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.
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Dentistry
Precious Dental Centre
Dr William Chong
BDS, MScD (Singapore)
FRACDS (Australia)
Dr. William Chong graduated from the National University of Singapore in 1985 with distinctions in Medicine, Oral Surgery and Operative Dentistry. He was accorded both the Singapore Dental Association and the Malaysian Dental Association’s Silver Medals, honours reserved for the top student in the fields of Medicine and Oral Surgery respectively.
He was further awarded the University Bronze Medal for achieving overall 2nd in the National University of Singapore’s Final Professional Examination.
Dr Chan Chee Hon
BDS, (HONS) (NUI)
Dr Chan Chee Hon graduated from the University of Western Australia with a Bachelor’s degree in Neuroscience. Following this, he pursued his studies at the National University of Ireland (University College Cork) and qualified with Bachelor of Dental Surgery (Honours). He was conferred the distinguished title of College Scholar for outstanding academic achievement and the Irish Dental Council award for being the top student throughout the clinical course.
He is excited to serve the community through holistic patient-centric dental care, whilst tapping on his Neuroscience exposure to create a relaxed and comfortable environment employing cognitive behaviour techniques. In his spare time, Dr Chan enjoys swimming, outdoor hikes and cooking.
Other Subsidiaries
Robertson Choo Oehlers & Lye
Dr Lewis Lee
BDS, MDS (Oral Surgery), FDSRCS (Edinburgh), FAM
Dr Lewis Lee graduated as a dentist in 1983 from the National University of Singapore and obtained a Masters in Oral Surgery in 1986. He followed this up with a Fellowship in Dental Surgery from the Royal College of Surgeons of Edinburgh in 1989. He then received recognition as a dental specialist in 1993 from the Academy of Medicine Singapore.
Dr. Lee underwent dental training in various institutions within the Ministry of Health Singapore, Singapore Armed Forces as well as a visiting dental specialist in the Royal Children; Royal Dental and Royal Melbourne Hospital in Australia. He practices a wide range of oral surgical procedures including the placement of dental implants and the surgical excisions of wisdom teeth, cysts and various lesions in the oral cavity.
Dr. Lee holds an adjunct teaching post with the National University of Singapore Dental Faculty as well being a Visiting Dental Specialist with the National University Hospital. He was the President of the Singapore Dental Association from 2001 – 2003 and again in 2007-2009 when Singapore hosted the World Dental Congress.
Dr Chung Kong Mun
BDS, MS (Temple U., USA), Cert in Periodontics (Temple U., USA), FAM (Periodontics)
Dr. Chung obtained his dental degree from National University of Singapore in 1983 and later completed his postgraduate training and obtained his Masters in Science and Certificate in Periodontics at Temple University Philadelphia, USA, in 1988
Dr. Chung served in the Ministry of Health and National Dental Centre from 1988 to 1998, and also completed research fellowships at both Eastman Dental Centre, University of Rochester and Harvard School of Dental Medicine.
Dr. Chung has been teaching part time at NUS for more than 20 years and served as an internal examiner for the NUS Master in Dental Surgery Programme (Periodontics). He has also presented many lectures, workshops and seminars in Brunei, Cambodia, China, India, Indonesia, Malaysia, Myanmar, Nepal, USA and Vietnam and authored a number of articles and abstracts in various peer-reviewed journals and other publications.
Dr. Chung left the public sector to become a partner in RCOLL in 1998, bringing with him more than 20 years of experience in Periodontics. His practice is limited to Dental Implants and Periodontics where he specializes in gum conditions and diseases such as gingivitis, bad breathe, gum abscess and recession.
Pacific Healthcare Specialist Centre
Dr Krushna Reddy
BDS (Singapore), BDS (Madras), MSc (UK) Pain Management (by research)
Dr. Reddy is a senior Dental Surgeon in Pacific Healthcare Specialist Dental Centre focusing on Cosmetic makeovers and Implant Dentistry.
