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Advanced cosmetic and general dentistry

Archives for November 2018

4 Facts about Dental Implants and Sinus Perforation

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Dental implants can be a lifelong solution for replacing missing teeth. But care must be taken to ensure precise placement and adequate bone support. Sometimes sinus perforation occurs during dental implant surgery. What can be done to prevent it? And what should you consider if it’s already happened to you?

1. Is Perforating Sinuses a Big Deal?

    • Some oral surgeons say perforation of your sinuses during dental implant placement isn’t a big deal. They say that if it happens, the site usually heals well and the patient is fine.
    • Other oral surgeons will mention cases where, after perforation, an infection from the sinus cavity spreads around the dental implant. Sometimes, chronic sinus infection results, making it difficult to keep the tissue around an implant healthy.
    • The issue of sinus perforation during dental implant placement also raises the question: If the dental implant pokes into the sinuses more than one or two millimeters, is it adequately supported by the jawbone? And will inadequate bone support by the bone contribute to dental implant complications or failure?

2. Dental Implant Surgery – Standard of Care

Diagram of three phases of dental implants, for information on implants and diabetes from the office of Lowell, MA dentist Dr. Michael Szarek.

Dental implants need enough bone to fuse to and remain stable.

High-quality implant surgery requires the surgeon to take x-rays. Most successful oral surgeons use three-dimensional x-rays to ensure there is enough bone density to support dental implants and maintain stability.

3D x-rays will also reveal your facial structure, nerves, and sinus cavities and assist in performing surgery with precision. 3D x-rays help anticipate the need for sinus lift, or sinus floor elevation, and bone grafting before dental implants are placed. A 2010 article in the Journal of Oral implantology reports that in one study of patients who received minimally invasive sinus lift surgery, there was a 97% implant success rate.

3. Have You Experienced Issues?

If you’ve received dental implants and are experiencing problems from sinus perforation, don’t ignore it. Your oral surgeon or implant dentist should communicate to you a clear plan to ensure the problem doesn’t get worse or result in dental implant failure. If you lack bone density to support dental implants, the solution will likely include a sinus lift, or sinus floor elevation, and bone grafting.

4. Consider a Second Opinion

After you speak with your dentist, we suggest that you consider scheduling an appointment for a second opinion. A dentist with advanced training and experience in implantology, an oral surgeon, or a periodontist can review your x-rays, and examine your implant site to determine the issues involved and recommend treatment.

This post is sponsored by Lowell, MA dentist Dr. Michael Szarek.

Will insurance pay for a tooth implant if a tooth gets knocked out?

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I am an avid hockey player, and I had a facial hit during practice last month so I am doing some research on tooth implants. Although I didn’t lose any teeth, the ligaments loosened in one of them. My dentist stabilized the tooth. She said that if I have another impact on my face, there is a chance I might lose that tooth. She also said that my dental insurance probably won’t pay for an implant. As a teenager, I wore braces and my teeth are straight and I’ve even had them whitened. I still wear a retainer every night. I’ve never had an impact that loosened a tooth, so I’m concerned how much this might cost me if I really do need a dental implant. Other than a mouth guard, is there something I can do to protect my tooth? – Chanz

Chanz,

Diagram of three phases of dental implants, for information on implants and diabetes from the office of Lowell, MA dentist Dr. Michael Szarek.

A dental implant fuses to the bone and a crown is attached

As you likely know, losing teeth is common for hockey players. Many players who have lost a tooth have obtained a removable form of cosmetic tooth replacement. They take the appliance out before games. Some only use it for special occasions.

Contact your insurance company and ask if limited benefits are offered for dental implants. Generally, insurance will provide benefits for the least expensive form of tooth replacement. Dental implants are the most effective and most expensive form of tooth replacement.

  • Partial denture – A partial denture has one or more teeth attached to a gum-colored base. It clasps onto adjacent teeth. It is the least expensive form of tooth replacement.
  • Dental bridge – A dental bridge requires shaving down the natural tooth on either side of the missing one. The replacement tooth is suspended in the middle of the bridge, and a dental crown is connected to the right and left of it. The crowns on the ends are placed over the shaved down natural teeth.
  • Dental implant – An artificial root form, usually made of titanium, is surgically implanted in the jawbone. After a healing period of three to four months, a dental crown is attached to the implant. If you play contact sports and experience an impact to your face, the dental implant can loosen and fail. This is the most expensive form of tooth replacement. And What Can You Do?

Do what you can to avoid needing a dental implant. Consider the follow precautions.

  • Customized mouth guard – Wearing a customized mouth guard can help. It’s important that you receive a mouth guard from your dentist. Impressions of your teeth will be taken to make it. But a mouth guard has limited benefits if a hockey puck or stick makes an impact with your mouth.
  • Full-cage mask – With a highly-interactive sport like hockey, only a full-cage mask attached to the helmet will prevent objects from impacting your face. This is not a popular option among players, but it provides maximum protection for your face and teeth and can help save a tooth and avoid the need for a dental implant.
  • Keep the tooth moist – If you lose a tooth, keep it moist with saliva or milk. Of course, if you’re in the middle of a game, milk probably won’t be within reach, so use your own saliva and see a dentist right away.

This post is sponsored by Michael Szarek, DMD, a Lowell, MA accredited cosmetic dentist.