Dental Implants in Victoria, BC
In the past we didn’t have a lot of options for replacing teeth. It was either a removable option (denture) or a fixed option (bridge). Due to the limitations of bridges and dentures, teeth were often not replaced at all. Implants have been around for a long time, but didn’t really hit mainstream dentistry until relatively recently. Implants are currently used in a great deal of situations that we didn’t have great solutions for previously such as stabilizing dentures, replacing individual teeth, replacing entire arches, and anchorage for orthodontics. With advances in our understanding of the biologic process behind dental implant integration and improvements in technology, implant use has became a routine part of dental treatment and is considered the standard of care in a lot situations that were previously treated with dentures and bridges.
The most common use of implants is when a single tooth has been extracted and needs to be replaced. The advantage of an implant over a bridge is primarily an advantage of long-term prognosis. Bridges most often fail due to the appearance of cavities on one or more of the teeth supporting the bridge. Implants are made of titanium that is embedded in the bone. The implant supports an artificial crown of metal or porcelain that replaces the missing tooth. Neither the implant or the crown it supports are susceptible to cavities. Also, to create a bridge, we must re-shape the teeth adjacent to the space created by the missing tooth. In re-shaping, we reduce the teeth in height and width. This is usually not desirable because in reducing the teeth we weaken them, especially if the teeth on either side of the space do not have crowns or large fillings on them.
Although single tooth replacement is the most common use for dental implants, we routinely use implants as a way to replace dentures that are not functioning properly or to avoid using tissue supported complete dentures altogether. This can be done a number of ways such as using several implants to stabilize a complete denture, or replacing the missing teeth with porcelain crowns, or using a metal framework to support acrylic teeth and gums, etc. Each situation has a number of different options, but implants give us better functional and esthetic options than we have ever had before.
What to expect for single tooth replacement with an implant:
Tooth structure has two main parts. What you see above the gum is called a clinical crown. What you don’t see, hiding below the gum, is the root(s). The implant functions as the root of a tooth. Implants are made of titanium and are roughly cylindrical in shape. Once the diseased tooth is removed, the implant is inserted into the bone. Depending on the situation, there may need to be time for healing and/or a bone graft done prior to the implant being inserted. The implant is given several months time to integrate with the bone. How much time is mostly dependent on the quality of bone that it is inserted into. Once the time for integration elapses, the head of the implant is exposed, and an impression is taken. From this impression, two things are made: an abutment and a crown. The piece that screws into the implant itself is called an abutment. This abutment is custom-milled for each case out of titanium or zirconia to match the contours of the gum above the implant and also to provide support for the crown. The crown is made to look like (or better than) the tooth it is replacing. It is either cemented to or screwed into the abutment depending on the situation.
What to expect when replacing all the teeth in an arch with an implant supported prosthetic:
When replacing all the teeth in an arch with an implant supported prosthetic, be it a removable or fixed solution, there is considerable planning and thought put into what the desired end result is. If someone has had all of his or her teeth extracted and wants a stable denture or has an existing denture that moves too much, implants provide an excellent way to anchor the denture in place which allows it to function more like natural teeth. The implants are inserted into the bone and given time to integrate. Following which, attachments are placed on both the implant and the existing denture (alternatively, a new denture could be made with attachments already in place). The attachments on the implants and denture snap together to prevent the denture from moving. If there is a significant amount of bone loss, a metal bar is made that attaches to the implants, joining all or several of them together. This bar splints the implants together to avoid having too much pressure on any individual implant which could possibly cause that implant to fail. The denture is built to attach to the bar to prevent movement. If someone prefers to have a prosthetic that cannot be removed, that can also be done. The prosthetic can be made of a metal sub-structure that supports porcelain teeth and gums or a metal sub-structure that supports acrylic teeth and gums. Currently the porcelain that we have is not strong enough to link several teeth together, which is why a metal sub-structure is needed. The decision between the two is very specific to what a person wants the teeth to look and feel like.