This was done with a zirconia abutment, which is white so there will be no “metal showing” even if the gum receeds. Which will probably not happen because this was such a thick gingival biotype.

Bridge Replacement

Bridge was sectioned, the patient healed for 6 months and after about a year has come back desiring teeth in that area. I explained that we could do implants. Below are the placed implants and the CT scan workup for this site.

Patient had a front tooth that jetted out and didn’t want to re-trude it with an appliance.

We placed an immediate implant. This is where we can take out the tooth atraumatically and place the implant in the extraction site. We then place a bone graft and a collagen membrane and suture the flap closed.

Lower Left Implant Placed where patient was missing a tooth.

A CT Scan should always be taken prior to implants to give the surgeon forsight in to the vital structures such as nerves and blood vessels.

Tissue Level Straumann SLA implant 4.8mm diameter was placed in the area of #18.

1. Advanced Periodontal Disease: where many teeth are loose and there is insufficient bone support for these teeth.

2. Gross Caries to Bone Level: When teeth are decayed all the way to the bone and there is no way the teeth can be saved.

3. Large Root Abscesses: The tips of the roots of teeth in bone have been abscess and infected for so long that large bone loss has occurred and it is necessary to extract the teeth.

4. Dentures do not fit well or have poor suction etc.

5. Patient does not like dentures and wants something that is non-removable or fixed.

Options to Replace Multiple Missing Teeth

Implant-Assisted Prosthesis

Locator Abutments

Bar and Clips

Implant-Supported Prosthesis

Fixed Hybrid Denture

Fixed Implant Bridge

Similar to a hospital CT scan, a cone beam CT takes a 3 Dimensional image of bones and hard skeletal structures such as teeth.  Essentially its a 3D X-ray.

This is a relevant and important topic for implant dentistry today. When a patient desires a dental implant, there are important considerations in the planning of where the surgeon will place that implant in solid bone.

A 3D X-ray such as a Cone Beam CT will allow for the surgeon to visualize in 3 Dimensional space where they can exactly place the implant. This is extremely important because it allows them to avoid vital structures such as nerves and blood vessels. Also, it helps them to plan for possible grafting necessary when the bone is insufficient to place an implant.

The Cone Beam CT is an excellent diagnostic tool which will enable your surgeon to avoid any complications or pitfalls in your surgery, before he goes into surgery.

The American Dental Associate and California Dental Associate both recommend a Cone Beam CT be taken before any dental implant is placed.

Below you can view the capability of this machine, and some of the 3D models it can produce.

We must understand that not everyone’s jaws and gums are the same. Certain characteristics make it easier to wear dentures and have them stay in better, other characteristics make it difficult for dentures and partials (especially lowers) to get good suction and stay in place while eating or speaking.

If you are a patient who is facing this challenge, you may want to consider an investment in implants. We have the capability in dentistry to modify your existing denture to clip on to the implants.

An advantage of  the “locator” abutments is there are severe types of inserts that can be easily interchanged to fit into the denture, once it is modified. These inserts have different capabilities of tightness. They can be set to clip on to the implants very tight or just tight enough to stay in place.  This enables older patients or patients with disabilities to easily remove the dentures.

Once the implants are placed and the abutments are attached. They will require 6 month maintenance. They should be cleaned regularly at home. About every 6 months to 1 year the replaceable inserts may need changing to maintain strong attachment.

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This powerpoint is meant to educate the Dental Health Professional. Therefore some of the terminology is quite complex. However, many dental patients may also find this information useful to understand the background of dental implants. This will allow them to have correct expectations for their treatment options and allow them to ascertain the limitations of treatment.

Straumann Dental Implant

I have elected to place straumann implants because of the quality, integrity and track record. I am very please with how they integrate with the bone and the ease of restoration. The parts are very user friendly and have long term durability. Six of the implants I restored this year were Nobel Biocare and they were very difficult to take an impression.

Straumann has revealed a new implant material, Roxolid [Rock-Solid], a Titanium- Zirconium alloy that is 50% stronger than pure titanium. Initial animal studies show a significant increase in removal torque values over Straumann`s current SLActive titanium implants. Human trials are underway in Europe and North America. Straumann expects to have the design released for initial markets in 2009.

Roxolid (Rock-Solid)

If I was missing a tooth I would definately want a Straumann Implant to replace it.

Remember to get implants your bone must be healthy, it is a good idea to quit smoking before getting implants.

Periodontal disease can affect implants in a similar way it affects teeth. Tartar buildup on the implants has bacteria which will trigger an inflammatory response in the gums leading to bone loss around the implant.

Implants require care and routine maintenance.