Implantologist and aesthetic dentist Dr. Sim Tang Eng sheds some light on a new procedure for replacing lost teeth deemed ‘Teeth-in-an-Hour’.

Besides giving us the ability to chew our food and to speak clearly, the appearance of our teeth goes a long way in complementing our overall appearance, even enhancing it. The proud owner of a nice set of teeth would have no qualms in flashing his or her smile – giving them an air of confidence and creating a positive impression.

As people become more aware of the importance of presenting a favourable image to others, they begin to pay more attention to their smile and teeth in an effort to maintain them in good condition. Some even go a step further and work to enhance their appearance.

Advances in dentistry provide ever-improving solutions to address crooked and uneven teeth, stained and/or yellowish teeth, decayed and broken teeth, as well as missing teeth. Indeed, one of the biggest challenges in modern dentistry is to replace missing teeth in such a way that the replacement teeth look, feel and function just like real ones, or even better!

Dentures, bridges & implants

There are three options available when it comes to replacing missing teeth – dentures, dental bridges and dental implants.
Dentures are removable prostheses, which are usually made of a special dental-grade plastic, or supported by a metal framework. The main advantage of dentures is that they are the least expensive option, and that they can replace many teeth within the same arch. The major disadvantage is that they are removable (i.e. not fixed), may rely on wires or clasps hooking around the tooth for retention (not aesthetically pleasing), may have a tendency to allow food to be trapped, and may be loose and/or move during function.

Dental bridges, unlike dentures, are fixed prostheses that are supported by the neighbouring teeth of the missing tooth or teeth. The advantage of bridges is that they are fixed, and that they feel similar to natural teeth. The main disadvantage of this method is that the neighbouring teeth have to be prepared (trimmed down).

There are other downsides as well. Bridges cannot be placed behind the last tooth, as they require teeth on both sides for support. Dental bridges will not look natural if there is severe bone loss at the missing tooth or teeth area. Dental bridges are also usually made of porcelain supported by an alloy framework.

Dental BridgesThen, there are dental implants, which are basically titanium roots that are surgically placed into the jawbone area of the missing tooth or teeth. As the titanium implant fuses with the jawbone (osseointegration), the bone will anchor the implant just like it would with a natural tooth. The main advantage of implants is that they feel and function very much like natural teeth. Unlike dental bridges, there is no need to involve the neighbouring teeth. Implants can be used to replace one missing tooth, a number of teeth, an entire arch of teeth, and even to anchor a denture.

‘Teeth-in-an-Hour’

A recent major breakthrough in the field of implantology is the revolutionary concept of ‘Teeth-in-an-Hour.’ This new approach uses a computer tomography scan (CT scan) and a 3D CAD-CAM software (Computer-aided design and Computer-aided manufacturing).

The patient will first get a CT scan of his or her jawbone. The data from the CT scan is then fed into the 3D CAD-CAM software. The software can then create an accurate 3D model of the patient’s jawbone. The dentist/implantologist will now be able to plan and position the implants on the 3D model, followed by the design of the crown, bridge or denture. Once the treatment planning on the 3D software has been completed, the information is used to fabricate a surgical guide and the final prosthesis (i.e. crown, bridge or denture).

1: Patient comes in with no lower teeth at all.
2: Data from the CT scan is converted into a 3D model of
the patient's jawbone. The ideal positions of the implants
are planned off this model.
3: The 'surgical guide' made from the 3D model.
4: The dentist/implantologist will use the 'surgical guide' to
guide the surgical insertionof the implants into the jawbone.
5: The full-arch bridge is screwed onto the implants.
6: Ready for function in one hour!

This surgical guide is made by the manufacturer in Sweden and will involve at least a two-week waiting period. But once the surgical guide is completed and the patient agrees to the treatment plan, the following appointment will see the patient having the implants surgically inserted and the final prosthesis fitted in, usually within one hour. Walking out from the surgery, the patient is able to smile and use his or her new teeth!
Thus, in comparing the ‘Teeth-in-an-Hour’ approach with the conventional method of implant placement, the former has a number of significant advantages. The most obvious advantage is that much less time is needed – everything will be done and completed during the surgery appointment, whereas the conventional method requires between four to eight or more visits after the surgery appointment.

The new method is also more precise and less traumatic because the surgical guide directs the exact placement of the implant(s). In other words, ‘keyhole’ surgery is performed. Therefore, less discomfort and trauma is experienced with faster healing times and no swelling. The conventional technique on the other hand is more like open surgery with a freehand approach by the surgeon, requiring longer surgical time with less precision. Best of all, the new technique allows the patient to smile and eat on the same day!