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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.

If you have teeth that are missing or need to be replaced, chances are you'll be deciding between a number of treatment options, each of which comes with a price tag. As you're weighing those options, you will probably learn why dental implants are today's premier solution to the problem of failing or lost teeth: They have the highest success rate of any tooth replacement procedure; they are the most lifelike in terms of looks and function; and with proper care, they can last the rest of your life.

Implants represent a significant investment for many people; however, when you look at all the options, we think you will find that they also offer the best value. Still, it's wise to weigh all the choices for tooth replacement — even the option of doing nothing. But can you really put a price tag on not taking action? When it comes to tooth replacement, you certainly can... and the true cost of doing nothing might surprise you.

The Hope: A Short-Term Gain?

In the short run, perhaps, the cheapest option is not to get treatment at all. Of course, you'll still be living with the obvious consequences of missing teeth — not only in terms of your appearance, but also with the difficulties you may experience trying to speak and eat normally, and the loss of self-confidence that goes along with these issues. Plus, there are the less-visible problems — like potential nutritional deficiencies, and an increased likelihood of continued bone loss — that can result from missing teeth.

These problems are quite real, but they're hard to put a price tag on. In one area, however, the price of waiting can be measured in dollars. To see how, let's look at what happens inside your mouth when teeth are lost.

The Reality: A Long-Term Loss

Consequences of Tooth Loss.Once you start to lose teeth, the bone in the jaw that formerly supported them begins to deteriorate. Over time, it can significantly decrease in volume and density — and as it does so, it may create changes in the facial appearance. Here's what happens: as you continue to lose more and more teeth, and as the bone atrophies (degenerates), the distance between nose and chin can decrease, the lips curve into a frown, and the lower third of the face partially “collapses.” You may have noticed that people who are missing teeth appear unhappy. Loss of bone structure is part of the reason why.

Removable dentures don't solve the problem of bone loss — they generally worsen it. In fact, bone loss is the reason why removable dentures need periodic adjustment and replacement: They put too much pressure on the jawbone, which causes it to erode even faster.

At a certain point, treatment may become imperative. The problem is, it's much more difficult to place implants when the bone quality and/or quantity has diminished. Bone grafts may be needed if the area of the missing tooth doesn't have enough bone volume to support the proper size implant. If several teeth are being replaced, it may also be necessary to use up to six or more implants, where only four would have been needed if the situation had been treated promptly.

The Bottom Line

By itself, the lack of sufficient bone doesn't mean that implants are out of the question. In fact, bone grafting is presently a relatively common in-office procedure that can be done as one stage of the implant process. However, chances are that treatment will now be longer, more complicated... and more costly.

How much more? That depends on the individual case; however, it's not uncommon to see a 50% increase in the total treatment cost if this type of additional work is needed. You could call that the cost of waiting. So if you're weighing tooth-replacement alternatives, don't forget that every option has its price — even doing nothing. When you consider the real value they offer, we think you'll agree that dental implants are the optimum solution for replacing missing teeth.

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Losing Teeth - Dear Doctor Magazine

The Hidden Consequences of Losing Teeth For those missing even one tooth, an unsightly gap is actually the least significant problem. What's of far greater concern is the bone loss that inevitably follows tooth loss. Dental implants can preserve bone, improve function and enhance psychological well-being. Learn how implants serve both as anchors to support replacement teeth and preserve bone... Read Article