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Early loading of sandblasted, acid-etched implants in the posterior maxilla and mandible: a 1-year follow-up report from a multicenter 3-year prospective study... (click here)

Osseointegrated implant for single-tooth replacement: a retrospective multicenter study on routine use in private practice... (click here)

Dental implants by case

Let's take a detailed look at every situation:

  • single tooth replacement. The traditional method employed for single tooth replacement consists in the use of a partial prosthesis (bridge) which is cemented on both sides of the abutment teeth. The simplest and most conservative form of fixed partial prosthesis is represented by a bridge of composite resin, though resulting in a minimal tooth structure reduction, it can be only employed under specific ideal circumstances. The conventional fixed partial prosthesis foresees that the abutment teeth on both sides of the missing tooth be reduced in size in order to leave room for the metal or metal-ceramic crowns that are then cemented to the prepared tooth. The artificial replacement tooth is fixed to these crowns before the cementing process. If executed in an optimal manner, these reparations can last many years. However, when the abutment teeth are already weakened due  to cavities or other reasons, the implant is an autonomous element that does not require crown positioning on the surrounding teeth, therefore it reveals itself as being the most indicated and conservative solution;

Single tooth missing (Click here)
When both the tooth and root are damaged, the best permanent replacement is a dental implant in conjunction with a ceramic crown. This solution both looks and functions just like a natural tooth.

- Immediately functioning teeth
- Excellent aesthetic result
- Life long, stable solution

 

Installing the new tooth – step-by-step
The course of treatment described here is one of several options available. Consult your dentist to find out what the best solution is for you, given your specific condition.

1: Before the procedure
The dentist makes a first examination and takes one or more x-rays of the area to prepare for the procedure.
2: Installing the implant
The implant is installed. At this time, a temporary tooth is provided that allows you eat and function like normal almost immediately.  The implant will need a few months to integrate with the jawbone before the next step is taken.
3: Attaching the new crown
The final step is the placement of the permanent ceramic tooth. The new tooth is installed for life. No additional treatment is needed.
4: End result
You should expect the new tooth to fit and function just like a natural tooth. Do your usual dental hygiene to keep the tooth and gum around it clean and healthy.

  • Replacement of more teeth in the same area. When two or three adjacent teeth are missing, the partial fixed prosthesis could still be a valid treatment, but only in function of the supporting bone quantity present in the adjacent teeth. The higher the number of teeth missing, the greater the load exerted on the remaining ones will be. When the load becomes excessive, the bridge has less chance of remaining integral in time, therefore in this case we can also turn to a removable partial prosthesis. This can be supported by the soft tissue (gingiva or gums) and by the underlying bone; and in this way absorb part of the load that otherwise would only be exerted on the remaining natural teeth. This solution is less expensive than an implant, but presents numerous disadvantages: the removable partial prosthesis is more encumbering than a fixed partial prosthesis, it must be removed for daily cleaning, it is less stable, and more difficult to get used to. The replacement of more teeth in the same area of the mouth is one of the most frequent indications for implants, that placed in the space previously occupied by the missing teeth, are capable of providing the added support necessary for a fixed partial prosthesis.

Several teeth missing (Click here)
The course of treatment described here is one of several options available.

1: Before the procedure
The dentist makes a first examination and takes one or more x-rays of the area to prepare for the procedure.
2: Installing the implant
The implant is installed. At this time, a temporary tooth is provided that allows you eat and function like normal almost immediately.  The implant will need a few months to integrate with the jawbone before the next step is taken.
3: Attaching the new crown
The final step is the placement of the permanent ceramic tooth. The new tooth is installed for life. No additional treatment is needed.
4: End result
You should expect the new tooth to fit and function just like a natural tooth. Do your usual dental hygiene to keep the tooth and gum around it clean and healthy.
  • Replacement of all teeth in an arch
    The conventional method is here represented by dentures, but when the bone does not supply enough support we must turn to implants and to the bone reconstruction or integration. The dentures are set upon the soft tissues (gingiva) and on the underlying bone, and when it is employed for the upper arch it can distribute the masticatory forces on the entire top wall of the buccal cavity. The forces that can tend to move the dentures are contrasted by the surface tension and by the space that is created by the dentures and the palate, which contribute to holding the prosthesis in the correct position. Many people adapt quite well to the upper dentures, but in the case of the total inferior set the process of adaptation and use can be much more difficult. In this case the loads are concentrated in a much smaller area and nothing else can contribute to stabilise the dentures, further destabilised by tongue and other muscle movement.

