Replace a Single Missing Tooth
By far the most common reason patients have dental implants is to replace a single missing tooth with a single dental implant. Single teeth need to be extracted for the following reasons:
- Fractured tooth
- Extensive tooth decay
- Failed root filling
- Failed post crown
- Failed apicectomy
- Maryland/adhesive bridges frequently de-bonding
- Failing conventional bridgework
- Replace a single tooth denture
The most obvious reason that patients request that a front tooth is replaced is to maintain their appearance. Few patients would want to have a front tooth missing for very long.
The approach we use depends on a number of factors and would be thoroughly assessed at the initial consultation.
Single missing tooth
If there is already a gap, the usual procedure is to place the implant into the jaw bone and to allow 3 months healing before restoring it with a crown. The space would be filled with either a temporary denture or temporary Maryland bridge while the treatment is being carried out, if such a restoration is not already in place.
Replacing a tooth that needs to be extracted
1. “Delayed approach”
The standard procedure is to remove the offending tooth and to allow 6-8 weeks healing before the implant is placed. Depending on the situation, either a temporary denture or Maryland bridge is fitted at the same time as extracting the tooth, so there is never a gap. As above, the implant is then restored with a crown after 3 months healing.
The challenge with any implant at the front of the mouth is to accurately mimic nature and to get a result where it is difficult to identify the false tooth. From the pictures below, can you tell which is the false tooth?
2. “Immediate approach”
This is where the tooth is removed, an implant fixture is placed into the extraction socket and a provisional dental crown is fitted, all in the same visit. A permanent crown then replaces the provisional crown after the jaw bone has healed, which is around 3 months.
This technique allows patients to leave the dental clinic with a fixed front tooth that looks natural without the need for a temporary denture or bridge.
With this approach, because there is no need to cut the gum, there is virtually no bleeding or need for any stitches. Although the procedure takes a little over an hour to do, the majority of this time is taken up making the provisional crown, which is mostly done outside of the mouth. The actual implant placement takes 5 minutes.
Single tooth implants at the back of the mouth
Why is it important to have a back tooth replaced when aesthetics are not a concern?
It’s a simple question of balance. If you lose a single molar, this will increase the loading of the teeth either side of the space when you chew. The same is true of the teeth on the opposite side of the mouth as they will also be doing more work. By having a single tooth replaced with an implant shares the workload in your bite which will help reduce the wear and tear of the other teeth in the mouth in the long term. This may be particularly important since research shows the average person chews their teeth an average of 1 million times per year.
The other risk of losing a molar is that the tooth it used to bite on in the opposing jaw can overgrow. This can cause jaw problems which can lead to tooth grinding, jaw discomfort and even headaches, neck pain and shoulder stiffness.
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