When it comes to replacing missing teeth, we have numerous options. However, two of the most common treatment options include bridgework and dental implants. See how much you really know about dental implants and bridgework by taking our quick and easy true/false self test.

1. When it comes to costs, dental implants may initially cost more than bridgework but are less expensive than bridgework over a lifetime.
   True or False
2. Both bridgework and dental implants can last a lifetime when properly maintained.
   True or False
3. Prior to placing a three-unit fixed bridge, if the surrounding teeth have crowns, they must be redone so that the bridge fits and wears properly.
   True or False
4. Replacing a single tooth with a three-unit bridge, requires removing the enamel on the adjacent teeth even if these teeth are disease-free.
   True or False
5. In addition to being permanent tooth replacements, another advantage of dental implants is that they don't decay like teeth supporting bridgework.
   True or False
6. It is not uncommon for root canal treatment to be required to save teeth that support bridgework if they have been subjected to severe decay and their nerves become infected.
   True or False
7. Placing a dental implant requires more time when compared to placing a three-unit bridge.
   True or False
8. Both bridgework and dental implants require minor surgery to replace a missing tooth.
   True or False
9. Dental implants are more desirable than bridgework because placing them does not affect the adjacent teeth.
   True or False
10. Studies indicate that bridges are only 67% successful at 15 years whereas dental implants have success rates into the 90s.
    True or False

Answers: 1) True. This fact shocks many people. 2) False. This is more commonly true for dental implants. 3) True. 4) True. This is one of the disadvantages of bridgework. 5) True. This is just one of the advantages of a dental implant. 6) True. 7) True. 8) False. Dental implants require surgery to be placed. 9) True. This fact is a significant advantage for dental implants. 10) True. Your results may vary; however, this statistic represents what you might expect.

To learn more, continue reading the Dear Doctor magazine article “Implants vs. Bridgework.” Or, you can contact us today to schedule an appointment or to discuss your questions.

The best method for permanently replacing a missing tooth is with a dental implant. But did you know that there are two main techniques for placing implants? Implants can be placed either using a one stage or a two stage surgical technique, and as their names suggests, one is performed in one step while the other requires a second surgery.

With a one-stage procedure, a healing abutment is placed at the time of surgery. An abutment is a connector that attaches the implant from the bone into the mouth and which protrudes through the gum tissues. Following a 3 to 6 month healing period in which the implant fuses to the bone, a crown is then placed on the implant restoring the immediate appearance of a healthy, normal tooth. One-stage implant systems are generally used when the bone quality is good, guaranteeing good initial implant stability. They are also used when cosmetics is not a concern, such as the back areas of the mouth.

Under special conditions an implant can be placed and a crown placed on top of it at the same time. However, this is a very special circumstance requiring ideal conditions and surgical experience as well as crown fabrication know-how. It is generally safer and wiser not to subject an implant to biting forces until it is fully healed and integrated with the supporting bone.

A two-stage procedure is typically used for replacing teeth where there is no immediate need for a cosmetic solution and when more of a margin of safety is required. With this approach, the implant(s) are placed into the jawbone and the gum tissues cover them. They are not exposed to the mouth, but stay buried and left to heal. Once healed, a second surgery is performed to attach an abutment for securing the crown in place. This approach is used when there is poorer bone quality or quantity. This may make it necessary to regenerate bone around the implant at the time of its placement. There may also be other health considerations dictating that a two-stage approach may be indicated.

Depending on your individual situation and medical status, our implant team will determine which approach is best for you. To learn more about these two procedures, read the Dear Doctor article, “Staging Surgery In Implant Dentistry.” You are also welcome to contact us to discuss your questions or to schedule an appointment.

Worldwide it is generally accepted that the best method for permanently replacing a missing tooth is with a dental implant. However, one fact that can affect the timing of placement of dental implants is that the person should be fully mature. In this case, it means that growth is complete, in particular the jawbones have completed growing. And while we are sensitive to teens who may beg for a dental implant to replace a missing, damaged or traumatized tooth, parents or caregivers should know that research and experience have shown that it is better to wait.

The main reason it is best to wait is because natural teeth grow and move with the jaws as they mature whereas implants don't. Natural teeth change positions and move with the jaws as the jaws grow, implants don't. They are fused to the bone in one position and as the jawbone grows, they get left behind and appear to sink as the adjacent teeth and jawbone grow in harmony.

