Implant Supported Overdentures - Another Tooth Replacement Option

Guidelines for Recommending Implant Supported Overdentures

• Does the patient have complaints of soreness, instability or decreased function with his/her current denture?
• Is the patient's dissatisfaction or desire for additional function a result of the original appliance design or inadequate retention?
• Has the patient been infomred of the benefits of implant-supported overdentures: increased prosthesis retention, increased chewing ability, improved nutritional status, and reduction of future bone loss?
• Is there adequate interocclusal space in the anterior segment to accommodate the prosthetic attachments on the implants? Posts extend about 3-4 mm coronal to the tissue level. Attachments add an aditional 1-2 mm of height. The retentive device occupies 3-5 mm of buccolingual space.
• Is there adequate mandibular height for implant placement? In patients who have recently lst their teeth, the alveolar ridge may actually need to be reduced to provide adequate interocclusal space for the implants and the prosthesis. Often ridge height reduction is necessary to have enough buccolingual bone width. Optimally, a 13 mm implant is employed in the antierior mandible. The mandibular residual ridge can be assessed for height with a panoramic film.
• Is the current denture adequate in height and width to retain implant overdenture attachments? The height and width of the appliance must be adequate, the borders properly extended, and the occlusion balanced.

Two Main Categories of Michigan Dental Implants

Dental implants can be divided into two main categories: 1.) root-form implants and 2.) periosteal and blade implants.

Root-Form Dental Implants
The most widely used implants today are root-form implants. While they may resemble a cylinder or a screw, the screw type root form implant is the most common. These implants are manufactured in varying lengths and diameters so that most clinical situations can be accommodated. Most root-form implants have an attachment that is utilized in the final restoration process, i.e., a place for the crown to attach to the dental implant. These replacement crowns can attach to the dental implants in one of two ways: with an internal connection or an external connection.

External Connnection
The attachment rises approximately 1 mm above the implant when there is an external connection. The shape of the attachment may be a hexagon or a castle-like design depending on the type of root-form dental implant used and will have a screw hole in the center of the attachment for the abutment or crown. In cases where the abutment contains the screw in one piece, the implant attachment is non-engaging. For example, the head of the dental implant may be a hexagon but the abutment is round allowing rotation into place.

Internal Connection
If there is an internal connection, the attachment lies inside the implant and the shape of that internal space varies. Abutments might be threaded and screw-retained into the dental implant Michigan or, in systems known as "internal friction systems", abutments may be retained only by friction against the inner walls of the dental implant. Abutments might be shaped like a tooth prepared for a crown (for cemented restorations), or they may have a built-in hole for a screw (screw retained restorations). The implant platform may be flat or have beveled edges, although the beveled-edge type is becoming the most popular type of dental implant.

One-Stage vs Two-Stage Implants
Another major division of root-form dental implants is between one-stage implants and two-stage implants. On the day of surgery, a one-stage implant is exposed to the oral cavity immediately following placement while two-stage implants are covered by gingiva after surgical placement. With two-stage implants, a second surgery is necessary to expose them to the oral cavity. When surgical stability is good, two-stage implants can be purposely exposed at initial implant placement, thus eliminating the need for later re-entry. This is done by placing a healing abutment.

Periosteal and Blade Implants
A much less common type of root-form dental implant is the periosteal/blade implant. Periosteal implants are flat, mesh-like framewords that lie on the bone surface and cover a large portion of the bone, wrapping around buccally and lingually. Blade implants are small, flat plates that are inserted into a thin cut in the bone. With both of these types of root-form dental implant, the abutment is generally inseparable from the implant, but instead forms an inseparable part of the implant itself.

To learn more about root-form implants or any type of Michigan dental implants, call Joseph R. Nemeth, DDS, MaCCS & Associates at 248.357.3100 or visit us on the web at http://www.drnemeth.com/.

Systemic Influences May Affect Michigan Dental Implants Prognosis

Certain systemic influences may interfere with osseointegration and adversely affect implant prognosis. As a patient's systemic condition changes for the worse, negative influences on local etioloy and the physiologic response of the surrounding soft tissues and bone are not unusual. Smoking and many medications also affect oral flora, soft tissue and bone metabolism.

Common systemic diseases such as diabetes and osteoporosis have been demonstrated to affect the bone-to-implant contact. It is will known that medications such as calcium channel blockers and immunosuppressants may have a profound effect on the inflamatory response of the peri-implant environment. Bisphosphonate drugs used to treat a variety of bone metabolism disorders can also lead to bisphosphonate-related osteochemonecrosis (BROCN) of the jaws following tooth extraction. As with any patient, a regular, updated medical history is of critical importance.

Finally, home care of implants must be excellent. There must be an absolute patient commitment to keeping the implants and the rest of the mouth clean. That includes regular maintenance visits to identify any problems before they can cause implant loss. Excessive alcohol consumption and a poor diet also affect implant success.

Dental implant maintenance is not often mentioned in dental literature, but like regular prophylaxis for natural teeth, its importance cannot be underestimated.

To learn more about dental implants Michigan or if you are interested in having a consultation with a Michigan dental implant specialist, call 248.357.3100 today or visit http://www.drnemeth.com/.

Basic Principles of Michigan Dental Implants

Understanding the basic principles of Implant Dentistry can make your decision about whether or not a Dental Implant is right for you much simpler. A well informed patient will know how to ask the right questions and better make an informed decision.

General Considerations:

• An implant is a man-made replacement for a tooth root.


• Because of their very unique design, they become securely attached to the jawbone through a process called osseointegration.


• After a waiting period that allows the bone to heal around the implant, final restorations are screwed or cemented onto the implant or implant component.


• The final restoration is made utilizing procedures that are very similar to traditional crown and bridge dentistry.


• With Michigan Dental Implants, it is possible to replace a single tooth, multiple teeth, or an entire arch of teeth.


• For patients who are faced with losing all of their teeth, implant dentistry provides a tooth-replacement option that is much more stable and permanent than removable dentures or partials.

Implant Composition

• Implants are constructed from titanium.


• Titanium is a lightweight, soft, noncorroding metal.


• The surface of the titanium forms a natural ceramic coating when exposed to oxygen which enables bones cells to attach to it.


• Since bone cells react better to titanium surfaces that are rough, most implants are put through a roughening process by the manufacturer.


• To enhance bone healing, implants are sometimes coated with hydroxyapatite.


• Implants are often threaded. In order to enhance implant placement and stability, thread shape and pitch are carefully calculated to help transfer biting force to the surrounding bone.

Osseointegration

• Osseointegration describes the attachment of bone to the surface of an implant.


• Observation of an osseointegrated implant under a microscope reveals that bone attaches to the implant surface, but not in a continuous fashion. There are areas of direct contact separated by marrow spaces; therefore, only 40%-50% of the implant is in contact with bone.


• Surface treatment, such as a hydroxyapatite coating, work to increase the bone/implant contact.


• Under clinical observation, an osseointegrated implant will feel solid with no present mobility.


• When an implant fails to osseointegrate, slight mobility is noted. In such cases the bone surface is separated from the implant surface by a thin fibrous membrane which may be visible with careful x-ray analysis.


• A waiting period is required for successful osseointegration to occur because a complex series of events must occur.
  

For more information about Michigan Dental Implants visit the Joseph R. Nemeth, DDS & Associates website and submit your question online. The American Academy of Periodontology is also a helpful resource when deciding if you are a candidate for dental implants. Visit them on the web at http://www.perio.org/. Call (248) 357-3100 to schedule an appointment with our Dental Implant Specialist.