Multiple Tooth Replacement
Dental implants can replace a single tooth and multiple teeth, as well, so patients no longer have to receive removable partial dentures or long span fixed bridges. When you are considering replacing multiple teeth, you options for replacement increase but sometimes that gets confusing.
For a long span traditional fixed bridge, the teeth on either side of the space are ground down to nubs to allow for adequate thickness of metal and porcelain in the bridge to try and mimic natural contours. Because of the need of extra strength, often times, multiple teeth on either side of the space are ground down to try and fortify the space by bringing in extra help from adjacent teeth. The false teeth are fused under the porcelain being suspended over the blank site by the two or more side teeth just like the span of a road “bridge” does, thusly how a bridge got its name. The problems with a natural bridge include: 1. The adjacent teeth are ground down which weakens them and puts additional stresses on them which they were not naturally intended to take. This can ultimately lead to bone loss, fractures, recurrent decay and loss of the teeth holding the bridge. 2. The false tooth is suspended over the blank space. This can lead to speech issues, food impaction, hygiene difficulty and issues, halitosis and mediocre cosmetic results. 3. The bone in the blank space will continue to resorb or shrink. The sole purpose of the specialized bone that hold our teeth in is support of the tooth. If there is no tooth or implant in the site, the bone will continue to disappear which will worsen everything mentioned previously. Even worse, if adjacent teeth are added into the bridge for strength, you cannot floss between those natural teeth leaving floss threaders as the only way to clean interproximally. This is not optimal, but it has to be done at times. When it’s done on natural teeth, the chance of recurrent decay and periodontal disease increase substantially.
The next option is a removable partial denture. In order to replace the missing teeth, an entire prosthesis made usually of plastic and metal is fabricated that covers the entire roof of your mouth and has hooks on both sides of the mouth in the front and back. This is done to distribute forces to your entire dentition and hold the partial denture in place. This puts undue forces on the teeth as well as the soft tissues. They are often the least esthetic option and can cause difficulty with speech, taste and function. Often time, teeth have to be crowned so the removable partial denture clasps can have something to cling onto. Although initially this may sound like the least expensive alternative treatment, the prices can added up with adjunctive procedures that may be needed. It is typically the least favorite for patients.
Multiple missing teeth are replaced by two or more dental implants. For multiple or single tooth dental implants, an implant fixture is placed and allowed to heal to the bone in a process known as osseointegration. This is highly advantageous because it serves several key purposes simultaneously. First, it preserves bone. The bone that holds teeth in is a specialized type of bone that begins to shrink, or resorb, as soon as there is no longer a tooth there to support. The dental implant tricks your body into thinking that a natural tooth is still there and the bone will no longer resorb. This is not only beneficial to that site, it is also beneficial to the adjacent teeth and gum tissue. Second, it is functional. Dental implants function exactly like the natural teeth they are replacing. The only difference in what patients notice is that, unlike natural teeth, dental implants have no hot and cold sensitivity. Most patients, over time, cannot remember which tooth is the implant. The third benefit is ease of oral hygiene. Dental implants are brushed and flossed just like its natural counterpart. Multiple teeth are sometimes replaced with an implant bridge. There are special tools needed to clean around implant bridges, and it is as easy to clean as all your other teeth, even when you see your hygienist. A dental bridge requires special tools such as floss threaders or proxy-brushes to clean around. However, the entire bridge and abutments are designed by the laboratory to minimize issues with food and bacteria trapping to make cleaning as simple as possible. The other replacement option is a removable partial denture. These can trap bacteria and fungus on all surfaces and require the wearer to remove it to brush, and it is recommended that the wearer soak the partial denture in denture cleanser for 30 minutes to an hour. The fourth benefit is esthetics. The multiple tooth dental implant option, typically, will give the best cosmetic result for replacement, especially when placed by a specialist with experience and an experienced restorative doctor that uses a top notch dental lab. It is almost impossible for a dentist to tell which teeth are natural and which are implants when looking at a patient without x-rays.
Dental implant surgery is extremely safe and very predictable, especially if done by a specialist who has examined your mouth including your bite, positioning of adjacent teeth, and distances between the teeth. A full radiographic exam should be done as well. There are no images that give a qualified surgeon more information for overall safety and accuracy than a 3D CBCT (Cone Beam Computerized Tomography). Your overall dental health should be considered before any procedures are considered. But first and foremost, Dr. Culley begins every new implant consultation by finding out what you want and what your ultimate goals of implant therapy are. After collecting all the necessary data, Dr. Culley will evaluate all the information and give you options (if there are any) for various replacement options as well as the pros and cons of each. If he doesn’t feel that what you want is possible or realistic, he will be honest with you. Sometimes, he may offer you alternatives that you didn’t even know were possible that meet your wants and needs more than you could have ever imagined. Regardless, until you are satisfied and understand, no treatment is initiated. We want you to love your implants and be at our door if you ever need another dental implant.
The dental implants act as a tooth root on which your restorative doctor will place crowns or bridges. Dr. Culley has years of experience in placing dental implants, and has been placing them since 1995. He also has valuable experience in implant restoration, which every implant surgeon needs. He understands the challenges faced by restorative doctors when a surgeon leaves an implant placed in a less than ideal position. To avoid this, Dr. Culley uses the latest technology using CBCT 3-D images combined with intraoral scans to virtually plan your surgery in a computer program prior to your surgery. From this, he and your restorative doctor can view the prosthetic plan and the implant placement to determine if any changes need to be made. From that point, a surgical guide is fabricated to assure the plan is carried out in your mouth just as planned.
There are also many area dentists and their family members that have dental implants functioning in their mouths right now that they chose to have Dr. Culley place. With so many choices available, that is a fact in which we take extreme pride and consider it the highest honor.
With tremendous advances in implant strength and stability, in many cases, a hopeless tooth can be removed and replaced with a dental implant in the same visit. This prevents the patient from enduring multiple procedures.
It is also often possible to receive your final restoration in as little as six weeks (thanks to improved bio-engineering of implant surfaces) where as a few years ago it was as long as 6 months to a year.