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| Today's dental patient is better informed than ever about the varying types of therapies available to them. Consequently, they are seeking out strategies for healthier teeth and supporting tissues, better function, and aesthetics that suit their particular requirements. Dental professionals are also better prepared and able to communicate to patients the current advances in both the scientific and clinical arenas. The 2 topics of greatest interest are:
Patients experiencing or who at risk for tooth loss due to trauma, disease, bone loss, etc. have several
treatment options available to them at present. These options are a result of substantial advances in dental implant therapy and bone reconstruction over the last 15 years, and can dramatically alter a patient's perspective about the possible outcomes, hopefully alleviating some of the stress that occurs when tooth loss is imminent.
Although, general information is widely available on the basic concepts of implant dentistry, there is still
a gap in patient knowledge about the detailed, required, treatment steps to ensure long-term success. There is also the question of where to go for an appropriate evaluation and diagnosis, so patients are often uncertain of the correct course of treatment. It is important to note that a patient's dental and general health could benefit from implant therapy.
This site was developed to inform patients about the sequence of treatment: step-by-step, as well as
the benefits, risks, and commitments associated with each type of procedure. Remember, the primary goal is to provide healthy, optimal, results directed by informed patients who understand the treatment process.
The patient section of this site is still under construction, we are temporarily referring you to the web
pages of the American Academy of Periodontology (AAP). You will find useful information on dental implant therapies and related topics.
GENERAL TREATMENT STEPS:
Pre-Implant Diagnosis: This intial phase determines the exact type and location of the implants needed
to support the final prosthetic teeth and the patients available jaw bone structures and gums.
Implant Placement: A titanium implant is placed in the jawbone in relationship to the future teeth. If the
jaw bone is not sufficient a bone reconstructive procedure is needed. This procedure can sometimes be done simultaneously with the implant placement.
Healing period: The implant is allowed to heal within the bone for 2-6 months without any load. In specially
selected cases implants can be loaded immediately. If not, an interim restoration is worn by the patient during the healing time.
Prosthetic Phase: This final step involves the fabrication of the new teeth which are securely anchored to
the underlying implants. The overall predictability and success of the complete implant therapy depends upon the anatomic situation of each individual patient, the expertise of the dentists involved, the communication between them, and the expertise of the dental laboratory technician to artistically create natural aesthetics with the new teeth.
FREQUENTLY ASKED QUESTIONS:
Yes. Dental implants can provide artificial teeth that look natural and feel secure. Dental implants can
also be used to attach full or partial dentures. Implants, however, are not an option for everyone. Because implants require surgery, patients must be in good health, have healthy gums, have adequate bone to support the implant and be committed to meticulous oral hygiene and regular dental visits. If you are considering implants, a thorough evaluation by your dentist or dental specialist will help determine if you would be a good candidate.
First, surgery is performed to place the implant into the bone. If insufficient bone is available a bone graft
surgery might be necessary to increase the height and width of the jaw bone to accomodate the placement of an implant. Surgery can take up to several hours, and up to six months may be required for the bone to grow around the implant and firmly hold it in place. Some implants require a second surgery in which a post is attached to connect the anchor to the replacement teeth. With other implant systems, the implant and post are already attached and are placed at the same time. After the gum tissues have had several weeks to heal, the next step is begun. The artificial teeth are made and fitted to the post portion of the implant. Because several visits to the dentist for fittings may be required, this step can take one to two months to complete. Implant surgery is usually done in a dental office, sometimes in a hospital, depending upon a number of factors. A local or sedation anesthetic may be used. Usually pain medications and, when necessary, antibiotics are prescribed. Your dentist will give you instructions on diet and oral hygiene.
Arnica Montana promotes healing, minimizes bleeding, and diminishes swelling. Arnica has no reported side
effects and is compatible with commonly used surgical medications, is well tolerated by patients with good compliance, and is claimed to be an effective anti-ecchymotic. In addition, it is a natural product and free of side effects. Homeopathic regimens are starting to be recognized as beneficial in enhancing patient healing and comfort.
Basically a full regime of antimicrobial mouth rinses, antibiotics, analgesics and narcotics, and homeopathic
agents. The mouth rinse of choice is chlorhexidine started 3 to 4 days before surgery and continued until the sutures have been removed. The antibiotic of choice is usually broad-spectrum and is started 1 hour before surgery and continued up to 7 days post operative. The analgesic of choice is an NSAID like ibuprofen, but if allergic reaction exists an acetaminophen is given. With more severe pain levels a codeine derivative is prescribed, but note the addictive risk of codeine. The NSAID's are given during the first 48 to 72 hours predominantly for pain-relief and anti-inflammatory actions. As homeopathic agents we recommend Arnica Montana and Hypericum. The first to reduce swelling and bruising and the second to aid in nerve regeneration after bone harvest procedures.
Predominantly the patients own bone (autogenous source) from the maxillary jaw bone or mandibular jaw
bone due to its far superior results for bone reconstructive procedures. Bone fillers or substitutes like allografts (DFDB) or xenografts (Bio-Oss) are used too, but only as an addition to the autogenous source. They can be mixed into the graft material or placed as an outer layer to support the soft tissues and enhance the augmentation procedure. These bone substitutes have no vital cells and therefore funstion only as a filler material. The healthier and more abundant the base of present bone is to support the regenerative capacity of the graft, the more a filler material can be used. In any complex and large reconstructive procedure a full autogenous bone graft is preferred.
An effective way of thinking in autogenous bone harvesting is to evaluate the risk and benefit of the procedure involved. Therefore, the quality and quantity of bone harvested from a donor site, the trauma associated and the efficacy of the bone graft are important factors in choosing the harvest site. In general, the three areas of intra-oral bone harvesting in order of least to more traumatic are maxillary tuberosity, mandibular ramus and mandibular chin In most single tooth cases a graft harvested from the tuberosity and mixed with bone from a suction filter is efficient in its application. All larger cases will need bone from the mandible. In those cases a ramus bone graft will be preferred due to its reduced trauma and risk for tissue damage. The biggest advantage of a chin bone graft is its abundance of available bone. In patients with severely deficient jaw bones an extra-oral bone harvest procedure is indicated. A good example is the severely resorbed edentulous maxilla. |
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