    The pressure on the gums and bone may provoke small changes within the underlying bone itself that in turn provoke adhesion loss, this is one of the reasons that the dentures must be examined by the dentist in regular intervals. When the tissues show a high degree of change, the dentures must be re-made or rectified in function of the specific conditions detected. In fact, if there is the continuous use of a badly fixed set of dentures, the pressure tends to concentrate in very small areas thereby provoking bone depletion is such a radical manner that no set of dentures will be able to “hold”.

    In these conditions, there is nothing left to do but consider implant employment. If instead the treatment is well-timed, the implant can be designed in order to adhere to the remaining bone, but if the condition lasts too long, the arch bone can thin out until fracturing, at times simply provoked by biting into a relatively hard food. This sort of bone in not suitable for implants, that can't come about without an autologous bone transplant (bone is taken from the patient himself). In function of the remaining bone, the implant modalities are basically two: underlay or overlay implants. The first case is the most wide spread, but within the category of endosteal implants the selected type depends above all on the remaining bone condition and configuration. There is not one only implant type for all situations, on the contrary every specific situation must be evaluated in the light of individual conditions and needs;

All teeth missing (Click here)

Benefits of a fixed bridge on implants
When all teeth are missing or in such condition that they need to be replaced, a fixed bridge anchored to dental implants is the best permanent solution
Before dental implants, there were no fixed solution available for people who lost all their teeth. Today, it is possible to replace a full jaw with dental implants and a fixed bridge that results in a permanent, stable and high esthetic solution.

· Lets you eat and function like having natural teeth
· A solid, stable solution that will serve you for life
· Preserves your facial appearance and prevents bone loss

Treatment:
The treatment procedure and number of visits is largely dependent on the specific conditions. But all in all, 8-10 visits should be enough to have a fixed bridge installed. Most patients report that they were much more comfortable following the procedure than they had anticipated.

Installing the fixed brige  - step-by-step
The course of treatment described here is one of several options available. Consult your dentist to find out what the best solution is for you, given your specific condition.

1. Before the procedure
The dentist determines what needs to be done and prepares both himself and the patient for the coming treatment procedure.
2. Installing the implants
The first step is installing dental implants to replace the lost tooth roots. In this case, five implants are used. Temporary teeth are attached that enable you to eat and function like normal while waiting for the permanent bridge to be installed.
3. Attaching bridge
The final bridge is securely installed on top of the implants. With a full jaw replacement like this, it normally takes 2-3 visits to have the bridge completely attached.
4. End result
Your new teeth should be hard to tell from natural – both for you and others. People who have had traditional dentures before getting a fixed bridge often describe this as an overwhelming and very positive experience.

 

Placing a new crown – step-by-step (Click here)
The course of treatment described here is one of several options available. Consult your dentist to find out what the best solution is for you, given your specific condition.

1. Before procedure
The dentist makes a first evaluation and makes an impression of the existing crown. The impression is used as the prototype for the new crown.
2. Preparing the old tooth
The natural tooth is given minor preparation or adjustments. A temporary crown is attached.
3. Placing the new crown
A week or so after the first visit, the permanent crown is securely fitted. Normally, it will serve its owner for life.
4. End result
The end result is a new tooth that should blend in perfectly with the others. Brush and floss as recommended by your dentist or dental hygienist.

last update: 21 January 2008

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