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Dental Implants
A dental implant is an artificial replacement for the root portion of your
natural tooth. and is anchored into a pre-drilled socket in your jaw-bone to
support a crown, bridge or secure a denture firmly in place. Implants are
made from titanium, a material that is well tolerated by bone and integrates
easily with bone tissue. During the placement of a dental implant the goal
is to achieve a close contact between the outer surface of the implant and
the surrounding bone tissue so they can “fuse” together (osseointegration)
creating a stable support for the new teeth.
The Procedure
The gum where the implant is to be placed is cut and lifted and a small hole
is drilled in the jawbone at the precise location of the intended implant.
The titanium implant is tightly fitted into this socket and the gum is
stitched back over the implant. If there is insufficient bone material to
accommodate the implant a bone graft may be required or alternatively the
dentist may use smaller sized mini implants if suitable.
Once the implant has been placed it is left to heal and integrate with the
jawbone for between 6 weeks to 6 months. The bone tissue will grow and
anchor itself into the microscopic rough surface of the implant.
During this “healing period” patients are given temporary teeth (bridges) or
continue to wear dentures. It is important that any temporary teeth do not
exert any forces on the healing implant. After the healing period the gum is
lifted again and a post is attached to the implant with a temporary crown.
Four to six weeks later when the surrounding gum tissue has matured the
final permanent restoration can be fitted to the implant.
What are the advantages of dental implants over dentures and bridges?
• Reduced bone loss
Normally, the bone tissue surrounding the root of your tooth is maintained
by your body’s natural renewal process. However, if you loose a tooth, you
will be left with a hole where your tooth root used to be and the bone
around this area will slowly begin to disappear (atrophy) and may change the
shape of your jaw. A dental implant placed in that area can actually
stimulate bone growth and production, preventing loss of valuable bone
structure. In some patients where bone loss is substantial a bone graft may
be required before placing a dental implant. Bone loss is a problem for
people who have dentures and as the shape of the jaw slowly changes the
dentures need to be adjusted or re-made to fit the new shape of the jaw.
Bone loss can also make a person look older since the area around the mouth
can sag as bone is lost
• Improved function
Once dental implants are fully integrated into you jaw they function just as
well as your own natural teeth and you can eat the foods you want and speak
with complete confidence. With dentures, eating hard foods such as an apple
can be a problem, either the dentures come loose or patients cannot
withstand the hard biting forces as they cause pain in the gums. Irritation
and inflammation of the gums is a common problem amongst denture patients.
Dentures can be supported by implants or mini-implants which will improve
function greatly enabling patients to eat the foods they want with complete
confidence and not having to worry about bone loss and loose dentures
falling out.
• Improved dental hygiene
Unlike bridges and dentures, which require special cleaning instructions and
extra attention, dental implants just need regular brushing, flossing and
hygiene appointments just like your natural teeth.
• No need to drill or remove any healthy tooth structure
When replacing missing teeth with dental bridges, the teeth adjacent to the
gap need to be prepared and healthy tooth structure is removed to
accommodate a crown or bridge abutment to fit over the top of the tooth. In
the future if one of the supporting teeth is damaged the entire bridge
restoration will also be compromised whereas with an implant the restoration
is independent of any of your other teeth. By replacing lost teeth with an
implant, no support is required of the adjacent teeth, and hence your
natural teeth do not need to be prepared or altered in any way
• Better aesthetics
If done correctly a dental implant should be indistinguishable from your
surrounding natural teeth. Dentures can come loose and look un-natural if
they do not blend with your gums and some bridges and dentures have
unsightly metal clasps to hold them in place. Dental implants provide a much
better cosmetic and functional end result.
How many teeth can a dental implant support?
Traditionally an implant placed into your bone supports a single crown and
this is know as a “single tooth implant”. However if you have several
missing teeth you do not necessarily need an implant for every missing
tooth, one implant can support several teeth via a bridge or a denture. The
number of implants required depends on the volume and density of bone tissue
available at each implant site. Often smaller sized “mini implants” are used
to secure dentures in place.
In the case of full mouth reconstructions where an arch of several teeth
(10+) need to be supported in either the upper or lower jaw a minimum of 5-6
implants in each jaw would be required. The exact number of implants needed
would depend on the individual case and your implant surgeon would be able
to advise you on the best solution after a through examination and
assessment.
Am I a suitable candidate for dental implants?
Dental Implants can be placed in patients of any age (with fully developed
jawbones) provided that they have sufficient quality and quality of bone
tissue available. Most healthy individuals that maintain a good oral hygiene
program are suitable candidates for dental implants. Circumstances where
implants may not be suitable or situations that have an increased risk of
implant failure include:
• Heavy smoking – this slows down and hinders the healing process
• Excessive alcohol intake – disrupts healing of the gums
• Periodontal gum disease – all active gum disease must be treated prior to
any implant procedure to ensure long term success of any treatment.
