Dental Implants - Types , Procedure, Advantages - Deccan Multispeciality Hardikar Hospital

1. No Teeth to FunctionalTeeth WhatHappensifdidn’treplaceteeth 1. Opposite arch teeth getextruded • Long term effecton TMJ • BestToothReplacementOptionsforMissingTeeth • Single Tooth orCap • Tooth-Supported FixedBridge • Resin-Bonded Bridge/ Merryland Brides • DentalImplant • Implant-Supported FixedBridge • All-on-FourImplantSupportedDentures/All-on-Six • Removable PartialDenture • Removable PartialDenture • Flipper – a Temporary ReplacementOption • DoNothing • New TreatModality DECCAN HOSPITALPUNE

2. Thebest possibleoptionforyouroralhealthandyourgeneralhealth would be to replace each tooth with a dental implant, as implants are the closestthingtorestoringa naturaltooth.However,thisoptionisn’talways realistic as single implants can be quite expensive, putting them out of reach for manypeople. • Ifyouareconcernedyoumaynotbeabletoaffordalloftheimplants you need right way (here’s how to find low cost dental implants), this doesn’t mean you cannot revisit this option at a later date when your financial situation has improved. While it’s certainly possible to wait and get implant treatment at a later date, there are other, more affordable solutions for replacing missingteeth. DECCAN HOSPITALPUNE

3. A]SingleToothorCap DECCAN HOSPITALPUNE

4. B) Tooth-Supported FixedBridge • Atooth-supportedfixedbridgeisthemostcommonalternativetohavingimplant- supported restorations, particularly where a single tooth is missing. A tooth- supported fixed bridge consists of two crowns, normally fitted onto the teeth either side of the gap and these are the abutment teeth. The abutment crowns areattachedtothereplacementteethwhicharecalledpontics. • Thistypeofrestorationispermanentlycementedinplace.Itcanbe madefroma number of different materials that include gold, precious metal alloys, and porcelain,ora tooth-supportedfixedbridgemaybemadefromacombinationof thesematerials. • Benefits • Feelandfunctionjustlikeyourrealteeth • Procedureisverystraightforwardandtreatmentwillnormallyonlytake twoorthreeweekstocomplete • Maintenanceiseasy,asa fixedbridgecansimplybebrushedandflossed • Costeffectivewaytoreplacemissingteethandislessexpensivethan implant supportedteeth • Treatment isrelativelylowrisk–ifthebridgefailsthenitcangenerallybe replaced quite quickly andpainlessly DECCAN HOSPITALPUNE

5. Disadvantages • Moreexpensivethanaremovabledenture • Teethadjacenttothegapmustbegrounddowninordertosupportthe bridge,removinghealthytoothstructurethatcanonlyeverbeartificially replaced • Oncetheseteetharegrounddown,thereisanincreasedriskthatthey couldbecomedecayedandinfectedinthefuture • Mustthoroughlycleanunderneaththeponticandthereisa possibilitythat thiscouldbecomeafoodtrap,especiallyasbonelossoccurs • Doesnotprovideanystimulationtotheboneunderneaththebridge • Doesnotgenerallylastas longas animplant-supportedbridge • WhentoChooseaTooth-SupportedFixedBridge • This option can be best for anyone looking for a quick solution to tooth loss and/or who doesn’t want to undergo surgery. Not everyone wishes to or is suitableforimplantsurgery,especiallyiftheyhavemedicalconditionsthathave compromisedtheirimmunesystemwhichcan slowdownhealing, increasingthe risk ofimplant failure. • People in these situations can often obtain better and more predictable results throughusinga fixeddentalbridge.Treatmentcanoften becompletedwithina matterofjusta fewweeksratherthan theseveralmonths requiredforimplant treatment. DECCAN HOSPITALPUNE

6. C)Resin-BondedBridge/MerrylandBrides • Aresin-bondedbridgeissometimescalledaMarylandbridgeora Rochettebridge and tends to only be used to replace front teeth. This is because it is relatively fragile and is unable to withstand the chewing forces created by back teeth. It consists of two wings that are attached to the abutment teeth on the tooth surfaces nearest to the tongue, and the wings are attached to the replacement tooth orpontic. • Theabutmentteethmustbe healthyandstrong,butit’s unlikelythatyourdentist willneedtochangetheiroverallshapeverymuch.Sometimestheymaychooseto remove a small amount of tooth enamel, as a slightly rougher surface will help increasethebondbetweenthetoothandthebridge. • A Rochette bridge has holes drilled into the wings to help increase this retention.Itisabettersolutionthanaremovabledenture,butitisn’tasstrong oraspermanentasafixedbridgeanditwillnotfunctionaswellasimplants. • Benefits • Cheaperandlessinvasivethana fixedbridgesupportedbyyournatural teeth • Restoresyourabilitytosmileandtoeat andspeak • Providesthecorrectamountofsupportforyourlips • Preventsyourremainingteethfromdriftingoutofplace DECCAN HOSPITALPUNE

