Introduction to dental implants

Dental Implants are rapidly transforming dentistry. Traditionally, the ways of replacing missing teeth were by removable dentures, fixed bridgework (where the "dummy" teeth are suspended off of crowns on adjacent teeth), or adhesive bridges, where the "dummy" tooth is adhesively bonded to the adjacent natural teeth with resin composite cements. Each one of these has disadvantages.

Dental Implants vs Bridges

Dentures

Removable dentures may seem like a simple and cost effective solution but they tend to damage the adjacent teeth by increasing gum line cavities and periodontal problems, they appear false, while feeling bulky and unnatural to those forced to wear them. Most patients really dislike the falseness of these devices which affect speech, eating and self-confidence.

Bridgework

Fixed bridgework requires cutting down some of the teeth adjacent to the gap so crowns can be placed on them. These can then support the dummy teeth or "pontics". These can work well and have been the standard for the last forty years. However, it's a shame to cut down good healthy teeth. The failure of one supporting tooth can cause loss of the whole bridge. Bridgework also has another problem, the ridge under the pontics can shrink down so that the teeth appear unnatural.

Adhesive Bridges

Adhesive bridges became very popular a decade or so ago. They are relatively simple to construct but their success depends entirely on being able to get a good, strong adhesive bond to the adjacent teeth. Experience has shown us that this bond tends to break down in time and it's virtually impossible to to repair. A short term gain can turn into a long-term maintenance nightmare. This means that Adhesive Bridges are generally only suitable for short term tooth replacement.

 

image of missing front teeth without tooth implants image of teeth with tooth implants placed by Dr Peter Hunt

Replacing two front teeth:
These were knocked out many years ago. The best long-term result can usually be achieved with Dental Implant supported restorations. That's what was done here.

Dental Implants Cases

It's best to plan for the implant placement as soon as we notice that the natural tooth is beyond repair. Why? Because when the tooth is extracted the gum and bone in the region start shrinking down, sometimes to the point where it's not possible to support an implant.

The implant fuses (osseo-integrates) with the surrounding jawbone, literally becoming part of it after some months. Once fused then a connection through the over-lying gum is developed using a "healing-cap" and an impression can be taken to develop the final restoration. Generally this consists of an "abutment" which is screwed down into the implant and forms the shape of the tooth being replaced. On top of this a "crown" is cemented. This crown can be created to match the shape of your orignal natural tooth.

 

Illustration of the three Components of a dental implant: crown, abutment and implant.

The Three Components of a Dental Implant:
The Implant Body is placed in the bone, the Abutment comes up through the gum and retains the final crown restoration.

Dental Implant Case 1

The first molar in the lower jaw had been extracted after many years of root canal problems. The dental implant was placed down into the jawbone and the region has healed. Here, you can see down inside the implant. The screws and threads retain the restorative components.

  view of dental implant placed down into the jawbone by Dr Peter Hunt
The second view shows the "Abutment", which is retained in the dental implant with a screw. You can see this through the hole in the abutment. Note the "natural" tooth-like form of the abutment as it arises from the gum tissues.   Dentist in Philadelphia, view of the Abutmen which is retained in the dental implant with a screw
The third view shows the final crown which is cemented over the part of the abutment which lies above the gum. The final restoration looks and feels very natural. Now the patient wishes she had also asked for a crown on the tooth behind which is heavily filled with an old, silver amalgam restoration.   Final dental implant restoration with Philadephia dentist: Dr Peter Hunt
  The Three Components of a Dental Implant:
The Implant Body, the custom Abutment and the Final Crown Restoration.

 

Dental Implant Case 2

The patient was originally missing her natural lateral incisors. Many years ago she had fixed bridges placed, which meant that four natural teeth had to be cut down to support the bridges. The bridgework does not look natural, the pontics look suspended above the gum and the gum tissues about the canine teeth have some problems.

  Image of dental condition prior to dental implants at Philadelphia Dentist

When the treatment is finished a natural appearance has been developed. Two implants have been placed, one in each lateral incisor region. The gum situation around the canines has been improved. Finally six individual all-ceramic crowns have been placed.

 

Image of dental condition after dental implants at Philadelphia dentist
Changing from a bridge to individual restorations supported on teeth and on implants

 

Dental Implant Case 3

This is a case where things were going steadily downhill. Given much more time, she would had had full dentures, certainly for the lower teeth. She was nervous about dental implants as she had one many years ago which failed quite quickly.

  image of x-ray before philadelphia dentist placed dental implants.
To avoid a partial denture in the back upper arch she agreed to some dental implants. When this worked out well, she was happy to have some more placed in the lower arch. These have made a tremendous difference. Now she can eat salad again. For the first time in years she can bite an apple. All of a sudden she does not have to choose soft foods in a restaurant. She loves it and only wishes that she had gone to implants years ago.  

image of x-ray after philadelphia dentist placed dental implants.
Now she has back teeth once again and has regained all her lost function. She can eat, talk and smile normally for the first time in twenty-five years.


Placement of Dental Implants

Placement of dental implants involves a small surgical procedure with a short recovery time. It's performed under local anesthesia and most people have little or no discomfort post-operatively. It's important to be able to place them in the right position and we use low-dosage 3-D CAT scan technology to help us in that, sometimes supplemented with Guide Technology. Even the most complex case can generally be rehabilitated using dental implants as foundations. It is more complex in cases where the jawbone has resorbed, but it is usually still possible.

For those that have undergone this therapy the changes are extra-ordinary. They no longer feel as though they are "falling to bits". For those facing the need to lose all their natural teeth and who fear having to wear removable dentures, it is a lifeline. New function, better eating, improved speaking and a new smile. Implant therapy is transforming and re-vitalizing.

Implant therapy becomes confusing for many patients because most dentists that place dental implants do not restore them. Equally, many dentists that restore dental implants do not get involved in placing them. With his background and training in Maxillo-Facial Surgery and Periodontics combined with his extensive training and competence in Advanced Restorative Dentistry, Dr Peter Hunt has the expertise to do both, indeed he feels that this is of great benefit for his patients. Patients do not have to run around between various dentists. There is no missed communication between teams and patients know who they are dealing with. It also means that the overall costs of dental implants therapy can be reduced, often considerably. Finally, treatment time and overall number of procedures can often be shortened.

 

For an overview of how dental implants are replacing bridges and dentures in modern dentistry, read Jane Brody's article in the New York Times, Personal Health section:
A Dental Shift: Implants Instead of Bridges - click here

  dental implants process steps with Philadephia dentist: Dr Peter Hunt