Surgical Procedures

• Dental Implants
• Cosmetic Periodontal Surgery
• Gum Graft
• Crown Lengthening
• Osseous Surgery
• Bone Regeneration
• Ridge Preservation
• Surgery Instructions

Dental Implants

Dental implants are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. A person who replaces teeth with implants regains the ability to eat virtually anything and smile with confidence, knowing that implant teeth appear natural and their facial contours are preserved. The implants themselves are small titanium posts or screws that are placed into the jawbone where teeth are missing. The bone bonds with the titanium, creating a strong foundation for artificial teeth. In addition, implants can help preserve facial structure, preventing the bone deterioration that occurs when teeth are missing.

Dental implants are changing the way people live! With them, people are rediscovering the comfort and confidence to eat, speak, laugh and enjoy life.

Our Doctors has received extensive training in Implantology. They have been successfully placing implants since the late 1980’s. Through continuing education, Drs. Mandel, Keiser and Joseph keep abreast of the most current information on implant dentistry.

Evaluation

If, like many others, you feel implant dentistry is the choice for you, we ask that you undergo a dental/radiographic examination and health history. During these consultation visits, your doctor will address your specific needs and considerations. Your questions and concerns are important to us and our team will work with you very closely to help make your procedure a success.

Special 3-Dimensional x-rays are often needed to fully evaluate your jawbone and vital structures prior to placing implants. These 3-Dimensional x-rays represent a significant innovation in modern dentistry, which virtually eliminates any guesswork in the placement of dental implants. We have capacity to perform this service for you.

The most important part of dental implant placement is their secure anchoring for the proper restoration of the teeth. It is important that we work closely with your dentist to insure coordination to get the best result for you. Molds of your teeth and bite are usually needed to fabricate a simulation of a final result and a template that can be used for implant placement. These molds, or study models, along with your x-rays and clinical findings, will allow us and your dentist to properly plan the placement and restoration of your implants.

We will also discuss fees and insurance at this time. There are many types of insurance plans, and coverage for implants is varied. We will be happy to assist you in obtaining any benefits to which you may be entitled.

Procedures

Dental implants are metal anchors that act as tooth root substitutes. They are surgically placed into the jawbone. Small posts are attached to the implant to provide stable anchors in the gums for replacement teeth.

For many patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. Healing time following surgery varies from person to person and is based on a variety of factors that include hardness of bone. The second procedure is usually very minor and involves placing an extension (healing collar) to the implant to facilitate the final restoration. In some cases, implants may be restored immediately after they are placed.

For the first three to six months following surgery, the implants are beneath the surface of the gums gradually bonding with the jawbone. You will be able to wear temporary restorations and eat a soft diet during this time. At the same time, your restorative dentist designs the final dental crowns, bridgework or denture that will ultimately improve both function and aesthetics (your new teeth).

After the implant has bonded to the jawbone and the healing collar placed, you will be ready to see your dentist to start making the new teeth. Your dentist will fabricate an impression of the implants. Then posts or attachments can be connected to the implants. The teeth replacements are then made over the posts or attachments. The entire procedure usually takes three to eight months. There are many cases that can take less time and the specifics of your situation will be discussed with you. Most patients do not experience any major disruption in their daily life.

Bone Grafting and Dental Implants

Over a period of time, the jawbone associated with missing teeth atrophies or is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants.

Today, we have the ability to grow bone where needed. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionally and esthetic appearance.

Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease or injuries. The bone is either obtained from a tissue bank or your own bone is taken from the jaw. Sinus bone grafts are also performed to replace bone in the posterior upper jaw. In addition, special membranes and growth factors gels may be utilized that dissolve under the gum and protect the bone graft and encourage bone regeneration. This is called guided bone regeneration or guided tissue regeneration.

Bone grafting can often be performed at the time of implant placement. If this is possible then the number of surgical appointments can be reduced. Keep in mind, if bone grafting is performed then healing times for implant restoration maybe longer. Every situation and individual has a unique set of circumstances that need to be evaluated in making the correct plan of action.

Sinus Lift Procedure

The maxillary sinuses are behind your cheeks and on top of the upper teeth. Sinuses are like empty rooms that have nothing in them. Some of the roots of the natural upper teeth extend up into the maxillary sinuses. When these upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. Dental implants need bone to hold them in place. When the sinus wall is very thin, it is impossible to place dental implants in this bone.

There is a solution called a sinus graft or sinus lift graft. The dental implant surgeon enters the sinus from where the upper teeth used to be. The sinus membrane is then lifted upward and donor bone is inserted into the floor of the sinus. Keep in mind that the floor of the sinus is the root of the upper jaw. After several months of healing, the bone becomes part of the patient’s jaw and dental implants can be inserted and stabilized in this new sinus bone.

The sinus graft makes it possible for many patients to have dental implants when years ago there was no other option other than wearing loose dentures.

If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant well, sinus augmentations and implant placement can sometimes be performed as a single procedure. If not enough bone is available, the sinus augmentation will have to be performed first, then the graft will have to mature for several months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed.

Jaw Bone Rebuilding

In severe cases, the jawbone ridge has been reabsorbed or diminished and bone regeneration techniques are used to increase ridge height and/or width. This can happen when teeth have been missing in an area for a long time or there was bone loss from infection. There are jaw bone rebuilding techniques which will allow for enough bone growth so that dental implants can be placed to restore missing teeth. A healing period of several months is needed for the new bone to form before the implants can be placed.

Tooth Extraction and Dental Implants

It is often possible to place a dental implant at the time a tooth is removed. There is a great advantage in this immediate placement of the dental implant, a faster final restoration. This procedure requires a special set of circumstances related to your bone configuration, bite, dental and medical health. Additional bone regeneration procedures may be required for these immediate implants.

In situations when the implant cannot be placed at the time of extraction careful management of the site is needed to issue maximum growth of bone. Guided bone regeneration techniques are utilized so that the area will be a good future site for an implant and to add strength to the remaining adjacent teeth.

Growth Factors

We often utilize products known as growth factors or biologic factors that aid and accelerate healing in the treatment of periodontal disease and placement of dental implants.  One of these products is platelet rich plasma growth factor (PRP). This is a derivative of your own blood or can be synthetically produced. The PRP growth factor can stimulate your stem cells for better bone and soft tissue healing. We also use a growth factor call Emdogain®. (derived from animal stem cells) Growth factors have many applications for periodontal, jawbone and dental implant surgery.

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