Surgical Procedures

• Surgical Therapy
• Dental Implants
• Pocket Reduction/Elimination
• Reconstructive Surgery
• Cosmetic & Soft Tissue
• Gum Recession
• Frenectomy
• Soft Tissue Ridge Augmentation
• Cone-Beam CT Scan

Dental Implants

What Are Dental Implants?

Dental implants are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that their teeth appear natural and facial contours will be preserved. The implants themselves are tiny titanium posts which are placed into the jawbone where teeth are missing. They act as tooth root substitutes. 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. Dental implant use has been exploding in recent years and for good reason. They are among the most predictable and long-lasting methods to replace missing teeth. Dental implants allow for a missing tooth to be replaced without having to grind down the adjacent teeth. They act to stimulate the bone where a tooth has been lost and prevent bone resorption in these areas.

Procedures

Implants are surgically placed into the jawbone. This is an in-office procedure utilizing local anesthetic and oral sedation. General anesthesia is available but usually not necessary. Most patients can return to work the next day. After the implants have bonded to the bone, small posts (abutments) are then attached to the implant. These posts provide stable anchors for artificial replacement teeth. Depending on the complexity of each case, it could take four to nine months from implant surgery to final placement of the new teeth. However, in some cases, temporary teeth are placed the same day. Usually there are only three to five significant office visits during this time. Most patients do not experience significant disruption in their daily life.

Do They Work?

Implants act to stimulate the bone where a tooth has been lost and prevent bone shrinkage in these areas.

Implants are among the most predictable and long-lasting methods to replace missing teeth. Our office has over a 90% long-term predictability! Unlike natural teeth, implants cannot get decay and they do not have nerves, which can require root canal treatment. However, they can get periodontal disease if not maintained regularly. Proper oral hygiene and consistent professional cleanings can prevent this from developing in the same way as your natural teeth. In many instances, implants are a more conservative treatment option. A missing tooth can be replaced without having to grind down adjacent, healthy teeth, which can put them at greater risk for decay.

Am I A Candidate for Implants? - The Implant Evaluation

If, like many others, you feel implant dentistry may be the choice for you, we ask that you undergo an implant evaluation. Dr. Cataldo and his staff will address your specific needs and concerns. We believe that patients who are thoroughly educated can make the best decisions on their heathcare needs. Since implant dentistry is a team procedure, we work closely with your restorative dentist to ensure optimal results.

An implant evaluation can require up to one hour. If needed, dental films and study models are obtained. A Panorex radiograph is often necessary to provide a greater viewing area than conventional dental films. When necessary, Dr. Cataldo will refer you for a 3-D CT scan. Utilizing a highly sophisticated computer program called Simplant, Dr. Cataldo can analyze the CT scan data directly on the computer in 3-D and simulate implant placement. This technology allows Dr. Cataldo to more accurately determine your ability to support dental implants before any treatment takes place.

If possible, treatment recommendations and options, number of visits, fees, and time requirements will be discussed at this visit.

What Happens If I Don’t Have Enough Bone?

While most often implants can be placed immediately, at times there is insufficient bone available to accomplish this. Several procedures have been developed to restore bone levels to allow implant placement so that almost anyone can have implants. Click on reconstructive surgery to learn about these techniques.

Implant Site Preparation

There are times when there is not enough jawbone to place a dental implant. The bone must first be treated to allow subsequent placement of the implant. This is broadly referred to as implant site preparation. Depending on when the teeth are extracted, the area of the mouth and amount of bone needed, there are several techniques used:

 

Extraction Site Preservation – Prepares for implants at the time of extraction. The implant is placed approximately four to six months later, when the bone has hardened enough to hold the implant.

Ridge Augmentation – Builds up bone height and width to prepare the jawbone for Implants.

Sinus Augmentation – The maxillary sinuses are behind your cheeks and on top of the upper teeth. Sinuses are large air spaces in the upper jaw that help to lighten the skull. Some of the roots of the natural upper teeth extend up into the maxillary sinuses.

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.

When back teeth in the upper jaw are removed, bone shrinkage and expansion of the sinus cavity may result in an insufficient amount of bone to place implants. There are several different procedures used to restore the lost bone. These are both accomplished at our office:

Vertical Sinus Augmentation

When there is some remaining bone available, techniques have been developed to push up the existing bone. This has the effect of raising the sinus back to the position it had when the rear teeth were present. The voids left by moving the bone upward are filled with bone grafting materials. Implants are placed at the same time or four to six months later.

 

Lateral Sinus Augmentation

When there is minimal bone available this procedure allows for the maximum amount of bone regeneration. A window is created in the side of the existing jawbone which exposes the sinus membrane. The membrane is then elevated to provide room for the bone graft. Implants are placed immediately or six to nine months later.

What Is Involved in Getting Dental Implants?

There are four phases to implant treatment. They are:

1. Implant placement
2. Implant uncovering
3. Prosthetic phase (providing replacement teeth)
4. Maintenance phase

Phase I – Implant Placement

The implants are placed within your jawbone. This is an in-office procedure utilizing local (Novocain) anesthetic. Often, oral sedation is used to provide additional relaxation for the patient. A board-certified anesthesiologist is available for those patients wishing IV sedation. For the first three to six months following surgery, the implants are usually submerged beneath the surface of the gums and are not visible. Occasionally, they are left exposed, flush with the gumline. Over this period of time, the bone is essentially hardening (called osseointegration) around the implant. You should be able to wear temporary replacement teeth and if necessary, eat a softer diet. Most patients return to normal activity the next day if they follow the detailed directions. Comfort medications and antibiotics are prescribed.

Phase 2 – Implant Exposure (not always necessary)

If the implants are submerged, a second procedure will be needed to expose the implant after it has fused or integrated with the bone. With a relatively minor procedure, Dr. Cataldo will uncover the implants and attach a small healing collar. This allows the gum to form around the implant. You will still be able to wear a temporary appliance after this procedure. If the implant was not submerged, the prosthetic phase (Phase 3) can begin once osseointegration is complete.

At times, a single tooth can be completely replaced with five total visits in only 12-14 weeks.

Phase 3 – Implant Prosthetics (providing replacement teeth)

After four to six weeks for the tissue to mature, your restorative dentist will be able to start making your new teeth. Impressions and measurements will be taken to allow the dental laboratory to precisely fabricate the necessary components. The posts (also known as abutments) are then connected to the implants. The actual replacement teeth are then cemented or screwed into the posts. In other cases, the implants are used with attachments or bars to stabilize and retain full dentures.

Phase 4 – Maintenance

Just like natural teeth or the finest automobile, dental implants need ongoing maintenance if you are to realize their full benefit over many decades. This will include proper care at home as well as professional maintenance. Dr. Cataldo will work closely with your dentist to custom tailor your maintenance program to your specific needs

Immediate Restoration Implants

In certain circumstances, implants can be placed and temporary replacement teeth can be provided the same day. With very precise communication and coordination with your restorative dentist, Dr. Cataldo will place the implants and your dentist will restore them the same day with either temporary caps (crowns) or removable dentures. At times, we extract the teeth, place the implants and restore them all within a few hours! Dr. Cataldo will discuss if you are a candidate for this procedure.