Implant Dentistry Related Procedures
Dental Implants replace missing or badly broken teeth that can long longer be restored. Dental implants are essentially metal anchors that substitute for the root(s) of your teeth, and they are secured to your jawbone via a routine procedure with minimal disturbances to most patients. After proper healing, a new crown is secured to the implant, which often is even more esthetic than the old, real tooth. Whether you are replacing one tooth or securing an entire denture, dental implants have revolutionized modern dentistry by providing a long-term, cost effective, predictable, and esthetic outcome for missing teeth. Dr. Raz places hundreds of dental implants every year, and he is confident that nearly all patients can benefit from dental implants when treatment planned conservatively and correctly.
When a tooth is badly infected or broken, it is sometime necessary to remove (extract) the tooth or its remaining fragments. When this is attempted, it is very important that the utmost care is taken to preserve healthy surrounding bone and structures while protecting vital structures such as nearby nerves and arteries. Dr. Raz utilizes modern technology and techniques to minimize complications with extractions to promote quicker healing and maximizing replacement options in the future.
When a tooth is extracted, the body undergoes a transformation that can decrease the bone volume available for future restorative procedures. Additionally, bone loss can occur due to localized trauma, infections, abscesses, and other conditions that can negatively impact a patients treatment options. When necessary, bone grafting is performed in conjunction with other procedures to either preserve existing bone or regenerate lost structures.
Occasionally, patients seeking dental implants for the back teeth in the top jaw (maxillary premolars and molars) need an augmentation procedure either before or during the implant placement. Sinus lifts are performed to augment the current sinus anatomy to maximize stability and retention of the implants while minimizing long-term risks and complications in the area like chronic sinus infections. When necessary, Dr. Raz will thoroughly discuss sinus lifting procedures and options with the patient who will be thoroughly educated about this relatively minor additional procedure.
Dental Implant Placement
During dental implant placement, a metallic “screw” or implant is secured to the jawbone through a relatively quick and painless procedure. This implant will eventually connect to a new tooth or house “buttons” to support a denture. Dr. Raz places hundreds of dental implants per year, and he utilizes the newest, cutting-edge technology to aid in the planning and placement of dental implants to maximize results and decrease procedure time and healing time.
Periodontal Related Procedures
Periodontal-related diseases are chronic, inflammatory, and destructive responses to normal bacteria present in our mouths. There are several forms and types of periodontal disease (such as gingivitis and periodontitis), but most of these oral diseases are initiated and sustained by bacterial plaque. Although bacterium usually activates the disease process, most periodontal destruction is related to the host response (your body’s reaction to the bacteria) and not necessarily the presence of the bacteria alone. Therefore, most treatments for traditional periodontal diseases are performed to reduce and change bacterial load and composition, repair structures that were affected by the disease process, and alter the local environment to help protect the individual areas from disease reoccurrence. Although oversimplified, this rationale and strategy is used to treat a vast range of both periodontal and dental related problems.
Scaling and Root Planning
When dental plaque hardens and calcifies, it is called calculus. This living environment of bacteria can easily hide from the patient when normal, regular hygiene is performed leading to inflammation and even bone loss. When this occurs, the calculus needs to be removed from the roots, which are under the gum tissues. This is performed by a non-invasive procedure called scaling and root planning which is often called a “deep cleaning.” During this procedure, Dr. Raz will anesthetize the areas needing treatment so you can rest assured the procedure will be performed in a pain-free manner.
Osseous Surgery and Periodontal Pocket Elimination
When bone loss occurs as a result of periodontitis, inflamed gum tissues fill the void and periodontal pockets form around the teeth. When this happens, it is necessary to remove the causative agent (bacterial plaque and calculus) as well as correct any underlying deformities caused by the disease process. To accomplish this goal and reduce future repopulation of the harmful bacteria, the areas of concern are treated to eliminate areas bacteria can reside and continue causing problems. The ultimate goal is to create an environment that is cleansable and maintainable by the patient at home.
Esthetic Crown Lengthening
Sometimes, asymmetry exists in patient’s gum line due to developmental anomalies, past orthodontic work, or even past dental/restorative work. Esthetic crown lengthening is also performed in conjunction with other restorative work (veneers, crowns, full smile rehabilitations) to maximize esthetic outcomes performed by your general dentist or restorative specialist. This minimally invasive plastic surgery procedure aims to evenly match the contours, shape, and architecture of your gum line to give you the confidence back in your smile.
