Implants give people missing teeth more options.
By CYNTHIA RAMNARACE
Evening News staff writer
Missing a tooth? Or teeth? Would you like brand new ones that worked just as well as your old set, that stay in place just like your old ones, but are resistant to decay?
This may sound as likely as snake oil cures and pills that melt away fat, but it's not. Dental implants are here, and for those with the cash to spend they are sure to revolutionize dental care for those who have lost their teeth.
"The biggest real boon I've seen for implants is that they allow for the elimination of dentures," said dentist James Aberegg. "They improve chewing function incredibly."
Implants can be used for a single missing tooth or an entire set. For an upper or lower set of dentures, two implants are placed in the jaw. The new porcelain teeth have a bar and clip or ball and socket attachment so they can be removed for cleaning.
"What we've been able to do is place two implants on the lower," Dr. Aberegg said. "You snap that baby into place, and they can eat."
Implant-supported dentures work best for those who have recently experienced tooth loss. Over time, the jawbone recedes if there is no tooth for it to attach to. If the bone shrinks too much, the oral surgeon will not have enough space to insert and implant. Helping retain bone, and therefore the natural look of the chin and smile, is one of the greatest benefits of implants, Dr. Aberegg said.
Implants are also an alternative to crowns and bridge work. On a recent Friday, Dr. Aberegg placed a new tooth on a patient whom, before implants, would have had to receive a crown to replace a tooth ruined by decay.
The 33-year-old woman, who asked that her name not be used, had first undergone orthodontics to straighten her teeth and create an appropriate space for the missing bicuspid. She then underwent oral surgery with Dr. Lawrence Pompili of Monroe. He placed the implant, which resembles a screw, into her jawbone.
It took three months for the gum and jaw to heal before the new tooth could be placed. A mold was made for the new tooth, and its color was matched to that of her real teeth. At Dr. Aberegg's office, in less than an hour the new tooth was secured into place. It was immediately impossible to tell her real teeth from her prosthetic one.
"Implants are good because you can replace a single tooth without touching the adjoining ones," Dr. Aberegg said. If he had done a crown on this patient, he would have had to shave down the adjacent teeth to affix it in place.
There are some people for whom dental implants are not an option. Those include uncontrolled diabetics because of the healing process required, and people with health problems affecting multiple organs.
Dr. Aberegg placed his first implant in 1985. The success rate of these new teeth is more than 90 percent, he said. The procedure is revolutionizing dentistry.
"Dentistry has come so far," he said. "When I was in dental school (in 1976) we would talk about this and wonder what it would be like to put teeth back in."
When it comes to implants, Dr. Aberegg said cost is the biggest deterrent. Most insurance companies won't pay for the surgical placement of the implant. Some will pay for the placing of the new tooth. Costs vary depending on the number of teeth replaced and number of implants needed, and can easily total into the thousands of dollars.
For the patient in Dr. Aberegg's chair, the four-figure pricetag was worth it. Her high school reunion is coming up, and she's bringing to it her brand new smile.
--An oral surgeon replaces the tooth root with a titanium implant that is secured into the jawbone.
--A healing abutment is placed on the exposed part of the implant. The gum is given three months to heal around the abutment, creating a gingival socket.
--At the dentist's office, a permanent abutment, a gold-covered titanium screw, is placed in preparation for the new tooth.
--The dentist X-rays to make sure that the screw is placed correctly. Once the new tooth is placed, it is impossible to remove.
--The new porcelain tooth is dry-fitted. The dentist adjusts the tooth to create enough space for flossing. Gum care is essential with implants, because the gum does not grow to the prosthetic as it would to real enamel.
--The new tooth is adhered to the abutment. Within two hours, the adhesive will set and the tooth will be virtually indestructible.