Dental Implants or Teeth?

Dental Implants or Teeth?

Patients often ask if dental implants or teeth are better. The simple answer is if the teeth are structurally sound and have a good long-term prognosis, teeth are always better as they are part of your body.

However, there are situations where the teeth are severely broken down or have catastrophic structural or biological issues. The prognoses of these teeth are poor and they require removal.

Implants are the next best thing to teeth. They can restore the function and aesathetics of the missing tooth. However, even though they look like the tooth, it is not the tooth. As with most things, the devil is in the details. The profile is different from natural teeth, which may result in occassional food impaction. Furthermore, the implants do not feel like natural teeth when you bite down - some patients describe a hollow sensation.

The most important fact is that the dental implant is a foreign body that is embedded in the jaw bone. The success rate of implant therapy is very high, but there is always a chance of rejection. The teeth will not be rejected by the body!

If you have to choose between dental implants or teeth, unless the teeth have a catastrophic problem, the choice is always teeth! They are what God or Nature gave you, and are superior in function and aesthetics.

Does Dental Implant Surgery Hurt?

Does Dental Implant Surgery Hurt?

Are you concerned about the discomfort arising from dental implant surgery? Rest assured, pain medication can effectively manage any discomfort after the procedure.

The surgery involves numbing the mouth to ensure a painless experience. Although there might be some pain as the numbness wears off, you will be prescribed medicaiton to alleviate any post-operative pain and swellling. In most cases, any discomfort subsides within 5-7 days.

Most patients feel that the pain and discomfort they experienced was much less than after tooth extraction.

If the pain persists or worsens, it is crucial to reach out to your dental professional for guidance.

Remember, the remarkable benefits of dental implant surgery, such as achieving a beautifully restored smile, outweigh any temporary inconvenience. Embrace this long-lasting tooth replacement solution without allowing fear to hold you back.

Contact Us today to see if you are a candidate for implant surgery!

Managing Dental Implant Angle

Managing Dental Implant Angle

Is your dental implant angle off? you facing challenges with dental implants that are not in an ideal position? 

Whether the dental implant angle was a deliberate decision to avoid bone grafting or a surgical oversight, we understand the need for a solution.

Our expertise lies in compensating for misangulated implants prosthetically, using specialized components.

By carefully considering factors such as angulation, position within the bone, and implant depth, we can devise a bespoke plan to rectify the situation.

In more severe cases where the misalignment is substantial, implant removal procedures may be necessary, followed by grafting and healing.

Once the site is ready, we can place a new implant in a more optimal position and restore it to ideal function and aesthetics.

If the malignment is mild, a cemented restoration can be used to restore the clinical portion of the tooth. A ceramic or metal post is connected to the dental implant with a retaining screw, then a crown is fabricated to fit this abutment. This is similar to crowns which are done on teeth.

Care has to be taken during the cementation to ensure that all the excess cement is removed, to prevent the extra cement from causing infection under the gums.

The main disadvantage of a cemented crown is retrievability of the crown. Occassionally, the crown may need to be removed for maintenance of the implant. Cemented crowns sometimes cannot be removed without breaking, and a new crown might need to be fabricated.

Specialized parts known as angled multiunit abutments can occassiuonally be used to redirect the direction of the implant retention screw.

These come in predetermined angulations, resulting in some limitations to how much correction can be made.

The extra parts increase prosthetic complications as well as the cost of restoring the implant.

A more innovative solution has been the development of dynamic axes screws, such as the Dynamic Abutment. These sophisticated screws allow for engagement at an offset of up to 25 degrees. In most cases, this is sufficient to redirect the access hole from the outer surface of the crown to the inner surface.

They not only do not require additional restorative space, but do not require additional components. The conventional abutment screw is exchanged for the dynamic axis screw.

These can be used either as part of a conventional analog work flow, or as part of a integrated digital CAD/CAM workflow.

The reduced number of parts and the larger implant retaining screw also decrease the incidence of prosthetic problems.

These revolutionary screws have significantly impacted how these cases can be managed, reducing the number of implants that have to be removed and lowering the costs of restoring these cases.

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Something Broke!

Something Broke!

One complication can occur with dental implants is that something broke. Fracture of the dental implant or the implant restoration is not as uncommon as you may think. So what should you do if you encounter a breakage?

Firstly, we need to determine where the breakage occurred. The fracture could be at several different places. The dental implant (or fixture) could have fractured. Or the screw connecting the implant crown to the fixture could have broken. The implant crown could have split or the veneer porcelain of the implant crown could have chipped off.

The necessary treatment will depend on the location of the breakage. Simple solutions could range from simply smoothening out the porcelain surface, to changing the retaining screw. Should a catastrophic fracture of the fixture occurred, this would require surgical removal of the broken implant and possible replacement after a period of healing.

Should you be unfortunate enough to have encountered a breakage, do not hesitate to contact us! In addtion, any information you can provide us regarding your dental implant will be most relevant.

We will perform a comprehensive examination, complete with the relevant dental imaging. Finally, once we diagnose what your specific issue is, we will let you know exactly what your problem is and what needs to be done fix it.

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Implant Fracture – Flange Fracture – Case Study

Implant Fracture – Flange Fracture – Case Study

Michael* presented at our clinic complaining that the dental implant crown on the lower right side of his mouth  was rotating. The implant had been placed and restored 4 years previously. Clincial examination revealed the presence of a screw retained crown on #46 that had rotated anti-clockwise, resulting in a gap between #46 and 45. We did not initially suspect an dental implant fracture.

Radiographic examination revealed the presence of a gap between the impant crown and the fixture platform. There was angular bone loss on either side of the implant, but was more pronounced on the mesial aspect of the fixture.

There also appeared to be a delamination of part of the implant below the mesial part of the fixture platform. We had not expected that the rotation of the crown was due to an implant fracture.

The screw-retained implant crown was removed and the fixture platform was exposed. There was complete fracture of about 40% of the lip of the fixture platform flange on the mesial part of the implant.

There was also a partial implant fracture of about 20% on the lingual aspect of the implant fixture. A flap was raised and the fractured portion of the flange was removed and the fixture was smoothened.

The flap was closed with a resorable suture and the screw-retained crown was then reconnected and the occlusion was adjusted to ensure there was no uneven occlusal contacts.

The abutment screw was tightened to the torque prescribed by the manufacturer and the access cavity was filled.

The patient was aware the implant fracture severely afftected the prognosis of the dental implant, and the dental implant would need to be removed if another implant fracture occurred.

*Not his real name.

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