Dental Implants - The Permanent Solution For Tooth Loss

Dental Implants were not always such a mainstream fixture in dentistry. There was a time when dental implants were for all practical purposes experiments in seeing what worked and

Dental Implants for a Lifetime

what did not. In the last 15 years we have really entered a new age with dental implants being almost routine in their nature now. Most dentists cannot imagine a day without them anymore as a treatment for our patients.

Dental Implants are an artificial tooth root that a dentist, periodontist, or oral surgeon inserts into your jawbone to hold a replacement tooth or teeth(bridge). Dental implants are the perfect option for people with good oral health maintenance who are missing one tooth or multiple teeth due to periodontal disease, via trauma, or some other reason.

Dental Implants use the most modern materials that dentistry has to offer. Years and years of research have gone into the dental implants in use today. Dental implants are much more tooth friendly than traditional bridgework. Dental implants do not rely on neighboring teeth for support nor do the neighboring teeth need to be prepared to be part of the bridgework.

With optimal conditions and in the hands of a skilled dentist, dental implants can look as natural as your own teeth. Only you and your dentist would ever know you even have one. This gives patients the utmost in self confidence giving them the ability to broadly smile as well as eat as they choose. People missing teeth are generally self conscious about their smile and appearance. Following successful placement and restoration, dental implant patients can expect them to last a lifetimeif they maintain good oral hygiene.

Dental Implants for a lifetime

Modern dental implants can play a few roles in tooth or teeth replacement. These include:

-Replacement of one or more teeth without affecting the neighboring teeth.

-Act as support for a bridge. This will eliminate the need for a removable partial denture.

-Provide support and stability for a denture. Attaching a denture over dental implants make the denture more secure and comfortable. This is also called an implant supported overdenture.

Dental Implants and their advantages over Traditional Dentistry

-Cosmetics. When done properly dental implants will look and feel like your own teeth. Another plus is that since dental implants are placed directly in bone they prevent bone loss and gingival recession that happens over time in areas where teeth are missing. No one but you and your dentist will ever know you have a dental implant.

-Dental Implants allow conservation of tooth structure. Dental implants allow the dentist to save your adjacent teeth from preparations. A traditional bridge requires the preparation of neighboring teeth. Utilizing dental implants is a long term benefit to the patients dental health by saving their natural tooth structure.

-Self Confidence. The wonder of dental implants is that they allow patients to talk and eat full of self confidence. Dental implants offer security and freedom.

Dental implants Diagram

-Highly Predictable. Dental implants have had a long track record of a very high success rate. Due to this they are an excellent option for tooth replacement.

Treatment

Any treatment for dental implants begins with a thorough examination to develop a proper treatment plan.  Without a good game plan the treatment will be doomed to fail.

As mentioned earlier, dental implants are ideal in the following situations:

-Single tooth replacement. Dental implants are an ideal option for patients with the quantity and quality of bone necessary to hold an implant. The dental implant will allow you to maintain the natural tooth structure of adjacent teeth while replacing a lost tooth.

-Multiple teeth replacement. Dental implants are also ideal in this situation. If you are missing several teeth, implant supported bridges can replace them. Dental implants will replace both your lost natural teeth and some of the roots.

-Replacing all your teeth. If you are missing all of your teeth, an implant supported full bridge or full denture (also called an implant overdenture) can replace them. This renders traditional dentures to the curb as dental implants used in this fashion will be more stable allowing patients to eat and talk as if they have their own natural teeth.

In some cases, patients will need help to allow for placement of dental implants. Luckily, modern dentistry has developed a few procedures to “help” patients along. These include:

-Sinus Augmentation.  Dental implants need a good quantity of bone along with good quality of that bone to succeed. The upper jaw is known to have poorer quantity and quality

Dental implants

bone structure as opposed to the lower jaw. The maxillary sinus also plays a role in increasing difficulty in this area. Sinus augmentation can remedy these issues by raising the sinus floor and placing bone grafts in the area to aid in dental implant placement.

-Ridge Modification. When the bone is not 100% adequate for dental implant placement, dentists are able to make it perfect by performing a dental bone graft. A bone graft is the placement of bone in the jaw to to build it up. This gives an excellent platform for dental implants. Ridge modification has been shown to improve both appearance and long term success of dental implants.

Expectations of patient

Following placement of implants and restoration with crowns or dentures, patients can expect a life long restoration that will be stable and cosmetic. Just because these products are man made does not mean oral hygiene should be forgotten and neglected. Dental hygiene must be maintained at a high level if the patient wants to ensure these restorations last. Follow up dental visits are required just as if you had your own natural teeth. If dental implants are well taken care of the patient should expect them to last a lifetime!

© 2012, Marielaina Perrone DDS. All rights reserved. Las Vegas Cosmetic Dentist......Henderson Cosmetic Dentist

Periodontal Disease - What Are The Stages?

