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Dental Implant Treatments

  • Single Tooth Replacement
    When a single tooth is missing, the two most common treatment options are the traditional tooth supported bridge and an implant supported crown. When a traditional bridge is used to replace a missing tooth, the adjacent teeth are cut down into peg shapes in order to fit the cemented bridge in place.

    This method of tooth replacement can be very esthetic and functional for a period of time. However, a tooth supported bridge sacrifices the healthy tooth structure of the adjacent teeth and makes them more prone to future problems. It also does not replace the bone that previously surrounded the root. Since there is no longer a root to hold the bone in place, the bone deteriorates, or melts away. Benefits of replacing a single missing tooth with an implant supported crown
    • It looks, feels and functions like a natural tooth
    • It is much more esthetic long term
    • It does not decay
    • There is no need to grind down the adjacent natural teeth
    • The bone is preserved, preventing a visible bony defect
    • It is more hygienic (easier to clean) than a tooth supported bridge


    COURSE OF TREATMENT
    SURGICALLY PLACING YOUR IMPLANT AND
    IMPLANT SUPPORTED CROWN – STEP-BY-STEP
    The course of treatment described here is one of several options available. Please schedule a consult with Dr. Stanton to find out what the best solution is for you.

    1: Before the procedure
    Dr. Stanton performs an examination and takes one or more x-rays of the area to prepare for the procedure. 2: Installing the implant The implant is installed. At this time, a temporary tooth can be provided for esthetic replacement of the missing tooth. The implant will need several weeks to integrate with the jawbone before the next step is taken.

    3: Attaching the abutment and new crown
    The restorative steps of implant treatment involve the placement of an abutment that connects the implant to a new crown fabricated by your dentist and a dental laboratory. 4: End result In most cases you should expect the new tooth to fit and function just like a natural tooth. Continue your usual dental hygiene practices in order to keep the tooth and gums around it clean and in good health.

    ALTERNATIVES TO AN IMPLANT SUPPORTED CROWN
    Tooth-supported fixed bridge
    A traditional bridge involves grinding down adjacent teeth to support the bridge. It is a stable solution with good esthetics and function that is fairly easy to install. However, this alternative has two main disadvantages: continuous bone resorption in the area where the tooth is missing, and sacrificing healthy teeth on behalf of the bridge. Removable partial denture
    This is not an ideal permanent alternative to a lost tooth. Partial dentures are unstable and loosely attached, which affects both function and comfort. A removable partial denture is made of plastic or a combination of plastic and metal. The clasps that assist in retaining partial dentures can worsen periodontal disease and cause loosening of teeth they are attached to. The benefits of a partial denture are few but do exist: The adjacent teeth are minimally affected. It is easily and quickly installed and relatively inexpensive.
  • Tooth Extraction with Immediate Implant Placement
    In many cases single or multiple implants can be placed at the time of tooth extraction. With careful preparation of the extraction socket, the implant is placed where the previous tooth was located. Immediate implant placement following extraction saves time by reducing the number of surgical procedures and speeds up the healing and restoration process. If you think an immediate implant procedure might be right for you, please call us for a consultation.

    If you will be having a front tooth extracted, we make sure that you have an immediate temporary replacement fabricated by your Dentist or Dr. Stanton. Dr. Stanton will place the appliance so that your appearance will not be disturbed. For patients that have never worn a removable appliance, there is typically an adjustment period to the new appliance.

    In select cases, not only can we extract the tooth and place the implant at the same time, but Dr. Stanton can place a connector (abutment) on the implant so that a temporary crown can be connected to the implant that same day. At the time of your evaluation we can determine if you may be a candidate for this immediate implant with immediate temporization
  • Immediate Implant Provisionalization
    Dental implants have become a popular way to replace a missing tooth. When possible, Dr. Stanton is able to place an implant immediately upon removal of a tooth and even create a temporary on the implant in the same visit. Dr. Stanton has been performing immediate restorations on dental implants for more than ten years and considers it one of the most gratifying services that our practice provides. The positive psychological impact of having an esthetic tooth replacement that stays in your mouth while the implant heals cannot be overstated.

    The benefits of immediate implants are clear. The conventional method of therapy involves the removal of a tooth, then a healing period of 4-6 months prior to implant placement. Following an additional 6-8 weeks, the implant can be finally restored with a crown. A temporary removable appliance is worn during this healing process. Alternatively, a patient with a temporary tooth created on an immediate implant will have an esthetic tooth restoration the day the tooth is lost. An immediately placed implant and temporary crown can preserve the original shape and contour of the gum tissues and prevents the natural collapse of the jaw bone which occurs over time following the removal of a tooth.
  • Multiple Tooth Replacement
    Dental implants are man-made replacements for natural teeth for patients who have suffered the loss of function and esthetics caused by missing teeth or poorly fitting full or partial dentures. Because dental implants restore the look, feel, and function of natural teeth, you look better and feel better about your appearance, and your increased ability to chew, enjoy, and digest your food. Dental implants restore a lot more than just teeth. They produce significant psychological and emotional benefits as well, bolstering self-esteem and confidence while promoting a healthier outlook on life. Speech and chewing abilities can be hampered when several teeth are missing. With implant treatment there are two solutions available for the situation: separate crowns on dental implants or a bridge attached to two or more dental implants. Both options allow for replacing the lost teeth without grinding down healthy adjacent teeth or utilizing clasps to hold a removable partial denture in place. During your examination visit, Dr. Stanton will discuss your options along with their advantages and disadvantages.

