Treatments

Where damage to a person’s teeth is extreme, and apparently beyond repair, we can use porcelain crowns to make the smile appear “as new”. This is an extremely reliable technique for repairing severe dental problems, even permanently replacing missing teeth to offer a complete smile and a functional bite. We are renowned for the quality of our work and the fantastic changes we make for people using this technology. These treatments are used for a long-lasting correction of major dental problems. It is usual for these treatments to last for 20 to 30 years.

How long does it take to fit a dental crown?

Fitting a crown requires at least two visits to our office. Initially, we will remove decay, shape the tooth, and fit it with a temporary crown of either plastic or metal.

On the subsequent visit, we will remove the temporary crown and then fit and adjust the final crown. Finally, we will cement the crown into place and you have a new beautiful looking tooth.

Key Benefits of Dental Crowns

• Replaces missing teeth
• Offers support to misshapen teeth or badly broken teeth
• Looks completely natural
• Fixes “smile” and functional chewing problems

All of your teeth play an important role in speaking, chewing and in maintaining proper alignment of other teeth. Tooth loss doesn’t necessarily have to occur as you age, but if you do lose teeth they must be replaced to maintain proper function of your mouth. Fortunately, there are options for correcting tooth loss.

Dental Bridge Options

A bridge — a device used to replace missing teeth — attaches artificial teeth to adjacent natural teeth, called abutment teeth. Bridges are either permanently attached (fixed bridges), or they can be removable.

Fixed bridges are applied by either placing crowns on the abutment teeth or by bonding the artificial teeth directly to the abutment teeth. Removable bridges are attached to the teeth with metal clasps or by precision attachments.

If you’re missing one or more teeth, you may be aware of their importance to your appearance and dental health. Your teeth work together for many daily functions from eating to speaking. With missing teeth, it’s difficult to do these things. Missing teeth can and should be replaced. Fixed bridges are a great way to restore your dental health and appearance.

What exactly is a bridge or fixed partial denture?

A bridge (fixed partial denture) is a device which fills the gap where teeth are absent. Fixed bridges are bonded into place and can only be removed by a dental professional. Removable bridges, as the name implies, can be taken out and cleaned. Fixed bridges offer more stability than their removable counterparts.

Why do I need a bridge?

Oral functionality and appearance are important reasons for wearing a bridge. A bridge helps support your lips and cheeks. The loss of a back tooth may cause your mouth to sink and your face to look older.

Dental health is the most important reason for a bridge. Teeth were designed to complement each other. Unusual stresses are placed on the gums and other oral tissues when teeth are missing, causing a number of potentially harmful disorders.

Increased risk of gum disease has proven to be one of the worst side effects of missing teeth and can be minimized with a bridge.

Missing teeth can cause speech disorders as they are used to make many of the sounds we use to speak clearly.

What are dental implants?

Dental implants are a special device meant to securely hold removable dentures or permanent teeth replacements in the jawbone. They are a safe and esthetically desirable replacement for missing teeth lost as the result of dental trauma or periodontal disease. The placement of implants is often preferable compared to the use of fixed dental bridges or removable full or partial dentures. According to the National Institutes of Health, there is an intimate relationship between the masticatory apparatus and the cranium and cervical-scapular muscular system. Improper occlusal positioning resulting from missing teeth may result in headaches, neck pain, or pain in and around the temporomandibular joint. Cosmetics aside, dental implants may help optimize chewing and neuromuscular occlusion. By eliminating the bacteria-friendly surface where an opposing mandibular or maxillary tooth may come into contact with the site of a missing tooth, implants mitigate the effects of TMJ disorders and reduce the risk of bone loss in the jaw caused by the onset of periodontal disease.

Missing Teeth

Patients with missing teeth who wish to consider an implant should always consult a licensed dental care provider to determine if they are an ideal candidate for this procedure. Implants may be placed by general dentists with training and experience. In more complex cases, a patient may be better suited to having an implant placed by a dental specialist such as an oral surgeon, prosthodontist, or periodontist. The entire process of replacing a missing tooth with an implant and crown may be as long as six months, so it is imperative for both the provider and patient to feel comfortable with the time commitment necessary to complete the procedure.

Metal Cylinder

An implant is a small metal cylinder, most commonly made of titanium. Ceramic implants made from zirconium have been increasing in popularity, but they are not as durable as titanium and thus have a higher failure rate. Dental implants are inserted into the jawbone in a surgical procedure, and the patient may prefer the use of local or general anesthesia to minimize pain. The size of a dental implant is measured in diameters and typically ranges from 3.5 mm to 4.2 mm for anterior teeth and 4.5 to 6 mm for posterior teeth. The dental provider should carefully evaluate each patient and determine the ideal implant size before initiating the surgical process.

Common Types of Dental Implants

The most common types of dental implants are endosteal and subperiosteal implants. Endosteal implants are typically used in patients with adequate bone structure and no special complications. Subperiosteal implants are used in patients with weaker jawbone structure or minimum jawbone height that is not adequate to support an endosteal implant. This may be an ideal alternative to the use of dentures. Subperiosteal implants are fitted over a patient’s jawbone and supported by a surrounding metal framework as opposed to being inserted into the jawbone. After the gums and surrounding jawbone heal, subperiosteal implants are fitted with a crown resembling a natural tooth. Following the placement of a subperiosteal implant, a dentist may even recommend the use of a removable prosthesis in the form of a crown or denture. A removable prosthesis is often a metal frame that can be secured by the abutment, and it is less expensive than a permanent prosthesis.

