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Posts for tag: dental implant

By Paul E. Marcuz, DDS, PC
November 28, 2021
Category: Dental Procedures
Tags: dental implant  
ShouldYouTakeanAntibioticBeforeImplantSurgery

Although getting an implant requires surgery, it's usually a minor affair. Chances are good that after just a few days recuperation you'll be back completely to your normal activities.

But like many other minor surgeries, an implant procedure does pose a slight risk of post-op infection. That's especially so with any dental procedure like implant surgery, since the mouth harbors numerous strains of bacteria that could escape into the bloodstream. For most people, though, a post-op infection doesn't pose a major problem since their immune system kicks in immediately to defeat it.

But some patients with less than robust immune systems or other health problems can have serious complications from an infection. Among other things, infected tissues around an implant may not heal properly, putting the implant at significant risk for failure.

If you have a condition that makes a post-op infection problematic, your dentist or physician may recommend you take an antibiotic before your procedure. Known as prophylactic (preventive) antibiotic treatment, it's intended to give a weakened immune system a head-start on any potential infection after a procedure.

Using antibiotics in this way has been a practice for several decades, and at one time were recommended for a wide list of conditions. That's changed in recent years, though, as evidence from numerous studies seems to show the risk to benefit ratio isn't significant enough to warrant its use in all but a handful of conditions.

Both the American Dental Association and the American Heart Association recommend prophylactic antibiotics for patients with prosthetic heart valves, past infective endocarditis, a heart transplant and some congenital heart conditions. Some orthopedists may also recommend it for patients with prosthetic joints.

Even if you don't fall into these particular categories, prophylactic antibiotics may still be beneficial if you have a compromised immune system or suffer from a disease like diabetes or lung disease. Whether or not a prophylactic antibiotic is a prudent step given your health status is a discussion you should have with both your physician and your dentist.

If they feel it's warranted, it can be done safely in recommended doses. If your health isn't as robust as it could be, the practice could give you a little added insurance toward a successful implant outcome.

If you would like more information about dental implant surgery, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Implants & Antibiotics.”

By Paul E. Marcuz, DDS, PC
November 24, 2019
Category: Dental Procedures
Tags: dental implant  
GettingaNewToothinOneDayWillDependonYourBoneHealth

If you've thought the ads for a “new tooth in one day” seemed too good to be true, we have…sort of good news. You can get a new “tooth” in one visit, but only if your dental situation allows it.

The restoration in question is a dental implant, a metal post (usually titanium) surgically imbedded into the jawbone. They're especially durable because bone cells naturally grow and adhere to an implant's titanium surface, a process called osseointegration. Over time this process creates a strong bond between implant and bone.

Usually, we allow a few weeks for the implant to fully integrate with the bone before attaching the visible crown. With “tooth in one day,” though, we attach a crown at the same time as we install the implant, albeit a temporary crown. It's more aesthetic than functional, designed to avoid biting forces that could damage the implant while it integrates with the bone. When that process finishes, we'll install a permanent porcelain crown.

The health of your supporting bone and other structures will largely determine whether or not you're a candidate for this “tooth in one day” procedure. Your bone must be sufficiently healthy, as well as the gums surrounding the implant and the tooth's bony socket.

If, on the other hand, you have significant bone loss, gum recession or socket damage, we may first need to deal with these, usually by grafting tissue to the affected areas to stimulate new growth. Your implant, much less a temporary crown, will likely have to wait until the affected tissues have healed.

The bone can also be healthy enough for implant placement, but might still need time to integrate with the implant before attaching any crown. Instead, we would suture the gums over the implant to protect it, then expose and attach a permanent crown to the implant a few weeks later.

Obtaining even a temporary crown the same day as your implant can do wonders for your appearance. A more important goal, though, is a new tooth that you can enjoy for many, many years. To achieve that may mean waiting a little longer for your new beautiful smile.

If you would like more information on restoring missing teeth with dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Implant Timelines for Replacing Missing Teeth.”

