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 When I was a novice dental student 25 years ago, there were two options for patients with missing teeth. They could have a conventional bridge (in which the teeth on both sides of the missing tooth space were cut down for crowns) or a removable partial denture (often bulky with unaesthetic metal clasps anchoring it onto the remaining teeth). Unlike a partial denture, an implant is not removed at night and is easy to clean. Unlike a conventional dental bridge, the adjacent teeth are not affected and do not need to be cut down for crowns. Although dental implants have been in use for decades, I have seen dramatic improvement in their quality and long-term success in the past 20 years. Now when I give options to my patients for replacement of missing teeth, implants are often included. A dental implant replaces the missing tooth root with a screwlike device that is surgically placed into and integrated with the surrounding bone. The implant is often made of titanium, which is biocompatible with the human body. A crown is eventually placed onto the implant creating a very lifelike "new tooth." Although the process may vary for each person, generally it takes from six to 12 months to complete the entire case. It is important for the dentist to consider the health and thickness of the bone that will be needed to support the implant. Sometimes bone grafting is recommended prior to implant placement so that adequate supporting bone is present. In some cases an implant may be placed at the time that a tooth is extracted. In other cases the implant is surgically placed into the healthy and healed jaw bone several months after the tooth is removed. After the implant is placed, it requires time to integrate, or fuse with the surrounding bone. During this time, a small cap is placed on the top of the implant, slightly protruding above the gum tissue. The cap remains in place for several months, allowing the bone to heal and the tissue to form the proper contour for the eventual crown to be placed. After the healing is complete, the cap is removed and a postlike extension is attached to the implant. The implant and post provide the support for a crown. The dentist will discuss the material to be used for the crown. On back teeth, both gold or porcelain crowns are used, while on front teeth, tooth-colored porcelain crowns are preferred. The shade and shape of the crown can create the appearance of a natural tooth growing right out of the gums. Implants may be a great alternative for tooth replacement and can last many years. Considerations for the success of the implant include the overall health of the patient, health of the surrounding teeth and gums, and meticulous dental home care including thorough brushing and flossing of all teeth and the implant. Molly P. Newlon, DDS, MA, graduated from UOP Dental School in 1982 and completed a GPR residency at the Veteran’s Administration Hospital in San Antonio, Texas. She was director of the Faculty Dental Practice for nine years, and 11 years ago became director of health and safety for the UCSF School of Dentistry. Molly provides training in infection control and health and safety to faculty, students and staff, and is an active member on numerous campuswide committees on health and safety and terrorism preparedness. Send your questions to molly@smartnow.com. |
