This Won't Hurt a Bit (page 3 of 3)

Making Implants Easier

Implants are substitutes for tooth roots lost to decay or periodontal disease. Each is a titanium screw within a screw. The outer screw is implanted in the jawbone (the lower) or the maxilla (the upper). The inner screw supports a crown the way a post supports a mailbox.

Traditionally, dentists slice open gums, drill into bone and sometimes transplant bone (the patient’s own, from another area, such as the hip; from a bone bank; or an artificial type) so there’s enough on which to anchor the implant. Mini-implants such as IMTEC’s MDI and Dentatus’s Anew reduce the need for bone grafting, a painful, invasive procedure, because they’re just half the diameter of full-size implants, or about the width of a wooden toothpick.

Another new method gives patients implants quickly, and with fewer office visits and less use of the scalpel. Until now, getting implants meant at least two surgeries and months of dental visits: one to screw the devices into bone; another, three months later, to take an impression for a denture; and another to surgically uncover the implants and fit the denture or crown. Nobel Biocare’s widely advertised Teeth-in-an-Hour system, introduced in the United States in 2005, still requires several preliminary visits, but implants and dentures are placed the same day, sometimes within an hour.

That all sounded great to Hady Koraym, 47, of Baltimore. By the time Koraym, an electrical engineer, showed up at the University of Maryland Dental School, he had lost all but six of his teeth to advanced periodontal disease. At the Dental School, Debora Armellini, DDS, made a plaster replica of Koraym’s mouth and used that to make a clear plastic replica of the denture he would end up wearing. Koraym then underwent a recently introduced type of dental CAT scan known as cone-beam computed tomography. This three-dimensional image of the patient’s mouth is far more precise than traditional x-rays and reduces radiation exposure too.

Dr. Armellini sent the image to Nobel Biocare’s Göteborg, Sweden, laboratories, where technicians fashioned a plastic mold of Koraym’s gum with precisely positioned holes to guide a surgeon’s drill. Dr. Armellini and Liene Molly, DDS, installed Koraym’s upper implants and teeth on February 22, and his lower implants and teeth a week later. For the first time in years, Koraym has a full mouth of functional teeth. “I look good, and I feel more confident,” he says.

Some dentists worry that Teeth-in-an-Hour implants, which lack the initial three-month healing period of traditional implants, may not bond to bone well enough to keep them stable, says Eugene Antenucci, DDS, a spokesman for the Academy of General Dentistry. “The technology is not time proven, but the results seem to be very good,” he adds.

Implants help anchor crowns and bridges in the mouths of millions of Americans. But because gum disease erodes bone, there’s often not enough left in which to place the implants. Dentists of the future may be able to grow the patient’s own bone.

The FDA recently approved two compounds that stimulate bone to regrow: GEM 21S from BioMimetic Therapeutics in 2005 and Medtronic’s Infuse Bone Graft in March. Soon dental implants may release their own growth factors to help build bone. Ulf Wikesjo, DMD, professor of periodontics at the Medical College of Georgia, and his collaborators at Wyeth Pharmaceuticals and Nobel Biocare have developed one such implant and are conducting a small clinical safety trial.

Could we grow our own teeth someday too? The National Institutes of Health is optimistic: This summer the agency launched a $5 million effort to build a human tooth from scratch. Already scientists have made some significant advances. Last year, a team led by Songtao Shi, DDS, of the University of Southern California School of Dentistry used stem cells from human wisdom teeth to engineer a tooth root and ligament in the jawbone of a pig. Similar tissue-engineered roots could one day replace implants, and eventually scientists hope to grow replacement teeth we can use for a lifetime.

Better Living Through Dentistry
Composite is just one of several materials that are providing patients with lifelike tooth replacements. All-porcelain crowns have been replacing older models that have metal underneath the porcelain, which often gives the crowns a grayish tone. The latest porcelain veneers—thin, custom- made false fronts—can cover up worn-down, chipped or discolored teeth to make them look better. Veneers typically require dentists to grind enamel from your tooth so it won’t look too bulky, but Lumineers, introduced in 2005 by Den-Mat Corporation, are half the width of a regular veneer—thin enough to install without grinding.

Cosmetic products like Lumineers are exploding in popularity, and nearly 40 percent of general practices report a 15 percent growth in cosmetic dental procedures performed to enhance smiles, such as porcelain veneers, bleaching and bonding. This means that surprising numbers of people are heading to the dentist not because they have to but because they want to. Who would have imagined that?

From Reader's Digest - September 2007

 

• Healthy Heart
• • Breakthroughs
• • Fight Disease
• • Dental Hygiene
• Healthy Habits
• Heart Disease

• How Your Dentist Can Save Your Life
• The dentist may be the most important doctor you see this year.
• 
• 3 Surprising Ways to Keep Your Teeth Healthy
• Your toothbrush isn't the only weapon capable of protecting your teeth -- your diet helps too!
• 
• 22 Ways to Maintain a Healthy Smile
• 22 secrets for pearly whites.
• 

• Be Inspired
• 10 Celebrities Who Give Back
• 7 Amazing Stories, $700,000 to Charity
• Virginia Cervasio: Making It Matter
• PLUS:
• Quiz: What's Your Celebrity Cause IQ?