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TwoMajorCausesforImplantFailureandHowYouCanPreventThem

Dental implants are a reliable way to replace teeth. More than 95% of implants survive ten years after their installation, and many of these could conceivably continue for decades.

But that still leaves a tiny few that don't reach the ten-year mark. Some fail early because the implant didn't integrate fully with the bone to create a durable hold. But others fail later—usually for one of two major causes.

Some failures occur due to over-stressing of the implant from abnormally high biting forces, usually because of teeth grinding. People who have this involuntary habit generate excessive force as they grind their teeth, which can damage implants (as well as natural teeth). To reduce this force, a patient's dentist can fit them with a biteguard they wear in the mouth to prevent teeth from making solid contact with each other during a grinding episode.

Fortunately, teeth grinding isn't that prevalent among adults—but that can't be said about the other major cause for implant failure: periodontal (gum) disease. This is a bacterial infection caused by dental plaque, a thin, bacterial film that accumulates on teeth. The implant itself isn't affected by the infection, but the gums and underlying bone supporting the implant can be.

Implants are most in peril from a form of gum disease called Peri-implantitis, which spreads deeper into the gum tissues around implants faster than infections around natural teeth. That's because implants lack the gum attachment of real teeth, which supply a collagen barrier that slows the spread of infection. Peri-implantitis can quickly infect the supporting bone and eventually weaken its connection with the implant.

Because of its aggressiveness and speed, we must diagnose and treat peri-implantitis as soon as possible to limit any damage to the support structures around an implant. If you notice any swollen, reddened or bleeding gums, you should call your dentist as soon as possible for an examination.

And in light of this potential danger to your implants, you should also strive to prevent gum disease through daily oral hygiene. Brushing and flossing your teeth, including around your implants, removes harmful plaque buildup. This daily habit and regular dental cleanings will help you avoid a costly gum infection and ensure your implants are there for years to come.

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: A Tooth-Replacement Method That Rarely Fails.”

YourGumsandBoneNeedtoBeHealthyBeforeGettingImplants

If you've been dealing with a tooth that needs to be removed—or it's already missing—you may be looking to replace it with a dental implant. And it's a great choice: No other restoration can provide the appearance and function of a real tooth like an implant.

You and your smile are ready for it. The question is, though, are your gums and underlying bone ready? These dental structures play a critical role in an implant's stability and eventual appearance. A problem with them may make placing an implant difficult if not impossible.

An implant requires around 2.0 millimeters of bone thickness surrounding the implant surface for adequate support and to minimize the chances of gum recession. But tooth loss often leads to bone loss that can drop its thickness below this threshold. This can make placing an implant problematic.

Fortunately, though, we may be able to address the lack of sufficient bone through bone grafting. By placing grafting material within the empty socket, we create a scaffold for new bone cells to grow upon. Over time this subsequent growth may be enough to maintain an adequate thickness of bone for an implant to be placed.

The gums may also pose a problem if they've shrunk back or receded from their normal positions, as often happens because of gum disease (which may also have precipitated the tooth loss). Again, grafting procedures can help ensure there's adequate gum coverage for the implant. And healthier gums may also help protect the underlying bone from loss.

There are several techniques for placing gum tissue grafts, depending on how much recession has taken place. One procedure in particular is often used in conjunction with implant placement. A small layer of synthetic collagen material or gum tissue referred to as pa dermal apron is included with the implant when its placed. Settling into the bone socket, this apron helps thicken the gum tissues, as well as preserve the underlying bone.

During your preliminary exams, we'll assess your bone and gum health to determine if we should take any steps like these to improve them. It may add some time to the implant process, but the end result will be well worth it.

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 “Immediate Dental Implants.”

By James L Bialk DDS
March 10, 2014
Category: Dental Procedures
TheGapIsNoMore

This is the story of a well-known man, fearless in most respects, who was afraid of the dentist. Even though his fears had resulted in neglect and serious damage to his teeth, modern dentistry and a talented dental team were able to restore his smile to health. If you share this fear, his story may inspire you to take action.

We're talking about William Perry, former defensive lineman and fullback for the Chicago Bears. Here is a man who could fearlessly face a football squad — but not a visit to the dentist. Nicknamed “The Refrigerator” for his 380-pound massive frame, Perry played for ten years in the NFL before retiring in 1994. Since retiring he founded and operated a construction company in South Carolina in addition to making celebrity appearances.

With his celebrity in mind, a team composed of a talented restorative dentist, implant surgeon, and lab technician agreed to give “The Fridge” a makeover. After discussing modern technology and virtually pain-free dentistry with him, they managed to overcome Perry's fears. “I had been in constant pain for many years and I neglected myself, not having had any dental care for over 20 years, not even emergency care. Unfortunately, as I grew older my teeth started to get loose,” Perry told an interviewer. He had lost many teeth and became known for his gap-toothed smile.

Perry had severe gum disease and many of his remaining teeth were loose. In the past his only option would have been a full set of dentures. But his new dental team was able to place dental implants (permanent tooth replacements) supporting fixed bridges. In most cases dental bridges are attached to healthy teeth, but in Perry's case the implants served as anchors for the bridges. They also stabilized his jawbone, which would otherwise “resorb” or melt away after his teeth were lost. This is important because it helps preserve the contours of his face.

After careful planning “The Fridge” had eight dental implants placed in his upper jaw and seven in his lower. The final bridgework was completed four months later. It turned out that even though the gap between his teeth had become his trademark, “the Fridge” never really liked it. He was thrilled with his new smile.

Even if you have some fears, don't hesitate to follow Perry's example and make an appointment with us for a consultation about dental implants, smile makeovers, or bridgework. For more information about William “The Refrigerator” Perry, see the Dear Doctor magazine article “How Immediate Implants Saved 'Refrigerator' Perry's Smile.”