Permanent Teeth on Fast-Forward


Delaware Online

What took months, and multiple trips to the doctor’s office, can be done in a day!

By IN-SUNG YOO
The News Journal
12/06/2005

Susan Borden isn’t bashful about admitting she could have taken better care of her teeth.

The Wilmington resident underwent several root canals as a result of poor dental hygiene and was wearing a temporary bridge when she decided to look into permanent dental implants.

In the past, permanent implants required a drawn-out process and repeated visits to the doctor. It could take up to nine months to get a working set of teeth. But recent advances in implant technology now make it possible to go home with a set of working teeth after just one surgery.

In February, Borden underwent a procedure known as Teeth in a Day. After an initial doctor’s visit to determine whether she was a good candidate for the surgery, she returned to get a set of temporary implants. Within days, she was eating soft foods.

“It’s unbelievable,” said the Wilmington resident, who is in her early 60s. “My healing time was minimal and I had no problems at all. And you leave with teeth, not holes in your mouth.”

Borden returned to have her final implants screwed in three months later, a process that required no anesthesia and was completed in an hour.

For years, the accepted wisdom was that once the titanium “roots” of dental implants were fused to the jaw bone, they needed to be covered with the gums for about six months to heal, said Dr. Mark Reynolds, chair of the Department of Periodontics at the University of Maryland Dental School in Baltimore. Replacement teeth weren’t immediately attached to keep pressure off the implants.

“It was thought that in order for implants to integrate with the bone, you had to protect them from the oral environment which harbors microorganisms. The second reason was the belief that [chewing] forces would prevent integration of the implant,” he said. “But patients didn’t want to walk around with removable dentures. There were people crying to have permanent teeth immediately.”

Research now shows that implants are much more stable than previously thought, making it possible to be more aggressive in pursuing immediate teeth implantation. This approach spares patients from having to use bothersome removable dentures while the implants heal and it eliminates the need for gum flap surgery to re-expose the implants.

When using an expedited implant procedure, doctors must take into consideration if a patient has diabetes, osteoporosis or a tendency for wounds to heal slowly. But even these conditions don’t necessarily exclude patients from receiving fast implants.

At about $5,000 per tooth and upwards of $60,000 for a full set of teeth, the Teeth in a Day procedure costs significantly more than a dental bridge but is comparable to the slower traditional implant method. Insurance usually does not cover the procedure.

Advances in computer imaging have paved the way for even faster techniques like Teeth in a Hour. This procedure, which was approved last year by the U.S. Food and Drug Administration, uses computed tomography scans and software like that used in automotive design to plan and manufacture extremely precise implants. For some people, the procedure can send them home with their final teeth after just one surgical visit. People who already have dentures are ideal candidates for Teeth in an Hour because their dentures can be used to create a mold that will guide the placement of their implants.

Teeth in a Day can replace entire rows of teeth, but also is useful in fixing individual teeth. This is making bridges all but obsolete when it comes to fixing damage to individual teeth, said Dr. Thomas J. Balshi of Pi Dental Center in Fort Washington, Pa., who performed Borden’s surgery.

Using a bridge means having to shave down the two adjacent teeth to accommodate the prosthesis, a process that weakens them. By replacing the damaged tooth individually, surgeons spare patients such sacrifices.

“If we don’t have to abuse the tooth by cutting into the enamel, the patient will have a much better chance of having that tooth survive well into the future,” Balshi said.

Contact In-Sung Yoo at 324-2909 or [email protected]

Pi Dental Center, Fort Washington, PA