Dental Implant Surgery
Teeth serve an important role in our daily lives as it affects our speech, our ability to eat well and the way we look. Its loss through disease or trauma sets in motion the loss of underlying bony support resulting in tooth loss. This in turn affects support for our lips and cheek leading to a more aged appearance. Failure to replace missing teeth often leads to the opposing teeth overgrowing and the adjacent teeth tilting resulting in areas of food trapping which in turn may result in gum disease tooth decay.
What are the different ways of replacing missing teeth
Traditionally, missing teeth were replaced by either removable plastic or metal based dentures, or fixed bridges made of either metal alone, or porcelain fused to a metal base. Developments in dental material science have focused on developing more aesthetic materials with adequate strength, such as all-porcelain and zirconia bridges. While all of these are still very much in use today, implant based methods of replacing missing teeth are increasingly preferred as it provides greater biting ability and a more comfortable and natural feel.
What are dental implants?
Dental implants are sterile titanium screws which are inserted into the jawbone as artificial roots to support and retain replacement teeth. It comprises 3 parts. The first part or “fixture” is placed within the jaw bone to replace the roots of missing teeth. The second part or “abutment” emerges through the gums and is used to carry the 3rd part, which may be a single crown or a bridge depending on how many teeth are missing. If we have lost all our teeth, we can use 4 to 8 implants in each jaw which when connected can support dentures or even a fixed bridge
How do Implants compare with alternative options?
When compared with removable dentures, they provide stronger support, firmer retention and are more stable. The implant supported and retained replacement teeth occupy less space and are more comfortable. They are also able to generate much stronger biting force. When compared with fixed bridges, they can be used even when more teeth are missing as they can provide stronger support over a longer span. They are also preferred when the teeth adjacent to the gap are weak or too small to provide sufficient support. Additionally, they provide an alternative to trimming healthy teeth.
Benefits of Dental Implant
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Are permanent replacement for missing teeth
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Has predictable and good long-term success rate
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Prevents supporting bone from shrinking after tooth loss
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Does not decay as it is made from Titanium
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Able to generate stronger bite forces for better chewing and hence better digestion and nutrition.
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Restores appearance thus creating more confidence and self-esteem Able to provide better support for lips and cheeks for a more youthful look
Types of Dental Implant
Dental Implants have been widely used for more than 40 years since the original scientific research was published. While many different implant systems are now available and are generally of high quality, our clinic prefers using implants from Nobelbiocare, Sweden and Straumann, Switzerland due to the extensive research and long track record. These implants come in different sizes and lengths and are generally at least 3.5 mm in diameter and 8 mm in length which differentiates them from “mini-implants” which should be used only as temporary supports or in very specific cases.
Are you suitable for Implants
Implants can be placed in most patients from age 18-80, even if you have lost your teeth for many years as we are able to regenerate bone in order to place implants as a foundation for your denture or bridge. Patients with health conditions should inform the dentist so that additional precautions can be taken, if required. Conditions which require attention include patients with significant heart disease, unstable high blood pressure, uncontrolled diabetes and patients on therapy for cancer. Surgery can still be performed after clearance from your medical specialist.
What is the surgical procedure like?
After giving some local anaesthetic, a small incision is made through the gums and a point of insertion decided. Drills of a predetermined length and with increasing diameters are then used to gently prepare the site to receive the implant. The implant is then rotated to the desired depth. The top of the implant channel is then covered with a temporary cap and the gums stitched either over or across after cleaning the surgical site and allowed to heal undisturbed for 3-4 months. A higher temporary cap called a healing abutment is often placed to avoid a second surgery to uncover the implant.
Is Implant Surgery Painful?
No, implant surgery is generally a minimally invasive procedure and in most instances the pain is minimal. If more major treatment is required, some post-surgical pain may be present. If you are fearful, we can arrange for you to have a complete pain-free experience either by performing the procedure under intravenous sedation or general anaesthesia within an operating theatre. The mix of drugs given will help you relax, sleep and eliminate pain. You will also usually be given a painkiller to take before the procedure so that you will be comfortable after the surgery.
How long does it take to recover from the Surgery?
After the operation, you may feel uncomfortable but this can be eliminated by taking the prescribed painkillers regularly. Some swelling and bruising is to be expected for a few days after the surgery. You can resume normal activity within a day but should avoid strenuous exercise and swimming. A normal or soft diet is advised and can be commenced after the numbness from the local anaesthesia wears off, usually around 2-3 hours after the procedure to avoid biting your lip or tongue inadvertently.
Same Day Teeth Replacement
Rationale for immediate tooth replacement
Losing a tooth, especially one of our front teeth can be very distressing for most patients. In addition to the effect on appearance and confidence, it affects our speech and on the long-term, the gums and the supporting jawbone will also shrink. A common request from our patients is to get a replacement for their missing tooth immediately, hence the advent of protocols for "same day teeth replacement". This could be done by partially loading the implant on the day of the surgery, or more commonly by using the adjacent teeth as temporary supports.
