Michigan Dental Implant Impression Comparisons

Taking an impression is the first step in producing a model to indicate the positioning of Michigan dental implants and/or abutments in a patient's mouth. A device which facilitates the replication of implant positions on the study models is called and impression coping and is often required during the impression stage of placing dental implants.

Impressions may be taken in one of two ways: at the implant level or at the abutment level. Placement of an implant analog, a device which mimics the implant on the study model, must occur during an implant-level impression, while abutment level impressions require placement of an abutment analog or a device which mimics the abutment.

Which impression technique is used depends on the preference of the restorative dentist and also varies by implant system. With nonfriction implant systems, impressions can be taken at either the implant or abutment level. With internal friction abutments, delivery of the abutment to its final position is necessary before the final impression is taken.

Comparison of Implant-Level and Abutment-Level

	Implant-Level Impressions	Abutment-Level Impression
Ease of localization	Requires subgingival placement of copings	Easier, because margins are often supragingival
Impression copings	Necessary	Conventional impression without copings is available in some cases
Abutment selection and preparation	On a model in the laboratory	Can be done in the mouth, chairside
Abutment modification	Not needed once delivered	May be needed in the mouth
Custom abutment	Available	Not available (unless an implant-level impression was taken first).
Interim and final crown fabrication	Can be performed in the laboratory, together with the abutment selection and preparation	Chairside relines of provisional restorations and final impressions often necessary

*Source: http://online.lexi.com

Implant-level Impressions

Implant-level impressions are similar for any type of prosthesis. There are two main types of impression copings – closed tray and open tray. Closed tray or transfer impression copings remain on the implant complex after the impression is removed and need to be placed into the impression manually. Open tray or pickup impression copings are automatically retained in the impression after removal. This usually requires the manipulation of a long screw that is not present in transfer copings.

For more information on implant impression comparison, call (248) 357-3100 and talk to an implant specialist. If you're a general dentist who would like to see a demonstration of taking implant impressions in the Oakland, Wayne, or Macomb County Michigan area, feel free to contact Joseph Nemeth, DDS & Associates by phone or email jrn@drnemeth.com. Also look for us on the web at www.drnemeth.com.

A 3-Unit Bridge or Dental Implant

A 3-Unit Bridge or Dental Implant - Which is Right For You?

Each and every patient deserves a magnificent smile. Due to the incredible advances in aesthetic dentistry, there's no need for anyone to settle for less. With dental implants, missing teeth can now be easily, comfortably and most importantly, permanently replaced.

3-unit Bridge - The Traditional Option
Traditionally, a bridge has been the standard of care for replacing a missing tooth. Constructed of metal sub-frames and tooth-colored porcelain, bridges are fabricated to approximately match the natural shade of your existing teeth.

A bridge uses the teeth on either side of the missing tooth as support for the artificial tooth that replaces the missing natural tooth. The goal of a bridge is to restore chewing function while achieving an acceptable aesthetic outcome.

Unfortunately, since the jawbone under the replacement tooth is no longer being stimulated by being involved in the chewing function, bone is often resorbed into the body. This process creates a slowly-growing gap between the replacement tooth and the gums.

Key Features

• Slightly less expensive than a dental implant
• Achieve acceptable cosmetic outcome
• Restores chewing function

Drawbacks

• Requires healthy adjacent teeth to be ground down
• Potentially increases risk to the teeth that have been ground down
• Bone resorption results in compromises cosmetics over time
• Life span of only 5 to 7 years traditionally
• May contain metal

Single Tooth Implant - The State of The Art Solution

Dental implants can provide a more advanced replacement option for replacing a missing tooth than a traditional bridge, while preserving adjacent teeth.

Dental implants are small titanium screws designed specifically to replace a natural tooth root. Dental implants provide a highly biocompatible surface that encourages bone to attach to the implant during healing through a process called osseointegration. This process of bone attachment ensures long-term results.

Dental implants do not require adjacent teeth to be ground down or modified in any way. The implant also provides the added benefit of creating stimulation to the underlying bone.

Restoration with all-ceramic components can produce a beautiful, natural looking, translucent replacement tooth that looks almost identical to the tooth that is being replaced!

Key Features:

• Adjacent teeth remain untouched - no grinding down required
• Underlying bone integrity is preserved because stimulation is restored
• Helps to maintain long-lasting, cosmetically pleasing results
• Titanium is strong and is naturally accepted by the body resulting in a high level of osseointegration

Drawbacks

• Slightly higher cost than a bridge

When deciding between a dental implant and a three unit bridge, it is important to be educated about all of the benefits associated with choosing a dental implant. When you lose a tooth, your jawbone can shrink, aging your appearance prematurely. Implants help to prevent this premature aging.

Like natural teeth, your newly restored dental implant will be strong, stable and secure so you can comfortably eat all your favorite foods. Dental implants are a long-lasting solution - often lasting an entire lifetime.

And perhaps most importantly, your beautiful new teeth can give you back the confidence you may have lost when you lost a tooth. They can transform your daily life and can lead to a happier you!

If you'd like to know more about deciding between a dental implant and a three-unit bridge, visit implant manufacturer, Nobel Biocare on the web at www.nobelsmile.com. For an implant dentist in the Oakland County, Wayne County, or Macomb County, Michigan area, visit Dr. Nemeth and Associates on the web at www.drnemeth.com or call (248) 357-3100 to schedule a consultation visit.

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.

Dental Fear and Anxiety: Don't Let Your Fear Keep You Out of the Chair

AAP Patient Page, March/April 2001
Volume 2, No. 2

If your palms start sweating and your heart starts pounding at the thought of visiting the dentist, you are not alone. The vast majority of individuals experience some anxiety toward dentistry. However, about 10 to 15 percent of the population suffers from high anxiety, which has been associated with avoidance behaviors and adverse outcomes to dental health. It’s important to find ways to “unlearn” this dental fear because when dental professionals can catch a problem in your mouth early, it minimizes expense, time and discomfort. Here are some ideas:

• The first step is to identify where your fear came from. According to a recent AAP survey, periodontists report that the two most common origins for patient fear are family and friends or personal bad experience more than 10 years ago. Discuss your fear with family members, friends and your dental professionals. In many cases, the fears are no longer realistic because of advances in dentistry.


• Next, find ways to feel more in control of your experience. Ask your periodontist to explain any procedures being considered. Knowledge can be empowering. Your periodontist can also explain your options for techniques to control pain and stress, such as medications, anesthesia, sedation and relaxation techniques that can make your treatment virtually pain-free. And, you and your periodontist can agree on a signal, such as a raised hand, that will stop the procedure and allow you the opportunity to deal with your anxiety.


• Choose times for your appointments when you won’t be rushed or stressed by other issues. If you feel tense when you get into the dental chair, try relaxation techniques such as rhythmic breathing or visualizing calming scenarios such as relaxing on a beach. Or, distract yourself with an mp3 player or by focusing on something in the room.


• Once the dental visit is over, congratulate yourself for your courage and treat yourself to a special reward.


• Most importantly, remember that your dental professionals are your allies. Enlist their help in overcoming your fear by not being embarrassed to talk with them about it and by asking any questions you may have.

Don't let your anxiety keep you out of the dental chair any longer. If you want to learn more about curbing your dental fears, visit the American Academy of Periodontology Website. To read about sedation dentistry techniques, visit the website of Joseph R. Nemeth, DDS & Associates. Submit your questions directly to Dr. Nemeth by emailing jrn@drnemeth.com.