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What
is Root Replacement Therapy?
Root Replacement Therapy is the placement of root forms (dental
implants) into the bone to assume essentially the same positions
as the missing teeth to be replaced. Today, most all implants
are made of titanium, a material which, starting in the early 60’s
in Sweden had been researched in a scientific study for over twenty
years with human subjects. The results were astounding, with
a success rate well above 90%. They are utilized in the replacement
of single and multiple teeth as well as assisting in the retention
of removable or fixed dentures, full or partial. Dental implants
have been around for a long time, and those prior to the ones developed
in Sweden were placed into the bone, and the “post”, on which the
replacement tooth was to be placed, protruded through the gum immediately,
as the post and root form were all one piece. One of the problems
encountered with these, included bacteria traveling down between
the post and gum into the bony area where the implant was placed
during the time of healing. Infection and implant loss many
times followed.
Why
the high degree of success with these newer types of root replacements?
Besides the material, titanium, which was found to have a high
degree of affinity with bone, the technology of dental implant placement
has been modified substantially since the early implants, to give
them the high degree of success that they now experience.
The new style implants are no longer one piece, but two separate
segments. The root form itself is first placed under the gum,
with its top at the level of the bone with the gum covering the
site. A period of time, usually 4 months on the lower and
6 months on the upper mouth, allows the implants to integrate or
“take”. After this period of time, a minor second surgery
is performed, and the other post segment that will be dentally restored
is placed. In other words, we know that the implant has successfully
integrated with the bone prior to its utilization.
What can I expect during this procedure?
Dr. McBride refers to an exceptional oral surgeon (and teacher of
the craft) who performs surgery to anchor the “artificial root”
into your jaw bone. The procedure is done with local anesthesia.
Medications may be prescribed for soreness. Prior to this,
there is much planning between Dr. McBride and the oral surgeon,
as it is crucial to predetermine the optimum placement position(s)
of the implant(s).
How
long does the process take?
The process can take six to nine months to complete, depending upon
the site, health of the patient and complexity of the restorative
phase. Technology, however, is trying to decrease the healing
time involved. Each patient heals differently, so times will
vary. After the screws and posts are placed surgically, the
healing process can take up to six months and the fitting of replacement
teeth no more than two months.
How
do I care for implants?
As indicated above, your overall health may affect the success rate
of dental implants. Poor oral hygiene is a big reason why
some implants fail. It is important to floss and brush around
the fixtures at least twice a day, without metal objects.
Dr. McBride will give you specific instructions on how to care for
your new implants. Additional cleanings of up to four times
per year may be necessary to ensure that you retain healthy gums.
What
is the cost of dental implants?
Since implants involve surgery and are more involved, they can cost
more than traditional bridgework. However, if you are replacing
a single tooth, it would need one implant and one crown on it.
To replace the same tooth with a bridge would require three crowns.
The total fees for these services can be very close sometimes, so
ask Dr. McBride about all of your options before making a decision.
Some dental procedures and portions of the restorations may be covered
by dental and medical insurance policies. Dr. McBride's staff
can help you with this process.
How
is a decision made?
Like anything else, the decision to engage root replacement therapy
in a dental treatment plan involves their potential benefit over
and above other replacement modalities, the patient’s desires, costs
and general health. It is important, as with any dental treatment,
that the patient is made aware of all treatment options available
to him/her with attendant benefits, risks and costs.
What
determines whether a person should have root replacement therapy
(dental implants) or more conservative removable types of dentures?
This is an interesting question, as before there was such a thing
as dental implants, many people did quite well without them.
Although they definitely have their place, I believe that there
is much “overselling” of dental implants. It may have to do
with the dentist’s lack of interest and experience in treating more
conservatively, or possibly economic gain. The key is quality
communication between the patient and Dr. McBride, who has the interest,
ability and experience to perform either, as to what the benefits,
risks and limitations are with each modality of treatment.
A point of interest: Oral surgeons have referred me full denture
patients for whom they had prescribed implants, as they experienced
lack of success with newly made completely removable dentures by
the referring general dentists not versed in implant technology.
My method of treatment is to fabricate removable dentures for the
patient as if there were no implant technology available, with the
proper teeth shape, positioning, and other spatial values.
This is crucial prior to the placement of the implants, so as to
have a surgical template for their correct positioning if needed.
When these patients asked me if they now needed implants, as they
were doing fine with these new dentures – you guess! Upon
telling the oral surgeons of the patient’s successes, they were
happy that this concept worked. Again, the key is quality
communication – between the dentists (general dentist and oral surgeon)
and each with the patient, proper diagnosis, ability and experience
on the part of the dentist(s).
Is
Dr. McBride trained in root replacement therapy?
Some dentists have not developed an interest in providing root replacement
therapy. Most of those dentists who provide this treatment
have received training through an extensive program and keep up
with research and advancements in this field. Dr. McBride will team
with other specialists to produce the best root replacement therapy
and restoration. Ask him about his training in implant therapy,
he looks forward to sharing with you his passion--skillfully helping
people!
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