How long does it take for healing after tooth extraction and implant surgery
Teeth extraction and implant surgery are fairly routine and painless procedures and you will feel back to normal in just a few days. However, it takes around three months after tooth extraction for the bone to reform before placing an implant. In addition, it takes a further three months for the bone to grow around the implant in order to anchor it firmly in the jaw. During this waiting period, removable dentures, or temporary bridges made of plastic are used to prevent direct forces on the implant allowing the implant to heal.
Can this waiting period be shortened
Yes, it is possible to reduce this waiting period as implants can often be placed immediately into extraction sites for patients with missing front teeth. This reduces the waiting times significantly. In general, we are able to place implants to replace our front teeth on the day of extraction as there is usually adequate bone around and beyond the tooth socket to stabilise the implant. For back teeth, it is not always possible as there is usually insufficient bone after removing the tooth. Very often a bone graft will also be needed and is therefore a more technique sensitive procedure.
Immediately Loaded Implants
If the implant lies firmly within bone, it is possible to even allow partial loading immediately after the surgery. In combination, with the latest computer assisted techniques, it is possible to deliver aesthetic looking temporary teeth in selected cases within 3 hours after the surgery. The patients are however advised to avoid chewing on the implant, especially in the initial weeks after the surgery when the original bone anchoring the implant would have been resorbed with the new bone yet to form.
Is immediate loading of implants a new technique
No, the first controlled study of successful immediate loaded implants was published in 1997 after a successful 10 year study. Our lead clinician has been placing immediately loaded implants since early 1999. The success rate of immediate implants are comparable to that of implants placed using conventional protocols but is more technique sensitive as it requires the dentist to determine if the initial stability of the implant is sufficient for immediate loading. Done selectively, it is a useful option for patients with no other remaining teeth to anchor a temporary denture or bridge.
Sinovac Vaccine
科兴疫苗
Precious Medical will be providing Sinovac as part of the National Immunisation Programme effective 21 Dec 2021
Under the National Vaccination Programme, eligible patients will be able to receive free Sinovac vaccines at our clinic. If you need assistance, call 6708 8000 (Precious) or 6995 9299 (MOH Hotline)
Those who *do not qualify for free vaccines but prefer non-mRNA vaccines have may go to:
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Clinics which continue to provide Sinovac on a private basis.
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Clinics which provide Sinopharm (e.g. Pacific Medical Clinic @ Paragon #12-01)
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To see the list of clinics, kindly visit vaccine.gov.sg
* Patients who take Sinovac out of choice with no medical exemption from mRNA vaccines
Those who qualify for free Sinovac vaccines and have paid in advance on or after 23 October 2021 at Precious Medical but have not yet been vaccinated will be reimbursed.
Sinovac COVID-19 Vaccine
The Sinovac vaccine uses an inactivated COVID-19 virus to teach your body's immune system to make antibodies against the actual COVID-19 virus. The World Health Organisation (WHO) has validated Sinovac for emergency use in persons aged 18 and above as the known benefits outweigh the possible risks. While there is insufficient data to assess its safety in pregnant women, WHO concluded that as the vaccine is an inactivated vaccine similar to others used in pregnancy, its use is recommended when benefits outweigh the risks. Pregnant women, especially those aged 35 and above or who have medical conditions are at higher risk of developing severe COVID-19. Its use in breastfeeding mothers is also recommended on a similar basis.
Serology
Serology are blood tests which check the response of our body's immune system to the vaccine. While the routine use of blood tests is not essential before vaccinations, these tests do provide us a snapshot of our response to the vaccine and are available for those who wish to do so. These include:
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Anti-S: a numeric count of all binding antibodies against the "Spike" or "S" antigen found on the virus.
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cPass™: tests for presence of neutralizing antibodies against the specific section of the "S" antigen that penetrates cells.
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Anti-N: tests for antibodies against a different part of the virus which may be induced after natural infection or inoculation with inactivated vaccine.
* Besides an antibody response, our body also has other methods of protecting itself against viruses. Antibody tests do not equate to protection.
** mRNA vaccines target only the S antigen and anti-N tests in these patients will be negative whereas some patients using inactivated vaccines
may get a positive response to the anti-N test.
What to expect
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No alcohol 24 hours before visit 接种疫苗前一天不要饮酒
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Light meal 3 hours before appointment time 预约时间3个小时前吃清淡⻝品，不建议空腹
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Vaccination by certified nurse 由专业护士接种疫苗
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Remain for 30 minutes observation 必须在诊所逗留观察30分钟
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Confirm date of next appointment 预约第二剂疫苗的日期和时间
Precautions
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For individuals 18 years and above only 科兴疫苗只限于18岁以上
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Please declare your medical history and if you have any allergies 请如实申报病史及任何过敏症
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Please disclose vaccination status 请如实申报之前接受过的任何冠状病毒接种疫苗
* Prices include GST, Not Medisave Claimable, Not covered by Vaccine Injury Financial Assistance Programme (COVID-19) * 价格含消费税, 不能向医疗储蓄保险索赔, 也不能通过疫苗致伤援助计划索赔