April 08, 2004

By: Ernest Horner
Website: http://www.teeth-whitening-smiles.com

Teeth Implants – Fill The Gap

It’s every parent’s nightmare, a child losing a permanent tooth due to a sport’s injury or other mishap. This is especially true if a big gap is revealed when the child smiles. Young patients now have a solution better than solutions of the past, according to doctors scheduled to speak at the 85th American Association of Oral and Maxillofacial Surgeons annual meeting in Orlando, Fla.

That solution is a dental implant—an artificial tooth root that resembles a golf tee made of titanium (the same material as artificial hips). The implant supports an artificial tooth (or teeth).

While implants were initially developed as an alternative treatment to removable dentures, they have been used successfully in children for about a decade, according to Stuart L. Graves, D.D.S., M.S., an oral and maxillofacial surgeon practicing in Fairfax, Va. Further, the timing of implant surgery is different in children than adults since children’s jaws are still growing. With growth, there is the possibility that the implant can gradually sink into the bone.

Although timing of implantation remains critical, research and years of clinical experience have taught OMSs that dental implants can be safely and effectively placed in children earlier than previously thought, Dr. Graves reports.

The ideal age for placement is 15 for girls and 17 for boys, says Dr. Graves. Even when the child is younger, the downsides of not placing an implant can outweigh the risks of placing one. Those downsides can include bone loss around the missing tooth, drifting of the adjacent teeth, or the need for braces to keep remaining teeth in place. All these factors need to be considered. It’s a tricky judgment call, says Dr. Graves.

Traditionally, the dentist places a bonded bridge or a removable retainer in the child’s mouth as a space holder until the child is ready for an implant. These appliances do nothing to prevent bone loss in the alveolar ridge (the bony ridge supporting the tooth). If bone loss occurs more rapidly than expected, the implant may need to be placed earlier, Dr. Graves notes. On the other hand, if an implant is placed and it sinks into the bone (with the growth process), the child may need a new crown within a few years.

Doctors are realizing that earlier placement of dental implants can have significant cosmetic benefits. Younger individuals tend to show more upper teeth and gums, so the difference of only a few millimeters in the height of bone (alveolar ridge) and gum around a single tooth draws attention to itself. If you wait too long, the bone around the lost tooth heals and shrinks and doesn’t look natural.

OMSs now know that implants can be placed safely in younger children, thanks in part to studies of children with ectodermal dysplasia, a hereditary disorder marked by abnormal development of the skin and associated structures, including teeth, hair, sweat glands and nails. ED affects about 1 in 10,000 children. Most children with ED have multiple missing and/or malformed teeth. Many need dentures as early as age five. Dental implants have been placed successfully in ED patients as young as seven or eight, according to Dr. Graves. And these children often require bone graft surgery before implant placement because they have little jaw bone to support the implants.

Dental implants are made of titanium, a highly biocompatible metal that bone grows into via a process known as sseointegration. In the past, it took up to six months to integrate with the implant. But surface changes made in the metal speeds the process of bone growth to the implant. Integration now takes only two to three months. Manufacturers etch the surface of the implants creating microscopic pits and valleys on the titanium surface. Bone cells fill the pits and valleys forming a strong bond. Once integrated, implants stimulate bone growth. An integrated implant is also much stronger than a natural tooth.

OMSs can place implants using local or general anesthesia. The procedure takes Dr. Graves approximately 15 to 20 minutes per implant. All patients receive antibiotics following surgery. The infection rate is only one percent, which is less than the rate for wisdom tooth procedures. The OMS only places the dental implant and a restorative dentist places the crown or cap.

Author Notes:

Ernest Horner contributes and publishes news editorial to http://www.teeth-whitening-smiles.com.  Everything you need to know to get a whiter, brighter smile!