Periodontal disease is a major cause of bone loss, which would hinder the
success of any implant procedure.
• Immuno-compromised individuals (steroids, auto-immune disease, patients
undergoing radiation treatment).
• Teeth grinders (bruxism) – a night time splint can be given to treat this.
How will I know if I have enough bone for implants ?
Using a combination of dental X-rays and a CT scan your bone density and
volume can be assessed as well as information about nearby anatomical
structures to avoid such as nerves.
What if I don’t have enough bone for dental implants?
The alternative options for replacing missing teeth include dentures and
bridges. However, there are various bone grafting and tissue regeneration
procedures that can be carried out to enable treatment with dental implants:
Sinus augmentation – if you need to replace missing teeth at the back of the
upper jaw then a sinus augmentation, whereby new bone in the sinus is
created can increase the height of the bone available for the placement of
implants in this area
Onlay Grafting – this is where a piece of bone from somewhere else is taken
and it is secured over an area that is deficient in bone, over time the
newly placed bone will fuse with the underlying bone creating a better
environment for an implant to be placed.
Where can bone be taken from for the graft?
The best source of bone for your graft is your own bone tissue from else
where in your body and areas that can be used for bone grafts include the
chin, back of the lower jaw, the hip and tibia. Bone taken from your own
body offers the most viable and faster healing time when compared to
alternatives. In many cases a combination of artificial bone substitutes and
your natural bone is used. In any bone grafting procedure the grafted bone
provides an anchor and stimulus for the existing bone to grow onto,
eventually providing an environment suitable for the placement of implants.
How long do dental implants last?
Dental implants have been used for over 30 years to replace missing teeth
and they can last a lifetime depending upon how you look after them. Like
any other restoration your implant-supported teeth can still be damaged by
trauma and affected by gum disease and poor oral hygiene.
How much do dental implant cost?
The price of dental implants tends to vary considerably and depends on
several factors including the level of skill of the surgeon, the type /
quality / brand of implant used, the clinic where the treatment is carried
out, the level of aftercare service provided and obviously the amount of
work required (i.e bone grafting) and number of implants required. In the UK
the costs of a single tooth implant can vary from £800.00 up to £3000.00.
Imagine a dental practice where you can go and have your new false tooth
made and fitted during a single visit within one hour. This is what CEREC
technology by Sirona dental systems UK has made possible.
Dental Crowns
Dental crowns are restorations that protect damaged, cracked or broken down
teeth. A crown strengthens your existing damaged tooth so as to preserve its
functionality. Dental crowns are also commonly known as caps because a crown
sits over your existing tooth covering the entire outer surface analagous to
how a baseball cap would cover your head. The animations below graphically
illustrate the procedure of placing dental crowns:
Why May I needs Crowns?
• If your tooth has undergone significant decay and there is not enough
tooth structure remaining to support a filling or an inlay and maintain
functionaility.
• If a large portion of your tooth has fractured and it cannot be built up
using traditional composite bonding techniques .
• If you have a large cavity andopt for the additional protection a crown
offers to your tooth over a large composite filling or an inlay.
• If you have had a dental implant to replace a missing tooth, a crown will
be fitted to the abutment of the titanium implant.
• Following root canal treatment a crown is often needed to strengthen the
tooth.
• If you grind your teeth and have a poor diet, acid erosion may reduce your
teeth to a point where the only option available is to crown them.
• For cosmetic reasons to improve the aesthetics of your smile, you may opt
for all porcelain cosmetic crowns.
Are dental crowns always the best option?
Crowns should not be the first treatment of choice just to improve the
aesthetics of your teeth, because a dentist needs to grind a significant
portion of the original tooth away. Less invasive alternatives include
veneers or dental bonding. Crowns are required when the strength of the
tooth supporting the restoration is compromised since veneers and dental
bonding restorations are only as h2 at the supporting tooth.
What materials can crowns be made from?
In modern day dentistry there is a wide variety of dental materials to
choose from. Some crowns are made from full gold, where as others are made
from an alloy of metals fused to a porcelain outer shell. After time, crowns
that are made from a combination of metal fused to porcelain can begin to
show dark gum lines that are not aesthetically attractive. All porcelain or
ceramic crowns are the best choice for a natural cosmetic look. There are
many different brands and types of porcelain crowns and the variation
between the costs of dental crowns at different dental practices may well
reflect the quality of the materials used.
What is the procedure of having dental crowns fitted ?