By Paul E. Marcuz, DDS, PC
November 14, 2019
Category: Dental Procedures
Tags: dental implant  
CleanYourImplantsJustLikeYourOtherTeeth

You feel great about your new smile, thanks to dental implants! And you may also be feeling relief as the problems with your former teeth fade into the past.

But that doesn’t mean you can drop your guard on periodontal (gum) disease. Even though implants are impervious to decay, the natural tissues supporting them are vulnerable to periodontal (gum) disease. If they become diseased, your implants could lose their bone support and eventually fail.

And that failure could happen quickly. That’s because, as life-like as they are, implants don’t have one important advantage of real teeth: an attachment to a connective tissue called the periodontal ligament. This tough but elastic ligament lies between the teeth and the bone, attaching to both with tiny extending fibers and holding the teeth in place.

And that’s not all: Because the periodontal ligament contains an abundance of blood vessels, it can supply antibodies to help fight infection. The body’s defenses may not be able to stop disease, but they can certainly inhibit its progress.

Implants can’t benefit from this infection-fighting mechanism. So, when an infection arises in the gums surrounding an implant, it can spread rapidly through a form of gum disease known as peri-implantitis (literally “inflammation around an implant”). If we don’t stop it with prompt treatment, you could lose bone support from your implant and eventually lose it, sometimes in quick fashion.

That’s why you should clean your implants everyday like you do the rest of your teeth with brushing and flossing. You should also visit us regularly for dental cleanings. A dental cleaning involving implants is similar to one with natural teeth, except the hygienist won’t use metal instruments on the implants—this could create tiny scratches on their surface. Instead, they’ll use nylon or plastic instruments or ultrasonic equipment to clean them.

You should also make a dental appointment as soon as you notice swollen, reddened or bleeding gums. If you have gum disease, we can stop the infection through treatment and restore your gums to health. This can be a long and involved process, but it’s necessary to preserve your implants.

It’s true that implants can change your life. If you want to enjoy that change for a long time, take care of your implants and the natural tissues that support them.

If you would like more information on caring for dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implant Maintenance.”

DiabetesDoesntHavetoStopYouFromGettinganImplant-ifitsUnderControl

You would love to replace a troubled tooth with a dental implant. But you have one nagging concern: you also have diabetes. Could that keep you from getting an implant?

The answer, unfortunately, is yes, it might: the effect diabetes can have on the body could affect an implant's success and longevity. The key word, though, is might—it's not inevitable you'll encounter these obstacles with your implant.

Diabetes is a group of metabolic diseases that interfere with the normal levels of blood glucose, a natural sugar that is the energy source for the body's cells. Normally, the pancreas produces a hormone called insulin as needed to regulate glucose in the bloodstream. A diabetic, though either can't produce insulin or not enough, or the body doesn't respond to the insulin that is produced.

And while the condition can often be managed through diet, exercise, medication or supplemental insulin, there can still be complications like slow wound healing. High glucose can damage blood vessels, causing them to deliver less nutrients and antibodies to various parts of the body like the eyes, fingers and toes, or the kidneys. It can also affect the gums and their ability to heal.

Another possible complication from diabetes is with the body's inflammatory response. This is triggered whenever tissues in the body are diseased or injured, sealing them off from damaging the rest of the body. The response, however, can become chronic in diabetics, which could damage otherwise healthy tissues.

Both of these complications can disrupt the process for getting an implant. Like other surgical procedures, implantation disrupts the gum tissues. They will need to heal; likewise, the implant itself must integrate fully with the bone in which it's inserted. Both healing and bone integration might be impeded by slow wound healing and chronic inflammation.

Again, it might. In reality, as a number of studies comparing implant outcomes between diabetics and non-diabetics has shown, there is little difference in the success rate, provided the diabetes is under control. Diabetics with well-managed glucose can have success rates above 95%, well within the normal range.

An implant restoration is a decision you should make with your dentist. But if you're doing a good job managing your diabetes, your chances of a successful outcome are good.

If you would like more information on dental care and diabetes, please contact us or schedule an appointment for a consultation.