My gums were burned using a strong bleaching agent, I sent you my pictures, can you tell me what my options are?

Answer:

Dear Anonymous:

I have very few teeth left and I am loosing all my teeth. Are Implants my Best option? What are my options?

Answer:

Ok, I will try to explain all your options, from the simplest and least expensive, to the more expensive and comfortable option.

• Complete Dentures – You can get complete dentures, but this option is the least desireable by todays standards, since it limits the kind of foods that you can eat with harder foods being more likely to hurt you and cause denture sores.  You also have to learn how to eat with them, since with natural teeth you eat on one side of the mouth, but with dentures you have to learn to eat small amountson both sides at the same time to stabilize and seat  the dentures as you eat.
• Mini Implants – These small diameter implants have become popular where cost is the most important factor.  Another advantage is the fact that the implants are placed almost always without surgery and therefore less discomfort for the patient.  To use mini implants to help hold a denture ir requires the placement of four of them in the area between the canines.  Due to their small diameter and the fact that they are placed in function immediately, there is a higher risk of failure associated with mini implants.
• Overdenture on two implants – This is a denture that is retained by two regular implants placed in between the canines.  The overdenture rests on the gums and moves a litle so you are still limited with what you can eat due to the fact that when you bite you are putting pressure on your gums.
• Overdenture on four implants – This denture moves less, is held more firmly in place and depending on where the implants are placed, it may allow you to bite harder foods and rely less on support by your gums.
• Bar overdenture on four implants – this option allows you to have a denture that rests totally on the implants and allows you to eat harder foods since you are not pressing on your gums when you eat.
• A Fixed-Removable Prosthesis or “Hybrid” – A hybrid prosthesis is made like a denture, but it covers a lot less gum tissue, for example, it does not cover the roof of the mouth with acrylic like a conventional denture.  it requires a minimum of four, but preferably six implants  and is screwed onto the implants so that only your dentist can remove it.  It is harder to clean than a removable overdenture.
• A fixed bridge on implants – This is the best option, but it requires the greatest number of implants to support it.  It is reserved for people that have plenty of bone to place the implants and feels almost like your natural teeth.  It is also the most expensive option and is usually made of porcelain.

It is worth mentioning that when you loose your teeth the bone starts to remodel and dissappears slowly under the gum, and the longer that you are without teeth, the more likely that you may not have adequate bone for implants.  Fortunately by placing implants, you can avoid that bone loss caused by extractions and healthy implants help keep the bone around them.

So the final answer is YES!  Implants are your best option.

Carlos Boudet, DDS, DICOI
http://www.boudetdds.com/

How is it that general dentists, oral surgeons, and periodontists all do implants? Who should I go see if I need an implant?

Answer:

All dentists possesing a degree of DDS or DMD and a license to practice dentistry are allowed by law to place implants, however,  the science of implantology is one of the most demanding aspects of general dentistry and requires extensive knowledge that can only be obtained by additional study and training.

The American Dental Association and the Board of Dentistry do not recognize Implantology as a specialty in dentistry, and it is  taught to a limited extent in dental school.

As dental implants are getting more successful and popular, the percentage of general dentists that are doing implant surgery is increasing.  Periodontists and oral surgeons are also involved as part or an interdiciplinary team in the surgical placement of implants.

The most important detail is the need for correct diagnosis and treatment planning.  This will create a blueprint for treatment that will be functional, cosmetic and comfortable.  Only a properly trained dentist in both the placement and the restoration of implants can do that.  It is my strong belief that a properly trained general dentist is the most qualified professional to provide such a treatment plan.

There are organizations dedicated to advancing the science of implantology that  provide certification as a means to demonstrate knowledge in the field such as the ICOI and the ABOI. Anyone needing implants may want to inquire into the credentials held by the dentist.

I have an implant that replaces my lower molar and I have been told that I have  bone loss and infection around my dental implant.  What can I do?

Answer:

Hi K J,
You have been informed that your dental implant is affected by a low grade infection called peri-implantitis that is slowly destroying the bone that supports your implant.

The surface of the implant is infected and contaminated by bacteria that will continue to destroy the bone unless it is removed.

There is treatment available for an ailing implant. The treatment consists of  removal of the bacterial contamination and detoxification of the implant surface.  The implant  is exposed and the bacterial  film and toxins on the implant surface and the infected soft tissues around the implant are removed. The surface is decontaminated by chemical and mechanical means, or in the case of Laser Treatment, an all tissue laser such as the Waterlase is used to clean and disinfect the implant surface .  The area is covered with a dressing for about a week and normal gentle cleaning resumes after that.