Once you have had a consultation with your dentists and discussed all the
treatment options, your dentist will prepare the tooth ready to be crowned.
The first stage is to clean the tooth, remove any decay and reshape it using
a burr (a special dental drill for shaping teeth) under local anaesthesia.
The shape of the prepared tooth is usually tapered to allow the crown sit
comfortably over the top of it. Once the tooth is prepared an impression
(mould) of your teeth will be taken using a special “dental putty”. This
impression is sent to a dental laboratory who will use the impression of the
prepared tooth as a guide to fabricate the new crown to the exact
specification of the dentist and to fit perfectly. It usually takes between
two to three weeks for a laboratory technician to custom fabricate your new
crown. During this time your dentist will fit you with a temporary crown to
cover and protect your prepared tooth.
On your second visit your dentist will remove the temporary crown, and
roughen the outer surface of your prepared tooth with a special etching acid
to give the dental cement a good surface to bond to. Your dentist will sit
the crown over your tooth to see if it fits with your smile correctly and is
the right colour match and shape. Once you are both happy with the
restoration and how it looks, your dentist will cement the crown firmly into
place.
How long do crowns last?
This will depend largely on how well you look after your teeth. Dental
crowns require the same level of care and attention as your natural teeth.
Provided you have a good oral hygiene program and attend regular check ups
at your dentist and do not suffer from teeth grinding, maintain a toothkind
diet and do not do things like open beer bottles with your teeth then a high
quality dental crown can last 10-15 years.
Dental veneers have long been used to create the ultimate smile makeover,
with this treatment it is possible to transform crooked, stained, damaged
and badly worn teeth into a brand new straight white smile as seen on many
of the Hollywood greats.
Dental Veneers
Veneers are wafer thin lamintates or shells of tooth coloured material
(which can be either porcelain, ceramic or composite bonding material) that
are “cemented” to the front surface of teeth to improve their cosmetic
appearance. Many dentists use the analogy that dental veneers are for your
teeth what false finger nails are for your hands. In a similar manner to how
false finger nails are placed or glued to your existing fingernails, veneers
are bonded to the front of your existing teeth. Thank you to Dr Riten Patel
from The Mulberry Dental Practice for donating the case photos above of a
smile makeover that he carried out on one of his patients.
What Treatments or problems are veneers used for?
There are a wide variety of reasons why patients opt for treatment with
dental veneers.
Stained Teeth - badly stained teeth that cannot be improved by teeth
whitening or prophyflex treatments can greatly be improved by dental
veneers, which function to cover and "hide" any existing stains on your
natural teeth.
Damaged Teeth - teeth that have either become badly worn with excessive
grinding, by carbonated drinks, or have been chipped or broken in an
accident can benefit from veneers. A small chip on a tooth can quickly be
repaired with composite bonding or "composite veneers" which are one and the
same thing. A single damaged tooth can easily be repaired with a single
porcelain veneer that has the same characteristics and colour to match your
surrounding teeth so that it looks natural.
Gaps - spaces or gaps (diastimas) between your teeth can be easily closed
using dental veneers giving you a more uniform looking smile.
Crooked teeth - although veneers are not the ideal treatment choice for
crooked teeth and from a point of view of preserving your natural teeth
structure orthodontics or invisalign braces would probably a better
solution. However, treatments can take up to a year or longer with braces.
For teeth that are not severely crooked veneers placed over their front
surface will give a straight and perfectly aligned looking smile. For this
type of treatment many people refer to veneers as "instant orthodontics"
since you get a similar end result in a fraction of the time.
So which are better composite veneers or porcelain veneers?
The most popular type of veneers are porcelain, which offer a stronger and
more durable alternative to its composite counterpart. Composite veneers are
also more prone to staining and do not last as long as porcelain veneers
which also offer more a natural looking, translucent tooth-like appearance.
Composite veneers are much cheaper than porcelain veneers in general, but
considering that they do not last as long and need replacing more often they
could end up costing more in the long run. Composite work is ideal for small
chips as this treatment preserves more of your natural tooth structure.
What is the proceedure of having dental veneers fitted?
1. The first part of any dental procedure is the initial consultation and
examination so that the dentist can get a feel for what you want and
understand your needs and concerns. The dentist should explain the treatment
procedure to you including an accurate guide to the likely costs of your
treatment.
2. Before your veneers are designed your dentist will need to reshape and
prepare the front surfaces of your teeth so that they can accommodate the
veneers. The first stage is to numb the teeth and gums with a local
anaesthetic so that you do not feel anything during the procedure.
3. Using a special tool called a burr (a dental drill or file) a tiny amount
of the front surface of your teeth will be shaved off. The amount removed
should be equivalent to the thickness of the veneer that will sit over the
top of the tooth.
