Photo by Peter Kasprzyk on Unsplash
In today's world, almost all teeth can be restored. However, there are some instances where this is not the case and there are other times where the prognosis for long term success is poor. In these instances, we look to remove the tooth or teeth and provide a replacement. Essentially, there are 3 ways to replace a tooth that is lost or missing. Let’s discuss the first of these, the single implant.
Implants: An implant is like getting the tooth back without compromise. A root is installed where the tooth used to be by our periodontist and it is allowed 3-4 months to “integrate”. This means that your bone (or the bone graft sometimes needed) will attach to the surface of the implant and it will become solidly held in place just like your tooth had been. During this period of integration, a small, round cap is attached to the top of the implant. The diameter of this cap is the same as the diameter of the eventual prosthetic tooth that will be made to go there. It allows the shape of the gums to be just right to fit snugly against your new tooth. At the end of the period of integration, the root is ready to receive the tooth and you come in to see us.
Impressions, shade matching and bite registrations are made for the fabrication of the 2 parts that will comprise the implant tooth. These 2 parts are the abutment and the crown that fits over it. For back teeth in our office, these 2 parts are usually fused together and securely screwed into the implant root to complete the tooth. For front teeth, the abutment and crown are often made separately with the abutment being screwed into the root and the crown cemented onto it. The reason front teeth are often made in 2 parts is that the screw that would secure a one piece restoration would often show and ruin the aesthetics of the case. Therefore we cement the crown over the screw to keep it hidden from sight.
Implants, once restored are treated the same as teeth with regard to function and hygiene. There is little to no difference between a natural tooth and an implant from the patient’s perspective. In my next entry, we will discuss the second way to regain a missing tooth: The fixed partial denture aka bridge.