Periodontal disease (or gum disease) is a serious and chronic infection of the gum tissue that can result in the breakdown of the tissue as well as the deterioration of bone that surrounds and supports your teeth. This infection process begins when bacteria and plaque form a sticky bio film on your teeth and causes inflammation of the gumtissue.  Periodontal disease will continue to progress if this is not resolved by maintaining proper dental care and hygiene.Periodontal disease is the leading cause of tooth loss in adults. Studies show that somewhere between 75% and 95% of all adults are suffering some stage of periodontal disease.

Periodontal disease and dental decay (cavities) are caused by different types of bacteria, and are considered to be two different conditions, however, you can suffer from both issues. Poor oral hygiene promotes the risk of both cavities and periodontal disease. Swollen and receding gums open up the more vulnerable areas of the tooth…The root areas, which, are not protected by enamel and can break down quickly to form root cavities.  On the flip side, In patients with significant decay, the broken down teeth allow for food trap areas which keep gum tissue chronically inflamed.

Gingivitis

Stages of Periodontal Disease

The first stage of periodontal disease is gingivitis (or simply inflammation of the gum tissues). This is the most mild form of periodontal disease. Symptoms include red, swollen (or puffy) and inflamed gums due to plaque-bacteria build-up. The gums may also bleed easily during brushing or eating of hard foods. During the earliest of stages the periodontal disease process it can be reversed thru proper brushing, flossing and professional dental care to remove the excess bacterial plaque. If the required oral hygiene does not occur, the periodontal disease then progresses  to the next stage. The majority of people with this early form of periodontal disease, do not even know a dental problem exists. This is a crucial period for the patient, as the condition can be reversed (since the bone and connective tissue that hold the teeth in place have not yet been affected) at this point if it is recognized and properly treated. Gingivitis is commonly seen during puberty, pregnancy, times of high stress, and menopause, as hormones can make you more prone to inflammation. As for the rest of the population, poor hygiene is generally the most common cause, followed by medication and certain medical conditions.

Periodontitis

As the periodontal disease progresses it is now becoming harder to treat and control. The difference between gingivitis and periodontitis is that gingivitis only infects the gum tissue that surrounds the teeth while the periodontal disease process also invades the bone that provides support and stability for the teeth. The bacteria eventually invades past the initial the gum line area and destruction begins to the point that gums may begin to separate or pull away from the teeth (taking away support and connective fibers with it). What results are called periodontal pockets. These pockets allow for bacteria to invade below the gum line.  They eventually become loaded with toxic plaque and bacteria that moves and works its way deeper. It begins to erode the bone below the gum line. A patient’s bite will be affected (as the teeth shift or loosen) by the lost support which then affects chewing and other functions.

Advanced Periodontitis

As the periodontal disease process advances, the fibers and bone that provide support for the teeth is destroyed. At least half of the bone support (if not more) will have broken down at this late stage of periodontal disease. It does not grow back naturally. Teeth may begin to loosen. Deep root cleanings and surgical intervention are typical at this stage. This may include cleaning with a periodontal microscope, (Perioscope), grafting of tissue, bone, placement of growth factors, (Emdogain), periodontal antibiotic regimen(Periostat), placement of antibiotics directly into pockets, (Arestin), open flap surgery, and, possibly tooth removal.

How Do I Know If I Have Periodontal Disease?

Periodontal disease can happen to a person of any age. It is most common among adults. Remember if periodontal disease is detected in its earliest stages it can be reversed so it’s important to see your dentist if you notice any of the following symptoms:

-Gums that are red, puffy or inflamed, or tender.

X-Ray showing Periodontal Disease Progression

-Gums that bleed easily during routine brushing or flossing.

-Teeth that appear longer due to recession of gum tissue.

-Changes in the way your teeth fit together when you bite or chew.

-Pus coming from between your teeth and gums

-Bad breath odor or bad taste in your mouth.

Treatment of Periodontal Disease

Arestin use in Periodontal Disease

The earliest stages of periodontal disease is reversible. This is accomplished thru proper brushing, flossing, and maintaining a regular schedule with your dentist. A professional cleaning by your dentist or hygienist is the only way to remove plaque and tartar. The hygienist will clean (also called scaling) your teeth to remove the tartar and plaque buildup from above and below the gum line. If the periodontal disease condition worsens, then a root planing procedure may be necessary. Root planing helps smooth irregularities on the roots to make it more difficult for plaque to deposit there. Also makes it easier for you to keep your teeth clean at home. , treatment can also include use of antibiotics.

If you have advanced periodontitis, your gum tissue may not respond to nonsurgical treatments and good oral hygiene. In that case, your periodontitis treatment may require dental surgery. These may include:

-Pocket Reduction Surgery (also called Flap surgery). In this procedure, your periodontist makes tiny incisions in your gum so that a section of gum tissue can be lifted back, exposing the roots for more effective scaling and planing. Because periodontitis often causes bone loss, the underlying bone may be recontoured before the gum tissue is sutured back in place. The procedure generally takes from one to three hours and is performed under local anesthesia.

-Soft tissue grafts. Gum tissue is often lost as part of the periodontal disease process making your teeth appear longer than normal. You may need to have damaged tissue replaced to return your cosmetic appearance back to normal. This procedure can help reduce further gum recession, cover exposed roots and give your teeth a more cosmetically pleasing appearance.

