October 1, 2007 Researchers find that by imaging the mouth with a 3-D CT scan, they are able to create and insert a complete dental implant in one day. Instead of waiting for six months between placing the implant and the crown, this imaging technique allows the surgeon to locate the exact spot to place the implant. As important is the technique of immersing the surface of the implant in an acid bath, followed by an anodic electronic charge, to create a porous surface, hastening the fixation of the implant to the bone.
About 100 million Americans are missing teeth. But dentures or crowns can look unnatural and don't last forever.
For years, Hady Koraym suffered with bad, weakened teeth. "I always had like, um, pain with cold drinks and hot drinks," Koraym says.
To help stop his suffering, dentists pulled most of his teeth, leaving him without a smile. Now, a new 3-D dental implant procedure gave Koraym permanent teeth in just one hour.
"Most of the patients, they come out with a smile," says Liene Molly, M.D., Ph.D., D.D.S., periodontist from the University of Maryland Dental School in Baltimore, M.D. Traditional implants can take almost a year to complete. The new procedure is a faster, less painful solution for missing teeth.
"The traditional way of having implants is having two surgeries. So, now we can reduce it to only one surgery. That's very pleasant for the patient," Dr. Molly says. Periodontists first use CT scans to make a 3-D model of a patient's mouth. Then, using the model as a guide, doctors locate the exact spot in the mouth to place the implant and crown on top, all in one, minimally invasive surgery.
"You can visualize the bone. You can visualize how the teeth will be and how they can come together in one area," says Deborah Armellini, D.D.S., prosthodontist from the University of Maryland Dental School in Baltimore, M.D. Prosthodontists say the new procedure is a more accurate and more natural looking solution for patients wanting a return to eating, drinking and smiling with confidence.
"The most exciting thing for me is the ability to give a higher quality of life for patients." Dr. Armellini says. "Now, I feel very good," says Koraym.
Patients are put under local anesthesia during the procedure. To find a dentist performing the new implant procedure, contact the University of Maryland Dental School at: www.umaryland.edu
BACKGROUND: Guided dental surgery based on three dimensional scans, new biomaterials, and what dentists call immediate 'loading' (installation) of the crown over a dental implant now makes it possible to get a complete tooth replacement in just one day. The one-day implant is now possible because the surfaces of the implants have been modified to enhance the rate of its fixation to the bone. The implant surface is treated by immersing it in an acid bath, followed by an anodic electronic charge to create a porous surface. The implant incorporates TiUnite as a replacement bonding agent, a biomaterial made of titanium that actively enables integration with human bone and soft tissue growth around the implant at the gumline. This allows the implant to look more natural, since there is no dark line where the implant and bone are connected.
BENEFITS: Getting an implant used to be a six-month procedure, first placing the implant in the bone and then waiting six moths for the bone to heal before placing the crown on top. With immediate loading, it's now possible to insert the crown the same day the implant is placed. At the same time, new 3D computerized tomography (CT) scanning techniques enable dentists to model and plan the restoration visually from start to finish. Looking at the converted CT scan image in a computer software program, dentists can inspect the bone in every direction, as if they were holding it in their hands. It removes the need for the surgeon to loosen the gum around the bone for inspection, and allows the fabrication of temporary teeth before the surgical procedure. This will make it possible to get a natural-looking dental implant from a regular dentist in just one day, with no need to visit a specialist. There is also less swelling, bruising and inflammation for the patient, in addition to spending less time in the dentist's chair.
ANATOMY OF A TOOTH: We think of teeth as being the part visible above the gum, but this is only the tip, or crown, of a tooth. There is also a neck that lies at the gum line, and a root, located below the gum. The crown of each tooth has an enamel coating to protect the underlying dentine. Enamel is even harder than bone, thanks to rows of tightly packed calcium and phosphorus crystals. The underlying dentine is slightly softer, and contains tiny tubules that connect with the central nerve of the tooth within the pulp. The pulp forms the central chamber of the tooth, and is made of soft tissue containing blood vessels that carry nutrients to the tooth. It also contains nerves so teeth can sense hot and cold, as well as lymph vessels to carry white blood cells to fight bacteria.
ABOUT CAT SCANS: CAT (Computerized Axial Tomography) scans are similar to conventional X-ray imaging, but instead of imaging the outline of bones and organs, a CAT scan machine forms a full three-dimensional computer model of the inside of a patient's body. Doctors can even examine the body one narrow slice at a time. The X-ray beam moves all around the patient, scanning from hundreds of different angles, and the computer takes all that information to compile a 3D image of the body.
Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.