    Benefits of implant supported restorations:
    In this case, when replacing three teeth in the far back of the mouth utilizing implant supported crowns or a bridge are the only fixed alternatives. Traditional removable partial dentures can't offer the same stability or function.
    Having dental implants replacing your lost back teeth will give you new, unparalleled strength and stability that allows you to eat what you want. It will also preserve your jawbone and facial appearance.
    • The only fixed alternative in this situation.
    • A stable, secure solution that lets you eat what you want
    • Preserves your facial appearance and prevents bone loss
    • Individual implant crowns allow the replacement teeth to act independently, making home care easier and more effective.


    COURSE OF TREATMENT
    INSTALLING AN IMPLANT SUPPORTED FIXED BRIDGE– STEP-BY-STEP
    The course of treatment described here is one of several options available. Consult with Dr. Stanton to find out what the best solution is for you, given your specific condition.

    1: Before the procedure
    Three teeth at back end of the mouth are missing. The only real replacement alternative is installing three individual implants or a fixed bridge supported by two implants. The bridge contains all teeth in one piece and is anchored on dental implants. 2: Installing the implant
    First, the implants are installed. This is normally done in a single session. The implant will need several weeks to integrate with the jawbone before the next step is taken.

    3: Attaching the bridge
    Following the integration of the implants, appropriate abutments are selected and a final bridge is fabricated by your dentist and a dental laboratory.
    4: End result
    The new bridge will handle all the pressure that your strong, natural back teeth did. You will have a stable and secure solution that allows you to eat what you want.

    ALTERNATIVES TO FIXED BRIDGE
    Removable partial denture
    This alternative is often perceived as uncomfortable and a bit complicated to use. Function can’t be compared to that of implant supported crowns or a bridge. This denture is made of plastic and metal, which affects its look. It can be quite expensive to fabricate due to its many parts. However, the installation process is simple, and natural teeth are spared.
  • Full Arch Replacement
    If you're missing all of your teeth in the upper and/or lower jaw, implant supported bridges or overdentures can offer many benefits over traditional dentures. You have the option of a permanent full bridge or smaller bridges that are attached to several dental implants, or a prosthesis that is securely attached to two or more dental implants but can be removed for easy cleaning and maintenance. Unlike traditional methods, implant supported dentures do not require adhesives.

    ALL TEETH MISSING
    Benefits of a fixed bridge on implants When all teeth are missing or in such condition that they need to be replaced, a fixed bridge anchored to dental implants is an excellent permanent solution. Before dental implants, there were no fixed solutions available for people who lost all their teeth. Today, it is possible to replace a full jaw with dental implants and a fixed bridge that results in a permanent, stable and highly esthetic solution.
    • Is not taken in and out of your mouth
    • Allows you to eat and function like having natural teeth
    • A solid, stable solution that can serve you for life
    • Preserves your facial appearance and prevents bone loss
    • Eliminate the discomfort and insecurity often associated with loose, ill- fitting dentures.

    COURSE OF TREATMENT
    INSTALLING AN IMPLANT SUPPORTED FIXED BRIDGE– STEP-BY-STEP
    The course of treatment described here is one of several options available. Consult Dr. Stanton to find out what the best solution is for you, given your specific condition.

    1: Before the procedure
    Dr. Stanton and your dentist determine what needs to be done and all parties prepare for the coming treatment procedure. 2: Installing the implants The first step is installing dental implants to replace the lost tooth roots. In this case, five implants are used. In some cases, temporary teeth can be attached that enable you to eat and function like normal while waiting for the permanent bridge(s) to be installed.

    3: Attaching the bridge
    A few months later, once the implants have bonded to the bone, your dentist will take impressions of the locations of the implants. He will work with a dental laboratory to fabricate your final bridge(s). The final bridge(s) is/are securely installed on top of the implants. 4: End result Your new teeth should be comfortable, secure, and with similar chewing capacity to your natural teeth. People who have had traditional dentures before getting a fixed bridge often describe this as life-changing.

