Dental implants: Yours teethfully

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Dental implants: Yours teethfully
22 Apr 2005
Dr P C JACOB
Deccan Herald

Teeth impart beauty to the face and missing teeth not only cause problems with appearance, but also make eating and speaking more difficult.
Teeth at the back must also be replaced, otherwise it can lead to an altered bite. If a number of these teeth are missing and not replaced, it may lead to collapse of facial features. Teeth work together as a finely tuned machine with the upper and lower teeth meshing with each other in a specific manner. Losing even one tooth could be the start of serious problems, if it is not replaced promptly.
Tooth loss has many causes, the most common being decay, gum disease and injury. Teeth can be replaced either with the help of implants, bridges or dentures. The method selected will depend on the condition of the adjacent teeth and gums, and the number of teeth missing and the cost.
Implants
Implant help replace missing teeth. An implant is a device made of titanium, which is surgically inserted into bone. The area is then allowed to heal for a period of about four to six months, after which the artificial teeth can be constructed on them. Implants can be used to replace a single tooth or multiple teeth.
Implant therapy has been tremendously beneficial in patients who have been unable to wear or do not want to wear removable partial dentures or complete dentures.
Multiple implants can be placed in the upper and lower jaws and a fixed prosthesis can be given. Implants can also be used to stabilise the dentures so they are more comfortable to wear. This is very effective for people who have been wearing dentures for an extensive period of time and whose jaws have shrunk to the point where the dentures are very loose. This is especially true of the lower dentures.
Bridges
Bridges are tooth replacements attached to adjoining natural teeth. They are best for people with a few missing teeth, either the front or the back teeth. To replace missing teeth with a bridge, the adjoining teeth must be healthy and have good root and gum support. The two common types of bridges are the fixed bridges and the bonded (Maryland) bridges.
Depending on the aesthetic requirements of the patient the bridge can be made of all porcelain, porcelain fused to metal or metal only. In a conventional bridge one or more artificial teeth are set between crowns placed over adjoining natural teeth. This procedure normally takes two to three visits.
A bonded bridge consists of one or more artificial teeth between metal wings. The anchor teeth are reshaped slightly, and the wings are bonded to them using resin cement.
However, there is a greater chance for these to de-bond as compared to the conventional bridges.
Dentures
A denture is a set of removable artificial teeth that rest directly on the gums and may be attached to adjoining teeth using clasps. Dentures are usually made with gum coloured acrylic resin to which artificial teeth are attached.
Dentures are usually of four types: removable partial dentures, overdentures, immediate dentures and conventional complete dentures
Removable partial dentures are usually for those who have a number of teeth missing and where fixed partial dentures are not recommended.
They usually consist of replacement teeth attached to gum coloured plastic bases, which are connected by a metal framework. Removable partial dentures are attached to natural teeth with the help of metal clasps or devices called precision attachments, which are more aesthetic than clasps. A new material called Valplast has recently been introduced which is a biocompatible nylon-based material.
Its main advantage is that it is flexible, gum coloured and the clasps are also made of the same material, making it much more pleasing.
In our country, the plastic removable dentures are used widely, because they are cheaper than the dentures with metal frameworks. However, in the long run these dentures can cause harm to the adjacent teeth.
Overdenture
An overdenture is a removable denture designed for patients who have a number of teeth missing, but have a few good teeth remaining. The best scenario being when there are canines and one posterior tooth remaining in each side of the mouth. These teeth are root canalled and the canals are filled with an inert material.
The teeth are reduced in height and the dentures are constructed over these teeth. In some cases attachments may be placed over the teeth to increase the retention of the dentures.
The denture is usually made with gum coloured acrylic resin, with the artificial teeth attached to it. Although this form of treatment is more expensive than conventional dentures, it has a number of advantages like better tactile sensation and better chewing efficiency.
In a few cases, patients may have to undergo extraction of all their remaining teeth like in advanced gum disease. Here, it is advisable to get an immediate denture done. The main advantage is that the patient is never without teeth.
The procedure involves extracting the remaining back teeth and waiting for a period of about ten days for healing to occur.
The patient is then called in to make the necessary records. The lab then fabricates a complete denture that duplicates the appearance of the natural teeth or altered if the patient so desires.
Complete dentures
Complete dentures are made of gum coloured acrylic with artificial teeth attached to them and they rest completely on the gums. Complete dentures are able to maintain or recreate lip and cheek support and restore the patientǃÙs smile.
Missing teeth need to be replaced within a period of three to six months as it restores appearance, improves speech and chewing ability. The dentist in consultation with the patient must select the method of replacement.