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Implant Prevents Bone Shrinking
Ms. Wang is a special lady. She has braces quite late in her life. Now she has a beautiful smile (Fig.1). What is the most special about her is that she notices by herself a big gap between the fake tooth and gums (Fig.2 arrowheads; Fig.2 is a blow up image of Fig.1 around *). The gap was not present when the bridge (1,2,3) was made initially. She worries a lot. The gap may gradually become so big that it may compromise her appearance.
In fact shrinkage of gums is due to shrinkage of bone underneath. In order to place an appropriate sized implant, she gets CT done. Cross sections of this fake tooth (Fig.4) and of a corresponding tooth on the other side (Fig.3) show that the bone is much wider on the normal side than that on the missing tooth side (9.5 mm vs. 6.7 mm). After tooth extraction, our jaw bone keeps shrinking after extraction. Only can implant prevent further shrinkage. Ms. Wang accepts this mode of treatment readily.
Fig. 5,6 are X-ray and CT taken before surgery. Her bone height is also limited naturally. So a short (6 mm), but relatively wide (4.5 mm) implant is planned (Fig.6). With her co-operation, the plan is executed successfully (Fig.7 I: implant) with removal of the fake tooth in the middle (originally #2). In several months, she is expected to get a new solid tooth. It will prevent bone from being shrunken any more.
Unfortunately the implant does not heal. When it is removed, a new larger and longer implant is placed at the same time (Fig.8 I). The bone at the bottom of the sinus (>) is pushed up for gaining bone contact.
Seven months later, the new implant heals (Fig.9). The bone on the top of the implant has got denser (whiter, <).
Fig.10 shows that the gums have been pushed outward (arrow) with insertion of the implant (I). When the crown (Fig.11 C) seated, the gums looks bulky and natural (*). There is no gap between the gums and the crown.
The bone around the implant becomes denser (stronger) 1.5 years after crown cementation (Fig.12 *, compare to Fig.9). There is no gag between the gums and the implant crown (Fig.13,14 C, as compared to Fig.2) 2.5 years after cementation.
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Xin Wei, DDS, PhD, MS 1st edition 06/10/2012, last revision 11/07/2015