Dental Implants in Beverly Hills
Dental implants in front of the mouth, in the smile zone, present unique set of challenges to the modern implant dentist. First consideration is that nobody is willing to go without a front tooth for a few months! As dentists we see many “emergencies,” conditions for which a patient insists on being seen over a weekend or at night. You would think a toothache would be the most common emergency, however, I have found over the years that people may be willing to put up with some pain when it is inconvenient for them to come to the dentist, but a missing or broken front tooth is something nobody tolerates.
Kay 1) Old fake looking bridge for number 9 (central incisor)
Kay 2) Implant placed at bone level for optimum esthetics.
Important Facts About Dental Implants
As you may know, when a root form Titanium or Zirconia dental implant is placed in the jaw bone, it takes about 1.5 to 6 months to fuse (osseo-integrate) to the jaw bone. During this period, traditionally, either the space above the implant is left empty or a removable partial denture (a flipper made for the patient to wear) is used. Needless to say that while first option is totally unacceptable for a front tooth, the second option is a big inconvenience.
Even today, many patients are needlessly made to wear a removable flipper because the surgeon who places the dental implant in the jaw bone either is not equipped or skilled to fabricate a reasonable and comfortable fixed tooth for the healing implant.
This is one of the many drawbacks of the so called “team approach” in implant dentistry. The dentists who have limited their practice to only the surgical aspect of implant placement, usually do not have the materials and necessary training to restore the empty space with a comfortable and fixed option. In these cases, the patient is forced to make a separate appointment at a later date with the cosmetic (general) dentist who is equipped and trained for fabricating teeth in order to replace the missing tooth.
I have worked hard over the years and have earned Mastership in the Academy of General Dentistry (MAGD) and a Fellowship at the International College of Oral Implantology (FICOI). For years now, I have been restoring the newly placed implants in front of the mouth at the same sitting with a provisional restoration, so that my patients never walk out of the office without a comfortable and fixed tooth. This approach is called Immediate Loading, or more commonly, same day implants. Immediate implants also help reduce recovery time, subsequent office visits and other issues that can occur when multiple dentists are involved in the process of installing a dental implant.
Kay 3) I shaped the abutment for perfect marginal adaptation.
Kay-4) Unparalleled esthetics.
Front Tooth Dental Implants
Nowadays, the reason most people end up having a single front tooth dental implant is that either their existing tooth is broken from the neck or is not salvageable anymore. In either event, they walk in with some form of remaining root in their jaw bone. In most cases, I have been able to remove the remaining root and place the implant in its place at the same time. This is called Immediate Placement of dental implants. In most cases, when I replace a front tooth, I practice immediate Placement and Immediate Loading of my implants. When patients follow the instructions in terms of rest and taking antibiotics, my success rate is 100%.
In cases that, for technical reasons, the implant cannot be immediately loaded, I fabricate a bonded fixed bridge over the implant before the patient is dismissed, so that the patient can leave the office confidently with a fixed tooth.
Dental Implant Considerations
A consideration in front teeth implants is their high esthetic demand. As far as clinical skills, knowledge, and experience is concerned, this is where the rubber meets the road. Look at the photograph labeled natural-looking single tooth implant. Also pay attention to Kay’s pictures. Kay, an otherwise handsome young man, was presented by a previous dentist with an old, fake-looking, bridge for tooth number 9. To correct this, I placed an implant at bone level for him (Kay2).
To avoid the usual grayish discoloration that we see at the neck of Titanium implants, I used a Zirconia abutment. Because the implant was at the bone level and the final 2 millimeter of the implant (the emergence profile) was in Zirconia, no grayish discoloration was shown through the gum margin. I prepared the Zirconium-based implant for optimal position of the Zenith (the highest part of arch of the gum). The result is an astonishingly natural-looking and indiscernible emulation of the adjacent natural tooth (Kay4).
A great degree of skill and experience is involved in shaping the emergence profile of the front tooth implant, so as to preserve the interdental papilla (the gum extending down from in between the teeth) where it exists (Jill’s case) or to create a pair where there is a flat ridge (Kevin’s case).
Zirconia Implants, often miscalled Zirconium Implants, are a more attractive option as there is little risk of an unnatural ‘greyish’ color appearing at the neck of the tooth. While titanium implants have been the standard bearer for years, full zirconia implants have been becoming increasingly popular due to their esthetic beauty and their higher biocompatibility. What is biocompatibility? A small margin of patients (4-5%) have an allergy to titanium, which does not present in ceramic based implants. This is why, even if you don’t know about titanium allergies or may even not have one at all, I still often recommend zirconia implants. They are less likely to cause problems down the line, are easier to maintain, and look more natural overall.
How Much Do Dental Implants Cost?
Dental implants can be expensive, but fortunately, many insurance carriers and medicare may cover at least part of the cost. On average, a dental implant should run $2,000-$3,000 for both the abutment and the crown before anything is covered by insurance. It also varies heavily on the type of work that needs to be done to safely install the implant. Discount dental implants are something that should raise an alarm, as implants are something that takes a great deal of skill, patience, and practice, and many dentists do not do implants simply because the process is so complicated to do correctly. Bone grafts, multiple implants, extraction of failing teeth, and so on can raise the cost of an implant treatment. The important thing to remember when considering the cost of an implant, is that you are being given something that you will likely be using for the rest of your life, if cared for properly. The costs are negligible too, compared to the potential bone loss and additional loss of teeth or damage to your appearance from teeth shifting because of the lack of pressure and balance in the mouth.
If you have a need or are interested in learning more about dental implants, do not hesitate to call us at (310) 273-9919 or schedule an appointment with our appointment coordinator.