Unique Requirements for Implants in Front Teeth:
Loss of a front tooth, whether due to an accident or decay, can be a very traumatic experience for a person. A dental implant is a great treatment option for replacement. However the front teeth and the surrounding smile zone present unique challenges that make therapy in this area among the most difficult to do. It requires the most expertise in both diagnostic and technical protocols. Here are the 5 key principles every patient should know about how to achieve great results with dental implants in the smile zone.
- Careful and detailed planning: the surgeon and the restorative dentist must fully evaluate the implant site and restorative needs and collaborate on a detailed treatment plan. The bite, aesthetic requirements, smile line, and patient desires must all be considered. “Fail to plan, plan to fail.”
- Preserve the foundation: The underlying bone and gum tissue must be preserved or augmented in order to support teeth that look and feel natural. This begins with grafting the site after a tooth is extracted.
- Precise positioning of the implant by surgeon: Once the foundation (underlying bone and gum tissue) has been developed, the implant is placed. Proper positioning and emergence of the implant is crucial in achieving an even gum tissue line and teeth that look natural. The surgeon must use special splints that guide him in proper positioning of the implants.
- Shaping the gum tissue: Following placement of the implant, a properly fabricated temporary crown must be placed for at least three months. This allows the doctors to design and shape the gum tissue exactly the way it should be: aligned, even, and with normal texture and color. This is especially important in those with high smile lines.
- Final crown: The final restoration must follow the same contour and shape as the final temporary restoration. The final crown may be made of all ceramic material or ceramic bonded to underlying metal. This is an important choice that the restorative dentist must make.
Implants Considerations in the Smile Zone:
Patient Example #1:
Patient Example #2:
How Many Implants Should be Placed in the Front?
If you have multiple missing adjacent teeth in the upper or lower front area of your mouth, implants should be positioned with spaces in between. This means that implants should not be placed next to each other for every tooth missing. Examples:
- Missing lateral incisor and central incisor: One implant is positioned in the central incisor and two-unit splinted crowns are placed replacing both teeth.
- Missing canine and lateral incisor: One implant is positioned in the canine site and two-unit splinted crowns are placed replacing both teeth.
- Four missing incisors (central and lateral incisors): Two implants are positioned in the lateral incisor positions and a four-unit bridge is placed replacing all four teeth.
- Missing canine, lateral incisor, and central incisor: Two implants are positioned in the canine and central incisor positions and a three-unit bridge is placed replacing all three teeth.
- Six missing teeth, from canine to canine: Total of four implants are placed. Two implants in the position of canine and central incisor on one side and similar placement on the other. Then two 3-unit bridges are placed separate in the middle (between the central incisors).
- One exception- Missing central incisors: Place one implant per tooth with single crowns.