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Duluth, GA 30097

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What are the Best Materials for Implants and Crowns?

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I am getting a smile makeover, which will probably include at least eight dental implants on my upper arch. I am trying to do my homework ahead of time and have some questions. First, as far as implants go, are the Astra Implants from the UK reliable?  I also wondered if zirconium was okay for crowns. I did read that porcelain fused to metal can leave a black line, but wanted something strong. I’m worried zirconium will be clear colored, though. Any help you can give will be appreciated, my appointment is coming up fairly soon.

Valerie,

Dear Valerie,

An assortment of titanium and zirconia dental implants.

 

I am glad you are trying to do research. However, I would like to steer you in a different direction. The most important thing to research is the dentist doing your dental implants procedure. That has a much greater impact on your result than the materials used. Before we get into what to look for, I want to ask you a question. You mentioned that the reason for your dental implants was a smile makeover. However, unless the teeth needed to be extracted, that is a gross overtreatment. The typical procedure for a smile makeover is porcelain veneers which hardly removes any tooth structure. A dental implant requires you to lose the entire tooth.  I just want to make sure the implants were necessary before you go through with this.

Dental implants are quite an advanced procedure. So advanced, however, that dental school is not enough training. It takes significant post-doctoral training to be able to do this the way it needs to be done. There is no way you can learn enough about the materials in the time you have. Plus, so much of it will also depend on your specific case. Look for a dentist with implant qualifications. As for the zirconium. That will be white, not clear. I hope that puts your mind at ease.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

 

Dentist Can’t Match My Implant Crown because I’m “Between Shades”

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I have a dental implant that was placed on a front tooth. While waiting for the healing time to take place I wore a dental flipper. It didn’t completely match the adjacent front tooth but I knew it was temporary and that the porcelain crown would be better so I tried not to think about it too much. Unfortunately, my experience with the dental crown hasn’t been much better. I’ve asked my dentist to re-do it twice and now he is getting frustrated with me. He said the problem is that my teeth are between the two shades offered for dental crowns. Is there no way to get an exact match on this? Am I being too picky? It would not matter to me nearly as much if it wasn’t a front tooth.

Cassie

Dear Cassie,

Color map for a tooth

You are not being too picky. It sounds like your dentist is used to doing a lot of general dentistry but does not have any extensive understanding of the aesthetic side of dentistry. There are shade guides that dentists use to match dental crowns to tooth color. However teeth are rarely exactly like the shade guides. On a tooth that is toward the back, this is not a big deal because close is enough with the shadows from our mouth hiding the minute differences.

A front tooth is different. A skilled dentist would not just send the lab a simple shade reference. They would send a color map along with it similar to what I have above. This uses different tints to help the lab mimic the variations that occur in our natural teeth. Your dentist may not be able to do this. It takes some skill and cosmetic training. He may not even have the material necessary to help him derive the correct color mapping.

So you know, when it comes to front teeth, even the most skilled cosmetic dentist will have to do several tries. They are harder than your other teeth because they are so exposed to the light. However, it sounds like your dentist isn’t trying to get an exact match and has just given up. In that case, you will be better served getting a refund for the crown part of your dental implant procedure and having that done by another dentist who is willing to put in the necessary work.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Will Metal Show On Front Dental Implant?

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I was playing football with some friends and was not wearing a mouthguard (or a helmet). I already know that was stupid so don’t bother getting onto me about that. I would like to get a dental implant to replace the tooth. I am concerned, however, that the metal from the dental implant will show through in the gums because it is a front tooth. Is there anything I can do about that?

Carl

Dear Carl,

An assortment of titanium and zirconia dental implants.

While everyone’s body is different, most people have no problems with their dental implants showing through. Your dentist will run tests to check all the factors involved in whether you are a good candidate for dental implants. Make sure your dentist includes a CT scan in the diagnostics. Dental implants are a 3-dimensional procedure and it requires 3-dimensional imaging. This will help with more than just bone density and gum depth. It will also help your dentist avoid your nasal cavity as well as any nerves.

The key to a successful dental implant procedure is a skilled implant dentist. Unfortunately, there is not a recognized specialty in dental implants. If a dentist wants to develop that skill set, they need to get post-doctoral training. You will need a dentist who has invested in that training.

