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- Rotten Tooth Pictures
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Dental implants are not teeth. Dental implants are very much like the roots of teeth. Crowns can be cemented to teeth or dental implants. Overdentures can be secured to either dental implants or tooth/teeth roots. Neither are the white things that people smile or chew with.
In this picture a hex driver is being used to tighten an abutment screw and the final crown is seen.
This picture and the narrative above outlines the detail of this specific case, but for the one stop shopping – comprehensive dentist, this is just one small but very important aspect of restorative dentistry. In my opinion, as I have stated before, Comprehensive Dentistry means ” accepting a patient in any stage of dental disease and restoring them to a state of health, comfort and esthetics consistent with their wants and being respectful of their finances.”
Future blogs will address infection control in the dental office as this is huge issue right now.
Dental Implants 101 (for non-dentists)
In this post I would like to take a little time to explain the different stages in the dental implant procedure. Sometimes friends and family ask me questions about different dental procedures and as the words get bigger and the procedure more complicated, it seems like their eyes glaze over, and before long I’m pretty sure they aren’t listening anymore. I know I can get pretty techie, and lots of dental procedures, even basic ones, often involve lots of steps and lots of technical terms. So this time I want to pay extra special attention to speaking in clear, non-technical language, so that even someone who has never heard of dental implants before, might be able to understand the basics of the procedure, the different options involved, and what to expect in the long term. To do this, I will explain the process in two parts. First, I want to discuss the steps and timeline. Second, I’ll explain the different parts of the actual implant (most people do not realize that the actual implant is only one piece of the larger puzzle!).
Regarding the implant steps and timeline, I want to talk about four main steps. The first is a consultation and an examination of the health of your gums and jawbone. This is the time when I will make sure you are a good candidate for dental implants, and it is also the perfect time for you to voice any concerns, worries, or general questions regarding your health and also the associated costs of the procedure.
Once we have determined that you are a good fit, the next step is the dental surgery. You will be placed under anesthesia so there shouldn’t be any discomfort during the surgery. The implant will be anchored into your jawbone and gum tissue, and a temporary denture, kind
of like a retainer, will be fitted. You will use this temporary restorative until the implant has “taken”. What happens is, in the next three to six months, the implant will fuse with your bone and gum tissue. This is called osseointegration, and once it happens, your implants are ready to be fitted with your dental restoration. Which leads us to the second part of this blog, what is a dental restoration, and what are the other parts of the dental implant process?
Implants basically have three parts: the fixture, the abutment, and the prosthesis (also known as the dental restoration). The fixture is the actual implant, which is something no one will ever see. The fixture is basically a titanium or titanium alloy screw that is fitted through the gum tissue, into the bone. The living bone tissue then fuses with this screw over the next few months. The second part of the implant is the abutment. This is screwed onto the fixture, at the gum line, once the fixture is fused with the jawbone. The abutment is made to hold the third part of the implant, which is the prosthesis. For most patients, this is really the most important part. This is the part that makes chewing comfortable, and this is the part that makes your smile look nice and healthy.
When it comes to the prosthesis there are a number of options from which the patient can choose, depending on what they would like to spend and what works best for their situation. For patients that have lost a number of teeth, the most cost-effective option is to have your dentist implant fixtures on each side of the jaw, and then have a denture that attaches to these implants. This is much more stable than regular dentures, and doesn’t slide on the gums. The downside is, you still have to take them out and clean them, and you shouldn’t sleep with it.
Dental Implants are now a common way to replace missing teeth, it was not always this way. When I graduated from Columbia University School of Dental and Oral Surgery in 1985, I remember the most conservative instructors warning “do not place dental implants, they rarely work.” Now in 2013, dental implants enjoy a success rate and longevity greater than traditional tooth supported fixed bridgework. A quick history.