-Bone graft. This procedure is needed when periodontitis has destroyed the bone surrounding your tooth. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone.

-Antibiotics and medicaments – A wide array of antibacterial rinses(Peridex), antibiotics taken in pill form, (Periostat) or localized placement directly into the affected pockets(Arestin), can aide in and promote healing of the affected gum tissue.

-Guided tissue regeneration. This allows the regrowth of bone that was destroyed by bacteria. In one approach, your dentist places a special piece of biocompatible fabric between existing bone and your tooth. The material prevents unwanted tissue from entering the healing area, allowing bone to grow back instead.

-Enamel matrix derivative application. Another technique involves the application of a specialized gel to a diseased tooth root. This gel contains the same proteins found in developing tooth enamel and stimulates the growth of healthy bone and tissue. An example of this is the use of emdogain.

To insure a successful result following periodontal therapy, patient cooperation in maintaining excellent oral hygiene is essential. More frequent professional cleanings can help reduce the likelihood of the periodontal disease ever returning.

By scheduling regular checkups, early stage periodontal disease can be treated before it leads to a much more serious condition. If your periodontal disease is more advanced, treatment in the dental office will be required.

© 2012, Marielaina Perrone DDS. All rights reserved. Henderson Cosmetic Dentist

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I Have Periodontal Disease...Now What?

Periodontal Disease - is a group of diseases that affect the tissues that support and anchor the teeth. If untreated,periodontal disease results in the destruction of the

See Your Dentist Regularly to Keep Periodontal Disease Away!

gums, alveolar bone (the part of the jaws where the teeth arise), and the outer layer of the tooth root. The earliest form of periodontal disease is called gingivitis. Gingivitis is reversible with proper treatment.

Once a patient is diagnosed with advanced periodontal disease (also called periodontitis), their dentist will recommend procedures above and beyond that of a normal professional cleaning to properly treat and manage the periodontal disease. In the initial stages, most treatment revolves around non surgical intervention but as the periodontal disease progresses surgical treatment is often recommended and required.

Periodontal Disease Treatment

Non Surgical Procedures

-Scaling and root planing. This procedure is a special type of cleaning that removes plaque and tartar from under the gum line and makes the root surfaces smooth. The smoother root surface is thought to promote reattachment of the gum tissue and promote healing. This type of cleaning is the only way to remove tartar from below the gum line. This is usually completed in multiple visits utilizing a numbing anesthetic to make the procedure more comfortable..

-Drug Therapy. In some cases, antibiotics or antimicrobials may be used to supplement the effects of scaling and root planing. In most cases of early periodontal disease, scaling and root planing in addition to continued daily cleaning at home (flossing, brushing , and rinsing) will achieve a satisfactory result of reversing periodontal disease.  A wide array of antibacterial rinses such as Peridex, antibiotics taken in pill form such as  Periostat, or localized placement directly into the affected pockets with an antibiotic such as Arestin, can aide in, and promote healing of the affected gum tissue.

-Periodontal maintenance or supportive periodontal therapy: Following a scaling and root planing, routine specialized  cleanings (every 3-4 months)  to target your periodontal problem area, can minimize the recurrence or progression of periodontal disease.

Surgical Procedures

-Pocket depth reduction procedures: Your dentist or periodontist will open up the affected gum tissue so that periodontal disease causing bacteria and calculus build up can be easily seen and removed. Some cases may require contouring and smoothing of the damaged bone and root surfaces to allow the gum tissue to reattach to healthy bone during the healing phase. The procedure also repositions the gum tissue so that it is easier to keep clean going forward.

-Perioscope cleaning: A deep cleaning requiring a microscope to be placed below the gum line to remove tartar, cement, or other debris.

-Regeneration. Your dentist will treat the affected gum tissue in the same way as in pocket depth reduction procedures, with the additional procedure of using membranes, bone grafts or tissue-stimulating proteins to stimulate the body’s natural ability to regenerate healthy bone and gum tissue. A good example of this is a bone and tissue growth factor calledEmdogain.

-Soft tissue grafts. Your dentist will take synthetic tissue such as Alloderm, or healthy gum tissue from the roof of the mouth (palate) or other areas of the mouth and use it to repair receding gums and cover exposed root surfaces.

-Hard Tissue Bone Grafts.  This procedure is needed when periodontal disease has destroyed the bone surrounding your tooth. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone. The dentist can use your bone, cadaver bone, cow bone, or a lab created calcium based bone matrix material.

Conclusion

If you have been diagnosed with periodontal diseaseplease take the news very seriously. Periodontal disease is a progressive disease that will continue to get worse without treatment. Periodontal disease  leads to tooth loss and oral infections. Your dentist can help you with diagnosis, prevention, better oral hygiene methods and instruction, and proper treatment for your particular needs.  Studies have shown time and again that there is a link between oral health and your general health. Keeping your mouth healthy will lead to better overall health. As always visit your dentist regularly for dental examinations and regular professional cleanings to stave off the onset of periodontal disease.

© 2012, Marielaina Perrone DDS. All rights reserved. Henderson Cosmetic Dentist

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