7. Disadvantages • Isn’tverystrong,whichiswhyitisonlyusedtorestorefrontteeth • Hardfoodcancausethebridgetopopoffyourteethandneedtobere- cemented • Relativelyfragilewhichdoesn’tmakeitagoodlong-termoption • When toChoose a Resin-Bonded Bridge • This option is cost-effective and non-invasive, particularly when compared to dental implants. It could be a good short-term solution and this type of bridge mayoccasionallybesuppliedasa temporaryrestoration,whileanimplantheals underneath thegums. DECCAN HOSPITALPUNE

8. D) DentalImplant • Dentalimplantshavebeendesignedtoartificiallyreplaceanaturaltoothroot and are inserted into the jawbone to support a restorative or replacement crown,bridgeordenture.Theycanbethebestsolutionforpeoplemissingone ormoreteethduetoinjury,periodontaldiseaseorotheroralhealthproblem. • Benefits • Successratesoftreatmentareinexcessof95% • They are durable andpermanent • Minimalmaintenanceisrequiredotherthangoodoralhygieneand professionaldentalcheckupsandcleanings • Feelnaturalandcomfortableandprovidethebestaesthetics • Onlytoothlosssolutionthat preventsjawboneloss • Teethadjacenttothegapdonotneedtobemodified • Canbemorecosteffectiveinthelongerterm,duetothelonglifespanof treatment DECCAN HOSPITALPUNE

9. Disadvantages • Treatmentismoreinvasive–a surgicalprocedureisrequiredtoinsert implant • Treatmenttakeslonger andrequiresa greaternumberofdentalvisits • compared to otheroptions • Mostexpensivetoothreplacementsolution • When toChoose Dental Implants • This is the best option if you are suitable for treatment and can afford dental implants.Treatmentisalong-termsolutionfortoothlossanditprovidesthebest aestheticresults. • Althoughtreatmentismoreexpensive, itcanbemorecosteffectiveinthelonger term as implant restorations will not need to be replaced as often as a dental bridge. Additionally, an implant preserves the jawbone and the gum tissue, and thereisnoneedforyourdentisttogrinddownhealthyteeth. DECCAN HOSPITALPUNE

10. E ) Implant-Supported FixedBridge • Withanimplant-supportedfixedbridge,itisnotnecessarytoreplaceeverysingle tooth with a single dental implant. Instead, the implant-supported fixed bridge will restore several missing teeth and it’s possible for this option to replace a complete arch of teeth. The number of implants required can vary according to thetypeofdentalimplantusedbyyourimplantdentist,andthenumberofteeth beingrestored. • Animplant-supportedbridgelooksverysimilarto atooth-supportedfixedbridge andcaneitherbecementedorscrewedintoplace.Sometimesanimplantdentist will choose to screw the bridge onto the implants as this makes it easier to retrieve the bridge should it need cleaning or repairing. The screw holes in the bridge are covered up with tooth-colored composite resin so they are virtually invisible. • Benefits • Providesverygoodaestheticresults • Feelsandlooksverynatural,makingiteasytospeakandtoeatvirtually anything • Easytolookafter andcanbebrushedandflossedjustlikeanordinary • tooth-supported fixedbridge • Costislowercomparedtoreplacingevery singletoothwitha singledental implant • Shouldlastformanyyearsbeforeitneedsreplacing • Noneedforyourdentisttogrinddownhealthyteeth DECCAN HOSPITALPUNE

11. Disadvantages • Onlysuitableifthemissingteetharesituatedadjacenttoeach other • Relativelyexpensive,particularlywhenusedtorestorea complete archof teeth • Requiresagreaternumberofvisitsandtreatmenttakes longertocomplete • comparedtoatooth-supportedfixedbridgeoradenture • Implanttreatmentdoesrequireasmallsurgicalprocedure • WhentoChooseanImplant-SupportedFixedBridge • Thisoptioncanbeidealforanybodywhowishestoenjoythesensationofhaving strong and stable teeth that are not removable. Although more expensive than All-on-Fourimplant-supporteddentures,thissolution doesmakeiteasytoforget you ever lost your teeth. The teeth are strong enough to allow you to eat just about any foods you like, within reason. It also provides excellent aesthetics, especially as the bridge can be constructed to replace any missing gum tissue using gum coloredporcelain. DECCAN HOSPITALPUNE

