Extraction and Immediate Implant Placement
This Case presents extraction of a fractured tooth, followed by Immediate replacement of the tooth with a dental implant. Trauma to the front tooth happened during a fall on the street. The fracture line was below the gums and saving the tooth would have been unpredictable. Replacement with a dental implant was discussed as an option and patient liked that better .
Immediate Implant placement has its own challenges. It required knowledge, skills and patients cooperation on the one hand and adequate jaw bone on the other hand. Replacing the missing tooth can also be achieved by different methods, one of which is using the adjacent teeth to bond the fake tooth to. It is a similar technique used in Maryland Bridge, however in this case it is a provisional crown and it is designed to last for a shorter time.
Single Implant Restoration
Single Implant Crown: Case I
This case presents restoration of a fractured tooth with a dental implant in the aesthetic zone. Implant was placed immediately after extraction and restored with a temporary crown, and finally was restored with a custom made abutment and a final crown.
The importance of using a “custom” made abutment is to achieve superior esthetics and more ideal support for the crown.
The “yellow” color of gold (instead of silver color of a cheaper material) will prevent the dark shadow under the gum (gingiva) and will make it look like a natural tooth. It is that meticulous attention to details that will bring a predictable outcome in our office.
Custom Abutmnt is not a modified (re-shaped) Stock (prefabricated) abutment. The way it is made is that, a digital image is designed and then it is milling machine is used to mill the digital image from a cylindrical block of ally ( usually titanium, or Zirconium).
Single Implant Crown: Case II
This female patient came with a request to have her crown re-cemented. She had previously received two root canal treatments and an apicoectomy. Her tooth fractured extending into the root and was no longer restorable. Replacing the fractured tooth with a dental implant (BioHorizons in this case) was offered.
There are three important things to consider before placing a dental implant. “Planning, Planning, Planning”. In cases like this, esthetics is the key to define success. In depth knowledge regarding the bone biology and healing is the key to successfully treat this case.
I sequenced the case in three phases, and assured the patient that we would methodically walk through the treatment without rushing to ensure optimal results. Patient education and bringing them on board is also an important factor for a successful treatment.
In my opinion providing dental care is not a “race” to rush through. Knowing when to take slower steps and when to accelerate is what differentiates between “excellent” and “average” outcomes.
Single Implant Crown: Case III
In this case, an upper molar was extracted and the site had become narrow after the tooth behind it moved forward.
A conventional implant, BioHorizons, was placed meticulously in the middle of the ridge in this restricted space. In addition a recommendation was made to graft the site to compensate for the horizontal bone loss.
When it can be restored with a conventional implant, why settle for less and use a “mini” implant? We are dedicated to provided the best solution in every case.
Single Implant Crown: Case IV
This case demonstrates the missing of the first molar on the lower right side due to failure in root canal treatment. A root form dental implant was secured in the jaw bone and after three months it was restored with a Customized Implant Crown.
Two Dental Implants to replace four missing teeth
This patient lost her lower front teeth due to a fairly large infection. The initial phase of treatment consists of eradicating the infection and extraction of the middle teeth and regenerating the large bony defect. After several months of healing, two dental implants were inserted in the jaw bone and patient was given a provisional bridge as an interim restoration. After a healing period, a four unit implant supported bridge was fabricate to replace the four teeth. Pink porcelain was also used to match the shade of the gum to idealize the look. This case demonstrates there is no need to replace each missing tooth with a dental implant.
About the Images
Dental Implants is not just about drilling into the bone and inserting an implant. No surgical implant placement should be started unless there is a definitive restorative plan, which is standard care in our office. Esthetics is a defining element in success of a dental implant and long term success cannot be achieved without in-depth knowledge about biology to achieve those aesthetic results.
Implant Supported Hybrid Prosthesis
In this page you can see a gallery of small (thumbnail) images in a grid. Please click to expand each image to see a larger view and a caption.
This female patient was referred to me for consultation regarding her loose lower front teeth. The patient had a history of gum disease and had lost many of her teeth in the past. Her upper jaw was subsequently restored with multiple implants and porcelain teeth. She was rather unhappy with her partial denture in the lower arch. She was afraid that if she lost the front teeth, she wouldn’t be able to tolerate the partial at all. Her main concern was to have a type of prosthesis that she did not have to remove from her mouth every day. She was extremely shy and sensitive about being seen without her partial denture, even at home by her family members. She also told me, if she was going to have dental implants when she gets older, she might as well enjoy them while she is middle age and can take care of herself better.
I offered her to replace her front teeth with six dental implants. An implant supported hybrid prosthesis was made to connect to six implants in the front of the jaw. A hybrid prosthesis is connected to dental implants by screws and can only be removed by a dentist. Patient was very happy with the outcome and following her up for 5 years, she only had one minor complication in the first year. The complication was when a tooth separated from the prosthesis and it had to be repaired. it was done chair-side and never happened again for 4 years when I was in contact with her.
Implant Retained Overdenture
This patient was referred to me for fabrication of a new set of dentures. Her existing dentures were not ideal and her complaint was that it was moving too much. Her general dentist had relined it several times but it was not better. Finally she decided to see a Prosthodontist.
As the first step, her dentures were re-based to provide adequate stability and she was recommended to get two implants in the lower jaw along with a new set of dentures. In this case she received two Nobel Biocare dental implants and two attachments to retain the denture. The improvement was like “the difference between day and night”, as the patient stated. All the clinical and Laboratory steps were completed by Dr. Noohi.
Costs for dental care vary widely and should always be compared based on the quality, comfort, function and esthetics of care.
Specialists do not charge you because they hold a specialty certificate, but because you are getting a higher standard of care. If you think your health is worth it, then go to a pro; see if a Prosthodontist could help you.