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Posts for tag: dental implants

By Scott A. Allegretti, DDS Provincetown Dental Arts
September 20, 2021
Category: Dental Procedures
Tags: dental implants  
ImplantsCanProvideEffectiveOptionsforTotalToothReplacement

Losing all your teeth can dramatically impact your life for the worst. Fortunately, we can give you your "teeth" back. The most common way, at least until a few decades ago, is with custom dentures, which reasonably restore life-like appearance and dental function. But it does have one major drawback—it can't stop bone loss.

Loss of bone in the jaws often occurs with missing teeth. Normally, the bone continuously generates newer cells to replace older ones that have died. Chewing stimulates this growth as the force generated travels up through the teeth to the bone. But when teeth go missing, new bone growth slows, eventually causing the bone's volume and density to decrease.

Dentures can't reactivate this lost stimulation, and so bone loss may continue. Dentures even accelerate this loss as the compressive forces applied to the bony ridge are detrimental. This often leads to a "loosening" of a denture's fit that can make them uncomfortable and less secure to wear.

Today, however, patients with total tooth loss have another option that could alleviate the problem of bone loss—dental implants. Since their inception forty years ago, implants have become the preferred method of both dentists and patients for tooth replacement.

Implants consist of a titanium metal post that's surgically imbedded into the jawbone. Bone cells are attracted to this particular metal, readily multiplying and adhering to the implant's titanium surface. Because of this, an implant can slow or even stop bone loss.

Most people are familiar with the single tooth implant with an attached lifelike crown. Although this use of implants could be used to restore total tooth loss, it can be quite costly replacing over two dozen teeth individually.

But implants could still be part of the answer for someone with complete tooth loss, because they can also be used to support traditional restorations. A few implants strategically placed around the jaw can support either a removable denture or a fixed bridge.

Besides being a cost-effective way to add support to these traditional tooth replacements, the inclusion of implants will likely decrease continuing bone loss. Most importantly, it can give you back your dental function—and your smile to boot.

If you would like more information on dental implant options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “New Teeth in One Day.”

By Scott A. Allegretti, DDS Provincetown Dental Arts
August 11, 2021
Category: Dental Procedures
Tags: dental implants   crowns  
WhichImplantCrownAttachmentMethodisBestforYou

If you've decided on a dental implant to replace a missing tooth, you've made a great choice. Implants are a big favorite of both dentists and patients, not only for their life-likeness, but also their durability. Studies show that more than 95% of implants survive after ten years.

As you may know, single tooth implants are composed of two main parts: a metal post (usually titanium) imbedded in the jawbone; and a life-like crown affixed to the end of the post. But what you may not know is that there are two ways to attach the crown—either with screws or with dental cement.

Neither way is superior to the other—both have their own set of advantages and disadvantages. A cemented crown, for instance, usually looks more like a natural tooth than a screw-retained crown (more about that later) and dentists have more flexibility in making them look natural.

But cemented crowns require an additional piece of hardware called an abutment to better match it with the implant, something unnecessary with a screw-retained crown. Some people can also experience a reaction to the cement resulting in inflammation or even bone loss. And once installed, removing the crown later for repair or replacement is much more difficult than with a screw-retained crown.

Besides attaching directly to the implant, screw-retained crowns don't require cement and are more easily attached and removed. But the screw-hole can pose some aesthetic problems: Although it can be filled with a tooth-colored filling, the tooth's appearance isn't as ideal as a cemented crown.

So, which one is best for you? That will depend on the type and location of teeth being replaced, as well as your dentist's preferences. For instance, a more attractive cemented crown may be better for a visible front tooth, while a screw-retained crown might be a good choice for a back premolar or molar where appearance isn't as big a factor.

In the end, it's likely your dentist will discuss the pros and cons for each method as it pertains to your individual case. Whichever way your crown attaches, the end result will still be a life-like tooth that could last you for years to come.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Crowns Attach to Implants.”

By Scott A. Allegretti, DDS Provincetown Dental Arts
April 18, 2020
Category: Dental Procedures
Tags: dental implants  
AlthoughRareAllergicReactionstotheMetalinImplantsCouldbeaConcern

You’re considering dental implants and you’ve done your homework: you know they’re considered the best tooth replacements available prized for durability and life-likeness. But you do have one concern — you have a metal allergy and you’re not sure how your body will react to the implant’s titanium and other trace metals.

An allergy is the body’s defensive response against any substance (living or non-living) perceived as a threat. Allergic reactions can range from a mild rash to rare instances of death due to multiple organ system shutdowns.

A person can become allergic to anything, including metals. An estimated 17% of women and 3% of men are allergic to nickel, while 1-3% of the general population to cobalt and chromium. While most allergic reactions occur in contact with consumer products (like jewelry) or metal-based manufacturing, some occur with metal medical devices or prosthetics, including certain cardiac stents and hip or knee replacements.

There are also rare cases of swelling or rashes in reaction to metal fillings, commonly known as dental amalgam. A mix of metals — mainly mercury with traces of silver, copper and tin — dental amalgam has been used for decades with the vast majority of patients experiencing no reactions. Further, amalgam has steadily declined in use in recent years as tooth-colored composite resins have become more popular.

