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Posts for tag: dental implants

By Enrique C. Escofet, DDS
February 22, 2021
Category: Dental Procedures
Tags: dental implants  
HowLongIstheImplantProcessItDependsonYourBoneHealth

If you're thinking about getting dental implants, you may be curious about how long it might take. The answer depends on the health of your supporting bone.

Bone is an integral part of implant functionality as bone cells gradually grow and adhere to the newly placed implant to give it its characteristic strength. The implant also requires an adequate amount of bone to accurately position it for the best appearance outcome.

If the bone is sufficient and healthy, we can proceed with the surgical placement of the implant. The most common practice following surgery is to allow a few weeks for the bone integration described previously to take place before finally attaching the crown. With an alternative known as a “tooth in one day” procedure, we install a crown right after surgery, which gives you a full smile when you leave.

There's one caveat to this latter method, though—because the implant still requires bone integration, this immediate crown is temporary. It's designed to receive no pressure from biting or chewing, which could damage the still integrating implant. We'll install the permanent crown after the implant and bone have had time to fully mesh.

So, if your supporting bone is sound, the complete implant process may only take a few weeks. But what if it's not—what if you've lost bone and don't have enough to support an implant? In that case, the length of process time depends on the severity of the bone loss and if we're able to overcome it. In some cases, we can't, which means we'll need to consider a different restoration.

But it's often possible to regenerate lost bone by grafting bone material at the implant site. If the bone loss is moderate, it may take 2 to 4 months of regrowth after grafting before we can perform implant surgery. If it's more significant or there's disease damage to the socket, it may take longer, usually 4 to 6 months. It largely depends on the rate of bone regeneration.

In a nutshell, then, the health of your jaw's supporting bone has a lot to do with whether the implant process will take a few weeks or a few months. Regardless of the time, though, you'll gain the same result—new, functional teeth and a more attractive smile.

If you would like more information on dental implant restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Implant Timelines for Replacing Missing Teeth.”

By Enrique C. Escofet, DDS
January 11, 2021
Category: Oral Health
DontNeglectOfficeCleaningswithDentalImplants

Semi-annual office cleanings are important for keeping teeth healthy and disease-free. If you’ve replaced some of your teeth with dental implants, though, you may be thinking they don’t need as much attention from your hygienist.

It’s quite the opposite — cleaning around implants is important, and actually requires additional attention. The reason for this relates to both how dental implants attach to the jaw and their constructive materials.

Natural teeth are held in place by the periodontal ligament with tiny fibers that attach to the teeth on one side of it and to the jawbone on the other. The ligaments and the gingival (gum) fibers (which are also attached to the tooth) provide some disease resistance to the teeth through its rich blood vessel and collagen network. Dental implants, on the other hand, anchor directly into the jawbone. The titanium integrates with the bone, which naturally attracts to the metal and grows around it, which provides the implant’s eventual attachment strength. The implant doesn’t attach to the gum tissue and won’t develop the same relationship with the periodontal ligament as natural teeth.

Bacterial plaque, the primary cause for tooth decay and periodontal (gum) disease, can collect on an implant crown just as readily as on a natural tooth. Although the materials that make up an implant can’t be affected by a plaque-induced infection, the gum tissues and supporting bone around it can. In fact, because implants lack the disease resistance of the gingival fibers and the ligament attachment, an infection can turn rapidly into a condition known as peri-implantitis that could cause bone and tissue loss and lead to the loss of the implant.

Your hygienist understands the importance of removing plaque and calculus (hardened plaque deposits) from around your dental implant. This often calls for different instruments made of plastics or resins that won’t scratch the implant’s highly polished surface. Scratches provide a haven for bacteria to collect and make it more difficult to dislodge them. Likewise, if the hygienist uses ultrasonic equipment that loosens plaque through vibration, the hygienist will often use nylon or plastic tips to minimize damage to the implant.

And don’t forget your own personal hygiene habits — they’re just as important with dental implants as with natural teeth. Keeping plaque under control, both at home and with your dentist, is crucial to longevity for your dental implants.

If you would like more information on maintaining and cleaning dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implant Maintenance.”

YoucanStillhaveImplantswithDiabetes-ifyouhaveitunderControl

If you're one of the more than 26 million people in the U.S. with diabetes, you know first hand how the disease impacts your life. That includes your dental health — and whether or not implants are a good tooth replacement option for you.

Diabetes is actually the name for a group of diseases affecting how your body processes glucose, a simple sugar that provides energy for the body's cells. The level of glucose in the blood is regulated by insulin, a hormone produced in the pancreas. Diabetes causes the pancreas to either stop producing insulin (Type 1) or not produce enough (Type 2). Also in Type 2, the body can become unresponsive to the insulin produced.