Although it is not really possible to determine exactly when a person has finished growing, it is generally best to wait until the jaw is fully matured and developed. However, we are the most qualified, along with our orthodontic colleagues to “guesstimate” based on family history, age and genetics. Specialized radiographs (x-rays) of the skull and jaws may also be helpful in determining the timing of jaw growth completion and when implants can be placed.

Dental implants are a permanent solution to a dental problem and thus should not be used until all growth is complete. Think about it. Your young child gets a beautifully restored smile through a dental implant...and for a year or two it looks fantastic. However, as your child's jaws continue to grow, everyone begins to notice gaps between the implant and adjacent teeth. So it makes sense to avoid this eventuality; by just waiting until late teens when beautifully restored crowns on properly positioned dental implants should last for many many years.

To learn more on this subject, read the Dear Doctor article, “Teenagers & Dental Implants.” You are also welcome to contact us to discuss your questions or to schedule an appointment.

Dental implants traditionally have a high success rate with numerous studies showing long-term success rates of over 95%. This is just one of the reasons they have been widely accepted as the best method for permanently replacing missing teeth. In fact, over-dentures, which are full dentures supported and stabilized by at least two dental implants, are now considered the standard of care by the American Dental Association (ADA) for people who have lost all of their teeth in one or both jaws. And while they have a high success rate, there are some factors that can compromise the success rates of implants.

These factors are generally divided into three categories: general health concerns, local factors, and maintenance issues.

• General health concerns: Your general health, lifestyle, and habits can play a major role in the success of dental implants. For example, smoking, diabetes, osteoporosis (porous bone) or a compromised immune (resistance) system can all negatively impact implant healing and success. And if you have a history of radiation treatment to your jawbones, you are at a higher risk for complications.
• Local factors: Some examples of local factors that can affect implant success include bone quality and quantity — having sufficient bone in the right place to accurately secure and locate the implants.
• Maintenance issues: While implants are excellent high tech replacements for missing permanent teeth, they do require routine maintenance. This includes daily cleaning and continued professional care. Otherwise, implants are just like any other technically sophisticated devices — they may be susceptible to breakdown.

To learn more about dental implants, read “Dental Implants, Your Third Set Of Teeth.” Or if you prefer, you can contact us to discuss your questions or to schedule an appointment.

Thanks to technological advances, today there are more than 40 types of traditional or standard implants. A traditional dental implant actually replaces the root of a tooth, upon which a crown is built — the part you see in the mouth. There are 2 others types that are quite similar to standard implants. Mini implants are most like traditional implants except they are smaller in diameter. Micro-mini implants are an even smaller variation with an even narrower, more screw-like appearance. Micro-mini implants are also designed to be used on a temporary basis, thus can easily be removed. Together all of these types of implants provide us with a wide variety of options for permanently replacing missing teeth.

The following list details the types of implant restorations:

• Single tooth replacements: As the name suggests, these implants are used to replace single teeth.
• Multiple tooth replacements: Implants can be used to replace multiple teeth in a variety of ways. This includes acting as bridge supports to permanently replace missing teeth.
• Combinations of fixed and removable bridgework: Dental implants can be used to support permanently fixed in teeth, bridgework or removable bridges or dentures. Their biggest advantage over dentures alone is that they stabilize the dentures and preserve the jawbone to which they attach, thus preventing the jawbone from melting away under the pressure of dentures.
• Over-dentures: These restorations are now considered the new gold standard. In this application two or more standard implants (or multiple mini-implants) are used to attach and stabilize full dentures. Over-dentures are especially useful for tooth replacement in the lower jaw, where denture stability is often problematic.
• Temporary Anchorage Devices (TADS): These special implants are a tool that orthodontists can use to obtain a stable, non-movable anchor for moving teeth more quickly and easily. They are small, easy to place and easy to remove once their job is done.
• Temporary bridgework: In this case, mini-implants are used to support temporary bridgework. They are placed between permanent implants and later removed when the permanent implants have healed and teeth are permanently placed on them. Mini-implants ensure that a person is never without teeth during the process of teeth replacement.

To learn more on this topic, read the Dear Doctor article, “Dental Implants, Your Third Set Of Teeth.” Or if you prefer, you can contact us to discuss your questions or to schedule an appointment.