Peter A Payne DMD
Implant Dentistry and Periodontics
"Coordinating all your dental treatment"
Call: (401) 273-6161

Dental Implant Options


   Implants are made of titanium like knee or hip implants. Unlike them they are not cemented to bone but are biologically attached. They replace the root of the tooth and support the tooth replacement you see in your mouth. They are the closest available alternative to your own teeth.

 If a tooth is nonrestorable and must be removed, an implant is the best long term solution. It restores the form and function of the lost tooth without involving other teeth.

    Every  treatment sequence is unique. Recommendations by Dr. Payne depend on the results of your examination.

    Examples include:

       1) Nonrestorable tooth is present with sufficient bone and soft tissue

           a) an immediate implant with transitional restoration can be placed

           b) Healing evaluation ≈ 3 months

           c) Final restoration

       2) Nonrestorble tooth, insufficient bone and soft tissue present

           a) Atraumatic extraction preserving existing bone and soft tissue

           b) ridge preservation/augmentation procedure to build sufficient support for the implant

           c) Transitional restoration, this and the above occur at the same appointment

           d) Healing evaluation at 3 ≈ 9 months - depends on extent of damage

           e) Implant placement

           f) Restore site with crown ≈ 3 - 4 months 

       3) Tooth missing  

           a) Evaluation of bone and soft tissue at missing tooth site

           b) Then same steps as above









1: Before the procedure
2: Installing the implant
The implant is installed. At this time, a temporary tooth is provided to fill the space immediately. The implant will need a few months to attach to the jawbone before the next step is taken.



3: Attaching the new crown
The final step is the placement of the permanent tooth. .
4: End result




A fixed bridge requires preparing the teeth on either side of the space for a crown. The number of teeth involved depends on your bite and the strength of adjacent teeth.

The advantages of this bridge is it is fixed in place, looks and functions like natural teeth.

Disadvantages are you need to cut down the teeth. Almost 1/3 of the time this can damage the pulp tissue requiring a root canal on the affected teeth.

The false or pontic tooth is attached to the adjacent crowns and the prosthesis is cemented .

The most common cause of failure of the fixed bridge is the loss of the cement seal. When a crown or bridge is placed it is physically retentive but requires cement to fill the space between the tooth and the crown. Where the tooth root meets the crown can be detected with an instrument but the space is too small to feel.

To a bacteria it looks like a doorway. If the cement seal is lost bacteria can enter causing decay under the crown. This is not detectable clinically or with x-ray until the decay is beyond the crown margin on the root surface. The bridge needs to be removed, evaluate the damage and plan a new restoration.


A removable bridge is not fixed in place. You remove it to clean your mouth and it is not worn when sleeping. Your mouth needs to rest so as not to cause inflammation and infection in the soft tissues the appliance rests on.

It requires metal clasps which are visible on other teeth to secure it in place. Precision attachments can be fabricated that will not show if the other teeth involved are crowned during fabrication.

When the removable bridge does not have a tooth for support on the back side, the bridge will press on the gum and bone causing bone loss and a space under the appliance. The removable bridge should be evaluated at your cleaning appointments and be relined to prevent damage to the supporting teeth.


Without a replacement, the teeth can shift into the space. These changes can adversely affect your ability to chew and your jaw joint(TMJ).