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Specializing in Dental Implant/Periodontics

Surgical Procedures
Listed below are the surgical procedures we routinely perform in our office for our patients.  We specialize in the placement of dental implants to replace missing dentition.  We also care for our patients periodontal concerns whenever necessary.

Dental Implants

Dental implants are titanium anchors that act as tooth root substitutes. They are surgically placed into the jawbone. A small abutment is attached to the implant to provide a stable anchor for the replacement tooth. Read more.

Extractions

When extraction of a tooth becomes necessary, we can quickly remove the tooth under local anesthetic. Many times, a replacement implant can be placed at the same time. Read more.

Bone Regeneration

Over a period of time, the jawbone associated with missing teeth atrophies or is resorbed. 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 regenerate 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 functionality and esthetic appearance. Read more.

Crown Lengthening

Crown lengthening (or crown exposure) is required when your tooth needs a new crown or other restoration, and the edge of that restoration would end deep below the gum tissue and would not be accessible. Read more.

Cosmetic Periodontal Surgery

Although your teeth appear short, they may actually be the proper length. The teeth may be covered with too much gum tissue. We can correct this by performing the periodontal plastic surgery procedure, crown lengthening. Read more.

Tissue Augmentation

When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, gum reconstruction using grafting techniques is an option. Read more.

Osseous Surgery

Osseous surgery is performed to treat periodontal gum diseases which do not respond fully to scaling and root planing. Osseous surgery involves cleaning out pockets between the teeth and gums, as well as re-shaping the bony structure holding the teeth. Read more.

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The Implant Process
When a patient decides that implant restorative dentistry is the option most suited to their needs, the implant process is outlined as follows.
Extraction, If Necessary

Implant patients fall into two categories; either they are missing teeth which need replacement, or they have failing teeth which need replacement.

If a patient has already lost a tooth, an implant can be placed as soon as eight to ten weeks after tooth loss.

If a patient needs extraction of failing dentition, we can in most cases place the implant(s) at the same visit as the extraction(s).

Implant Placement
Placement of a single implant is usually performed under local anesthesia, and requires a 1.5 hour office visit.  Approximately 15-20 minutes is spent at the beginning of the appointment to anesthetize the patient and to review the post operative procedures. The patient is then moved into a sterile suite, where we will spend approximately the next 30 minutes performing the extraction if needed, and placing the implant. Following implant placement, our patient is allowed to recover for another 15 to 20 minutes, while post operative care procedures are again reviewed, including post operative medications, and the patient is given an ice pack to take home. The patient will be advised to avoid rigorous exercise and to rest during the first 24 hours following surgery. In most cases, our patients can return to work the next day. A follow-up appointment is scheduled for 7-21 days later.

If a case is more complicated, or if additional implants are placed, supplementary time will be needed for the implant placement appointment. The above scenario is typical for an uncomplicated single implant with extraction.

Covered or Uncovered
When viewing the surgical area after placement of an implant, our patients will see one of two things. The area will either be sutured over allowing the tissue to heal covering the implant, or a small metal cap (the size of a pencil eraser) can be seen protruding from the tissue. If the implant is covered following placement, a short uncovering procedure will need to be performed before the final restoration (crown) is placed by the restorative dentist. A covered implant or uncovered implant is decided upon by the doctors, and is predicated upon the esthetic requirements of each case.

Healed Uncovered Implant
Covered Implant with sutures. The adjacent teeth have been prepared for crowns which are not in place
Post Operative Instructions

Following implant placement and a short recovery period, each patient will be released to go home with an ice pack and Post Operative Instructions. The success of your dental implant depends on your compliance with these instructions.  Accurate use of the prescribed antibiotic medication and antibacterial rinse is essential for timely healing, as well as reduced incidence of infection at the surgical site.

Additionally, the Post Operative Instructions advise patients regarding the non-use of their new dental implants. As a general rule, dental implants should not be used for chewing purposes until the healing phase has been completed.
Healing Time

Following placement of the implant(s), the area will need to be allowed to heal for a period of time before the final restoration (crown, bridge, or denture) can be placed. During this time, the patient should not chew in the area of the new implants.

Typically, an implant placed on the upper arch will need four to six months of healing time, and an implant placed on the lower arch will need two to four months of healing time. Individual healing times depend on each patient and the type of case involved.  Implant cases involving bone grafts require the extended healing periods.

Temporary Restoration
During the healing phase, a patient may elect to use a temporary restoration. A temporary restoration allows an implant patient to use an intermediate tooth replacement for esthetic purposes only. A fixed temporary crown can either be attached to a removable partial type of prosthesis, called a flipper, or it can be attached directly to the implant. Placement of a temporary crown direction onto an implant is typically reserved for areas directly seen in the patients smile, and cannot be used for chewing purposes. A temporary restoration is not generally needed for back teeth. A temporary denture can also be used for patients with no teeth, however patients heal best if a fixed temporary restoration is placed.

Temporary Denture

Flipper or Partial Denture

Pre-Operative

Fixed Temporary Restoration 
After Implant Placement

Final Restoration

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