    ALTERNATIVES TO A FIXED BRIDGE
    Implant Retained Overdenture with Attachments
    An alternative to a fixed bridge is a removable full denture, which is anchored on implants that have attachments screwed into them. This is an economical method for increasing the stability and retention of a denture. Because the denture still rests on the soft tissues and bone, this option does not prevent bone loss under the denture. Chewing strength is greater than with a full denture without implants but is significantly less than with a fixed bridge or a bar retained overdenture. This option is more predictable in the lower jaw than the upper. Please consult with Dr. Stanton if you are interested in an implant retained overdenture with attachments.
    Removable, Implant Bar Retained Overdenture
    A removable full denture that is connected to a bar attachment, which in turn is anchored on 2-6 implants. Additional implants allow a larger bar that extends back under the back teeth on the denture. This allows additional support and retention of the denture. Additional support by a larger bar increases the chewing strength and decreases the amount of the denture lying of the gum tissues and bone. The reduced pressure on the gums and bone decreases the bone loss under the denture.
    This procedure is common in the upper and lower jaws. Additional implants are needed in the upper jaw due to the poorer quality of jawbone. Please consult with Dr. Stanton if you are interested in an implant bar retained overdenture.
    Removable Full Denture
    A denture that is loosely placed on top of the gum to cover the lost teeth. This alternative has no real advantages – except for its low price and easy installation.
    The disadvantages are many: decreased chewing ability, discomfort in eating, poor esthetics, affected speech, and sore gums from denture movement. Moreover, a full denture placed in the upper jaw severely reduces the sense of taste.
  • Extraction with Ridge Preservation
    When you need to have a tooth or teeth extracted—whether it be due to decay, abscess, gum disease or injury—it is usually in your best interest to do so in a manner which preserves as much of your underlying jawbone as possible. From the time the teeth are removed, significant degeneration of the surrounding bone begins to take place. The amount of shrinkage is unpredictable. Many times the amount of remaining bone shrinks rapidly at first, followed by a more slowly progressing shrinking that occurs over the years afterwards. This shrinking is a natural process, but it is an undesirable result of tooth removal.

    You have many options to prevent the rapid initial loss of bone, and it is important that you consider them BEFORE any teeth are removed. Some of these procedures are best performed at the time the tooth is removed. Dr. Stanton is a surgeon who specializes in tooth removal, jawbone preservation and dental implant placement.

    To minimize the rapid shrinking of bone, a bone graft can be placed in the socket at the time of tooth removal. This type of bone graft is straightforward and produces little or no discomfort. A ridge preservation bone graft can often prevent the need for major bone grafting later on. Therefore, a ridge preservation bone graft helps to minimize the need for treatment with major bone grafting in the future.

    The slowly progressive shrinking that happens over time is really only prevented by replacing the missing tooth with a dental implant. The pace of this “slow” bone loss is difficult to predict and is influenced by the genetics of the patient.

    WHAT HAPPENS WHEN A TOOTH IS REMOVED?
    There is a special type of bone surrounding your teeth. This bone is called alveolar bone, and exists solely to support your teeth. When a tooth is lost for whatever reason, the body's natural response is to begin resorbing or getting rid of the bone in the area because it is no longer needed to hold the tooth in place. This "melting away" of bone occurs in two dimensions. The first is loss of horizontal width caused by the collapse of the bone surrounding the socket. This makes the remaining ridge narrower than when the tooth was present. The second is a loss of vertical height. This makes the remaining bone less “tall.” This process is faster in areas where you wear a partial or complete denture.

    WHY IS IT IMPORTANT TO PRESERVE THE BONE?
    You will have several choices of how you can replace the newly missing teeth. All of the options rely on bone support and bone contour for the best function and esthetics. Here is a list of the possible options:
    • You may choose to replace your missing teeth with dental implants. These are root-shaped supports that hold your replacement teeth. The more bone support you have, the stronger the implant replacements will be. In some cases, the bone can degenerate to a point where implants can no longer be placed without having more complex bone grafting procedures to create the necessary support. Obviously, preventing bone loss is much easier than rebuilding the bone later.
    • You may choose to replace the missing teeth with a “fixed bridge.” This is a restoration that is supported by the teeth adjacent to the missing tooth space. The replacement tooth (or pontic) spans across the space. If the bone is deficient, there will be an unsightly indentation in the gums and jawbone under the pontic that will trap food and affect your speech. In the front of the mouth, filling the space in where a vertical loss of bone has occurred results in a crown that appears too long when compared with the adjacent teeth.
    • Other replacement alternatives include removable partial or full dentures. These often perform better with more supporting bone.


