Why
Implants?
To
achieve the best results, it is often said that you should begin
with the end in mind. At our office, no procedure is started until
we agree and understand what the final goal of treatment will be.
A big factor in this is simply what you, the patient, wants! There
are so many options when it comes to treatment planning with implants
and the range of costs can be tremendous. Therefore, just like a
builder does not start constructing a house until the architect
has made final plans, we don't begin until a final treatment plan
is formulated.
The
first question we have to ask is what happens if nothing is done?
If a tooth is lost or needs to be taken out due to infection, fracture,
or bone loss from gum disease, there are usually ramifications
that extend beyond that one tooth.
Often,
when a tooth is removed, the alignment of the teeth next to it start
to change. This can have very expensive consequences. As the bite
shifts, it can become very difficult and time-consuming to repair.
Many times, the lost space has to be regained with orthodontics.
Other times, special sleeved crowns need to be used to parallel
the teeth for a bridge. Root canals can be needed if the angulation
is severe. The solution is simple. Replace missing teeth before
this shifting occurs and save money and time in the long run. Wait
too long and treatment becomes more involved.
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The
other thing that happens when we don't replace a missing tooth (or
teeth) is shrinkage of the jawbone. Our jawbones primary job is
to hold teeth. When there are no teeth, our body thinks that there
is no more job to be done and the bone simply dissolves away. Once
it's gone in significant quantity, there is no technology to bring
it back. There is also no way to prevent this bone loss except to
replace the load on the bone through implants. Look at the difference
between these two panoramic x-rays and see how much bone dissolves
after all of the teeth are lost:
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This
loss of bone has a profound effect on our facial appearance.
Patients who are edentulous, that is, they have no teeth,
continuously lose bone. Even with dentures, this loss needs
to be made up with plastic relines to refit the dentures.
In patients who don't maintain their dentures with relines
every 2-3 years, facial muscles contract and accommodate the
shorter distance between their chin and nose. This change
can be irreversible as the facial muscles can no longer accommodate
a change in length.
click
on the face to reset the image and see the changes that occur. |
Lastly,
these changes in the bone can often make it impossible for a person
to wear a denture. As the bone dissolves, the stability of the dentures
disappear as well. In the case of a single tooth or just a few teeth,
bone resorption can make it impossible (or at least very difficult)
to place implants. Again, the answer is to have a plan soon after
tooth loss occurs.
The
second question we always try to answer is what other methods besides
implants might be available? If there are other options that we
can choose, what are the advantages and disadvantages when they
are compared to implants?
Let's
first look at a single missing tooth.
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