The passion to provide an attractive smile for patients is realized with the combination of her experience of over 20 years, and using the CEREC-3D system, which is able to make aesthetic crowns/ veneers and fillings in a few hours. Cosmetic makeovers can be completed within days. She is also adept at root canal treatment using the surgical microscope and in children's dentistry.
A Dean’s list student, she graduated both from National University of Singapore and earlier from Madras Dental College in India. She also attained her Masters Degree in Pain Management (by research) from the University of Wales, UK, in 2000. She has also completed accreditation courses with the Australian Society of Implant Dentistry (ASID), as well as numerous continuing professional education courses in various aspects of general dentistry.
Dr Chan Lin-Li
BDS
Graduating from NUS in 1990, Dr. Chan was attached to the Ministry of Health as a dental officer for 2 years, after which she joined our group as an associate dentist in 1991.
Dr. Chan has developed her skill and expertise from 29 years of experience and is well versed in almost the entire spectrum of general dentistry from children's dentistry and braces to dental implants and wisdom teeth removal. She is warm, friendly and caring.
Dr. Chan is a certified CEREC practitioner, which is a computer-based ("CADCAM") system of producing aesthetic and durable restorations, crowns and bridges.
Dr Priyanji De Silva
BDS (Hong Kong)
FRACDS (Australia)
Dr. De Silva graduated from the University of Hong Kong, Faculty of Dentistry and has since acquired clinical experience abroad and locally. She provides a wide range of general dental care including all aspects of routine dentistry with a special interest in cosmetic (smile makeovers) and implant dentistry (replacing missing teeth to improve functionality).
She was awarded the prize for the most outstanding elective project by the University of Hong Kong upon graduation and has since obtained her fellowship with the Royal Australian College of Dental Surgeons, Australia. In addition to being registered in Singapore, Dr. De Silva is also registered as a licensed dental practitioner with the Dental Boards of Hong Kong, UK and the Sri Lanka.
Dr. De Silva devotes her free time perusing activities such as swimming, yoga and Latin American dancing. She takes an active interest in community service, having participated in multiple dental-medical missions in India and Sri Lanka to render free dental care for the needy.
Dr Alexia Kwan
BDS
Dr. Alexia Kwan graduated from National University of Singapore with Bachelor of Dental Surgery Degree. She served as a Dental officer in National Healthcare Group Polyclinics as well as in the SAF.
Dr. Alexia Kwan works closely with Dr. William Chong, whom she received her initial training in both cosmetic and dental implants.
She provides a wide range of general dental care with her principle areas of interest in these two areas (cosmetics and implants).
Atrai Pan Dental
Dr Cliff Ong Keat Siong
BDS, MDS, MSc (Wales, UK), PhD (Newcastle Upon Tyne, UK), FDSRCS (England), FFDRCS (Ireland), FDSRCPS (Glasgow), FRACDS (Australia)
Dr. Ong is a specialist oral surgeon with over 17 years of clinical experience. After graduating from National University of Singapore, he furthered his training in Oral & Maxillofacial Surgery and graduated with a Master of Dental Surgery. He has a special interest in pain management, and had completed a master degree and doctorate in this field from University of Wales and University of Newcastle upon Tyne respectively. Dr. Ong is also a fellow of the Royal Colleges of Surgeons of England, Ireland, Glasgow, and Australia.
Dr. Ong is an adjunct senior lecturer in the Faculty of Dentistry at National University of Singapore and a visiting consultant at National University Hospital. He is a certified specialist in Oral & Maxillofacial Surgery by Singapore Dental Council. He is also certified in the use of intravenous sedation and laser dentistry from Albert Einstein College of Medicine and American Society of Laser Medicine & Surgery respectively. He has vast experiences in all the surgical aspects of dentistry, e.g. dental implants, cosmetic, wisdom teeth, pathology, trauma, reconstructive, pain and anxiety management.