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.
Precious Surgery Centre for Endoscopy
We are a certified Day Surgical Centre in Singapore with two lead-lined operating theatres and an endoscopy suite. We also have a dedicated GA/ IV sedation operating theatre for General and Paediatric Dentistry, fully equipped with a dental chair and intraoral X-rays. Our operating theatres are positive pressure rooms equipped with HEPA air filtration and with more than 20 air exchange cycles per hour to ensure clean air. In addition, we have installed UVc (ultraviolet-C radiation) within our air-conditioning ducts to disinfect the air, and have also coated all surfaces with a quaternary ammonium compound disinfectant.
We are an independent provider of surgical facilities and our centre is open for use by all accredited medical specialists. Our nurses are trained to support a wide range of surgical procedures including endoscopy, orthopaedics, urology, eye, ENT and plastic surgery. We also have nurses specifically trained to assist in anaesthesia and recovery to ensure patient safety and optimal care. Precious Surgery Centre offers a private and welcoming atmosphere for your patient. We are committed to ensuring their comfort and well-being while paying close heed to high standards of infection control and sterility.
Dedicated GA/ IV sedation operating theatre for General and Paediatric Dentistry,
Precious Surgery Centre offers a private and welcoming atmosphere for patient.
Our nurses are trained to support a wide range of surgical procedures
Our priority is our patients' safety and optimal care after every procedure
Our operating theatres have Hepa-Air filters with more than 20 air exchange cycles/hour
We are MediSave accredited by the Ministry of Health (MOH), Singapore.
For Patients
Day surgery is an efficient, convenient and cost-effective alternative to hospitalisation, which allows patients to return home on the same day. We provide surgeons and patients convenient, spacious and modern facilities for day surgeries and outpatient procedures. Our centre offers a sterile environment for surgery as well as a private and welcoming atmosphere for patient comfort.
General Surgery Operating Theatres
Our two operating theatres and endoscopy room are available for a wide range of procedures in various subspecialties under general anaesthesia or intravenous sedation. Available surgical modalities include:
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Endoscopy
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ENT Surgery
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Eye Surgery
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General Surgery
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Obstetrics & Gynaecology
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Oral & Dental Surgery
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Orthopaedics
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Plastic Surgery
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Pain Management
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Urology
For enquiries / appointment from our Accredited Doctors, please contact +65 9437 9529 for further assistance
ENT SURGERY
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Dr Adrian Siew Ming Saurajen
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Dr Tan Nam Guan
GASTROENTOROLOGY
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Dr Lai Wai Kwan
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Dr. John Hsiang Chen
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Dr. Kenneth Koo Yih Meng
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Dr. Benjamin Yip Cherng Hann
GENERAL SURGERY
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Dr Lim Teck Hock Dennis
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Dr Peter Goh Min Yih
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Dr Tan Choon Heng John
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Dr Wong Nan Yaw
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Dr. Tan Chuan Chien
HAND SURGERY
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Dr Chee Kin Ghee
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Dr Jonathan Lee
ORAL/DENTAL SURGERY
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Dr Lewis Lee
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Dr Noah Teo
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Dr Stephanie Salanitri
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Dr William Chong
ORTHOPAEDICS
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Dr Chan Ying Ho Henry
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Dr Kanwaljit Kaur
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Dr Tan Sok Chuen
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Dr Tony Setiobudi
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Dr Yeo Khee Quan
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Dr Yung Wai Yin Ambrose
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Dr Yung Shing Wai
RADIOLOGY
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Dr Kenneth Sheah
PAIN MANAGEMENT
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Dr Tan Hsien Liang Terence
PLASTIC SURGERY
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Dr Khoo Kian Ming Andrew
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Dr Leo Kah Woon
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Dr Yeow Kok Leng Vincent
UROGLOGY
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Michael Wong Yuet Chen
Endoscopy
Endoscopy is a procedure in which a thin flexible instrument with an attached mini-video camera (an endoscope) is used to visualise the insides of your digestive system. The specialist will first help you relax by giving you some medication through an injection in the arm before insertion the scope either through your mouth or anus. You will be comfortable as you will be sedated throughout the entire procedure.
Purpose of Endoscopy
Having a clear view will enable the specialist to decide if further treatment is necessary. At the same time a sample of tissue can be taken for examination (a biopsy) and small lumps called polyps can also be removed, if necessary, at the same seating.
Gastroscopy
Gastroscopy involves the use of a thin fibre-optic scope to examine the food pipe, stomach and the first segment of the small intestine for ulcers and inflammations. The procedure is painless as you will be sedated. More importantly, it can also detect the presence of Helicobacter pylori, a bacteria known to increase the risk of stomach cancer without showing any symptoms. If the bacteria is detected, it can be eradicated with a course of antibiotics.
Colonoscopy
Colonoscopy uses a thin fibreoptic scope to examine the entire large intestine. There is no pain or discomfort as you will be sedated. Screening for colon cancer is recommended at the age of 50 or even earlier, if you have a family history of colorectal cancer. It is safe and accurate, and can at the same time remove suspicious polyps for biopsy unlike alternatives like CT scans or stool occult blood tests. Gastroscopy and Colonoscopy are commonly done together as a day procedure without the need for hospitalisation. Both are Medisave claimable and are covered by most medical insurances. Financial counselling will be provided during consultation.
Endoscopy Procedure
Endoscopy Pre-Surgery
Most procedures require fasting for 6-8 hours but you may drink water until 2 hours before surgery. Do follow your doctor’s advice regarding your regular medication.
During Admission
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Our staff will assist you to register and confirm your medical history.
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They will provide financial counselling and assist with Medisave/insurance claims.
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You may then proceed to the change area to prepare for the procedure.
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Feel free to ask our friendly medical staff if you have any further questions.
Endoscopy Post-Surgery
After the surgery, our nurses will monitor and assist you until you are ready to be discharged. Please ensure that you have someone to accompany you home.
Home Recovery
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Avoid driving, cycling, operating machinery, signing legal documents or making important personal or business decisions in the first 24 hours.
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Rest and take medications as instructed and avoid alcohol.
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Contact your Doctor's Clinic if you feel pain or discomfort, or if you have unusual bleeding or an allergic reaction to the medications.