support and precisely situate the implant for the best functional and aesthetic outcome.

Unfortunately, there are situations where a patient doesn’t have enough bone to achieve a satisfactory result. This often happens if there’s been months or years between losing the tooth and considering an implant. The reason why relates to the nature of bone as living tissue.

Like other cellular tissues in the body, bone has a life cycle: Older, worn-out cells die and are absorbed by the body, and new cells form to replace them. The growth cycle in the jaw receives stimulation from the forces generated when we chew, which travel up through the teeth to the bone.

However, this stimulation stops after tooth loss for the related area of bone, which can slow new bone growth. Over time, the volume and density of the bone around a missing tooth gradually decreases, enough eventually to make an implant impractical.

Insufficient bone volume, though, doesn’t necessarily mean an implant is out of the question. We may be able to address the problem by attempting to regenerate the bone through grafting. This is a procedure in which we insert graft material into the affected area of the jawbone. The graft then becomes a scaffold upon which bone cells can grow.  After several months, we may have enough regenerated bone to support an implant.

If there’s been too much bone loss, we may still need to consider another form of restoration. But if we can successfully build up the bone around your missing tooth, this premier restoration for replacing lost teeth could become a reality for you.

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

By Holly Scott-Hetchler DDS
September 14, 2019
Category: Uncategorized
Tags: dental implant  
TheDigitalRevolutionIsTransformingImplantTherapy

Compared to other dental restorations—a few of which have been around for over a century—implants are a relatively recent development. But even though it's just now entering its fourth decade, recent advances have catapulted implant therapy well beyond where it began.

That's due mainly to digital technology. Two examples of this, computed tomography (CT) and 3-D printing, are increasing the accuracy and efficiency of implant placement.

Properly placing an implant is one of the most important elements in achieving a natural and attractive result. But finding the best location is often difficult due to a lack of suitable bone volume, the patient's bite or the proximity of anatomical structures like nerves and blood vessels. CT imaging, especially Cone Beam CT scanners (CBCT), is helping to make implant placement planning easier.

Unlike the static, two-dimensional views of standard x-rays, CBCT takes hundreds of images and digitally blends them together to create a virtual 3-D model of the patient's jaw and face. Dentists can view this highly detailed model on a computer monitor from various vantage points and better identify possible obstructions. With better information about what "lies beneath," they can more accurately pinpoint the best implant site.

Creating the ideal plan is one thing—successfully implementing it is another. Dentists often create a surgical guide that helps them drill in precisely the right positions during surgery. The guide, which resembles a mouthguard, fits over the gums and contains marker locations for drilling.

Many dentists are now using 3-D printing to create these surgical guides. A 3-D printer turns a digital model of the guide based on measurements of the patient's mouth and proposed implant locations into an actual physical object "printed out" layer by layer of special polymer material. The end product can be more precise than guides created by other means.

These and other technological developments are helping implant therapy rise to a new level of success. With the resulting increase in accuracy, efficiency and less treatment time, tomorrow's implant patients will be the ultimate beneficiaries.

If you would like more information on restoring missing teeth 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 Technology Aids Dental Implant Therapy.”

By Holly Scott-Hetchler DDS
June 06, 2019
Category: Uncategorized
Tags: bridge   dental implant  
YourTeenagernotReadyforanImplantHeresWhatWeCanDoInstead

Losing a tooth can be traumatic, but a dental implant can dramatically turn that experience around. Providing functionality, life-like appearance and durability, implants stand out as the premier restoration for lost teeth.

For adults, that is. An older child or teenager with a missing tooth may need to wait a few more years for an implant. The reason: jaw development. A person's jaws, particular the upper jaw, continue to grow with most growth completed by early adulthood. Natural teeth with their periodontal attachments develop right alongside the jaw.

But because an implant attaches directly to the jawbone, its position is fixed: it won't change as the jaw grows and may gradually appear to sink below the gum line. That's why we wait to place an implant until most of jaw maturity has occurred after full jaw maturity. For females, we try to wait until 20 years of age and for males, usually 21 years of age. These are guidelines as some people mature faster and some slower, so a discussion with your dentist or surgeon is necessary to make an educated decision.

While we wait, we can install a temporary replacement for a child's or teenager's lost tooth, usually a partial denture or fixed modified ("Maryland") bridge. The latter affixes a prosthetic (false) tooth in the missing tooth space by attaching it to the back of natural teeth on either side with bonded dental material. It differs from a traditional bridge in that these supporting teeth aren't permanently altered and crowned to support the bridge.

During the time before implants we should understand that the area where the implant will be placed will undergo some bone deterioration, a common consequence of missing teeth. Forces generated as we chew travel through the teeth to stimulate renewing bone growth all along the jawbone. But with a lost tooth the chewing stimulation ceases at that part of the bone, slowing the growth rate and leading to gradual bone loss.

Fortunately, the titanium posts of dental implants stimulate bone growth as bone cells naturally grow and adhere to their surfaces. Before then, though, if the bone volume is diminished, we may need to graft bone material to stimulate bone growth that will enlarge the jaw bone enough for an implant to be placed.

It usually isn't a question of "if" but "when" we can provide your child with an implant for their missing tooth. In the meantime, we can prepare for that day with a temporary restoration.

If you would like more information on dental restorations for teenagers, 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 “Dental Implants for Teenagers.”



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