[건강]What are the advantages and methods of preserving natural teeth that are superior to implants?

Many people visit the hospital immediately when they have cold symptoms such as coughing or high fever, but the pain in the teeth is not a major cause, and many people visit the dentist only after a long delay and unbearable pain.

Since most dental diseases do not have subjective symptoms at the beginning and progress slowly and chronically, it is important to receive early diagnosis through regular oral examination.

Even if the early diagnosis period is missed and dental diseases such as dental caries (caries), fracture, periodontal disease (gum disease) have progressed considerably, rather than unconditionally removing the tooth and placing an implant, it is possible to leave natural teeth and use restoration treatment. It is good to try root canal (nerve) treatment and periodontal treatment.

For example, dental caries with direct damage to the tooth, if the caries is limited to enamel and some dentin, which is the outermost layer of the tooth, restoration treatment using resin is possible, but if it reaches the pulp beyond the dentin, the infected pulp is removed. And it may require root canal treatment filled with biocompatible materials. In some cases, treatment such as apical surgery or tooth replantation is performed.

However, in the case of periodontal disease in which the periodontal tissue surrounding the tooth (gingival, alveolar bone, periodontal ligament, chalky, etc.) is destroyed, even if the tooth itself does not have a problem, the tooth may be lost due to the destruction of the periodontal tissue. In the early stages of periodontal disease, inflammation is confined to the gingiva, which is called gingivitis, and when inflammation leads to alveolar bone destruction without proper periodontal treatment for a long period of time, it is called “periodontitis”.

Gingivitis is a symptom of swollen gums, a red color, and bleeding when brushing teeth. In the early stages of inflammation, it is possible to recover with simple treatments such as scaling, but since most of them do not cause severe pain, patients do not visit the dentist and therefore miss the right time for treatment and develop periodontitis.

Periodontitis occurs mostly when gingivitis is not properly treated. As the inflammation, which was limited to the gums, gradually spreads, alveolar bone destruction and gingival retraction (the tooth roots are exposed due to the loss of the gum tissue) occur. In severe cases, it causes tooth agitation (the tooth shakes side to side or up and down) and eventually leads to tooth loss.

Treatment of periodontal disease is largely divided into non-surgical treatment and surgical treatment. Non-surgical treatment is performed when periodontal disease is not severe. Scaling and root mobilization are typical, and it removes plaque and calculus to relieve inflammation and induce reattachment and regeneration of periodontal tissue. Surgical treatment includes gingival resection, gingival plastic surgery, periodontal valve surgery, regenerative periodontal surgery, and periodontal plastic surgery.According to the procedure, gingival resection and incision can be used to secure a field of view to remove or remove plaque located deep in the gingiva. It can ideally change the shape of tissue and promote the regeneration of lost tissue.

In particular, tissue-guided regeneration, one of the regenerative periodontal surgery, is a technique that restores the already lost gums or alveolar bones to their original state. A thin barrier layer (shield) is used to physically block unwanted cell intervention or proliferation, and promote healing by inducing cell proliferation of selected tissues, helping the supporting structures around the natural teeth restore their original functions.

The reason why natural teeth should be preserved as much as possible is that natural teeth have many advantages over implants.

First, you can feel the chewy taste with the unique taste of the food. Since natural teeth have their own cells and nerves, they can sense the temperature or hardness of food, and have excellent ability to cope with hot or cold stimuli, so they can chew food much more naturally.

Second, there is a periodontal ligament. The periodontal ligament is a thin film located between the teeth and the alveolar bone (gum bone), and acts as a kind of cushion to relieve the weight or impact on the teeth. In addition, since it acts as a barrier against bacterial invasion, it is possible to slow the rate at which inflammation initiated from the gingiva leads to periodontal tissue destruction. On the other hand, implants do not have periodontal ligaments, so periodontal tissue destruction proceeds faster than natural teeth.

Third, it has the shape and number of roots optimized according to the location and function. Compared to the implant having one artificial root (artificial tooth root), the molar tooth has several roots, which effectively disperse the chewing force given from various directions or the external impact.

Fourth, oral hygiene management is easy. Natural teeth are located at appropriate intervals between teeth. However, because implants have a smaller diameter at the roots compared to natural teeth, the gap between teeth is widened and food is easily caught.

Fifth, it has excellent aesthetics. It is not easy to perfectly reproduce the shape, transparency, and color tone of natural teeth in any implant prosthesis.

Professor Seong-Tae Kim (periodontist) of the Department of Periodontology at Seoul National University Dental Hospital said, “Implants have become a popular treatment as a replacement for natural teeth, but it is difficult to replace the superiority of natural teeth as much as possible.” It is advisable to try a treatment that uses and maintains, and it is better to leave the implant as the last option.”