12. F) All-on-Four Implant Supported Dentures/All-on-Six • It’spossibletosupportafull-archlowerdenturewithjustfourimplants,whilean upper denture may require six implants for support. With this treatment, two implants are inserted right at the front of the arch in the positions previously occupiedbyyourfrontteeth. • Theremainingtwoimplants areplacedeithersideandata 45°angletilting towards the back of the mouth. The overdenture will clip onto the dental implants using special attachments on its fittingsurface. • Benefits • Affordableduetothefewernumberofimplants requiredtosupporta complete arch ofteeth • Morestableandstrongthandentures • Makeitpossibletoenjoyawidervarietyoffoodscomparedtodentures • Canbeconstructedwithoutapalate soitwill feellessbulkyandeatingwill bemoreenjoyablebecauseyouwillbeabletotastefoodmoreeasily • Can easily be removed forcleaning DECCAN HOSPITALPUNE

13. Disadvantages • Dentureisstill removable,whichsomepeople mayfindundesirable • DCareneedstobe takenwheneating,as foodsthatareparticularlychewy orhardcoulddamagethedenture • DSpecialattachments onthefittingsurfacewillneedtoberegularly maintained and mustbe replaced periodically • WhentoChooseanOverdenture/All-on-FourImplants • Thistreatmentisrelativelyaffordableandeventhoughthedentureisremovable, it allows patients to enjoy the stability of having fixed teeth. Treatment may also besuitableforpeoplewhohavesufferedsignificantjawboneloss.Thisisbecause the implants are inserted towards the front of the jaw where the bone tends to benaturallythicker andstrongerandmoreabletosupportdental implants. • It’softenpossibletoloadtheimplants quitesoonaftertreatmentandpatients maybeabletoreceivetheirnewimplantsupporteddenturejusthoursoraday or twoafter surgery. DECCAN HOSPITALPUNE

14. G) Removable PartialDenture • A removable partial denture is designed to replace one or more missing teeth in thesamearchandwhichmayormaynotbeadjacenttoeachother.Thedenture consistsofanacrylicbasewhichissometimesstrengthenedwitha Cobaltchrome metalframework. • Itwillfrequentlyhavemetalclaspsthatfitoveryourexistingteeth,holdingthe denturefirmlyinplacebutstill allowingittobeeasilyremoved.Somearemade from a flexible nylon material and these have clasps made from gum colored nylonsotheyarelessvisibleinthemouth. • Benefits • Lessexpensivethanfixedbridgesorimplants • Veryeffectiveatfillinginthegapsinbetweenteethandrestoringyour ability tosmile • Restoringmissingteethcanhelpimproveyourspeech andyourabilityto eat comfortably • Sometimespossibleforadditionalteethtobe addedtothedenture • Procedureisnon-invasiveandrelativelyquick DECCAN HOSPITALPUNE

15. Disadvantages • Can be unstable anduncomfortable • Maynotalwayslookverynaturalandwillnotfunctionaswellasfixedteeth • Needtoberemovedeverydayandthoroughlycleanedandleftout overnighttoallowthegumsachancetorecover • Need tobe replaced or relined quite frequently • Quitefragileandeasilybroken,withtheexceptionofnylondentureswhich areunbreakable • Easytoloseormislayapartialdenture • When toChoose Removable Partial Dentures • Removablepartialdentures canbea goodoptionforpeoplewhocannotafford dental implants, or who do not have natural teeth that are strong enough to support a fixedbridge. DECCAN HOSPITALPUNE

16. Removable CompleteDentures • Removablecompletedenturesrestontopofthegumsandarea low-costand non-invasive alternative to dental implant treatment. Dentures consist of an acrylicgum-coloredbasetowhichdentureteethareattached. • Benefits • Can significantly improve appearance and may help to increase self-confidencebyreplacingteeththatmay havebeenworndown or decayed • Providethecorrectsupportforthemusclesinthecheeksandlips, restoringfacialdimensionsandcreatingamoreyouthful • appearance • Canhelpimprovespeechandtheabilitytoeatcomfortably • Affordable and treatment is relativelyfast • Look quite natural as they come in many different shapes, colors andsizes,whilegumtissuecanbeclosely matchedtoyournatural • gums • Can be relined or adjusted to accommodate the changing shape of thejawbone. DECCAN HOSPITALPUNE

