| Reconstructive Dentistry Milwaukee Mandibular Implant Replacement Denture Rehabilitation |
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Milwaukee Reconstructive ProstheticsDenture Implant Repair - ReplacementImplant supported dentures represent a best choice tooth replacement treatment that provides the best bone stimulating features of traditional dental implants while assuring significant cost benefits of denture prosthetics.Traditional implants (Nobel Biocare, Zimmer, Strausman, Tatum) are some of the common choices available for implant sites that require little or no tissue augmentation. Surgeries are performed to add more bone or soft tissues, as needed. Mini implants (Imtec, Sterngold, Intra-Lock) and Locator attachments (Zest, Tatum) that can be adapted to implant devices or healthy tooth roots can also be used for minimizing invasive surgeries and/or creating more treatment options for patients. Mini implants are now commonly used in combinations of 4 to 6 implants with a minimum of invasive surgery. Placements of 4 to 6 mini implant devices that provide a near Immmediate Function whereby dentures can be mounted on the same day of surgery is common. The implant placement protocol typically requires no periodontal related surgery. 
Dental implants are not a "place them - forget them" type of procedure however. When used for securing denture products, routine care must be practiced for removing bacterial build up that occurs. Microscopic organisms can migrate into even the tightest and most well healed dental implant sites.The infectious process can endure and grow at an undetectable rate. When infected implants do appear through xrays, cone beam scans or routine oral health exams, significant damage has already occured. Soft tissue loss and underlying loss of bone can be evident. In some instances however, implants will loosen before the infection is detected. Since bacteria will migrate alongside and past the length of the implant, the infections become stubbornly deep rooted in the jaw (upper or lower) and rapidly cause loss of osseointegration. This condition is commonly refered to as Peri-Implantitis. Peri-implantitis typically affects 5% to 10% of implant patients. It is a major cause of late implant failure. 
Habit FailureRoutine cleaning of implant sites and the underside of denture prosthetics is a must. There is no "clean on an as-needed basis" philosophy when caring for dental implants.Occlusal MonitoringSince implants don't move - they don't have a ligament like teeth, normal wear in surrounding teeth (be they denture or natural) will result in the implant tooth or teeth eventually hitting too hard. Wear of other teeth leads to traumatic occlusion on the immobile implant - which can lead to screw loosening, abutment - implant body fracture or failure of the prosthesis (bridges come loose, porcelain chipping of crowns, acrylic fractures).Implant dentistry must ALWAYS be followed up and monitored on a routine basis to check for uneven occlusal forces to prevent premature breakage. Our patient, a 50 something year old had denture implants. One implant did fail after about 5 years. Admittedly he did not practice the oral health habits recommended by his dentist as the years went by. As described above, bacteria became deep rooted in the mandible (lower jawbone) and caused one implant to fail. The lower denture started to rock and wobble, accelerating the wear and tear process, causing the loose implant to become unstable quickly. When the patient presented in our office, his goals were to regain the dental function he had before the implant failure and to also be fitted with dentures that were more aesthetically pleasing. He wanted teeth that were brighter and shaped differently. He felt his denture teeth were too dark. 
The faulty implant was removed and the deep rooted peri-implantitis infection was treated. Still undetectable via xrays and cone beam scanning, elimination of the infection required two sequential treatments. The adjacent picture of the lower jaw shows the placements of 5 traditional implants along with 2 Root Locator implants (specialized implant devices installed in healthy tooth roots), providing a total of 7 implant devices for securing the lower denture. 
Specialized Denture LinersThe patient's new denture products were lined with a soft relining product to protect the gum tissue while the peri-implantitis was being brought under control and eliminated. Dr Winter routinely provides the relines that allows the implants to heal undisturbed while patients can enjoy not being toothless.Cosmetic Denture MakeoverThe patient's choice of newly shaped denture teeth with a degree of color shading that was significantly brighter than his previous set of dentures created a very dramatic result. As can be seen in our last two photos, the dentures do not look like dentures.
After substantial healing time and re-osseointegration of a new Sterngold implant device, Dr. Winter used special coping attachments to the denture that creates the Snap In Denture result that most denture patients prefer. With the denture snapped in, normalized dental function was reestablished. Our patient was thrilled with his treatment outcome and especially thankful that his promptness in seeking treatment for the failed implant was early enough to prevent bone loss that might have required additional healing time for bone grafting. Maintaining the MaintenanceDental implant site maintenance has acquired new meaning for our patient. He will be following all recommended self care practices more diligently in the future to prevent another incidence of gum infection (peri-implantitis and/or periodontitis).
Tooth replacements, whether individual implants, fixed bridges or implant supported dentures are commonly used to overcome the losses caused by trauma, decay and gum disease. Nonetheless, they do require a level of after-care that must be practiced for assuring long term success.
Questions and AnswersCall us at 414-464-9021 to arrange a consultation with Dr. Winter to learn more about the treatment options that are available for diagnosing or correcting common implant failures.Patients from Illinois, Minnesota, Indiana and other areas of the Midwest are encouraged to contact Dr. Richard directly with our on-line Ask The Dentist form... to get more information about unusual cosmetic or reconstructive dentistry issues. See more examples of cosmetic and aesthetic dentistry including porcelain crown and veneer makeovers, diastema repair, tetracycline stain whitening and gum contouring at our Hampton Dental Associates Photo Gallery.
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