Prosthodontists Plan the Teeth Before the Implants

Wouldn't it be horrible if you had dental implants successfully placed and then couldn't have teeth on top of them?  You think it couldn't happen, but we've often seen unusable, misplaced implants.  That's why a prosthodontist should be the one to plan your implant therapy, because the final teeth have to be designed first and then the implants placed to facilitate the prosthesis.  Even in the case of a single tooth implant, the restorative requirements come first:  how much vertical space is there for the abutment and the tooth, what are the bite requirements, what does the tissue look like so the implant crown can emerge from the gums like a natural tooth?  These factors dictate where and how the implant must be placed, and also often which implant is most appropriate.  As more teeth become involved, the planning becomes more three dimensional.  What are the forces that will be applied to the new teeth?  How many implants are necessary for replacement of the multiple missing teeth?  How can you be sure implants don't end up between tooth positions?  Implants supporting a full arch fixed bridge, or a denture with a bar or attachments, are the most complicated.  What is the height of your bite?  Where do your teeth come together?  Where do the teeth need to be?  When the tooth position is determined, then how much volume or dimension of the prosthesis is necessary to have a restoration that is durable and long lasting?  How are the implants to be spread out, in what positions, at which angles?  Planning for teeth on implants needs to be made from the "top down", so when you know where the teeth are going to go, the implant foundation can be appropriately established.  Your Board Certified Prosthodontist is best suited to plan your implant treatment. 

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309