Endosteal Implants

Endosteal implants are usually performed in four phases: planning, insertion of the implant in the jawbone, insertion of the abutment, and attachment of the crown. We will elaborate on this procedure since endosteal implants are most commonly used. During the planning phase, the dental provider conducts a thorough examination of the mouth and instructs the assistant to take dental X-rays and create a dental impression of the future site of implant placement. In addition to the examination, the dental provider will comprehensively evaluate the patient’s medical history, medical conditions, and document all medications the patient is currently taking.

Inadequate Bone Structure

If there is an inadequate bone structure in the jaw to accommodate an endosteal implant, the patient and dentist may discuss the possibility of a bone graft. The bone graft may be performed by an oral surgeon if the dentist believes that a specialist would be ideally suited to performing the procedure. The bone graft may utilize biocompatible synthetic bone material or bone tissue from the patient’s own body to strengthen the jawbone.

Insertion of the Implant

During the insertion of the implant, the patient usually presents to the dentist office for a surgical procedure. In exceptional cases, the implant procedure may be done as an outpatient procedure in a hospital setting. Following the administration of anesthesia, the dentist makes an incision in the gums to expose the jawbone. Once the appropriate amount of jawbone structure is exposed, the dentist will drill into the jawbone and create a void which will hold the implant. The provider will drill just enough to accommodate the implant that is the ideal size for the particular tooth being replaced. The implant is screwed into the patient’s jawbone, and the gum tissue is closed with absorbable or nonabsorbable sutures. This leads to the process of healing. The healing process is officially referred to as osseointegration, where the jawbone heals and fully bonds to the surrounding implant. During the healing phase, a patient may use a temporarily removable denture to resemble an actual tooth. The healing process may take up to 6 months, depending on the patient.

Abutment

Following the placement of the implant, an abutment is commonly placed on top of the implant cylinder. The abutment may be placed immediately after the implant or done as a second surgical procedure following the implant. The dentist will determine which sequence is ideal based on the conditions of the individual patient and the respective tooth being replaced. The abutment will be visible during the healing period. Upon placement of the abutment, the gum tissue is sutured, and the top of the abutment will be visible above the gum line. The healing process following the placement of the abutment typically takes a few weeks.

Crown

Once the healing process is complete, the dentist will proceed to insert a false tooth, also known as a crown. A customized impression of the abutment area and the surrounding teeth is taken, and the impression is sent to a laboratory of the dentist’s choosing. The laboratory subsequently manufactures the prosthesis according to the provider’s specifications. The making of a crown is both science and art, and a ceramist in the lab is responsible for this task. Modern dentistry places a great deal of emphasis on cosmetics, and there is an array of corresponding colors to choose from. It is even possible to stain, glaze, and bake a crown to be virtually indistinguishable from a natural tooth and unrecognizable to others that the patient has a dental implant. Once a dental crown is made according to the custom needs of the patient, the prosthesis is permanently cemented onto an abutment. Patients should carefully choose a dental provider based on their prior experience in implant placements as well as cosmetic outcomes.

Side Effects and Complications

With proper care, dental implants may last several decades or even a lifetime. However, there is always a risk of side effects and complications following implant surgery. Common side effects include swelling and bruising of the gums and face, pain, bleeding, and stiff facial muscles. Less common complications may involve an infection around the site of the implant, damage to nearby teeth or blood vessels, and nerve injury. A panoramic X-Ray is a valuable diagnostic tool, and a dentist should thoroughly evaluate the positioning of sinuses and the positioning of the inferior alveolar nerve to minimize the possibility of sinus infection or nerve injury. If the inferior alveolar nerve is damaged, the patient may experience a loss of sensation in the gums, lips, and cheeks. In rare cases, the process of osseointegration may fail, and the jawbone may not close properly around the implant cylinder. If the implant cylinder is loose due to poor placement or placement of an endosteal implant in a patient who may not be an ideal candidate, the implant must be removed, and the surgical process needs to be repeated after the bone has healed.

Implant Care

Following the placement of an implant, patients are advised to care for implants as natural teeth and keep the surrounding gum area clean by regularly brushing and flossing. Immediately after surgery, patients should eat a diet consisting of soft foods. Upon healing, patients should avoid hard foods such as candy and jawbreakers which may crack the implant crown. If a patient experiences bruxism, they should consider using a mouthguard to minimize the possibility that the implant crown will break. All patients are advised to abstain from chewing tobacco or smoking because tobacco can stain teeth and smoking can injure the gum structure.

What are Dental Implants most useful for?

Dental implants are most useful for patients who do not wish to use partial or full dentures which are in good oral health. If patients have a condition that impedes healing or do not have enough bone tissue to anchor an implant, the only option to replace missing teeth may be the use of a removable denture. With recent advancements in dentistry, implants are usually an ideal choice for replacing missing teeth, and long-term success is contingent on the selection of an experienced dental provider and a patient’s commitment to maintaining optimal oral health.

Contact Cranio Associates Today

If you believe you require dental implants or oral surgery, Cranio Associates has over 40 years of experience providing quality implants to patients. Call (201) 297-9837 to schedule your appointment with an experienced dentist or oral surgeon at Cranio Associates located at 2185 Lemoine Ave, Fort Lee, New Jersey 07024