Clinical Crown Lengthening
If a crown is treatment planned on an existing tooth but the remaining tooth structure does not provide your dentist enough support for the new crown, clinical crown lengthening is indicated and performed. This procedure literally lengthens the existing crown structure of the tooth, which enables your dentist to stabilize and retain your new crown more effectively and efficiently. Clinical crown lengthening ultimately yields a healthier, more esthetic restorative outcome for both you and your restorative dentist in a relatively simple, easy, quick procedure.
Bone and Soft Tissue Regeneration
Often times, both hard and soft tissues degenerate in the mouth. This can occur from a variety of reasons. Sometime this is due to a disease process like periodontitis. Other times, it is product of harmful patient habits. Regardless of the cause, it is now possible to regenerate these lost structures. When appropriately planned and performed, bone grafting and tissue transplants can replace lost structures and prolong the life of your dentition.
Dental Implants Restoration
Your dentist will take the impression of your dental implants to fabricate a restoration replacing missing teeth. An implant crown is attached to the dental implant via an abutment, a small connector that is screwed inside the implant post. Once the abutment is screwed in and tightened, an implant crown or bridge will be either cemented or screw-tightened on top of the abutment. Implant crowns are similar to natural tooth crowns since they are individually attached to a supporting dental implant, allowing patients to easily floss between the teeth. This is a preferred option to replace single missing teeth.
Dr. Raz is an expert at minimizing the numbers of surgeries and types of treatments needed to place dental implants. He has learned how to make the procedures safe, comfortable, predictable and easy to have performed. Training, experience and skill levels vary significantly with dentists placing dental implants. There are multiple types of specialists that place dental implants as well as an ever increasing number of general dentists. It is wise to ask a lot of questions when considering dental implant therapy.
Initially the implant is fixed to the bone much like a screw. Over time the bone bonds to the dental implant on a microscopic level (osseointegration), making the dental implant reliable to build on and this is when the second phase of tooth building begins. Much like when a foundation for a house is poured in concrete, sometime needs to pass before the final results can be delivered. Dr. Raz will determine the stability of the implant by taking an x-ray, confirming that you have been comfortable since the implant(s) were placed and performs a resonance frequency analysis (ISQ or Implant Stability Quotient), which will confirm the dental implant stability. You will be directed back to your general dentist, who will then take the impressions, shade, bite and fabricate your new teeth. In this “Team Approach” you get the best skills of both the surgeon and the restorative dentist. The entire procedure usually takes four to five months for simple treatments and most of the time is spent waiting for the bone to grow tightly to the dental implant. Most patients experience minimal disruption in their daily life during this time.
Using the most recent advances in dental implant research, Dr. Raz is most often able to place dental implants immediately at the time of an extraction of a hopeless tooth and get better results than extracting the tooth as a separate procedure. These implants do not require a second or third procedure to place the implant or to uncover it, but it does require a minimum of 8-12 weeks of time for the bone to connect to the implants before the final prosthetic teeth can be placed on them. The more time lapses after the implant is placed, the more the bone has connected with the implant and the more stable it is. He routinely extracts failing teeth and places dental implants at the time, even with infected teeth, thus eliminating extra surgeries, reducing costs and total treatment time. He does this routinely even with molars with very high success rates – further minimizing the number of surgical procedures. Advances in dental implant technology have made it possible, in select cases, to extract teeth and place implants with crowns at one visit. This procedure is called “immediate loading“. See the section on that treatment method.
Implants are a team effort between Dr. Raz and Dr. Yousefi. While Dr. Raz performs the actual implant surgery, initial tooth extractions, and bone grafting if necessary, Dr. Yousefi, the restorative dentist fits and makes the permanent prosthesis. Dr. Yousefi will typically make any temporary prosthesis needed during the implant process.
Our Drs at South Valley Periodontics and Dental Implants and Woodland Hills Dentists are happy to answer any oral hygiene questions that you might have. Please feel free to call us at 818-225-9410 for more information or to schedule your periodontal disease screening today.