After losing teeth, there will be vertically and horizontally resorption of socket bones. The resorption is more pronounced on the buccal side (cheek side) than on the lingual side (palate and tongue side) and more pronounced at the anterior region than at the posterior ones due to thinner bone wall.
Excess bone resorption of the buccal plate will affect patient’s lip profile in the anterior region. Inadequate remaining bone also affect implant placement which lead to more complicated treatments.
In the long run, placing an implant helps preserve remaining bone structure and prevent further bone resorption at the area. Please note that some parts of the socket bone will be inevitably resorbed as a natural process of bone healing. Placing an implant can preserve the remaining parts.
Benefits of dental implant treatment
Preserve intact tooth structure
Preserve remaining bone
Better support for full mouth denture
Alternative treatment of conventional fixed prostheses
Dental implants restoration types 1. One implant can replace one missing tooth ( Single tooth implant ) 2. Implants replace multiple missing teeth ( Dental Bridge implants ) 3. Implants replace full mouth missing teeth ( Full jaw dental implants , Overdenture , All on 4 )
Senior dentistry – Dental implant
Conventional Single Dental Implant procedure
Diagnosis with CT-Scan(3D images X-RAY) and treatment planning
Dental implant post placement (extraction natural tooth in the same day in some cases)
Wait for bone healing for 3 months
Prosthesis (dental crown/dental bridge) process.
These will take 2 trips separated for 3 months. Each trip required 5-7 days
Full Jaw dental implant procedure
Diagnosis with CT-Scan(3D images X-RAY) and treatment planning
Prosthesis preparation process
Dental implant post placement and final prosthesis
We could complete full jaw dental implants in one trip by requiring 12 days stay
Post operative care
Avoid hot food.
No rigorous exercise.
Take prescribed medicine.
Remove plaque.
Rinsing with chlorhexidine.
Wound healing is normal but if there is a puss occur, the patient should contact the Doctor.
No poking the wound.
Use cold pack to reduce swelling on the first few days.
No smoking, no alcohol consumption.
Factors affecting dental implant treatment
Systemic disease
Periodontitis; Patient who has a history of periodontitis has a higher chance of implant failure.
A: For healthy patient without systemic disease and no pathology of the edentulous site, in some cases implant could be placed immediately and in some cases implant could be place after 6-8 weeks of extraction to allow soft tissue healing
For those with pathology in the bone which cause bone defect or in case of infection in the area of future placement, usually the waiting time is longer, around 3-4 months after extraction.
Please note that timing and treatment planning will be discussed with patient on a case by case basis.
A: It is possible to have implants placed but it might need bone graft to reconstruct the bone for implant placement. Also alternative treatments such as bridges or other types of prostheses can be an option.
Ostoporosis patients who receive Bisphosphonate intravenous more than 3 years
Cancer in craniofacial area which currently has radiotherapy
Heavy smokers especially more than 20 cigarette/day. Smoking cessation should be done before the treatment.
Pregnant patient should delay the treatment
Patients who take anticoagulant or patient who has history of stroke within 6 months- 1 year should consult physician before treatment
Patients who take immune suppressant should consult physician
Patients with liver disease which leads to unstop bleeding should consult physician
Q: Should I have other treatment before placing an implant?
Any infection in the oral cavity should be removed before implant treatment to avoid the risk of infection at the implant site and to failure of the implant
Periodontitis should be treated before placing and implant since patient with history of periodontitis has higher risk of implant failure
Caries : defected tooth structure should be removed to reduce oral cavity germ
Endodontics : root canal treatment should be done since apical infection especially adjacent to the site in the bone can infect the implant site
A:New dentures may feel a little odd or loose for a few weeks until the muscles of the cheeks and tongue learn to keep them in place and you get comfortable inserting and removing them. Also, it is not unusual for minor irritation or soreness to occur and for saliva flow to increase when you first start wearing dentures, but these problems will diminish as the mouth adjusts.
A:Dentures are made to closely resemble your natural teeth so there should be only a small noticeable change in appearance. In fact, dentures may even improve your smile and fill out your facial appearance.
