For 40 years, Lorene Koren considered apples a forbidden fruit. Her ill-fitting dentures were unforgiving. The fruit was hard to chew. Stray fibers got stuck in the lining and inflamed her gums. She was miserable. My Dentures were always uncomfortable. I just never felt good with them. I couldn't eat what I wanted. But now, Koren, 68 can chomp, chew and crunch anything she desires. She can nibble on nuts, snap on steak and chomp on corn. Koren is one of many patients who have had dentures screwed into their jaws. It's like having my own teeth. I don't have to worry about anything. Im really glad I had it done. I wish they would have had this procedure years ago. The permanent denture implants were developed in Sweden more than 40 years ago. The implants are becoming more common in the United States, says Dr Burnette, an oral surgeon who has been performing the operation for many years. About 30 to 40 million Americans are missing all their teeth on one or both jaws. In the Valley, up to 500,000 people might be candidates for permanent dentures. There are probably very few jaws that implants can't be used. Anybody who is missing all their teeth in their upper and lower jaws is probably a candidate. The implants are useful for patients who have difficulty wearing conventional dentures or who can't tolerate removable dentures of psychological reasons. These people are at the end of their ropes. They can't chew or eat. They've tried all conventional means. They have no other way to go.
The people I see are highly motivated. Some can't chew their food. But another factor is they don't want a removable appliance in their mouths. They don't feel whole. It's humiliating. It's frustrating. It's painful. If they could eliminate all that, they'd feel like they were new people again. The procedure can take 4 months or more to complete. A surgeon begins by cutting throught the soft gum tissue to the bone. The doctor then drills holes in the jaw and inserts a series of titanium screws. The screws are used to anchor the implant. The gum tissue is sewn over the screws. Then the patient is fitted for a temporary set of dentures. After three to eight months, a small incision is made in the gum tissue above each screw. Abutments are connected to the screws and the wound is closed. After two weeks of healing, the permanent denture is screwed into the abutments. The dentures aren't removable by the patient, but can be removed by the dentist if they need work.
The implants can be brushed , polished and flossed just like teeth. The procedure is 95% successful on the lower jaw and 85% successful on the upper jaw. Upper implants are less effective because the upper jaw bone is softer and thinner than bone in the lower jaw. Four factors can cause the operation to fail. First, the jaw bone might be too soft to support the screws. It's like putting a screw into drywall. It will pull right back out. Bacterial infections can cause the implants to fail too. If the temporary dentures are improperly fitted, they can put pressure on the screws and bend them. Finally, if the bridge work is poorly made, then the pressure of denture will not be evenly distributed across the fixture. That will cause pain. But pain isn't a usual part of the procedure.
Patients are afraid it's going to hurt. They think My God, you're going to put screws in my mouth, it must be terribly painful. In reality, it hurts more to get your wisdom teeth taken out. Yes there is some discomfort but it passes in a week or so. It's just like any other dental work you might go through. It's probably less painful than having a root canal. About 15% of insurance companies cover the operation. The cost is pretty relative. You'll spend less on this than you will on shaving cream, tooth paste and hair care in the same 30 year period.
It just depends on how you want to spend your money. You can spend it to be able to eat and to look great, or you can choose to spend it on a microwave or a new car. It's just a matter of what you value more. Patients often say, I think this is the best thing that has ever happened in dentistry. I feel 100% better about myself. There is no way anybody could pay me enough money not to have it done.
Fifteen years of clinical research in Sweden has provided what appears to be a breakthrough in the area of dental implants. Using pure titanium implants of defined finish and geometry, combined with a meticulous and specific surgical technique, clinicians have achieved excellent results for both maxillary (upper jaw) and mandibular (lower jaw) implants. The concept responsible for this success is called osseointegration, and it promises to be a byword in the future of dental implantology.
Osseointegration has been researched for more than 30 years in Sweden, and it encompasses basic science, surgical, biomaterials and prosthodontic disciplines as they apply to dental implants. Basically, osseointegration means that not only do osseous tissues heal following implantation procedures, but they actually integrate with the titanium implant fixtures and solidly incorporate them into the bone. In addition, there is no apparent soft tissue intervention between the normal bone and them implants.
Dental implants of various designs have been used for years, and a great number of these methods assume the existence of a connective tissue capsule which surrounds the implant and isolates it from the adjacent bone. However, according to researchers, the presence of such a pseudo-periodontium has resulted in inadequate long-term resistance of the peri-implant tissues to mechanical, chemical and microbial trauma. These researchers go on to say that osseointegration can achieve a firm, intimate and lasting connection between the implant and the vital host bone, which remodels in accordance with the masticatory load applied.
The meticulous surgical procedures, which prevent overheating and subsequent bone necrosis and minimize contaminants, ensure that a high percentage of osteogenic cells survive and remain active. This prevents the subsequent occurrence of a thin perifixtural zone of connective scar tissue which can lead to unpredictable results, and the active cells can regenerate bone which actually grows into the spiral design of the titanium implant fixtures, thus achieving a solid anchor.
After the surgical procedures are accomplished and healing has taken place, the patient visits the prosthodontist for treatment. Researchers emphasize that this portion of the treatment is as vital as the surgical portion, since full attention must be given to proper stress distribution when fabricating various prostheses. If occlusal stresses are not properly distributed, an initially established osseointegration may later be lost.
Osseointegration requires a planned team approach by both the presthodontist and the oral surgeon, and unlike other methods of dental implantation, it has been proven to work exceptionally well. The pure titanium is fully compatible with human tissues and becomes totally integrated with the bone. The implanted fixtures beautifully accommodate the masticatory load applied and even help stimulate the healthy maintenance of supporting bone levels.
Researchers cite the following reasons for placing the implants. 1-Patients had insufficient retention of a denture, generally due to extreme resorption of the jaw bones; 2- Patients were emotionally unable to wear a denture, even in the cases where retention. Was technically adequate; 3- patients suffered from functional disturbances such as pressure nausea and vomiting reflexes that were caused by dentures.
In upper jaws 81% of the originally installed fixture remained stable and supported bridges after 5 to 9 years. Continuous bridge stability was achieved in 89% of these jaws. In lower jaws 91% of the original fixtures were stable and bridge supporting after 5 to 9 years. Continuous bridge stability was attained in 100% of these jaws. In the routine case the fixtures and their abutment are surrounded by hard and soft tissues which have remained healthy for follow up periods of up to 15 years. The small number of fixture losses and the low values of the mean annual marginal bone loss in the follow up periods indicate that a reliable prognosis can be made in the individual cases after the first year has passed. Finally, this method exceeds the procedural requirements set by the 1978 Harvard Conference for a successful dental implantation. For the first time we have a predictable technique for dental implants and the prostheses they support.
Dr James A Miller, Aesthetic Dentist - Providing cosmetic dentistry and smile artistry to the areas of Hillsboro and Portland, Oregon.
Portland Cosmetic Dentist
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