What are Front Tooth Implants?
When a front tooth is lost, the choice of replacement is many. From a temporary replacement with a “flipper or stayplate” – like a retainer with a tooth. Another option is a bridge (where the adjacent teeth to the missing tooth or teeth are prepared/ cut down for a crown so that a three tooth or larger bridge can be placed to fill in the gap of the missing tooth or teeth. Another option is a dental implant. An implant is a metal titanium core that is placed in the bone, allowed to heal and fuse to the bone for a minimum of four months, and then a post or abutment is placed on the implant to simulate the “prepared tooth in a crown preparation”. Often a temporary resin crown is placed to allow the tissue to adapt properly. Then a final restoration is placed on the post to simulate the missing tooth.
The Post can be metal which will need to be masked or it can be zirconium, a material that is strong but tooth colored. The restoration placed on the post will be selected based on the aesthetic needs as well as the functional requirements for strength. The more the esthetics is the primary concern, the more likely that an all porcelain post and crown are fabricated over the implant. With this, come some risks of fracture, which are not as often associated with a metal post.
Who is a good candidate for Front Tooth Implants?
he best candidate for a front tooth implant is a patient that has adequate bone for implant placement (if the bone is not adequate, then the implant has a higher risk of failure or the esthetic result may be less than optimal). Also the home care (how well one takes care of their teeth) as well as the periodontal health of the adjacent tissue are critical factors in selecting a patient for a front tooth implant.
The benefits of front tooth implants
TIf a patient has lost a front tooth and the adjacent teeth have never had a filling, restoration or crown, and the bone quality of the area where the tooth is missing is optimal, then the implant would be ideal. This allows the adjacent teeth to not be touched or prepared (cut down) for a crown, thus preserving the natural tooth.
Also, if an adjacent tooth to the missing tooth has had a root canal, then the bridge has a higher risk of failure, as the root canal tooth has a greater risk of fracture, thus compromising the whole bridge. Generally a bridge will last longer than an implant unless one of the adjacent teeth has a root canal. With this in mind, not cutting down a perfectly good tooth is a great reason to do an implant vs. a bridge, if all other factors are equal.
The cost can be a little more for an implant than a bridge, but preserving good tooth structure is often preferable. If a bridge is large or long, a metal substructure is important. With a single implant, the option of no metal is available which can lead to better aesthetics.
What is the difference between front tooth implants and regular dental implants?
Implant(s) in the front teeth takes more time for diagnosis and planning. For an excellent result, the matching of the adjacent tooth color and translucency is critical for a good aesthetic result. If the smile line is high then the ridge or ridge development is critical for an aesthetic result. An implant in a back tooth in a patient with a minimal smile line will function well and be aesthetically acceptable even if a metal margin is showing. On a front tooth, this is seldom acceptable unless the smile does not show the crown, implant interface. In such a case, a front tooth implant can be functional and preferable to a removable appliance even if it does not have ideal aesthetics when the lip is retracted.
One must understand that implants are not generally a quick fix. First an evaluation of the bone quality must be done. Is an implant even predicable or possible? Next there can be a cost difference with an implant vs. another restoration. If the bone quality is in question, then a bone scan to show the exact quality and location of the bone for an implant site is often critical. If multiple implants are placed, these bone scans are used to create a guide for exact implant placement for the best results. Next one must evaluate if a bone graft or tissue graft is indicated.
Once the implant is placed, a minimum of 4 months is required to allow the bone to fuse to the implant. Some implant sites require a bone grafting procedure or multiple bone and or tissue grafting procedures prior to the implant being placed. Once the implant has been placed, and the healing time is over, then a post must be fabricated to be attached to the implant and a temporary restoration placed. The crown over the implant can be fabricated on the implant post or off an impression of the post. There are benefits and disadvantages of each. Once the final restoration is fabricated, the cementation is critical. One cause of implant failure is inadequate cement removal. It is critical that the cement is completely removed around the implant for tissue health and longevity of the implant.
How long do results last?
There are so many critical factors in implant longevity, the list is long. Technique of the surgeon or dentist placing the implant, the amount and quality of bone available for the implant site, the bite relationship and the stress of the bite or occlusion placed on the implant, the removal of residual cement around the final cemented implant crown. An implant can last for many years but does have some risks. If you are interested in implants, our Dentists at Deer Park Dental will do a complete diagnosis to evaluate if you are a candidate for a dental implant and discuss the options available to you, as well as the risks, benefits and costs of treatment. Properly selected sites for dental implants can give excellent aesthetics and/ or function as well as a long lasting restoration.
What is the recovery time?
Implants don’t happen overnight. To have a successful result, good planning and using a skilled specialist to place the implant and follow-up is important. We work with many local specialists that can give you an excellent result. Understand that implants are often a year long process but the wait is worth it. The first step is a good diagnosis and treatment plan, healthy tissue, excellent home care (how well you clean your teeth is just as important as how well we clean your teeth at your recall appointments) as well as a laboratory that delivers quality results.
The implant placement can often have minimal discomfort as well as the impression is often more comfortable than a traditional crown preparation. Once the temporary is placed over the implant, the final restoration placement can be very flexible. Other than the time factor for placement and healing, implant restorations can be a very simple procedure. In areas of minimal bone or aesthetic concerns, due to ridge resorption or inadequate bone or tissue, more time and planning is needed to create the best aesthetic result possible. Don’t be in a hurry!
Other uses for dental implants
Implants are often placed for single or multiple tooth replacement for a single tooth or a bridge where more than one tooth is missing. Implants are also very successful in aiding in retention for a denture or partial. Dentures on the lower arch are often uncomfortable and lack retention. Simply placing two implants in the lower arch, attached to a quality fabricated denture, can allow for excellent retention of the denture and greatly increased chewing and function. If adequate bone is available, more implants can be placed for increased comfort, retention and function.