The standard of care in the US for missing teeth is to replace the "gap" with dental implants. The implants are typically made of titanium and are placed into the jaw to aid with a tooth or a few teeth. The titanium implant can osseointegrate with the jaw. This means that the bone from the jaw can grow into the sides of the titanium implant, which will make the stability of it very solid.
During placement of a dental implant, drilling is achieved into the bone taking special care to avoid the nerves that are close by such as the inferior alveolar nerve. Typically irrigation is used during the drilling to prevent overheating.
The dental implants may be used to replace a single tooth or to support a full dental bridge, even replacing a full set of teeth. The most common form of dental implants are "root form", also termed "endosteal" implants. The shape of the implant resembles the natural root of the tooth and is ideal for those with a deep and healthy jawbone. If a patient does not have adequate bone for implant placement, a bone graft can be utilized.
Another type of dental implant that is used when the jaw is narrow and bone grafting is inappropriate is a plate form implant. Conventional surgery is used for placement with a second stage necessary to allow for initial healing.
If the patient does not have enough bone for either a root form or plate form implant, a subperiosteal dental implant may be the next best option. They have a higher failure rate and a higher cost, so this should be considered. It is a custom implant designed from an individual CT scan or dental impression with a 3-d model.
One of the more recent trends involves mini-dental implants. They are smaller versions of root form implants. Originally, the option was to use them for temporary implants, however, they have morphed into being a permanent implant option, especially for those with smaller teeth. They do not fuse as well to bone as the larger versions, but can provide an effective long lasting solution and be cheaper.
As newer techniques evolve, there are times when patients can have their dental implants placed in a single stage setting. Reasons for this evolution are that some dental practices have the 3D modeling systems in-house and do not need to outsource everything. Another reason is that there are now companies who can model everything for same stage placement. So the patient can have all of the pre-procedure work accomplished via 3d modeling, and the implant fashionable and ready to go during the one stage procedure. Check with your local dental implant specialist to see what's available.
Although I find myself placing composite fillings 99% of the time, but always review all of the options with patients before deciding on what type of filling material will be placed in their tooth. As a dentist I do not endorse products of one company versus the other, but I find peace of mind using products of reputable manufacturers. Dental fillings must survive in the extreme conditions of the mouth. The human mouth is a perfect environment to test any material to its limits. It is mostly neutral in pH (due to neutralizing effect of saliva), but depending on the food content it can have rapid upward or downward spike in pH. The same thing can happen with temperature swings of up 60 degrees Celsius (from ice cold to coffee hot). Any type of filling material has to end normal chewing forces and also abnormal para functional grinding which can put up to 20 times more pressure on the teeth compared to normal chewing forces.
1. Amalgam Fillings: Composed mainly of Mercury, Silver, Tin, Copper and sometimes Aluminum alloys.
Advantages: Very durable; works in wet or dry environment when placed; releases antibacterial silver ions that fight future cavities that may form around the filling.
Disadvantages: Has mercury; does not match tooth color; most amalgams are not bonded to the tooth which may render back teeth in people who grind their teeth more susceptible to tooth fracture; in general teeth with metal filling may become more sensitive to cold drinks.
2. Composite Fillings: Composed of inorganic fillers such as Silicon Dioxide, organic resins and photo initiators.
Advantages: Color match with the tooth; can be polished to a very high luster; is bonded to the tooth vs. just sitting in it; the only type of filling that can be placed in very shallow cavities (does not require thickness for strength.
Disadvantages: Require dry field during placement; can absorb stains over time; more sensitive than other types of filling to left over decay in the tooth.
3. Porcelain or Ceramic Fillings (Onlay): Composed mainly of inorganic minerals.
Advantages: Excellent color match to the tooth; lasting luster and does not stain easily; very durable but rather to fracture in people who grind or clench their teeth; is bonded to the tooth; can be used on severely broken down teeth; excellent replication of the tooth anatomy since is made by a lab technician.
Disadvantages: Cost (more expensive that amalgam or composite fills); requires two appointments.
4. Gold Fillings (Onlay): Composed of gold alloys in different quantities of gold from 30% up to 90%.
Advantages: The most durable type of dental filling.
Disadvantages: Cost; no color match; takes two appointments.
5. Glass Ionomer Fillings: Composed mostly of inorganic fluoride releasing salts, and organic matrix, may also contain photo initiators ans oxygen inhibitors.
Advantages: Can be placed on wet or dry environment; is white in color (but does not exactly match tooth shade); bonds to the teeth; releases fluoride hence has decay fighting properties.
Disadvantages: Not very durable; used mostly on baby teeth, not the best choice for adult teeth specifically on the load bearing surfaces.
In early 2008 several European countries made the move to ban use of dental amalgam in concern about safety of mercury vapors released during placement on the filling. So far there has not been a strong evidence showing health risks associated with dental amalgam. US Food & Drug Administration (FDA) and American Dental Association (ADA) endorse safety of the dental amalgam.[Top]
The fitting of dental veneers is one of the latest and more popular cosmetic dentistry procedures. A tooth veneer is a wafer-thin shell made of porcelain or resin composite material. Veneers are typically bonded on the front surface of the teeth to fix a number of defects such as broken or chipped teeth, discoloration, gaps between teeth and poorly shaped teeth. They are mostly recommended by dentists to conserve teeth structure and give a glossy, beautiful appearance.
Dental Veneers Procedure
The dental veneers procedure is usually a two or three appointment process which requires a few minor teeth preparations. During the first visit, the dentist will examine your teeth, take dental x-rays, and then explain whether you are a qualified candidate for dental veneers. You will also have to explain the type of income you desire. The dentist may in some cases recommend teeth whitening instead of veneers. After the preliminary consultation, the dentist will get down to work.
A dutiful cosmetic dentist will consider a number of factors such as your facial structure, gum color, hair color, complexion, etc. They will then customize a smile shape based on this information. This is usually done in a dental laboratory and your custom-built veneer is ready within a week or so. Next is the try-in process, where the dentist will temporary attach the veneer to your teeth to see if it fits correctly and the color is suitable. An added try-in appointment may be scheduled until your smile looks perfect. The veneer will then be permanently bonded to your tooth and any final modifications will be made as needed.
This dental solution is known to last long, but it's important that you schedule regular visits to the dentist for checkups and cleanings. This will help to maintain your oral health as well as prolong the life of the veneers. Avoid biting or chewing on hard objects to protect your veneers from fracturing or chipping. It may take some time to get used to the feel of your new bite. Brush and floss daily and continue to follow your normal oral hygiene practices.
Benefits of Veneers
Veneers offer a number of advantages. Firstly, they are extremely natural looking. Darker or yellow teeth can easily whitened using this dentistry procedure. Also, porcelain veneers are exceptionally stain-resistant and the gum tissue tolerates the porcelain material quite well. What's more is that veneers provide a preservation approach and do not require a lot of painting before the procedure. They are actually a stronger and more aesthetic option and the results are utterly remarkable.
The costs of dental veneers vary depending on many factors. The dentist fees, the scope of the procedure, the number of veneers needed, and the location of treatment, are some of the factors that influence the cost of this dental procedure. The cost may range from $ 500 to $ 1500 per tooth. This cost also varies depending on the material used. Porcelain veneers are more expensive than resin composite veneers, but are more durable.
Dental veneers are used to change the shape, color, size or length of teeth. This dental solution will dramatically change your appearance, and most likely boost your self-confidence.[Top]