Implant Dentistry

What are dental implants?

Dental implants are basically sophisticated screws made of a medically pure, very strong and biocompatible metal, Titanium. These screws are then placed in the jaw bone and rest under the gum for 3 - 6 months. During this time they actually fuse to the jawbone and become osseo (bone) integrated. After the appropriate healing time, we take an impression just like on natural teeth and we can do crowns, bridges and dentures attached to implants.

Dental implants have been available for the past 50 or so years. There are significant differences, however, between the various types of implants that have been used to replace missing teeth. These differences are important since they are directly related to the implants success rates. The implants currently in use today, OSSEOINTEGRATED IMPLANTS, were originally developed in Sweden by Dr. P.I. Branemark., a Swedish Orthopedist approximately 30-35 years ago. They have been used in the U.S. for the past 17 years.

All implants in use in the United States are regulated by the Food and Drug Administration. Originally, the only system available was the Noblepharma Branemark implant. Today, there are numerous implant companies in use on a daily basis. All of these companies are FDA approved and must meet very stringent requirements. We will choose the system that is best for you and the one that allows them to accomplish your mutual restorative goal. Implants are made of commercially and medically pure Titanium. This is the same metal that has been successfully used in hip implants for many years. It is inert and is not known to cause any type of rejection phenomenon.

Would you like to read more details about implants?

Implant surgery is done in two stages. The first stage involves the placement of the implants into the available jaw bone. This is most commonly done with just local anesthesia. It is a very uncomplicated procedure done in one hour or less. Every attempt is made to insure success, the equipment thoroughly sterilized and the most modern techniques utilized.

Stage two involves the uncovering of the implants after they have integrated (fused). This can be accomplished with minor gum treatment or with a dental laser and it is a relatively minor procedure. It takes a few minutes and is painless. In certain cases I will require a CT Scan, a 3 Dimensional X-ray that will help me evaluate the quality and quantity of bone before I start the surgery. A 3 Dimensional X ray will tell me how much bone exactly there is present. We work with a very good Radiologist who can offer the highest resolution CT Scan, the lowest radiation exposure, and also the fairest price.

Success rate is about 96% for dental implants. That is the highest rate of success in any kind of surgery on the body.

Although implants simulate the roots of teeth, biomechanically one implant can be used to replace one or more teeth. This will depend upon the mechanical requirements of your chosen prosthesis. At your consultation we will discuss the various treatment alternatives and the type and number of implants that are needed in order to fulfill our treatment objectives.

Dental implants take approximately 3-4 months in the lower jaw and 6 months in the upper to integrate. Once integrated, it usually takes only two visits to complete the restoration.

Once the implants has healed you have several choices of Implant Restorations:

I have placed a substantial amount of Implants and have learned throughout my career the limitations. You cannot replace experience when it comes to perfection in dentistry. The implant placement in many cases is the easy part. Believe it or not the restorative part, the crown or over denture, requires much more knowledge, hands on experience, know how in physics, biomechanics, occlusion, centric relation, TMJ and much more. Many restorative devices can be done – but is the restoration the best solution for a particular case?

Is long-term success guaranteed?

Is it comfortable and predictable?

Is your dentist able to give you all the options and chooses the one, which suits you the best?

Option 1
One implant, one crown. This is a fixed crown, not removable, like a natural tooth. You can floss in between teeth, as it is a separate crown not connected to the adjacent teeth.
A single implant is attached to a single crown. The Rolls Royce of dental implantology, since it gives you the closest feeling next to natural teeth. Single Crowns can be flossed and are not connected to adjacent teeth. I recently finished a case where a lady had 12 upper implant placed. Over each implant one single crown was placed as a restoration. What a quality of life improvement from edentulous to full reconstruction of your bite, function and esthetics.

Overdenture
In this case a denture is attached to your implants. Since implants are holding the denture, the denture is smaller than a conventional denture; there is no palate coverage, the implant denture is very retentive and very comfortable.It can be taken out for easy cleaning and you can place it right back to sleep with it . Several attachments such as a bar system, a locator system are available to connect the denture with the implants. As mentioned before, the highly retentive construction eliminates any denture adhesives of course and has no palatal coverage, which makes this solution very desirable.

Upper Denture
Remarkable is the absence of any palatal coverage! Wow , that is minimalistic. Conventional, non-implant supported upper Denture as a comparison. Since the palate is not covered, food can be tasted much better and it is much more comfortable.

3) Bar system connecting implants together
In this case the 4 implants placed in the patients mouth were limited in strength due to the patients high age and weak bone. We were still able to achieve a successful outcome by means of connecting 2 implants together in a bar system. Once two implants were connected they become much stronger and much more solid than a single implant on its own. In this case the suprastructure (Overdenture) will be screwed in with titanium mini screws and will be fixed and sturdy. The patient cannot remove it.

Frontal view of implant-retained denture

Option 2 Overdenture with Locators
Four implant attachments, Locators attached to 4 implants in the patients mouth. Since this patient was not able to place 14 implants and 14 single crowns, this was a great alternative giving her back 14 teeth with only 4 implants. Also reinforced inner part of the denture, which is invisible on the outside of the denture.

World Class Reconstructive Dentistry

Several implants placed by Dr. Goodman

Final Restoration

X-ray showing an implant
The implant is percent parallel to the natural teeth

Please look at some of the cases that we have done for our patients in our office.

Bob with no teeth and no implants

Bob with 10 implants and 10 implant crowns
A case like this requires profound knowledge in functional, phonetics, esthetic and surgical dentistry.