All on Four Dentures & More in Belleville

 

Bone grafting procedures,

Reconstruction &

Implants

 

 

  More times than not, if you and your dentist have determined that placing an implant is your best option, this will be possible without additional surgeries.

 

  However, depending on the time elapsed since the teeth were removed as well as the local anatomy, some additional preparatory bone grafting may be necessary.  Almost invariably this will add some overall time to your treatment, but in the scheme of things, always remember 'good things come to those who wait'.

 

  Click on the links below for more information regarding: 

Implant Options
Bone Grafting
Reconstruction
All-on-Four
Ridge preservation
Ridge grafting
Sinus lifting
Maxillary reconstruction
Mandibular reconstruction
rhBMP

Single-tooth implants:

 

A single-tooth dental implant is probably the next closest thing to your original tooth.  This is because it is comprised of a "root" (the implant fixture) and a crown (the prosthetic crown).  Like a tooth you'll be able to pass floss in-between it and the adjacent tooth.  Like a tooth it will stay fixed when eating without movement; and, like a tooth it will require your committment to its care including brushing, flossing and professional dental checks.  

 

Once you and your dentist have determined that an implant is the best option for you, an appointment will be made for you in our office for a consultation.  At this consultation you will meet with your surgeon.  We will discuss with you: the planned procedure(s) involved, the time committment required, the prognosis of the implant.  We will also discuss the manner in which the surgery will be performed and offer possible options for your comfort (e.g. sedation).  You will be presented with an estimated fee of services and payment options.

 

We realize at Bayside that dental implants are an investment of your time and money.  To that end, we:

  • will give you a fair estimation of what will be needed for your overall treatment (i.e. no surprise fees later);

  • will commit to the success of your implant which means should the implant fail in an innapropriate time span, replacing it and performing related surgery;

  • perform follow-up (recall) visits with you taking radiographs as necessary with no additional charges to make sure the implant is in good health during the healing period.

  • communicate with your restorative dentist to make sure the implant is restored with a crown in a timely fashion.

 

There is a FAQ below on implants.  As you will see during your consultation, we are here for you.  Your surgeon is always open to questions during the day and after hours.  

 

When is the best time to place an implant after extracting my tooth?

That varies on the condition of the extraction site and your healing but, in general terms, the soonest one would place an implant is at the time of extraction.  In some cases this is possible particularly if the tooth has a single root and the area is uninfected.  The next reasonable time would be after the extraction site has healed fairly well which would typically be 2-3 months.  This could be longer if bone grafting was done, if the site was slow to heal or for other possible reasons.

 

Am I definitely a cadidate for an implant?

That depends on three factors:

  • Medical / social factors:  These will be addressed at your consultation; but generally, those in stable health are typically good implant cadidates.  Certain medical conditions (e.g. poorly-controlled diabetes) and social habits (e.g. heavy smoking) has been shown to be negative factors in implant success.

  • Surgical factors:  What is the condition and amount of bone present in the area?  What is the condition of the gingiva (gums) around the anticipated implant?

  • Prosthetic factors:  Is there enough room between the teeth for an implant?  Is there a reasonable tooth opposing the anticipated implant?  What is the condition of the remaining teeth?  What is the conditon of the adjacent teeth?

 

As you can see, there are good reasons to have a thorough surgical consult before your surgery.

 

Are implants for life?

Nobody can answer this with a 'yes'.  What we do know (and I would echo from experience) is that implants placed in patients who are good candidates and are placed in good bone are expected to have at least the following survival at 15 years after placement:

  • maxillary (upper jaw) implants:  94-96% success

  • mandibular (lower jaw) implants:  96-98% success

This isn't to say that at 15 years the remaining implants all fail.  It just suggests that at the 15-year mark that's how many implants are still functioning.

 

So, once I leave your office, I'll have a tooth right?

No.  It is important to understand that implants are a 2-part restoration.  Just as a natural tooth as a root and a crown; so too, does an implant.  The implant is typically placed by a surgeon or a dentist with that level of comfort and the crown (the top part that you see in the mouth) is placed by your restorative dentist (usually your general dentist).

