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Medical Edge Newspaper Column from Mayo Clinic
TILL WE CAN REGROW TEETH, DENTAL IMPLANTS ARE BEST BET
DEAR MAYO CLINIC: Is it possible to regrow teeth? Five of my permanent teeth were knocked out in an accident, and I prefer to avoid dental implants. — Arlington, Texas
ANSWER: Possible? Yes. Feasible at present? No, and far from it.
The formation of teeth is an extremely complex process. It’s an elegant dance of diverse tissues from which a variety of tooth shapes and sizes ultimately emerge to work as a system. Efforts to replicate this process in the lab are at a very early stage.
Some scientists have begun experimenting with genetically engineered tooth tissue; others are looking for natural stem cells that could be turned into teeth. But even if researchers manage to grow a small ball of dental tissue in the not-too-distant future, that still would be a far cry from building a functionally useful tooth, much less an integrated set. We do not understand, for instance, how the body knows it must grow a molar, as opposed to an incisor, at a particular spot in the gum.
So if you wish to replace your lost teeth, you will have to use a more conventional approach. The quickest and least expensive options are prosthetics — a removable partial denture or a permanent bridge. Partial dentures consist of artificial teeth and gum, both made of acrylic resin, that are connected by a metal framework. The assembly is usually held in place by clasps that attach to the natural teeth, which need to be altered only minimally, if at all. A bridge is a similar device, except that it is bonded with adhesive to the natural teeth, which must be significantly reduced and modified to accommodate the addition.
Both options have shortcomings. They can impose limits on eating, exert unusual force on the natural teeth and, depending on the location of the gap, affect speech. Moreover, without teeth embedded in it, some of the jawbone may waste away. This can cause the remaining teeth to shift, producing other problems and limiting the life of the prosthesis. The loss of bone could also make it difficult to have dental implants, if you decided to pursue that option in the future.
Although you say you’d like to avoid dental implants, they are often the best alternative for patients in good health. The main drawback is the expense. Dental implants can be very costly if your medical or dental insurance does not cover the procedure. Implants are best from a medical point of view because they are the closest thing we have to duplicating a person’s natural teeth with little or no disruption to the rest of the mouth.
Implants are expensive because they involve several steps and several practitioners, including surgeons. To replace the lost root, a small titanium cylinder is implanted into the jawbone. It becomes solidly anchored as bone cells fuse to it in a process called osseointegration. After the patient has fully recovered from this surgery, the gum is reopened and a small threaded post is screwed into the implant. When the gum tissue has again healed, the dentist or prosthodontist may then create a replacement tooth that attaches to the post and functions like a natural tooth. Depending on the size and location of the gap, each tooth may have its own implant or one implant may support several teeth.
Having one implant reduces the cost somewhat, though other factors may increase the cost. For example, if you also have suffered nearby tissue or bone loss, it may require reconstruction, at additional expense, before the dental-implant process begins. This possibility is greater when the tooth loss has been caused by trauma, as in your case. But the traumatic origin of your problem also means that reconstructive surgery or dental treatments may be covered by medical insurance.
— Christopher F. Viozzi, D.D.S., M.D., Oral and Maxillofacial Surgery,
Mayo Clinic, Rochester, Minn.
Additional Resources:
Dental Implants
Appointment Information
More Information on Dental Implants
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Medical Edge from Mayo Clinic is an educational resource and doesn’t
replace regular medical care. To e-mail a question, go to www.mayoclinic.org,
or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave.,
Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.
© 2005 TRIBUNE MEDIA SERVICES, INC.
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