    HOW CAN THE BONE BE PRESERVED?
    There are two important phases in retaining your alveolar ridge during and after the tooth extraction. Not all extraction techniques are the same, some can be rather destructive of the bone around the roots. Dr. Stanton uses the most careful techniques to extract the teeth while preserving as much bone as possible. Second—and key to preventing the collapse of the socket—is the addition of bone replacement material to the extraction socket. After the tooth is extracted, the socket will be packed with a bone replacement material and covered with a small barrier material and/or sutures. Early on, the grafting material will support the tissue surrounding the socket, and in time will be replaced by new alveolar bone. Postoperative recovery following this procedure is usually no more complicated than that following the removal of the tooth without ridge preservation.
    Although the bone created by socket grafting supports and preserves the socket, it will not do so indefinitely. Placing dental implants four to twelve months after the extraction and socket grafting will provide the best long-lasting support for preserving your jawbone and allow you to function as before. Otherwise the graft may “melt away” or resorb over time.

    IMMEDIATE DENTAL IMPLANT PLACEMENT
    In some selected cases it is possible to actually extract the tooth and place the dental implant at the same time. We call that immediate implantation. If you are interested in replacing your tooth with an implant and want to be considered for immediate implantation, please call Dr. Stanton’s office for a consultation prior to your extraction.
  • Ridge Augmentation Bone Grafting
    Deformities in the upper or lower jaw can leave you with inadequate bone in which to place dental implants. These defects may be caused by bone loss from or following the extraction of a tooth, periodontal disease, wearing dentures, developmental defects, injury or trauma. Not only do these deformities cause problems in placing dental implants, they can also cause unattractive indentations in the jaw line near implant restorations. These indentations may be difficult to clean and maintain.

    To correct the problem, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone, or bone substitute, to build up the ridge. Dr. Stanton will explain the graft options prior to the procedure. The graft options are based on the extent and location of the defect. Once the graft is secure and contained, the incision is closed and healing is allowed to take place. Depending on your individual needs, the bone will usually be allowed to develop for about four to six months before implants are placed. In some cases, the implants can be placed at the same time the ridge is modified.
  • Sinus Elevation
    The upper back jaw (molar and premolar area) has traditionally been one of the most difficult areas to successfully place dental implants due to poorer quality of the bone that grows in this area as well as the close proximity of the maxillary sinus, an air- filled space within the upper (maxillary) jawbone. The issues with the quality of the jawbone have largely been addressed by implant manufacturers through advances in the surfaces of the implants utilized today. Microscopically roughened implant surfaces maximize the amount of bone that can contact the implants which increases the success rate of implants placed in this area of the jawbone.

    The maxillary sinuses are cavities in the skull located behind the cheekbones, directly above the upper teeth. The actual evolutionary purpose of sinuses is unknown but there are several theories including reduction of the weight of the skull, acting as sound chambers to make the voice louder, humidification of the air, or even as crumple zones to protect the brain from trauma in the event of an injury. The floor, or base, of the maxillary sinus is generally located near the ends of the roots of the upper molars and premolars. If you’ve lost bone in that area due to periodontal disease or tooth loss, you may be left without enough bone to place implants without a secondary bone grafting procedure referred to as a sinus elevation or sinus lift.

    A sinus elevation procedure can help correct the problem of having too little bone for the placement of an implant by elevating the skin-like tissue that lines the sinus floor and placing a bone graft under the elevated tissue to gain additional height. Several techniques can be used to raise the sinus and allow for new bone to form.

    When at least 5 mm of jawbone is present below the base of the sinus cavity, Dr. Stanton can often perform what is called a crestal (or internal) sinus elevation. To perform this procedure, Dr. Stanton prepares the implant site as he would anywhere else in the mouth except to a more shallow depth. He will limit the depth to a position near the base of the sinus. He then utilizes a special drill attachment that can cut the bone at the base of the sinus but not penetrate through the skin-like sinus membrane. Once the sinus membrane has been exposed, it can be further elevated hydraulically through the introduction of the bone graft. Once sufficient bone height has been established, the implant can be placed during the same surgery. A crestal sinus elevation procedure can usually be performed when only a few millimeters of additional bone height needs to be regenerated.

    When more than a few millimeters of bone height is necessary, Dr. Stanton utilizes a procedure known as a lateral wall sinus elevation to regrow the needed bone. Following an incision, a small circle is cut into the bone on the side (or lateral) wall of the sinus. Care is taken to not injure the skin-like membrane that lines the sinus. This bony "window" and the attached membrane are pushed inwards towards the hollow sinus much like a trap door. As the window and the membrane are pushed inwards, Dr. Stanton carefully separates the membrane from the bony floor of the sinus so that it can be elevated upwards. The space underneath the elevated membrane is filled with bone graft material. Finally, the incision is closed and healing is allowed to take place. Depending on your individual needs and the amount of bone being regrown, the bone usually will be allowed to develop for about six to nine months before implants can be placed. After the implants are placed, an additional healing period is usually required. In some cases, the implant can be placed at the same time of the sinus elevation.

    Sinus elevation has been shown to greatly increase your chances for successful implants that can last for years to come. Most patients experience minimal discomfort during this procedure.

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