A:Eating with new dentures will take a little practice and may be uncomfortable for some wearers for a few weeks. To get used to the new denture, start with soft foods cut into small pieces. Chew slowly using both sides of your mouth. As you get used to new dentures, add other foods until you return to a normal diet. Be cautious with hot or hard foods and sharp-edged bones or shells. And, avoid foods that are extremely sticky or hard. You should also avoid chewing gum while you wear the denture. Also, don’t use toothpicks while wearing dentures.
A:After getting dentures, you may have difficulty pronouncing certain words. If so, practice by saying the difficult words out loud. With practice and with time you will become accustomed to speaking properly with dentures.
If dentures “click” while you’re talking, contact your dentist. Dentures may occasionally slip when you laugh, cough, or smile. Reposition the dentures by gently biting down and swallowing. If any speaking problem persists, consult your dentist or prosthodontist.
A:Your dentist or prosthodontist will instruct you as to how long to wear dentures and when to remove them. During the first several days after receiving your denture, you may be asked to wear it all the time, including while you sleep. Although this may be temporarily uncomfortable, it is the quickest way to identify the areas on the denture that may need adjustment. Once adjustments are made, you should remove dentures before going to bed. This allows gum tissues to rest and allows normal stimulation and cleansing by the tongue and saliva. The denture can be put back in the mouth in the morning.
A:A denture adhesive may be considered under the following circumstances:
To enhance satisfaction with a properly constructed denture. Adhesives enhance retention, stability, bite force, and an individual’s sense of security.
To assist individuals with dry mouth conditions that lessen denture adherence, such as individuals taking cold medications, those with neurologic disabilities including strokes, and the elderly.
To provide added stability and security for those who place unusual demands on facial muscles, such as public speakers or musicians.
A:There are situations when denture adhesives should not be used. Those cases include:
When it is used as a “fix” for ill-fitting or poorly constructed dentures. If dentures begin to feel loose, cause discomfort or cause sores to develop, contact your dentist as soon as possible.
When a dentist has not evaluated dentures for a long time. Dentures rest on gum tissue and the jawbone, which shrink and deteriorate, respectively, over time. Therefore, the real problem might be a need for a denture adjustment or new dentures.
When oral hygiene practices cannot be sustained.
When adhesives have been used for a long time, especially when visits to the dentist are infrequent, and when the frequency and volume of the adhesive use increases. These developments may indicate the need for a denture adjustment or new dentures.
When any known allergy exists to the adhesive’s ingredients.
Use the minimum amount necessary to provide the maximum benefit. Apply less than you think you need, and then gradually increase the amount until you feel comfortable.
Distribute the adhesive evenly on the tissue bearing surface of the denture.
Apply or reapply when necessary to provide the desired effect.
Always apply the adhesive to a thoroughly clean denture.
Remember adhesives work best with a well-fitting denture.
21.Paste application. Apply this denture adhesive to a dry or preferably wet denture. Avoid placing adhesive close to the denture borders. If the adhesive oozes, use less of the product. For dentures on the upper jaw, apply three short strips of adhesive — or a series of small dots — along the ridge area and one down the center. For dentures on the lower jaw, apply three short strips of adhesive — or a series of small dots — in the center of the ridge area.
2.Powder application. Sprinkle a thin, uniform layer throughout the tissue-bearing surface of the denture. Shake off excess powder and press the denture into place. Powders may be preferred over pastes because they are easier to clean off the denture and tissue. In addition, they don’t have the same tendency as pastes do to “shim” (keep the denture away from the tissue).
A:Dental adhesives are safe as long as they are used as directed. If the denture is well-fitting and the adhesive is only used to give added stability, there should be no ill effects. If adhesives are used excessively to fill voids for an ill-fitting denture, they can be harmful to the underlying soft and hard tissues. Occasionally, in these cases, inflammation of the soft tissues can result. In addition, because of its movement on the soft tissue and underlying bone, an ill-fitting denture can cause bone loss.