4. Next an impression or mould (copy) of your teeth is taken. A special
dental "putty" is placed into your mouth on a tray and pushed into your
teeth so that it takes an imprint of your teeth, similar to how you would
leave a footprint in sand.
5. This "impression" or mould of your teeth is then sent to a dental
laboratory. The laboratory use the impression to cast an accurate model of
your teeth which is used as a guide to fabricate your new veneers, this
process can tae between one to three weeks.
6. whilst you are waiting for your veneers to be fabricated your dentist you
may be fitted with some temporary veneers to protect your prepared teeth.
Not all dentists will offer temporary veneers.
7. On your second appointment your dentist will fit your new veneers to your
teeth. First the dentst may just sit the teeth over your teeth to see how
they look with your smile and he or she may need to trim or adjust the
veneer.
8. Next your teeth will be thoroughly cleaned and the front surfaces etched
(roughened) with a special acid gel so that they provide a good surface for
the dental cement to stick to.
9. The veneers are then cemented into place and a special curing light is
used to activate the dental cement so that it permanently bonds the veneer
to the front surface of your prepared tooth. If there is any excess cement
it is usually trimmed away and polished to leave a beautiful and natural
looking restoration.
How long do dental veneers last?
Porcelain veneers will typically last between 5-10 years and composite
veneers maybe a year or two at the most. The bottom line is that eventually
your veneers will need to be replaced. Although veneers are strongly
cemented into place they have been cases where they come loose and fall off,
in such situations it is important that you keep hold of your veneer and
contact your dentist immediately. To make your veneers last longer it is
important to follow a good oral hygiene program and also visit your dentist
for check ups on a regular basis.
Is it possible to have veneers fitted on the same day?
Usually porcelain veneers are placed over a minimum of two visits as
described above. A few cosmetic dentists have invested in CAM/CAD in-house
ceramic studios (CEREC) which can custom produce high quality ceramic
veneers on site in as little as six minutes. This CEREC technology enables
the dental practice to offer single visit, same day ceramic veneers which
are fitted within an hour. To read more information about CEREC technology
click here.
How much does this cost?
You would probably think that restorations made with this state of the art
technology would cost a lot more than standard lab made veneers and crowns.
However there is often very little if any difference in price because you
only need one appointment with the dentist and there are no laboratory fees
to incorporate into the price of your treatment. CEREC crowns can vary in
price from as little as £380 up to £700+ per tooth. Many dentists offer
interest free finance plans to help spread the costs of your treatment.
Thank you to Dr Kailesh Solanki for providng the above photos where 17 CEREC
crowns and veneers were fitted in a smile makoever case to repair worn down
and discoloured teeth.
Sirona dental systems UK Ltd are the only trusted partner in the UK for
CEREC.
Lumineers minimal preparation Veneers
LUMINEERS are a special type of ultra-thin (comparable to a contact lens)
veneers by CERINATE. Just like traditional veneers, Lumineers can reshape
your smile or that perfect smile makeover. They can cover gaps between teeth
and enhance the appearance of worn down and discoloured teeth.
Teeth whitening
Teeth whitening is the process of removing stains and discolouration from
teeth and improving their colour through a bleaching process to make them
look “whiter”.
For heavily stained teeth a significant improvement in their appearance can
be achieved following a procedure as simple as a scale and polish from a
dental hygienist.
Home Teeth whitening Kits
The take home whitening kits provide more permanent results over a longer
time scale whereas laser whitening offers immediate results. A combination
of the two provides the perfect solution to both immediate and long-term
whitening.
How much whiter will my teeth look?
This varies from individual to individual and also the type of whitening
system used. Some people respond very well to teeth whitening and have
dramatic whitening results whereas others may notice very little difference
at all. Your dentist will be able to advise you on the likely results
expected with your teeth.
Does it hurt ? what are the side effects of Teeth whitening?
Some people experience no pain or sensitivity with their teeth. However, the
majority of people will experience some kind on sensitivity either during
and / or after the initial treatment. This is usually described by patients
as sporadic sharp shooting pains coming from your teeth. This should settle
down after approximately 48 hours. Your dentist may give you a special gel
or mouse to apply to your teeth to help with the sensitivity. It is
advisable to avoid and hot or cold food or drinks within the first 48 hours
of your whitening treatment.
Which is the best teeth whitening brand / System?
There are many different brands of professional teeth whitening systems each
claiming to provide the best results depending on who you believe, with the
most popular systems being Zoom!®, as featured on extreme makeover,
Opalescence® , BriteSmile® and the latest Enlighten system. Each of the
systems have their pros and cons and your dentist will be able to discuss
which system would be best suited for your teeth
Quotation to here…
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