One of the most exciting advancements in dentistry to date is the dental implant. The process boasts a 97 to 98 percent success rate for the life of the patient. It preserves bone instead of destroying it. It can look, feel, and behave like a natural tooth.
Implants may be appropriate for you if you have:
- A bridge that requires replacement
- An ill fitting full or partial denture
- An ill fitting partial denture
- Missing teeth
- A tooth you are losing due root canal or gum disease failure
The finished prosthetic complex has three physical parts: the fixture, the abutment, and the prosthetic crown. The fixture is a milled titanium screw roughly one-quarter of an inch in diameter and three-quarters of an inch in length. The abutment is the connecting post which screws into the fixture and supports the final prosthetic crown. And the prosthetic crown is a precisely engineered crown that is either glued or screwed in place to the abutment.
The process involves the coordination of two specially trained doctors; an oral surgeon or periodontist to place the fixture/screw into the bone and the restorative dentist to build the prosthetic crown to fit the screw. The proper and constant communication between these two professionals ensures the best possible esthetic and functioning outcome.
Numerous companies manufacture the implant parts. The big name players are Nobel Biocare ©, Straumann, and Dentsply Friadent®. Others are also proving their place in the market. But the main advantages of choosing one of the big companies are:
- Increased length of time in the industry leads to product stability
- Amount of funding for research and development leads to superior engineering
- Existence of product warranties
- Readily available service representatives worldwide.
We use, and are certified and trained by all three major suppliers, but choose to limit the practice to Straumann and Dentsply Friadent® products. Dr. Madurowicz believes the simplicity of their design and engineering increases the prosthetic’s longevity and stability. Additionally, their proven esthetic results are indisputable.
1 implant 3 veneers“Working with Dr. Madurowicz and his team is a wonderful experience. They take great care of every need. Dr. M. never rushes you or makes you feel like you are asking too many questions. He gives you all the time you need to feel confident of your decision. Dr. M. gives you all the options with no pressure to do anything that is out of your budget. He provides a perfect job with plenty of advanced notice of what to expect. Dr. M. will make sure you look fabulous!”– Suzanne
10 Uppers, 1 Front Tooth Implant, 9 crowns/veneers and Whitening“I no longer feel self conscious about smiling. I love showing my beautiful teeth and now my smile is contagious.”– Liz
Glued vs. Screwed In Prosthetic Crown
The first prosthetic crowns were of the retrievable/screwed-in variety. They would occasionally come loose, because of the flat table design of the components. The design required an access hole on the chewing surface of the crown which now can be well masked with a tooth colored resin. Recent evolution in designs by Straumann introduced the “Morse Taper” in which the mating surfaces meet at an angle, causing a cinching down of the components. This design virtually eliminated the screw loosening of the previous designs. Other companies have now followed suit.
The main advantage of the screwed-in design is the opportunity to remove and disassemble the prosthetic complex in the face of a complication. If compromised bone and/or tissue are present this feature can be a future benefit. The recent success rates and the desire not to see a visual screw hole in the crown has moved the desired choice of mating the components to the glued-in variety. This is very similar to traditional cementing of crowns and bridges.
In some cases we now have a choice of a lateral screw (i.e., set screw) that is well hidden at the interior gum line if retrievability is desired and a surface hole is not.
Superior Implant Esthetics is now possible
Patience is required throughout the process. It can take anywhere from four to 18 months, start to finish. If the tooth is already missing and the bone level is good, with no sinus interferences, then you can expect the minimum time. Complicating factors such as tooth infection, gum disease, sinus proximity, jaw ridge insufficiency, and smoking will increase the time required.