 

Here is where there is confusion.  Even though an implant looks like a 'screw' and one would think that is what holds the implant in the jaw; that is not fundamentally correct.  It is true that an implant has threads but the threads are there mainly to hold and stabilize the implant initially.  In a way, one can think of the threads as a cast on a broken arm - it holds the implant still.  Implants actually are only 'successful' when they become one with the bone around them - again similar to the healing of a fracture.  A fair waiting period for this to happen might be 2-3 months for a mandibular implant and 4-6 months for a maxillary implant.  Some might think this is conservative but, let's consider again the time and money put in and everyone's efforts.  

 

I have a nickel allergy, I guess I'm out of luck for an implant?

Not necessarily.  There is no nickel in the body of an implant.  It is mostly titanium.  However, any fixture that is going to be placed on the implant needs to be confirmed to be nickel-free.  There is also the option of a non-metallic implant.

 
 

Multi-tooth implants:

 

Depending on the way your teeth are missing, you may be able to replace multiple teeth with less than one implant per tooth (see illustration).  This may also be a good option if there is more bone missing in the middle such as where a traditional bridge once existed.

 

If your goal is to replace tooth-for-tooth that could also be an option; in other words, one implant is placed for each missing tooth.  

 

Visit the FAQ on this page for additional implant information.

 

Replacing three teeth with two implants

Replacing many teeth with a traditional fixed prosthesis

Hybrid dentures (e.g. all-on-four):

 

A hybrid denture is essentially what the Nobel(R) All-On-Four concept is based on.  The idea is that denture teeth and the resin that would normally be around them (pink gum part) is bonded to a milled titanium bar.  This bar is then screwed down to the implant abutments (four to six).  It is a hybrid in that it borrows features from a conventional denture and from a conventional fixed prosthetic (like shown above).

 

A hybrid overdenture is indicated for patients with:

  • Significant bone loss such that the bone is no longer where the teeth should be and such that the soft tissue (e.g. lips, cheeks) would benefit from support;

  • An inabillity to tolerate a conventional removable denture;

  • More limited finances since fewer implants are required compared to a conventional fixed implant prosthesis.

 

Steps in the fabrication of a hybrid overdenture:

  • The dentist will make impressions, have an initial denture constructed and have the dental lab construct a surgical guide to tell the surgeon where implants should be placed;

  • The surgeon will remove any remaining teeth, place 4 to 6 implants in the strategic positions that will allow the prosthesis to affixed to;

  • One of two routes will proceed from this point.  

    • If the patient and dentist want the initial temporary denture initially screwed down to the implants, the surgeon will place special abutements on the implants, suture the tissues and have the patient meet up with the dentist for the temporary denture to be adapted to be screwed down.  

    • Alternatively, a flat cover screw will be placed on the implants, the gums sewed over the implants and the denture will be able to be worn after a short healing time. After 4-6 months, the implants will be uncoverred from the gum in a small surgery, abutments (caps) will be placed on them and you will return to your dentist for the final hybrid overdenture.

 

Visit the FAQ on this page for additional implant information.

Implant-retained overdentures:

 

Perhaps the biggest 'bang for the buck' option for patients is the option of placing two to four implants in the lower jaw and modifying the existing denture to 'snap' on to these implants.  

 

Advantages:

  • Minimal surgery and usually no bone grafting needed;

  • Often your existing denture can be used and retro-fitted to accept the implant attachments;

  • Time between implant placement and their use can be as little as weeks;

  • Least costly implant-denture option;

  • No longer do you have to worry about spitting out your denture when smiling, talking, eating;

  • Usually can be placed even after many years of being without teeth (i.e. even after signifcant bone loss has occurred);

  • Minimal patient upkeep involved.

 

Two Locator abutments to retain a lower denture (image from Zest Anchors)

Four Locator abutments to retain a lower denture and bar (image from Zest Anchors)

Visit the FAQ on this page for additional implant information.