There are way too many dental implant horror stories from patients who underwent the procedure with an underqualified dentist. I do not want that to happen to you. My suggestion is that you look at Dr. Marion’s qualifications to get an idea of the type of dentist you need.

One other consideration. Generally, an oral surgeon will do the surgical part and then the dentist will do the restoration. However, it is very important that it is the dentist who determines the placement of the implant. Go to the dentist first, then the oral surgeon.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Should I Update My Dental Implants?

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I have had my dental implants placed about ten years ago. I keep reading about these advances in the technology. I’ve got two on my bottom left and one on the upper right. I’m about to need another one and wondered if I should just go ahead and switch out the rest of them at the same time. If so, what are your thoughts on the zirconia dental implants?

Dean

Dear Dean,

An assortment of titanium and zirconia dental implants.

Most of the dental implants used ten years ago were made of titanium. There is abundant data that these are very biocompatible and will last for a lifetime if well cared for. The only part that will still need replacement, even with care is the crown that tops it. You may find that they need to be replaced every ten years or so.

Should You Replace Your Dental Implants?

Replacing dental implants is not as simple as taking the old ones out and putting in new ones. Because the dental implants integrate with your bone, there will be some bone loss when you extract the implants. That bone is essential to the retention of any new implant placed. In order to have enough bone again, you will need to do a bone grafting porcedure. That means a surgery to remove the implants. A surgery to get the bone grafting done. Then, a surgery for the new dental implants. That is three different chances for something to go wrong. At the moment your dental implants are just fine, so I am not sure it will be worth the trouble, expense, and risk of doing the multiple surgeries.

The newer implants are made from zirconia rather than titanium. Honestly, though, most dentists still use the titanium implants because they have been studied for decades and have a phenomal long-term success rate. Zirconia implants could be fine, but they have not been studied as long.

In your place, I would keep the current implants while they are still working fine and, if you want to, you can get the newer zirconia implant for the tooth you need to replace currently.

There are things you can keep an eye on for your other implants and if they show signs of failing, then you can go ahead and replace them then.

  • Discomfort and difficulty biting
  • Pain and discomfort around the implant
  • The implant shifting or loose
  • Gums receding around the implant
  • Swollen or inflamed gums

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Is a CT Scan Truly Necessary for All-on-4 Dental Implants

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I am considering getting dental implants, specifically the all-on-4 dental implants. I’ve done a ton of x-rays and such and now the dentist wants me to get a CT scan. Is this really necessary or is this more of a way for him to line his pockets? I don’t want to spend unnecessary money and I certainly don’t want more radiation than is necessary.

Billy

Dear Billy,

all-on-4 dental implants

I’m glad you wrote. It is great that you chose dental implants as your tooth replacements. They are top of the line and the closest thing to having healthy, natural teeth in your mouth. Generally, all-on-4 is used for people who are already dealing with some bone loss. If that ends up not being you, it may be in your best interest to get implant overdentures. With all-on-4, if one implant fails, the entire thing has to be redone. However, that is not the case with an implant overdenture. Now to your question.

Importance of a CT Scan

Diagnostics on Your Bone Capacity

In order for dental implants to stay in place, the surrounding bone needs to integrate with the implant in a process known as osseointegration. However, if you don’t have enough bone then, you need to look at your options.

Finding the Best Procedure

In some cases, there isn’t too much bone loss and you can still get the all-on-4 procedure. However, in some cases, there is enough bone gone that you would need to do a procedure to replace it known as bone grafting. This will enable you to get overdentures if you are interested or you could stick with the all-on-4.

Getting the Correct Landscape

Getting dental implants of any type is a 3dimensional procedure. X-rays alone will not give the dentist enough information. They need 3D images of your mouth and jaws, including close to the nasal cavity. This will give them adequate measurements for safe placement of your implants. Dentists who take short cuts will often end up misplacing the implants or puncturing the nasal cavity.

So, in your place, I would definitely get the CT scan.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Can I Get Implant Parts Online?