The implications for either type are serious and can be life-threatening. If glucose levels are chronically too low or high the patient could eventually go blind, suffer nerve damage, or develop kidney disease. Diabetes also interferes with wound healing and creates a greater susceptibility for gangrene: diabetics thus have a higher risk for losing fingers, toes and limbs, and can even succumb to coma or death.

Type 2 is the most common form of diabetes. Fortunately, most people with this type can effectively manage it through diet, exercise and regular glucose monitoring; if need be, prescription medication can help regulate their levels. Even so, diabetics with their disease under control must still be alert to slower wound healing and a higher risk of infection.

Because implant placement is a minor surgical procedure, the aspects of diabetes related to healing, infection and inflammation could have an adverse impact on the ultimate success of the placement. Implant surgery creates a wound in the surrounding gum tissues and bone that will need to heal; the body's immune response in a diabetic can interfere with that process. And if infection sets in, the risks of implant failure increase.

But research has shown that diabetics with good glucose management have as high a success rate (over 95% after ten years) as non-diabetic patients. That means the implant option is a viable one for you as a diabetic — but only if you have your disease under control.

If you would like more information on the relationship between dental implants and other health conditions, please contact us or schedule an appointment for a consultation.

By Enrique C. Escofet, DDS
December 10, 2020
Category: Dental Procedures
Tags: dental implants  
ToothinOneDayProceduresRequireSpecialAttentionforSuccess

You've seen the ads for obtaining a new tooth in one day with a dental implant. Those aren't exaggerated claims — you can leave the dental office the same day with a new tooth that looks and functions like the old one.

But the dramatic marketing aside, there is a bit more to the story. Same day tooth replacement isn't appropriate in every situation. And even when it is, there are risks for failure.

We can minimize those risks, however, by focusing on certain goals during the three distinct phases in the process: removing the natural tooth; placing the metal implant into the jawbone; and affixing the visible, crown.

It's crucial during tooth extraction that we avoid damaging the socket bone that will ultimately support the implant's titanium post. If the socket walls break down it could set up future gum recession or cause us to abort the implant procedure altogether that day.

When placing the implant, we want to focus on achieving a strong hold. Due to its special affinity with titanium, bone cells gradually grow and adhere to the post to firmly anchor the implant in time. But since we're immediately loading a crown rather than allowing the bone to fully integrate first, we need to ensure the implant has a secure hold from the get-go. We can only achieve this with precise placement based on careful examination and planning, as well as adequate bone.

Even so, the implant still needs to integrate with the bone for a lasting hold, and that takes time. Even with normal biting forces the implant risks damage during this integration period. That's why we place a temporary crown a little shorter than the surrounding teeth. Those adjacent teeth will take the brunt of the biting force and not the implant.

Once the bone has fully integrated, we'll replace the temporary crown with a permanent one the proper height proportional to the other teeth. Even with the temporary crown, though, you'll still have a life-like tooth the day we removed the older one.

The key to success is planning — first determining if you meet the criteria for a same-day implant and then mapping out and carefully executing each succeeding step. Doing this will ensure your same-day implant is a success from day one.

If you would like more information on same-day tooth replacement, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Same-Day Tooth Replacement with Dental Implants.”

By Enrique C. Escofet, DDS
October 29, 2020
Category: Dental Procedures
WemayNeedtoBuilduptheBoneinYourJawbeforeImplants

Dental implant technology has advanced at such an astounding rate in recent years that you can now walk into a dentist's office with a problem tooth and out the same day with a new one. Unfortunately, not all dental situations allow for this possibility.

For example, you might be considering an implant many years after losing a tooth. But there's a potential problem: there might not be enough supporting bone. While an implant might still be possible, inadequate bone complicates the matter.

Because implants are essentially tooth root replacements, they require a certain amount of bone for stability and the best attractive outcome. As a general rule, implants need to be surrounded by  at least 1.5-2.0 millimeters of healthy bone to support an implant. But you might not have enough if your tooth has been missing for awhile, regardless if you have or haven't worn dentures or other restorations.

That's because bone has a life cycle in which older cells die and newer ones form to take their place. As we chew or bite, the force generated travels up through the teeth to the bone to stimulate this new growth. Without a tooth the bone doesn't receive this stimulus, which can slow the growth rate. Over time the affected bone can lose its volume and density.

If we find you've experienced loss to the point your bone won't support an implant, that doesn't automatically mean this popular restoration is out of the picture. But it will require us first performing a procedure known as augmentation or bone grafting to help rejuvenate some of the lost bone.

With grafting, we place processed bone grafting material in the jaw through a minor surgical procedure to form a scaffold for new bone to grow upon. After several months this can result in several millimeters of new growth maintaining the width of the underlying bone, which in turn may be able to support an implant.

Bone grafting is quite common, often performed at the same time as tooth extraction if there's going to be a time lag before installing an implant. Even if performed later, though, it can successfully rejuvenate lost bone and make it possible for you to take advantage of durable, life-like implants.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants after Previous Tooth Loss.”