Jovan Prosthodontics

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Many people do not like going without a front tooth. Practitioners are often faced with the dilemma of restoring patients as quickly as possible. However, our body requires time to heal and stabilize. A dental implant, although the treatment of choice for single-tooth replacement, is not always the quickest. You have to wait for your body’s bone to fuse, known as osseointegration, into the implant surface. Immediate implant placement and provisionalization is a predictable treatment concept. With proper case selection, long-term success rates are comparable to data published for single-tooth implant placement using standard protocols in healed sites.

For the patient, the main advantage for immediate replacement and provisionalization is fewer surgical visits while providing immediate esthetics. For the clinician, immediate replacement allows for minimal disruption of the gums, helping maintain the health and stability of the gingival tissues, which is necessary for a successful esthetic outcome. Whether it’s one tooth, or many teeth, immediate implant placement and tooth replacement can be an option for you. Ask Dr. Ace what plan is best for your dental care!

Single Tooth Replacement

If a front tooth needs to be replaced, and adequate bone is available, immediate implant placement and provisionalization can be an option. When extra bone is available, the surgeon can stabilize the implant, allowing the Prosthodontist to immediately place a crown on the implant. If the bone is of poor quality, or not enough bone exists, the surgeon may elect to perform a bone graft. Options to restore your temporary front tooth include:

1. Removable partial: Known as a flipper, the appliance is similar to a retainer with a tooth attached to it. Since flipper is made of acrylic and is temporary, you should not bite into very hard foods. The advantage of having a flipper is that the bone/gum can heal without having any direct pressure applied to the healing site. The disadvantage to a flipper is that it can be lost (since it is removable). If a removable appliance needs to be worn longterm, a metal version, known as a cast partial, can be a stronger alternative.

​2. Clear retainer: Known as an “Essix” or clear retainer, is similar to an Invisalign tray. When they’re worn, they are fairly unnoticeable. Made of clear material, the Essix style orthodontic appliances are also sometimes referred to as “invisible” retainers because they’re made using clear plastic. They may also be referred to as “overlay” retainers because they fully cover both sides of the teeth. While usually less so than with a flipper, Essix appliances can interfere with speech. Because they are thin, an Essix retainer should be inspected regularly and examined by your dentist if a problem (tear, crack, hole or breakage) has been detected. The plastic may distort if exposed to excessive heat/cold.

3. Maryland bridge: A “winged” bridge that is bonded only on the back surface of the adjacent teeth. A number of times the wings can be created without having to prepare the teeth on either side. Kevlar-type fiber reinforcement can be used to bond the bridge to the tooth with resin. This can be done on the study models prior to surgery. A fixed temporary with an ovate pontic gives the patient a more comfortable and esthetic temporary than a chunk of plastic. The advantage is that the temporary is “fixed,” or permanent, meaning it cannot be removed. The disadvantage is that the patient must be careful not to put too much force on the temporary, as to dislodge or de-bond it.

Full tooth replacement: What is the All-on-4 process?

Imagine having years of dental problems disappear in one day. No more root canals, no more decay, no more pulling teeth. With the All-on-4 procedure, your dental problems can be resolved. Known as “Teeth in a Day,” this procedure replaces all of the teeth in a single arch, or both arches, with a custom-fabricated fixed bridge. With as little as four dental implants, your new, beautiful teeth are anchored permanently to the jawbone, and cannot be removed. The “All-on-4” procedure is a great long-term solution with many advantages over traditional, conventional removable dentures. It may sound too good to be true, but our team is on the forefront of this procedure. In fact, we have restored the most “All-on-4” cases in Williamson County.

In the past, patients who needed full-mouth extractions have had limited options: a removable denture being the most common. Dentures have limitations to function and comfort—they move! The best denture can only have about 1/3rd of the chewing efficiency compared to natural teeth or implants. While relatively inexpensive, a denture needs to be relined or replaced periodically, making adaptation difficult. Because of the gap between these two options, many people would avoid dental treatment altogether. Today, there is an option that offers the natural look and stability of implants, with reduced healing time. After an initial consultation, we will fabricate a custom set of teeth for a natural look and exact fit. On the day of surgery, teeth are extracted, implants placed in the morning, and a temporary bridge fastened in place in the afternoon. Immediately, you will be able to return to normal activity and will regain the ability to eat all of their favorite foods, without the hassle of glue. In a few months, the provisional fixed bridge is replaced with a stronger, definitive prosthesis. You will be given the temporary to serve as a backup (just incase any maintenance is needed in the future, you will never be without teeth). Think of it as getting a new set of teeth, in one day.

While the concept is simple, the procedure requires a high skill level to ensure that the implants are precisely placed so as to withstand the day-to-day load of chewing. Since Dr. Ace only works with the most highly skilled surgeons in implant placement, along with an in-house lab and state-of-the-art technology to fabricate your bridge, we have all of the components in place to ensure success for our patients. Without exception, they love their new smiles!!

image for immediate teeth

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