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By Alan M. Simons, DDS Oral Implantology
November 28, 2020
Category: Uncategorized
Tags: dental implant  
GettingImplantsCanBeaLongProcess-ButWorthit

Dental implants aren't simply prosthetic teeth, but rather an innovative system that restores both smile appearance and dental function. And while an implant can indeed replace a single tooth, they can do so much more. Integrated with removable dentures or a fixed bridge, they provide a secure solution to multiple missing teeth.

Implants essentially replace a missing tooth's root, the basis for their lifelikeness and functionality. As such, they're also the most sophisticated restoration used today, requiring a high degree of technical and aesthetic skill to place them properly. In reality, implantation is more a process than a procedure.

If you're considering implants, that process begins with a comprehensive dental exam. During the exam, we'll assess the exact condition of your oral and facial structures like the length of remaining teeth, your bite and jaw dimensions. We'll use this information to plan the type and placement of your implants. The exam may also reveal problems like bone loss that might postpone your implants or suggest another form of restoration.

Using digital technology, we then locate the exact positions for your implants on the jaw to ensure the best outcome. This often results in the creation of a surgical guide, a plastic template placed over the jaw that accurately pinpoints the locations for the drilling sequence during implant surgery.

In most cases once the implants are surgically installed, gum tissue may be sutured over the implant to protect it while it integrates with the bone. In some cases, though, a visible crown may be placed immediately, so the patient can enjoy a tooth-filled smile the same day. This immediate crown, though, is temporary and will be replaced with a more durable, permanent one in a few months.

During this interim, the titanium in the implant post will attract bone cell growth, which will build up on the implant surface. This increased bone contact will help secure the implant fully in the jaw, giving the implant its signature durability.

Once the integration is complete, the permanent crown is affixed to the implant (or implants in the case of a fixed or removable dental appliance). It may have been a long road, but you'll have the closest thing to real teeth.

If you would like more information on implant restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “New Teeth in One Day.”

By Alan M. Simons, DDS Oral Implantology
November 18, 2020
Category: Oral Health
Tags: dental implant  
AlthoughChallengingCleaningAroundImplantsBoostsTheirLongevity

Daily oral hygiene and regular dental cleanings help keep your natural teeth and gums healthy and disease-free. But they're also a priority with dental implants. Here's why.

Unlike other restorations, an implant replaces both a tooth's crown and root, the latter by way of a titanium metal post imbedded into the jawbone. Bone cells grow and adhere to the metal surface, forming a secure and lasting hold.

But although quite durable, this hold differs significantly from natural teeth, which are actually held in place by a tough, elastic tissue called the periodontal ligament. The attachment of the ligament's tiny fibers to both tooth and bone secure the tooth in place, as well as supply it and the surrounding gums with nutrients and defensive antibodies to fight infection.

Implants don't have this relationship with the periodontal ligament. The tissues around an implant are thus susceptible to an aggressive form of periodontal (gum) disease called peri-implantitis. This kind of gum infection can progress rapidly, leading eventually to bone loss and possible failure of the implant.

Daily brushing and flossing of both natural and implant-supported teeth lowers the risk of gum disease, particularly peri-implantitis. It's also imperative that you undergo regular cleanings, at least every six months, with your dentist or dental hygienist.

These, however, won't be the typical cleanings performed on natural teeth. Hygienists don't use metal cleaning implements to remove plaque and tartar deposits because they can scratch the metal materials of the implant and crown. These microscopic scratches can then attract bacteria that trigger gum infections. Instead, they'll use instruments made of plastics or resins.

Hygienists also rely heavily on ultrasonic equipment that vibrates plaque loose on or around implants, which are then flushed away with water. The tips used with these instruments are also typically made of nylon or plastic sheathing.

Even with the extra hygiene care needed, implants still enjoy a 95% or higher survival rate after ten years. You can ensure your implants achieve that level of durability by keeping them clean and seeing your dentist at the first sign of a gum infection.

If you would like more information on maintaining dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implant Maintenance.”

By Alan M. Simons, DDS Oral Implantology
November 08, 2020
Category: Dental Procedures
YouCanHaveaStraighterSmile-JustLiketheQueenofEngland

The monarchs of the world experience the same health issues as their subjects—but they often tend to be hush-hush about it. Recently, though, the normally reticent Queen Elizabeth II let some young dental patients in on a lesser known fact about Her Majesty's teeth.

While touring a new dental hospital, the queen told some children being fitted for braces that she too “had wires” once upon a time. She also said, “I think it's worth it in the end.”

The queen isn't the only member of the House of Windsor to need help with a poor bite. Both Princes William and Harry have worn braces, as have other members of the royal family. A propensity for overbites, underbites and other malocclusions (poor bites) can indeed pass down through families, whether of noble or common lineage.

Fortunately, there are many ways to correct congenital malocclusions, depending on their type and severity. Here are 3 of them.

Braces and clear aligners. Braces are the tried and true way to straighten misaligned teeth, while the clear aligner method—removable plastic mouth trays—is the relative “new kid on the block.” Braces are indeed effective for a wide range of malocclusions, but their wires and brackets make it difficult to brush and floss, and they're not particularly attractive. Clear aligners solve both of these issues, though they may not handle more complex malocclusions as well as braces.

