When it comes to Implant teeth, the work should begin with proper diagnosis and treatment planning with the restorative dentist who will fabricate your final restorations. If the restorative dentist does not place the implants, he/she will coordinate with the surgeon so that the outcome of the treatment can be optimized for both esthetic and function.
In the case below the patient went to an oral surgeon before coming to me for a consultation for crowns to be placed on the implants in her mouth. This is actually a reversed pattern of treatment. Sometimes the ideal final result cannot be achieved because the implants have been placed in the wrong position.
We will be gathering some detailed diagnostic records and studies to come up with a plan to restore these teeth, but there are obvious issues with the case.
In the X-ray you can see that Implant # 1 and # 2 were placed too close to each other. Here are the potential problems:
1. The crown for Implant # 1 may be much smaller than its ideal size.
2. The gum tissue between the teeth for Implant # 1 and Implant # 2 will not have any room to sustain a normal shape and healthy environment.
On the other hand, you can also see that implant # 2 and # 3 were placed too far from each other. Here are the potential problems:
1. The crowns between these 2 implants may appear unusually large/wide and may not fit the patient’s smile esthetically.
2. It may also be impossible to create normally looking gum tissue between these two implant teeth.
Additionally, Implant # 3 was placed too close to the adjacent natural tooth. This may cause the natural root to resorb if indeed the threads of the implants have impinged on the ligaments and/or root of the natural tooth.
To ensure an optimal dental implant result, it is always recommended that the patient seek proper consultation with qualified clinicians prior to proceeding with the treatments.
In order to place an implant in the patient’s jaw, we need to assess several criteria at the location of the planned implant. Some of the important factors may include:
1. The patient’s bone height
2. The patient’s bone width
3. The proximity to the nerves in the lower jaw
4. The proximity of the sinus cavity in the upper jaw
Using a 3D Cone Beam Scan (CT Scan) we can precisely analyze all of the above criteria and predetermine the exact size and location of the implant prior to the surgical placement.
Here is a screen capture of the planning process for two implants to replace two missing molars in our actual patient’s lower jaw. The red line below the two planned implants is a nerve in the lower jaw. That nerve is often the limiting factor in the lower jaw where some implants for posterior teeth may be needed.
Proper use of technology helps ensure optimum results and safety of dental implant treatment.
Besides an in depth understanding and mastery of the art and science of cosmetic dentistry, we spend a tremendous of time communicating with our ceramist so that every detailed concern is addressed on behalf of our patients.
Here is a snap shot of a Skype session with a master ceramist. Delivering a case to a patient who flies across the country to see us is serious business. We take every measure to make sure the time and resources our patient entrusts in us are worthwhile investments.
May 2013 bring you tremendous health, luck, and prosperity. Our team is always grateful for the opportunity to take care of your dental needs, and we look forward to another year of beautiful and healthy smiles with you !