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I have snap on dentures. I often have to replace the male retention caps. At this point, I am having trouble affording even the basics in this economy. Last week I had to choose between food and replacing my retention caps. My dentist charges $25 per cap. So a set costs me $100. I just can’t do this anymore. I looked online and you can get four for $20 for the whole set. That is quite a markup. I tried to order them online, but you have to be a dentist for them to send them to you. Is there any way for me to get these?

Larry

Dear Larry,

Snap on Dentures

You have three good options here. First, would just be to talk to your dentist directly. Let him know your situation. While it is true that dentists need to mark up some things to help with overhead, this will be such a minor boost to his overhead that he should be willing to work with you on this. If he doesn’t, here are two other things you can try.

Call around to some other dental offices and talk to the staff. Most dentists and the people who work for them are compassionate. It’s normally the staff that orders these and not the dentist directly anyway. They just use his information on the orders. Start with dentists who offer affordable dental implants. They are more willing to work with people on tight budgets.

If both of those things fail, I looked on Ebay. They do sell them and some of the overseas sellers do not require you to be a dentist to purchase them. The only downside to this option is you’ll have to know how to pop them into your denture as well as exactly what you need. There are varying strengths and resistance on these items.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Perforated Sinus During Dental Implant Procedure

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I had a failed dental implant procedure and the dentist recently removed the implant. He said there was no trouble removing it because the implant had not integrated with the bone at all. During the procedure, the sinus cavity was perforated by a few millimeters, which my oral surgeon says happens all the time. At that time of the removal, he said there was no need to do any preventative antibiotics. He did suggest I take Flonase as well as be gentle with the area. Though he stitched the gums, he said there was no need to close up the sinus cavity because it will heal on its own. He wants me to wait a year and then we will try again for the dental implant. A few days later, I started having congestion and this weird crackling sound even though I was taking the Flonase as instructed. I went back to have him look at it and he said for me to be patient. I told him I felt I needed an antibiotic. At first, he said no but I pretty much insisted. He finally gave me some antibiotics and I started feeling better and everything cleared up. My question is would it have been better to get the antibiotics during the removal procedure to prevent this?

Leslie

Dear Leslie,

illustration of a dental implant next to a tooth

While the way he handled the antibiotics is fine, I want to let you know that there is something much more concerning about this whole situation, which is the sinus perforation itself along with the lack of integration with the bone. While there are times that a sinus cavity will be perforated, a few millimeters is way too much. That is a huge distance by dental standards. Additionally, most of the time this is completely avoidable with adequate diagnostics.

Before letting him work on you again I would want to know two things. First, what diagnostics will he do in order to prevent this from happening again? Secondly, why didn’t the dental implant integrate with the bone? That will be important to know. It is standard procedure for him to do x-rays to ensure there is adequate bone there to begin with. This should have included a CT scan to ensure that something like a sinus perforation doesn’t happen. Placing dental implants is a three-dimensional procedure and requires three-dimensional diagnostics.

My suggestion is you make sure he can answer these questions before moving forward. It would also be helpful for you to get a second opinion on your case to give yourself the best chance of a successful outcome.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Bone Grafting Didn’t Work. Now What?

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I don’t know if third time can be the charm for me or if I should just give up. My dentist has placed many dental implants over the years so I felt fairly confident going into my dental implant procedure. Unfortunately, once he got in there he realized there was some problem with my bone structure and did not place the implants. He suggested we do a bone grafting procedure and then try again. I agreed and off we went to the bone grafting procedure. After the specified period of time, we went in for a second stab at the dental implants. Again, he said there was still not enough bone and he thinks I should just get a dental bridge. If I absolutely must, I supposed I must. However, I’ve invested so much in there and really wanted an implant. Is there any chance I can get one?

Kevin

Dear Kevin,

illustration of a dental implant next to a tooth

I believe it is still possible for you to get a dental implant, however, you may have to do it with another dentist. One with stronger implant credentials and experience. I don’t want to be hard on your dentist. He actually sounds like one who has integrity, a passion for getting it right, and is upgrading his skills. Those are fantastic things to have in a dentist.