17. Disadvantages • Canbecomeill-fittingwithin averyshortwhileas thejawbonechanges shape • Notpossibletoeatcertainfoodsthatareveryhardorverystickywithout • riskingdamagetothedenture • Havetoberemovedforcleaningandmustbeleftoutovernighttogivethe gums a chance torecover • Canacceleratebonelossinthejawduetothepressureofthedenture restingonthegumsandthejawbone • Mayaffectyourabilitytoproperlytastefood,andtheymaymovearound whenyoueat orspeak • Canrubongums,creatingpainfulsorespots • Dentureadhesivesareoften messyanddonotoffera long-termsolution • May makeaclickingsoundwhenyouspeak,whichcanbeembarrassingin socialsituations • WhentoChooseRemovableCompleteDentures • Theycan beagoodlow-costsolutionforreplacingacompletearchofteeth.They arealsogoodforanybodywhodoesn’twishtoundergodentalimplant surgery, orwhoisnotasuitablecandidatefortreatment. DECCAN HOSPITALPUNE

18. I)Flipper–aTemporaryReplacementOption • Aflippertoothisatemporarypartialdenturethatisusedtorestoreoneormore missingteeth.Itspurposeistofillinanyunsightlygapssothatyoucansmileand talk without feeling self-conscious. A flipper tooth is only used until a more permanent replacement can befitted. • Benefits • Treatment is veryinexpensive • Fabricatedpriortotoothextractionandfittedrightafteranaturaltooth is removed • Processrequiresfewertripstoyourdentistcomparedtoamore permanent partialdenture • Lightweight–makingthemeasiertowearandtotolerate • Disadvantages • Notverystrongorstable • Fragile and easilybroken • Canbebulky,makingthemuncomfortabletowear,particularlytowardsthe end of a longday Deccan HospitalPune

19. When toChoose a Flipper Tooth Thistypeofrestorationispurelyfortemporaryuse,soitcanbeusefulwhileyou decide how to more permanently restore a missing tooth, or while waiting for dental implant treatment tobe completed. DECCAN HOSPITALPUNE

20. J] DoNothing Those were the most popular ways to replace one or more missing teeth, but thereisanotheroption– doingnothing.However,thisisnotanadvisablechoice if you can helpit. Jawbone density decreases after a natural tooth is removed due to the lack of stimulationthatwouldnormallybe providedbyanaturaltoothroot.Ifyoulater decide to replace the tooth with an implant, you’re more likely to need a bone grafttomakeupforthelostbone. Doing nothing will also allow any adjacent teeth to move out of position, potentially destabilizing them and affecting your bite. While it’s not always possible to replace missing teeth immediately after their loss (financially and/or physically),itisimportanttofigureouta morepermanentwayofreplacingthem as soon aspossible. DECCAN HOSPITALPUNE

21. K] NewTreat Modality *72HOURSIMPANTOLOGY/STRATEGICIMPLANT* *WHAT ISIMPLANT?* Dentalimplantaremetal postsorframesthat aresurgicallypositionedinto jaw bone beneath your gums. Once in place, they allow your dentist to mount replacement oftooth. *HOW IT WORKS? * Itfusestoyourjawbone,providestablesupportforartificialteeth.Dentureand bridgemountedtoimplantswon’tsliporshiftinyourmouth. Onanaverage3monthstimeisrequiredforosseointegration. *BASAL IMPLANTS/CORTICAL IMPLANT* Trendingalternativefortreatmentmodalityforatrophiedridges Isatermusedinreferenceto theprinciples ofutilizingbasalboneareaswhichis free of infection and resorption, and employing of the cortical bone areas. The load bearing tolerance of the cortical bone is many time higher than that of spongiousbone. *Types of BASALIMPLANTS* BOI-Basalosseointegrated{lateralbasalimplants} BCS- Basal corticalscrew ScrewableBasalImplants-{BCSBRAND}-Diameterupto12mmforinsertion into immediate extractionsocket DECCAN HOSPITALPUNE

22. *ADVANTAGES* • Safe and painlessprocedure. • Use of single piece implantology. Very fast procedure (Within 72 hoursfixandpermanentteeth)andhighrateofsuccess. • No need of bonegraft. • No screw loosening and crestal boneloss. • No cantilever is placed. • Sinus is not involved, so no chance ofsinusitis. • BOI/BCSrequirepatientsownresidualboneforanchorage. • Avoidingriskyboneaugmentationcomplications. • Immediateloading-noedentulous phase,nosecondaryoperations • ,good patientacceptance. • Can be placed even if periodontal involvement is present. BOI and BCS implants can be placed immediate after teeth or infected tissue isremoved. • Low demand forpatient compliance. • As corticalboneisresorptionandinfectionresistanceload transmissionareasarestrictlycortical. • Even skeletal discrepancies can be neglected teeth maybe • positionedinregionswherenoboneispresents. DECCAN HOSPITALPUNE

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