Missing teeth

 

Replacing a missing front tooth is very important, not only for esthetic reasons, but also for function.  We use our front or anterior teeth for pronunciation and to eat.  MIssing one front tooth will jeopardize your speech; it will be very difficult to pronounce the letters “D” or “F.”  With the loss of a front tooth it will also be difficult to bite or tear into foods such as bread.

 

When a tooth is missing the remaining bone will reabsorb, due to the lack of force stimulation.  This will eventually lead to the teeth next to the empty space shifting.  For these reasons it is important to replace the missing front teeth immediately.  The missing tooth can be restored with conventional dentistry such as a bridge, removable appliance or with implant dentistry.

 

There are many ways an anterior tooth can be lost.  Some reasons are caries, bone loss around the tooth, fracture or even trauma.  If the tooth or root is still present in the mouth it is very important to try to preserve it with conventional dentistry such as crowns or bone regeneration.  These must be taken in consideration before thinking about dental implants.

 

This case was restored with a dental implant, because the patient had enough bone and gingival still present.  In some cases an extra procedure is required (soft tissue graft or bone graft) before lacing a dental implant in order to provide the best "gum level" results aesthetically and functionally.  If the bone and soft tissue is not adequate it may be a contraindication for a dental implant.  If a dental implant is not the solution then conventional dentistry like crowns and partials are recommended.

 

Once the implant is stable in the patients’ bone, the selection of the type of porcelain crown is also critical. Not all porcelains look the same, especially when restoring a dental implant. In this case a Zirconia crown with feldspathic porcelain was used to provide maximum aesthetic results.

 

After the implant and crown have been place and completed you will need to brush and floss your new implant crown, as if it was a natural tooth. To assure the success of the implant you will need to have a professional implant cleaning every six months. Otherwise the possibility of peri-implantitis, bone loss around your dental implant, can increase the risk of failure of the implant.


 

Implant sequence

 

For your implant consultation, you will have a complete oral evaluation including a 3D Radiograph. Most of these radiographs emit high doses of radiation, but at QDT we use the latest technology utilizing ultra low dosage Plan Meca.

2.     With the clinical exploration and the CT Scan we will plan your implant case on the computer in 3D. We will simulate the implant placement on the computer and we will be able to see the final results prior to performing the   real procedure. The objective of this planning is to accurately select the right size of implant or to determinate whether you need replacement bone, a bone graft, to achieve our desired results.

3.     After your evaluation, we will present a comprehensive treatment plan that informs you of any fillings, crowns, orthodontics, or any other dental treatment you may require. We will together address the findings on the treatment plan and once accepted you will be able to schedule your implant placement procedure and any other treatment you would like to complete.

4.     The first stage is the most simple. For a single posterior implant we will need to numb the area where the missing tooth or tooth that needs to be removed is located. Next, we make a small incision and screw the implant into the jawbone.  It is very important at this stage that the implant is fixed into your bone. The healing of the implant is similar to a bone fracture. If someone breaks their leg it will be casted so the two fragments do not move. If the fragments move then the healing process will be compromised. The same thing occurs with the dental implant. If the implant is not secure into your bone it will not heal properly. Therefore the healing process if a very important step in the implant procedure, and therefore we want to be certain everything is as it should be prior to taking impressions to fabricate your new crown. After we acquire an impression of your implant we will then stitch the area and let it heal.  If the implant is in the esthetic zone we will provide you with a temporary tooth. If the implant is not in the esthetic zone the healing will be much easier without temporary tooth.

5.     We will have a follow up appointment 2 weeks after your impressions are made.  We will make sure that your gums are healing well and we will remove the stitches if needed.

6.     Four months after placement, if we were able to obtain impressions at the time of implant placement you will receive your implant crown. We will need to again numb the work area in some cases. We will cement the crown on your implant and restore your bite.

7.     6 month later you will need to come to our office once more for a routine Radiograph, and follow up cleaning.