Some dentists, with less integrity than your dentist, would try to save themselves the embarrassment of saying their procedure did not work and just go ahead and place the dental implant. Then, in a year or so, the implant would fail. You would have no idea it was because of something your dentist did wrong. Instead, your dentist did what was best for you in the long run.

It sounds like, though he has done many implant placements, he is new to doing the bone grafting. This is also a good quality in a dentist. It means that he is actively working to learn new skills and have more options for his patients. Most dentists who do dental implants don’t even try bone grafting and will just have you get a dental bridge just saying you don’t have enough bone for an implant. I would not give up on him as your dentist. You definitely have a keeper. I just think this one procedure needs someone a bit further along.

So, who should you get? I would look at the implant credentials on Dr. Marion’s bio to give you some idea of the type of training and experience you will need for this.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

16 year old Still Has Baby Canine Teeth

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I am 16 and still have my top two baby canine teeth. They look really stupid next to my big teeth. Is it possible to take the baby teeth out and replace them with dental implant teeth that are the right size?

Allie

Dear Allie,

metal and zirconia dental

My first question is to know whether or not you’ve been under the care of a dentist as you were growing up? If so, he or she was quite negligent in not taking care of this for you. Do you know whether or not you have adult canine teeth beneath the baby teeth? That would determine what solution is best. If you’re not sure, the first thing you will need is a good set of x-rays.

If you do have your adult teeth but they just haven’t erupted yet, then the most common reason for that is that they are impacted. You’ll need to have the baby teeth extracted and then have an orthodontist help you get them in the right position to erupt properly. Dental Implants will not work in that situation because you have teeth that are already there.

There are occasions where you’ll have congenitally missing teeth. In that case, dental implants will be a great permanent solution after your jaw has fully developed. What you can do in the meantime is have the baby teeth extracted and get your other teeth back into alignment in order to make room for the adult teeth. Then, when there is enough space for the adult teeth, you can get a temporary tooth replacement. Don’t spend a lot of money on that because you won’t need it for too long. I would get something like a dental flipper.

Once your jaw is fully developed, it will be time to get that permanent replacement. Make sure the dentist has significant post doctoral training in dental implants. Dental school is not enough for such an advanced procedure. Three great post-doctoral institutes for this will be the Dawson Academy, The Pankey Institute, or The Las Vegas Institute for Advanced Dental Studies.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Titanium Versus Zirconia Dental Implants

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I have concerns about metal being used in a body. I already have two metal implants and now found out that I will need another one. My understanding is there are now non-metal implants. But my dentist doesn’t feel these have been around enough yet to warrant using them yet. Is there a reason why I shouldn’t? Should I switch out my older implants for these newer ones?

Carol

Dear Carol,

metal and zirconia dental

I am going to start with your last question first. Unless there is something wrong with the dental implants, I would not switch them out. Here is why. When your dental implants are removed they take some of the jawbone with it. That bone is essential for you to have a successful implant procedure, so before you can put the new implants in, you will have to have a bone grafting procedure in order to build back up that bone. Once that is healed, you can then have another surgery to place them. That is three additional procedures to replace successful dental implants. Each of those three procedures carry the risk of complications and failure. I would leave the succesful implants in place for as long as possible.

It is likely that your dentist’s concerns over the zirconia implants has to do with the lack of data we currently have on their longevity. The reason for that lack of data is they haven’t been around as long. We have tons of data on the titanium implants because they have been in use for decades. The zirconia are likely just as enduring, they just haven’t been around long enough to say that. Zirconia, nicknamed ceramic steel is certainly strong enough.

So, which should you get? Honestly, whichever one you want. However, I don’t want you thinking that the ones you have are dangerous to you. You mentioned concern over having metal in your body. Not only is titanium, the metal your current implants are made of, extraordinarily biocompatible, but our bodies need and use metals every day. One major example is our blood. If it doesn’t have enough iron, you become anemic, which can cause serious health problems.

If you do decide that you want the zirconia implants, my suggestion is that you do it with another dentist. Your current dentist does not seem comfortable wtih them and it is never a good idea to push a medical provider outside of their comfort level. You are better off finding a metal-free dentist who will have done this procedure quite a bit.

This blog is brought to you by Dr. David Marion, who tries to be the best dentist in Duluth, GA.