Dental implants are a great way to replace missing teeth and also provide a fixed solution to having removable partial or complete dentures. Implants provide excellent support and stability for these dental appliances.

Dental implants are artificial roots and teeth (usually titanium) that are surgically placed into the upper or lower jaw bone by a dentist or Periodontist - a specialist of the gums and supporting bone. The teeth attached to implants are very natural looking and often enhance or restore a patient’s smile!

Dental implants are very strong, stable, and durable and will last many years, but on occasion, they will have to be re-tightened or replaced due to normal wear.

Reasons for dental implants:

• Replace one or more missing teeth without affecting adjacent teeth.
• Resolve joint pain or bite problems caused by teeth shifting into missing tooth space.
• Restore a patient’s confident smile.
• Restore chewing, speech, and digestion.
• Restore or enhance facial tissues.
• Support a bridge or denture, making them more secure and comfortable.

What does getting dental implants involve?

The process of getting implants requires a number of visits over several months. X-rays and impressions (molds) are taken of the jaw and teeth to determine bone, gum tissue, and spacing available for an implant. While the area is numb, the implant will be surgically placed into the bone and allowed to heal and integrate itself onto the bone for up to six months. Depending on the type of implant, a second surgery may be required in order to place the “post” that will hold the artificial tooth in place. With other implants the post and anchor are already attached and placed at the same time. After several weeks of healing the artificial teeth are made and fitted to the post portion of the anchor. Because several fittings may be required, this step may take one to two months to complete. After a healing period, the artificial teeth are securely attached to the implant, providing excellent stability and comfort to the patient. You will receive care instructions when your treatment is completed. Good oral hygiene, eating habits, and regular dental visits will aid in the life of your new implant.

A dental crown is a tooth-shaped "cap" that is placed over a tooth – covering the tooth to restore its shape and size, strength, and/or to improve its appearance. The crowns, when cemented into place, fully encase the entire visible portion of a tooth that lies at and above the gum line.

A dental crown may be needed in the following situations:

• To protect a weak tooth from breaking or to hold together parts of a cracked tooth
• To restore an already broken tooth or a tooth that has been severely worn down
• To cover and support a tooth with a large filling when there isn't a lot of tooth left
• To hold a dental bridge in place
• To cover misshaped or severely discolored teeth
• To cover a dental implant
• To cover a root canal treated tooth

Procedure

After numbing the area with a local anesthetic, we typically prepare the tooth for the crown by shaping and recontouring the tooth by removing a portion of the enamel to allow room for a crown to be placed over the tooth. As part of the preparation, we make sure to remove any remnants of old filling material and replace it with a new filling, if necessary. We will take an impression of the tooth, which will serve as a model from which the crown will be made by the dental laboratory. We send you home with a temporary crown (a natural looking plastic tooth) made out of acrylic resin, which is cemented to cover the prepared tooth. It typically takes approximately two weeks to receive the crown back from the laboratory. At your second visit with us, we remove the temporary crown, clean the prepared tooth and try in the crown to check for adequate fit. If adjustments are necessary, they are done chairside outside the mouth. Once the crown fit is acceptable, we cement the crown with permanent cement. Our patients can expect to eat, brush and floss once they leave our office following cementation.

Materials available for Crowns

Permanent crowns can be made from all metal, porcelain-fused-to-metal, or all ceramic materials.

Metals used in crowns include gold alloy, other alloys (for example, palladium) or a base-metal alloy (for example, nickel or chromium). Compared with other crown types, less tooth structure needs to be removed with metal crowns, and tooth wear to opposing teeth is kept to a minimum. Metal crowns withstand biting and chewing forces well and probably last the longest in terms of wear down. Also, they rarely chip or break. The metallic color is the main drawback. Metal crowns are the preferred choice for out-of-sight molars.

Porcelain-fused-to-metal dental crowns can be color matched to your adjacent teeth (unlike the metallic crowns). However, more wearing to the opposing teeth occurs with this crown type compared with metal or resin crowns. The crown's porcelain portion can also chip or break off. Next to all-ceramic crowns, porcelain-fused-to-metal crowns look most like normal teeth. However, sometimes the metal underlying the crown's porcelain can show through as a dark line, especially at the gum line and even more so if your gums recede. These crowns can be a good choice for front or back teeth.

All-ceramic or all-porcelain dental crowns provide the best natural color match than any other crown type and may be more suitable for people with metal allergies. However, they are not as strong as gold crown or porcelain-fused-to-metal crowns and they wear down opposing teeth a little more than metal or resin crowns. All-ceramic crowns are the most natural looking. However, the limitation is their strength in the molar region due to strong chewing forces. This is why we recommend all-ceramic crowns to be a good choice for front teeth.

Dental bridges literally bridge the gap created by one or more missing teeth.

A bridge is made up of two crowns for the teeth on either side of the gap – these two anchoring teeth are called abutment teeth – and a false tooth/teeth in between. These false teeth are called pontics and can be made from gold, alloys, porcelain or a combination of these materials. Dental bridges are supported by natural teeth or implants.

Benefits of Bridges:

• Restore your smile
• Restore your ability to properly chew and speak
• Maintain the shape of your face
• Distribute the forces in your bite properly by replacing missing teeth
• Prevent remaining teeth from drifting out of position

There are three main types of bridges:

Traditional bridges involve creating a crown for the tooth or implant on either side of the missing tooth, with a pontic in between. Traditional bridges are the most common type of bridge and are made of either gold, porcelain fused to metal or ceramics.

Cantilever bridges are used when there are adjacent teeth on only one side of the missing tooth or teeth.

Maryland bonded bridges (also called a resin-bonded bridge or a Maryland bridge) are made of plastic teeth and gums supported by a metal framework. Metal wings on each side of the bridge are bonded to your existing teeth.

Procedure

During the first visit, the abutment teeth are prepared. Preparation involves recontouring these teeth by removing a portion of enamel to allow room for a crown to be placed over them. Next, impressions of your teeth are made, which serve as a model from which the bridge, pontic, and crowns will be made by a dental laboratory. We typically make a temporary bridge made out of acrylic resin for you to wear to protect the exposed teeth and gums while your bridge is being made. During the second visit, your temporary bridge will be removed and the new permanent bridge will be checked and adjusted, as necessary, to achieve a proper fit. Multiple visits may be required to check the fit of the metal framework and bite. This is dependent on each individual's case.

It is important to keep your remaining teeth healthy and strong as the success of the bridge (depending on the type selected) depends on the solid foundation offered by the surrounding teeth. Brushing twice a day and flossing daily helps prevent tooth decay and gum disease that can lead to tooth loss. Our dental team can demonstrate how to properly brush and floss your teeth. Keeping a regular cleaning schedule will help diagnose problems at an early stage when treatment has a better prognosis. Selecting a balanced diet for proper nutrition is also important. Dental bridges can last 5 to 15 years and even longer. With good oral hygiene and regular check-ups and dental prophylaxis, it is not unusual for the life span of a fixed bridge to be over 10 years.