Restorative driven implant placement
Our implant placement is what we call "restorative driven implant placement" which means that we will place the implant where it needs to go to make the patient function and smile without reservation. This means that if there is no bone in that location then we put bone there or treatment plan accordingly.
Our goal is predictability and that is why we have special treatment planning software which assists us in determining where the implant must be placed for optimal utilization. An implant placed in a bad position is worse than an implant not placed yet this has been the case far too many times in the past and without using modern technology this still occurs regularly. This is why we use low cost, low radiation cone beam CT technology.
If the surgeon doesn’t identify available bone parameters and vital anatomical structures such as nerves, arteries, sinus membranes, etc., gross errors may occur which will harm the patient. Using cone beam ct allows us to identify all these important structures and to do a mock implant placement on the computer prior to the actual surgery on the patient.
Since our cbct is digital the exposure to radiation is minimal and we have the specifications to show you how low it is when you come into our office. We have restored a plethora of implants since 1990.
We have since surgically placed over 2,000 implants by the time this was written in early 2020.
When a patient loses a tooth the jaw resorbs leaving inadequate bone height and width to qualify for dental implants. The longer the patient waits the more severe the problem. Also if the surgeon failed to use a technique during the extraction which prevents loss of the bone’s buccal and lingual plates during the procedure then the case is immediately compromised and the patient is not a candidate for implants without advanced bone grafting.
We are proficient in all aspects of advanced bone grafting required which includes sinus augmentation (lifting the sinus up and placing bone in the upper jaw to allow height/width for implants) and onlay or block grafts (providing bone to a jaw which is deficient in height/width).
We demonstrate an actual recent case in which we did a sinus augmentation, placed implants, and made a 4 unit bridge on the 3 implants. The patient is an E.N.T. surgeon who had minimal bone. The pneumatized sinus membrane was close to the ridge thus requiring us to do a sinus lift with bone grafting to place implants for him to have teeth on the upper left maxillary jaw.
We are currently doing a very innovative technique of using both bone expansion and compression to lift the sinus with very minimal surgery. This keeps the postoperative symptoms very minimal for the patient as well as reducing the cost by thousands of dollars as compared to a more aggressive lateral window sinus augmentation surgery. The photos are 2 cases we did in January 2013, in which the sinus has been lifted almost 9 mm by our own unique system. The usual lift using similar "sinus bump" techniques typically lift the sinus 4 mm at best.
Advanced training in surgical reconstruction
Our training has been accomplished at 2 medical colleges, 2 hospitals, university clinics, and mission clinics under the direct guidance of oral surgeons watching, advising and training us during surgery on patients (not just cadavers and models). We chose to receive this advanced training in surgical reconstruction because it seemed like every time we sent a patient to the specialist for a sinus lift or bone augmentation the patient would never have it done.
In many cases the fees were not affordable to the patient and in addition we realized that it was either something the surgeon wasn’t current enough to do with modern techniques or didn’t want the hassles associated with that type of reconstruction. Now we do it ourselves routinely.
Yes we still refer some cases to select specialists and appreciate their advanced training and skills as part of the team. Our credentials speak for themselves as we have received 2 fellowship awards, 1 mastership, and 2 diplomates. The latest award was the Diplomate Award from the International Congress of Oral Implantologists (ICOI) which is considered the highest award recognition in implantology. (see ICOI Press Release).
We have also had the privilege of training international surgeons on how to perform extensive block grafting by using bone from the patient’s own mandibular ramus and chin.
We operate based on extensive training, experience, and a desire to please you the patient. We almost always offer you a couple of choices if there are options because some patients require less invasive procedures based on their compromised medical health and others simply have to consider their finances. It is our sincere goal to use the best materials and the most modern, effective technology while striving to keep implants affordable to the general public. In most cases advanced bone grafting is not required and implant placement and restoration is a simple and straightforward procedure.
We have extensive training and years of experience in "piezosurgery" implant reconstruction which offers more precise surgery and less errors to patient treatment. We now operate with the Italian made piezosurgery 3 which is the 3rd generation of piezosurgery technology. Piezosurgery cuts bone but will not damage the vital soft structures such as the sinus membrane, nerves, arteries, etc., so you can understand how valuable this modern technology is to ensure both safety and success for the patient. Piezosurgery 3 yields extreme precision cuts and therefore preserves critical bone for future reconstruction with implants or even traditional bridges and partials.
Implants also typically perform best if given some time to heal before loading with the final crowns or bridges which helps some patients be involved in a payment schedule over time rather than to pay everything up front.
The photos above show a case in which the patient needed immediate temporary crowns at the time of implant placement so she could smile, chew, and speak without being self-conscious at an upcoming wedding.
When extracting a tooth and grafting the socket most of us clinicians have typically waited 6 months after placing bone into the socket for the bone to mature enough to place an implant there. We are now using Biohorizons mineross® which we have found matures as early as 2 ½ months allowing the patient to have teeth sooner with the predictability of a mature bone foundation for the implants. In many cases we are able to place the implants at the time of the extractions and the bone graft procedures. We offer options of using autograft (your own bone), allograft (human cadaver), or xenograft(other species) for your peace of mind in making an educated choice of materials. The concept of grafting is that eventually all the graft material resorbs and is replaced by your own natural bone remodeling process.
Our implants have technology which allows the bone and soft tissue to form an impenetrable seal to keep out bacteria and infection thus allowing your implant long term success. We have been tracking our results and will show you our cases which prove this claim. If you study many of the implants of the various systems you will discover that the bone levels almost always recede down to the first thread of the screw type implant. With our implants this simply is not happening. Bone levels which exist at the time of implant placement are preserved. So we are convinced that we are using the best materials with the best technology and by doing so making a sincere attempt to keep our reconstruction simple, safe, predictable and affordable. We are aware of some clinicians using "generic" implants which are copies of major brands and yet they are charging $500 more than we do. We’ve seen some clinicians charging almost $1,000 more for laser loks than we charge. We could do the same thing. We were influenced by Dr. Gordon Christensen from Utah who challenged me personally to get trained properly to place dental implants and once trained keep them affordable to the average family.