Cary  A. Shapoff D.D.S.
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Dental Implants

Dental implants have been used in a clinical practice of dentistry for over fifteen years with great success. This restorative and surgical dental alternative should now be a consideration in every patient treatment plan.

Dental implants are an exciting new advance in dental care for our patients. Success rates exceed 95% in most situations. There are, however, factors that reduce the long-term success of this procedure.Smoking, diabetes, poor dental health, inadequate jaw bond size, excessive biting forces and poor patient follow-up after the dental implant is restored are factors which reduce the success of this procedure.

X-ray shows tooth with root canal
Tooth has been removed and ready for implant
X-ray shows implant
Implant in place

Restoration by: Dr. Jeff Babushkin

What is a dental implant

Today, dental implants are a very popular and exciting treatment option for patients. These dental implants are made of Titanium metal and are shaped like teeth. They can be used to replace a single tooth, support a permanent bridge, or anchor your denture or removable partial denture.

Why do I need an Implant?

Many factors go into considering if a single dental implant or dental implants are a good, restorative dentistry option for you. After a careful clinical and radiographic examination of your mouth and jaw structure, it can be determined if you are a good candidate for this procedure. First, you need to have acceptable jaw bone space to surgically place these implants. Second, you need to have acceptable medical and dental health to ensure proper surgical healing and a good long-term prognosis of the dental implants and the tooth or teeth placed on these implants. Third, you need to know that this treatment option is the best alternative for you. You will be given other options to replace your missing tooth, teeth or secure your denture.

Inplant information

The surgical dentist placing the dental implant needs to work closely with the dentist restoring the implant in planning and providing the treatment. You, the patient, benefit from the dental implant procedure because teeth can be replaced without having to perform dental procedures on adjacent teeth. A single tooth dental implant is an excellent alternative to a fixed bridge when one tooth is missing. The cost of the dental implant and crown is often the same as a three-unit bridge. When two or more teeth are missing, dental implants can permanently replace the missing teeth when the other permanent (fixed) options are not available. Dental implants are also ideal for anchoring clips and bars that hold a denture or removable partial denture in place. Loose dentures can now be a problem of the past.

The not so-good part of dental implants is the time factors for proper healing of the implants in the bone. Implants placed in the upper jaw need to heal in the bone for six months before they can be restored. The implants placed in the lower jaw take three to six months to heal. During this time, you will need to be seen monthly for a short follow-up visit. You may need to wear a temporary tooth (teeth) replacement during this healing period.

Dental implants represent one of the many new technological advances in dentistry to provide better care for our patients. This may be your best option for treatment of your dental problem. Teeth that have fractured, are non-restorable due to decay or have been lost from periodontal disease can be replaced. Loose and uncomfortable dentures and removable partial dentures can be firmly secured in your mouth. Please do not hesitate to discuss these issues with your family dentist.

Once the implants are restored, you will need to take care of them as if they were your own natural teeth. Daily home care by you is essential, as are regular follow-up visits to the restorative dentist and the surgical dentist. From there, your dentist fabricates the tooth, bridge or anchoring clips for your denture.

The surgery to place the dental implants in an office procedure using the same dental anesthesia you are familiar with for other dental procedures. The procedure is usually painless and very precise and often takes between one and two hours. Occasionally, additional bone grafting is necessary to improve the bone space for the dental implant. At the end of the healing period, there is small simple second surgical procedure to uncover the implant and place a post on the top of the implant.

care for your implant

Daily Homecare

You must clean around the implant(s) everyday just as you would your own teeth. Use your regular toothbrush, an end-tufted brush, and a plastic-coated interproximal brush (looks like a Christmas tree shaped brush). Dip the brushes in the special mouthrinse solution that has been prescribed. You may also want to use the special dental floss made for implants, called "Superfloss" or other similar types of dental floss.

The Prescription Mouth rinses

Currently "Peridex" and "PerioGard" are the only two prescription mouth rinses which contain the special chemical, chlorhexidine gluconate (0.12%). This chemical is anti-bacterial and is needed to keep the tissues healthy around the implant(s). These chemicals can cause minor staining of the adjacent teeth but this can be easily polished off.

Maintenance Visits

We ask that you see us every three months in the first year after implant placement. After the first year you will need to be seen twice a year by us to check on the health of the implant(s) and the surrounding tissue.

After the first year we need to take an x-ray of the implant site once a year. A copy of this will be sent with a report to your general dentist.