Depending on the size and shape of the bone defect, the dentist may place a bone graft.

It is normal for the tissues to shrink after the surgery, so part of the abutment (post) or even the implant may be visible after healing.

In cases where access is simple, one surgical treatment may be all that is necessary but in more difficult cases more than one treatment may be necessary to get the infection under control.

It is very important to develop a good daily oral hygiene routine to keep the gums around your teeth and implants healthy, and to supplement that with regular checkup and maintenance appointments in the dentist’s office.

Good luck!

I am going to lose one of my two front teeth. It has a failed root canal and the root is cracked. Also it looks a lot longer than the other. I was told I need an implant, but I am afraid that after I get the implant, the tooth will look longer still. What can I do?
Thanks in advance for your help.

G G

Answer:

Dear G G:

When your two front teeth are a different size it detracts from your smile, so I agree that you should make every effort to correct that.

There are two options that are available to you to help you correct this situation.

The first option, and the one I prefer, is to use orthodontics to extrude the tooth.  This stimulates the bone and gums to grow and will make the teeth the same size again. The process is called forced eruption and it is an excellent minimally invasive procedure to improve your situation.  At the end of the forced eruption you can replace the tooth with an implant.  This also minimizes the amount of grafting that you may need.

The other option is called a block graft and it requires a larger surgery to graft the deficient area before the implant is placed.

Forced eruption is definitely the preferred procedure generally.

Hope this helps, and good luck!!!

I had a root canal retreatment on tooth #3. About 2-3 weeks after that, a bump developed  on the gum above the treated tooth (there was no bump  pre-op). The
endodontist suspects the MB root is cracked and suggests  root amputation. But he
said there is chance it is not cracked and only  apicoectomy will be needed.
There is deep pocket on the gum in question,  therefore my dentist said a crack
is very likely. Please see the  radiography  attached. (I also wonder if the RC
retreatment was too  aggressive since the roots became much wider than pre-op,
and as the result the RC retreatment caused  the crack?)

Answer:

You can also find many questions about dental implants answered by West Palm Beach Implant Dentist Carlos Boudet at one of the best dental implant information sites in the web  called choosedentalimplants.  To avoid duplicating the content by posting them here, you can go directly to the list of questions by clicking here.

What is the percentage of implant failure? I have heard other people comment on implants not lasting a long time.

Lucy

Answer:

Dear Lucy:
I probably should answer this in two parts.
The first part, the percentage of implant failure is very low, which means the success rate is very high. A success rate of 95 to 99% is seen in the literature.
The second part, which deals with the longevity of implants has more variables in it. Implants lasting twenty years are not uncommon, but an implant that has been clinically successful for many years can eventually fail if the routine conditions of good oral hygiene and regular professional care are not followed by the patient.
For the majority of cases, implants are very long lasting.

Answer:
Hi,
These are the alternatives for augmenting the amount of the bone in an extraction site:
1- A Bone Graft with particulate bone, for augmenting the width , or
2- A Block Graft from another area in your jaw (preferable) or from a cadaver, to augment both width and height, which is what you need if your tooth appears longer than the adjacent central.
3- A third alternative is Distraction Osteogenesis, but in that area of the mouth, and because of cosmetic concerns, I doubt it would be acceptable to you.
4- A fourth alternative, which is Crown Lengthening Surgery, I would only consider if your front teeth seem short for your smile because it removes bone from around the teeth.
The last alternative, and the one I would recommend is called Forced Orthodontic Eruption, and it utilizes braces to slowly pull the tooth out, which physiologically brings the attachment (the bone and the gums) with it.  This allows the gums to be at the same level, for teeth that look even instead of one longer than the other, and it avoids the need for block graft surgery.

I have an overdenture on implants.  Can I have fixed teeth instead?

Answer:

In most cases, yes.  You can redesign your case to be “fixed” instead of removable and at the same time get rid of some of the acrylic covering the palate and extending around your gums that was necessary to obtain a good seal when your work was removable.

If your overdenture was done with the minimum number of implants, you will need to have additional implants placed.  For fixed teeth the minimum  accepted number of implants needed in  the mandible is six, and eight  in the maxilla.

If  you discussed this with your dentist as a posibility and the implants were placed with that contingency in mind, it will be easier.  If not, the work can still be done, but the position of the implants may create difficulties in designing the teeth.

Talk to your dentist about the details of your particular case.