Palatal expanders. When the upper jaw develops too narrowly, a malocclusion may result from teeth crowding into too small a space. But before the upper jaw bones fuse together in late childhood, orthodontists can fit a device called a palatal expander inside the upper teeth, which exerts gentle outward pressure on the teeth. This encourages more bone growth in the center to widen the jaw and help prevent a difficult malocclusion from forming.

Specialized braces for impacted teeth. An impacted tooth, which remains partially or completely hidden in the gums, can impede dental health, function and appearance. But we may be able to coax some impacted teeth like the front canines into full eruption. This requires a special orthodontic technique in which a bracket is surgically attached to the impacted tooth's crown. A chain connected to the bracket is then looped over other orthodontic hardware to gradually pull the tooth down where it should be.

Although some techniques like palatal expanders are best undertaken in early dental development, people of any age and reasonably good health can have a problem bite corrected with other methods. If you are among those who benefit from orthodontics, you'll have something in common with the Sovereign of the British Isles: a healthy, attractive and straighter smile.

If you would like more information about orthodontic treatment options, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Magic of Orthodontics.”

By Alan M. Simons, DDS Oral Implantology
October 29, 2020
Category: Dental Procedures
Tags: dental implants   crowns  
ChoosingaScreworCementtoAttachanImplantCrown

If you've lost a tooth, you have a number of options for replacing it. Perhaps the best choice in terms of lifelikeness and durability is a dental implant.

All implants have the same basic architecture: a titanium metal post imbedded in the jawbone to replace the root; and an abutment, a metal collar that links the post with a lifelike porcelain crown. But implants can vary in how the crown attaches to the abutment and post — either cemented to the abutment or screwed through the abutment to the post.

Either method will permanently secure the crown to the implant. But there are advantages and disadvantages for each.

A screw-retained crown may better facilitate any future repair that might be needed. For a skilled dentist it's a simple matter of removing the screw and then the crown from the abutment. There's less risk of damage to the implant during repairs or crown replacement. Many dentists also prefer screws for crowns placed at the same time they're installing the implant post (a procedure called immediate loading).

The screw access hole, however, could pose a cosmetic problem. Although we can cover it over with tooth-colored filling, it may still be noticeable and unattractive especially for a tooth visible when you smile (in the smile zone). There's also the possibility the porcelain around the access hole could chip.

By contrast, cemented crowns have a smooth, unbroken surface and are aesthetically ideal for smile zone teeth. But the cement could interact poorly with gum and bone tissue in some patients, causing inflammation and possible bone loss.

And unlike screw-retained crowns, cemented crowns are difficult to remove for implant repair. We may have to drill through the crown to access the screw between the abutment and the post, and then repair it cosmetically if we use the same crown. Again, the final result may not be quite as visually appealing.

In the end, it will depend on the implant's location, how your body reacts to the cement or your dentist's preference. In either case, though, you'll have a tooth replacement that's functional, life-like and able to endure for many years to come.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Crowns Attach to Implants.”

By Alan M. Simons, DDS Oral Implantology
October 19, 2020
Category: Oral Health
Tags: metal allergies  
HerearetheFactsontheImpactofMetalAllergiesonDentalWork

Allergic reactions aren't necessarily bad: they're your body's responses to possible threats from foreign substances. But the response can go too far and cause a reaction as minor as a skin rash or as life-threatening as a multi-system shutdown called anaphylaxis.

Anything can cause an allergy: animal fur, food, chemicals — or metals. Because metals play such a large role in dental care, it's only natural we're alert to the possibility of allergic reactions from a procedure.

But don't postpone your implants or other dental work just yet — the threat isn't nearly that ominous. Here are a few facts about dental metal allergies to help you sort it out.

Allergic reactions are rare for metals used in medical and dental procedures. Although reactions to metals in joint replacements or coronary stents leading to failure do happen, actual occurrences are rare. Most metal allergies manifest as a skin reaction to jewelry or clothing. It's less likely with medical or dental metals because they're chosen specifically for their compatibility with living tissue.

Amalgam fillings account for most dental work reactions. Dentists have used this multi-metal alloy for fillings and other restorations for well over a century. Tooth-colored resins are now used for most fillings, but amalgam is still used in less visible back teeth. It's very rare for a person to experience a reaction to amalgam, but when it does occur it usually results in minor inflammation or a rash.

Implant titanium isn't just bio-compatible — it's also osteophilic. Titanium is the perfect choice for implants not only because it's tissue friendly, but also because it's bone friendly (osteophilic). Once implanted in the jaw, bone cells naturally grow and adhere to it to create a more durable bond. Not only does the body usually tolerate titanium, it welcomes it with open arms!

While it's still possible for you to have an allergy to implant titanium, the chances are remote. In one recent study involving 1,500 implant patients, titanium allergies occurred in less than 1%. So the chances are high a metal allergy won't stop you from obtaining a smile-transforming restoration with dental implants.

If you would like more information on allergies and dental work, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Metal Allergies to Dental Implants.”





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