Historically, for implant dentistry “I think that we have to start with the first modern, successful implant that was placed in 1948 by Gustov Dahl. Then I believe we jump over to the introduction of successful, widespread use of endosteal implants following the development of the Ramus Blade by Harold Roberts and the the esplosion of the implantololgy being brought around the world by Leonard Linkow and his many modifications of the concept of blade implants.” This is a quote form my mentor, O’Hilt Tatum Jr from AAID’s Winter 2013 “AAID News” page 16. Dr Tatum then goes on with what he considers the most important milestones in implant dentistry. I personally think the next major step was the exquisite scientific studies published in the book, “Tissue-Intregrated Prostheses” in 1985 by Per-Ingvar Branemark, MD., Ph.D., George A. Zarb, DDS and Tomas Albrektsson, M.D., Ph.D. These long term, controlled, human scientific studies were done over a 15 year time period in Goteborg, Sweden. These studies gave a scientific basis for the safety, predictability and longevity of dental implants.
All on 4 is the concept that all of ones lower teeth can be supported by 4 dental implants. In this picture, 4 lower dental implants are connected via a gold bar with two ball attachments supporting a lower overdenture. This patient presented to my Palm Harbor dental office in 2013 to have a new lower overdenture fabricated. The original surgery and prostetic’s were done by my friend and former associate of Dr. Tatum, now retired, Richard Borgner DDS.
All on 4
What is meant by “all on 4″ in Dentistry?
Although “all on 4″ is a very broad use of 3 words, it has a very specific meaning when it comes to Implant Dentistry. Lower full dentures are the most universally unacceptable type of teeth made by dentists throughout all time. Some dentists even refuse to make full lower dentures due to the very high level of most people receiving this type of treatment. I practice Comprehensive Dentistry in my Palm Harbor Dentist office and have done so since 1988. My definition of Comprehensive Dentistry is: treating any patient in any state of disease and restoring them to health, comfort, function and esthetics to the best of my abilities considering their wishes, health and finances.”
I restored this woman’s mouth in my Dentist Palm Harbor office in 2006. She requested removal of her remaining 7 lower teeth, a full lower denture and a new full upper denture. As previously stated, few patients are comfortable in a full lower denture. These pictures show before and after pictures of a all on 4 case, also known as “4 on the floor.”
The dental implant itself is not seen in this picture. I placed the dental implant 6 months prior in my dentist Palm Harbor office, now it comes time to restore this dental implant. The hand driver has the white circular part. The hand driver goes through the abutment and is inserted in the fixation screw (not visible as it is inside the abutment.) This will be screwed in to the implant and tightened with a torque wrench. The dental crown will be cemented to the abutment.
Dental Implants are not teeth. Dental Implants are very much like a titamium tooth root. I took this picture in my Palm Harbor dentist office. This picture shows a crown on a dental implant in the tooth #9 position. As is typical of tooth loss, along with the tooth goes some of the gum tissue and bone. Hence, this crown delivered in my Tampa area dentist office, is longer than the other front tooth, tooth #8. If, when this patient smiled, this was visible, I would have used pink porcelain on the crown at the gum line.
The bigger of the two front teeth is tooth #9. It is a crown that was cemented to a dental implant abutment.
Unfortunately, it is not rare when a dental implant is done in this region for the final crown to be bigger/longer. Fortunately, in this particular situation, this asymmetry is not visible when this man smiles. The techniques used to restore dental implants in my dentist office, Palm Harbor have changed favorably over the more than two decades that I have been placing and restoring dental implants in Palm Harbor, Tampa Florida.
This is a dental flipper to replace tooth #9. A dental flipper is a term that can be broadly used for any type of all acrylic removable partial denture. This flipper was not made in my Palm Harbor dentist office, it was made in New Jersey. The young man had lost his front tooth #9 when visting his family. His dental implant was place while in New Jersey. He came back to his home in the Tampa Bay area in search of a dentist to restore his dental implant. He found his way into my dentist office Palm Harbor.
His goal was get rid of this flipper and to once again have a non removable front tooth. There are scores of different dental implant systems, the restoration of his smile begins with communication with his dentists in New Jersey to determine exactly which dental implant was placed.
Immediate Post Surgery
This is a picture of a completely finished bone graft, dental implant and tooth extraction procedure. This tissue is neatly sutured. To protect the bone graft a non resorbable material was used and a small portion of it can be seen.
This dental work was done in my Palm Harbor dentist office for a patient referred to me by a Clearwater dentist.