Which brings us to dental implants: the vast majority are made of titanium alloy. Titanium is preferred in implants not only because it’s biocompatible (it “gets along” well with the body’s immune system), but also because it’s osteophilic, having an affinity with living bone tissue that encourages bone growth around and attached to the titanium. Both of these qualities make titanium a rare trigger for allergies even for people with a known metal allergy.

Still, implant allergic reactions do occur, although in only 0.6% of all cases, or six out of a thousand patients. The best course, then, is to let us know about any metal allergies you may have (or other systemic conditions, for that matter) during our initial consultation for implants. Along with that and other information, we'll be better able to advise you on whether implants are right for you.

If you would like more information on the effects of metal allergies on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Metal Allergies to Dental Implants.”

By Scott A. Allegretti, DDS Provincetown Dental Arts
March 19, 2020
Category: Dental Procedures
Tags: dental implants   smoking  
DentalImplantsandSmoking-CauseforConcern

You probably already know that using tobacco causes significant health risks: It increases your odds of getting various cancers and coronary diseases, to name just a few. Unfortunately, not everyone is able to kick the habit, even when they know they should. Tooth loss is another issue that can cause trouble for your health, in the form of bone loss, malnutrition, and social or psychological problems. Dental implants are a great way to replace missing teeth — but does smoking complicate the process of getting implants?

The short answer is yes, smoking can make implant placement a bit riskier — but in the big picture, it doesn’t mean you can’t (or shouldn’t) have this procedure done if it’s needed.

Smoking, as you know, has harmful effects in your mouth (even leaving aside the risk of oral cancer). The hot gases can burn the oral cavity and damage salivary glands. Nicotine in smoke reduces blood flow to the soft tissues, which can affect the immune response and slow the processes of healing. At the same time, smoking promotes the growth of disease-causing oral bacteria.

How does this affect dental implants? Essentially, smoking creates a higher risk that implants may not heal properly after they are placed, and makes them more likely to fail over time. Studies have shown that smokers have an implant failure rate that’s twice as great as non-smokers. Does this mean that if you smoke, you shouldn't consider implants to replace missing or failing teeth?

Not necessarily. On the whole, implants are the most successful method of replacing missing teeth. In fact, the overall long-term survival rate of implants for both smokers and non-smokers is well over 90 percent — meaning that only a small percentage don’t work as they should. This is where it’s important to get the expert opinion of an implant specialist, who can help you decide whether implants are right for your particular situation.

If you do smoke, is there anything you can do to better your odds for having a successful dental implant? Yes: quit now! (Implants are a good excuse to start a smoking-cessation program.) But if you can’t, at least stop smoking for one week before and two weeks after implant placement. And if that is not possible, at least go on a smoking diet: restrict the number of cigarettes you smoke by 50% (we know you can at least do that!) Try to follow good oral hygiene practices at all times, and see your dentist regularly for checkups and cleanings.

If you have questions about smoking and dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine article “Strategies to Stop Smoking.”

By Scott A. Allegretti, DDS Provincetown Dental Arts
September 01, 2019
Category: Dental Procedures
Tags: dental implants   dentures  
Implant-SupportedDenturesCouldImproveYourBoneHealth

Generations have depended on dentures to effectively and affordably replace lost teeth. But they do have a major weakness: They contribute to jawbone loss that creates not only mouth and facial problems, but can also ruin a denture’s fit.

Bone loss is a normal consequence of losing teeth. The biting forces normally generated when we chew stimulate new bone to replace older bone. When a tooth is missing, however, so is that chewing stimulation. This can slow bone replacement growth and gradually decrease the density and volume of affected bone.

While dentures can restore dental appearance and function, they can’t restore this growth stimulation. What’s worse, the pressure of the dentures against the gum-covered jaw ridge they rest upon may irritate the underlying bone and accelerate loss.

But there is a solution to the problem of denture-related bone loss: an implant-supported denture. Rather than obtaining its major support from the gum ridges, this new type of denture is secured by strategically-placed implants that connect with it.

Besides the enhanced support they can provide to a denture restoration, implants can also deter bone loss. This is because of the special affinity bone cells have with an implant’s imbedded titanium post. The gradual growth of bone on and around the implant surface not only boosts the implant’s strength and durability, it can also improve bone health.

There are two types of implant-supported dentures. One is a removable appliance that connects with implants installed in the jaw (three or more for the upper jaw or as few as two in the lower). It may also be possible to retrofit existing dentures to connect with implants.

The other type is a fixed appliance a dentist permanently installs by screwing it into anywhere from four and six implants. The fixed implant-supported denture is closer to the feel of real teeth (you’ll brush and floss normally), but it’s usually more costly than the removable implant-supported denture.

While more expensive than traditional ones, implant-supported dentures still cost less than other restorations like individual implant tooth replacements. They may also help deter bone loss, which may lead to a longer lasting fit with the dentures. Visit your dentist for an evaluation of your dental condition to see if you’re a good candidate for this advanced form of dental restoration.

If you would like more information on implant-supported dentures, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Overdentures & Fixed Dentures.”