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Imagine this: An implant surgeon is performing a thorough examination of your mouth. The surgeon rotates your jaw from side to side and up and down, looking for the optimal sites in which to place dental implants — and the proper size, shape and orientation for the implants to have. He or she may test several alternatives, considering the underlying anatomical structures, and the bone density and quality that the examination reveals. Finally, a surgical plan is developed: This includes a set of precise specifications for implant position, size and depth, and a template for creating a perfectly fitting set of replacement teeth. But no invasive procedures of any type have been performed so far. In fact, you aren't even present.

Welcome to the world of computer-guided dental implant surgery. What we have described is one step in the process that allows you to receive a set of replacement teeth with the minimum amount of surgery (and time spent in the dental chair), and the maximum level of preplanning foresight. It can result in faster overall treatment time, less discomfort, and an outcome that pleases everyone. Let's look a little more closely at the entire process of computer-guided implant surgery — a procedure at the forefront of dental implant technology.

The First Phase: Making A Virtual Model

It all begins with a complete examination and modeling of your existing teeth, gum and jaw structures. In many cases, a physical impression (replica) of the jaws is made, which will aid in planning the location of the new teeth. But the modeling doesn't stop there: A high-tech, three-dimensional CT (computed tomography) scan is also performed. This allows us to examine the structures (including bone, nerve tissue and sinus cavities) which lieinside the jaw. It is often accomplished using “cone-beam” CT technology, in which the scanning device quickly captures a complete digital image of internal structures as it rotates around your head.

The next step of the process relies on powerful computers and sophisticated software to take the raw CT scan data and translate it into a 3-D model of the jaw. This virtual model can be manipulated on a computer screen — rotated, measured, even “operated” on — so that we can visualize the placement of dental implants and determine their optimum position with a high degree of accuracy. Using this technology, it's now possible for us to evaluate anatomical structures virtually — structures it once would have taken surgery to reveal — and to plan out the implant procedure accordingly.

The 3-D model we have developed is then used for two purposes: to create a precise guide for the implant surgery, and to allow the dental laboratory to pre-manufacture a set of replacement teeth that will fit precisely in the jaw. An advanced set of CAD/CAM (computer aided design/manufacture) processes is used to generate the physical objects — in this case, the surgical guide and the prosthetic teeth. Depending on your individual situation, the new teeth may be attached the same day as implant surgery, or after a healing period of 6 to 12 weeks. In either case, our precision modeling ensures that they will fit perfectly with the implants and the jaw.

Implant Surgery: Following the Plan

The implant surgery itself is typically performed under local anesthesia, and often requires no sutures (stitches). In the surgical procedure, the template we have produced (which resembles a nightguard or athletic mouthguard) is securely (but temporarily) fixed in position on the jaw. The openings in this template form precise guides for the placement of the implants — accurate in terms of position, width and depth. In fact, the implants fit so perfectly into these prepared sites that we can have new teeth placed the same day as implant surgery.

Since so many of the details have been accomplished in the planning stages, computer-guided implant surgery is typically uneventful for the patient. It can result in shorter time in the chair, less discomfort during recovery — and a highly pleasing result. It has even been called the most significant innovation in implant technology since osseointegration — the fundamental process by which a dental implant becomes fused with the bone.

Adolescent orthodontic care.For many teens, braces are a rite of passage: They're one more example of the changes adolescents go through at this time — along with growth in stature, edgier tastes in clothes and music, and an increasing degree of self-awareness. But is there any particular reason why orthodontic appliances and teenagers seem to go together? In a word: Yes.

There are several good reasons why adolescence is the optimal time for orthodontic treatment, though occasionally even earlier intervention is called for. One has to do with the development of the teeth: There's no set timetable for every kid, but generally by the age of 11-13 the deciduous (baby) teeth have all been lost, and the permanent ones have largely come in. This is the time when we can go to work correcting the problems that cause a bad bite (malocclusion), improper tooth spacing or poor alignment.

Orthodontic problems don't improve with age — they simply become harder to treat. It's easier to treat many orthodontic problems during adolescence because the body is still growing rapidly at this time. Whether standard braces are used, or appliances like palatal expanders, improved appearance and function can be created in a short period of time. In later years, when the bones of the face and jaw are fully developed, many conditions become more difficult (and costly) to treat.

There's even a social element to getting orthodontic treatment in adolescence. If you need braces, you're not alone! Chances are you'll see some of your classmates in the dental office, and you may even make new friends as you go through the process together. When it's done, you'll have a smile that you can really be proud of, and benefits that will last your whole life.

The Orthodontic Treatment Process

What can you expect when you have orthodontic treatment? It all depends on what kind of treatment you need. At your first appointment, pictures and radiographic (X-ray) images of your mouth are usually taken, along with impressions of your teeth, so that a model of your bite can be made. This information will be used to develop a treatment plan. It may involve regular braces, with or without elastics (rubber bands). A specialized appliance may also be recommended for a period of time. Here are some of the most commonly used orthodontic appliances:

Metal braces.Metal Braces need no introduction. But you might be surprised to find they're smaller and lighter than ever. They may even offer some customized options, like colored elastic ties on the brackets.

 

Clear braces.Clear Braces feature brackets made of ceramic or composite materials which blend in with your teeth, making them harder to notice. They're suitable in many situations, but they cost a little more.

 

Clear aligners.Clear Aligners for teens is a series of removable, clear plastic trays that gradually straighten teeth as they're worn (for 22 hours per day). Formerly recommended only for adult patients, they now come with special features — like compliance indicators to tell how often you've been wearing them — that make them appropriate for teens in some situations. The advantage: they're practically invisible!

 

Lingual braces.Lingual Braces offer the most unnoticeable form of orthodontic treatment because they are attached to the back (tongue side) of the teeth, where they cannot be seen at all.

 

Other orthodontic appliances may be recommended in some cases, where major tooth or jaw movement is needed. They can range from small devices that fit inside the mouth to external headgear. But don't worry: You'll get used to them, and they're temporary — but they provide a long-term benefit in a short time.

How Long Will I Wear Them?

There's no one answer that fits everyone: It all depends on what has to be done in your individual situation. Generally, however, the active stage of orthodontic treatment lasts 6-30 months. Afterwards, you will wear a retainer for another period of months. When your orthodontic treatment is complete, a new smile will be yours for a lifetime.

 

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