Why Some Implants Fail

Implants fail for two reasons-
  1. Improper forces placed on the implants can cause damage to the implants or to the surrounding and supporting bone.
  2. Remember-Bacterial plaque forms around implants every day- You must clean the implant(s) everyday

Call us if you feel as if something is "loose". Every so often the retaining screw of the restoration becomes loose and it needs to be re-tightened by us. A second reason for failure is inflammation of the tissues around the implant by the mouth bacteria. Proper daily care by you can prevent this inflammation.

Remember

If you have your teeth "cleaned" in another office- please remind them of your dental implant(s). Do not let the hygienist clean the implant with a metal instrument as it might scratch the implant surface.

Toothpastes

Remember to use a low abrasive toothpaste around the implants. Our hygienists can recommend a few brands that will not damage the implant surface.

Power Toothbrushes

These can be used around your implant(s) if you keep the setting low. Ask our hygienists for specific instructions about the type of electric toothbrush you use. You may want to purchase an electric brush from us (at our professional discount).

case study

Steps for Dental Implants

Clinical photograph of fractured maxillary lateral incisor (small tooth in center of photo) as a result of decay under the porcelain crown on the tooth.
Radiograph demonstrating the large amount of decay under the crown resulting in the fracture of the tooth crown from the root..
Clinical photograph of the remaining fractured root portion of the tooth requiring extraction. A simultaneous extraction of the tooth root and immediate placement of a dental implant was planned.
Radiograph exhibiting the dental implant positioned in the extraction socket as an "immediate" implant. A provisional "temporary" crown was also immediately placed on the dental implant to allow the patient to function as normal with a visible tooth in place.
Radiograph demonstrating the restored dental implant utilizing a CAD-CAM milled titanium Laser-Lok abutment and all porcelain crown on the implant. The implant was a BioHorizons Tapered Internal "Plus" (platform-switched).
Clinical photograph of the restored dental implant with exceptional tissue health and esthetics.
Restoration by
Dr. David Wohl, Fairfield, CT

Dental Implant Candidate

Patient with fractured root-canal treated bicuspid tooth exhibiting bone loss and infection. This tooth required extraction and bone grafting repair of the damaged jaw bone.
Radiograph demonstrating repair of the bone ridge following grafting procedure. Dental implant surgery could now be performed.
Dental implant placed as "single stage" with the healing abutment in place. The implant is a BioHorizons Tapered Laser-Lok "Plus" (platform switched). Currently the most scientifically advanced dental implant in dental practice.
The restored dental implant with a porcelain crown on the implant abutment. Bone levels and soft tissue health are excellent
Restoration by
Dr. Janice Hunt, Fairfield, CT

Molar

Radiograph demonstrating a root-canal treated mandibular molar with non-restorable decay. This tooth required extraction.
Radiograph of repaired extraction socket following bone graft and 6 month healing. The exact location of the mandibular nerve channel is not evident on this scan therefore the patient was sent for a CAT scan.
Cross-sectional image from cone beam CAT scan demonstrating complete repair of bone ridge. Note position of the mandibular nerve channel ( colored in orange). Three-dimensional imaging (CAT scan) is valuable in showing exact jawbone width, position of nerves and success of bone graft procedures.
Radiograph showing a positioning pin in the dental implant surgical process. This allows us to check for proper positioning and depth.
Dental implant (BioHorizons Tapered Internal Laser-Lok "Plus"- platform switched) with healing abutment placed as "single stage". This will be allowed to heal in the bone for 60-90 days before completing the final crown by the restorative dentist.
Final crown in place with excellent bone and tissue health.

Two

Clinical photograph of female patient with two crowns on the maxillary central incisors (front teeth) demonstrating unesthetic inflammation of the gingival (gum) tissue resulting from ill-fitting crown margins and decay.
Radiograph of the two maxillary central incisors with bone loss and minimal natural tooth surface to support crowns. Both teeth required extraction and replacement with dental implants.
Clinical photograph exhibiting inadequate natural tooth surface to support crowns.
Radiographic marker pins in place after extraction of teeth used to assist in determining position during the implant surgical procedure.
Dental implants placed within the extraction sockets of the maxillary central incisors. Healing abutments placed to support the gingival (gum) tissues.
Radiograph showing the two dental implants restored with crowns. Note the excellent bone levels around the implants
Clinical photograph of the final crowns on the dental implants. Note the excellent tissue contours around the crowns resulting in dental implant crowns which appear like her natural teeth.

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