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.
Laser & Light-Based
LASER & LIGHT BASED TREATMENTS
SCITON BBL
Sciton BBL (BroadBand Light) is a form of intense pulse light therapy (IPL) that is used to improve the appearance of skin with scars, excessive pigments or sun-damage. It works by using light as an energy source to stimulate the collagen and elastin fibers in skin, which in turn reduces fine lines and wrinkles, brown spots and freckles giving visibly smoother skin texture, and a more even skin tone.
It is suitable for patients of all ages including younger patients who do not have damaged skin, or older patients who may not need corrective treatment but desire to maintain healthy skin and delay skin aging. It can also be used as a maintenance regime for patients who have had laser treatment previously for damaged skin.
MAIN BENEFITS
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Anti-pigmentation
BBL allows targeted treatment for pigmentation, age-spots and sun-spots. The treated sun-spots will start to darken right away, and over the following days will begin to slough off to reveal clear new skin underneath.
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Spider Veins
Also known as telengiectasia are small dilated blood vessels that occur close to the surface of the skin – usually on the face, around the nose, cheeks and chin. Sciton BBL can be used to remove these tiny dilated or broken blood vessels.
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Skin Rejuvenation for aged skin
Forever Young BBL™ - in addition to effectively correcting aged or damaged skin, vascular and pigmented lesions, scars and acne, the benefits of BBL can be expanded to include maintaining healthy skin and delaying the signs of skin aging. .
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Hair Removal
The trademarked Forever Bare™ treatment sends multiple lower fluence pulses at a high repetition rate, resulting in a highly effective, safe and comfortable hair-removal treatment. Useful for Legs, Armpits, Bikini and the famed “Brazilian treatment”
WHAT IS THE PROCESS?
Think of Sciton BBL as a machine-based skin peel. With an average treatment time of 12-15 minutes for a full face, along with little or no downtime, patients can resume normal activities immediately. There may be a mild sensation during the treatment, akin to rubber bands snapping along the skin, although most patients tend not to experience any discomfort at all.
Studies have shown significant age-delaying benefits and optimal results are achieved with just 4 sessions a year. With proper post-treatment care, the results have been shown to be long-lasting and the treatment can be used on all body areas. Discoloured areas that have been removed do not recur. However, these treatments cannot prevent future sun damage from occurring so it’s imperative to use sunscreen regularly to protect your skin from future sun damage.
FRAXEL
Fraxel® Dual Laser System is a non-invasive fractional laser treatment that uses light energy to promote collagen production. It does not cut through but gently passes through outer skin layers to deliver its effect in a controlled manner to precise microscopic areas known as microthermal treatment zones (MTZs) without affecting overlying areas. As a result, healing is faster and the recovery period shorter compared to traditional laser resurfacing.
MAIN BENEFITS
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Whole Face Rejuvenation (for fine lines and wrinkles)
Works by stimulating the skin’s natural wound-healing response, repairing and rejuvenating skin and reducing laxity.
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Pigmentation (such as Melasma)
It minimizes age spots, sun spots, skin discoloration and lesions, resulting in less blotchy and pigmented skin which looks clearer, younger and fresher.
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Acne Scars and Surface Scarring
Acne and other skin scarring is reduced through the stimulation of natural collagen in the skin, leading to an improvement of skin texture and smoother skin over time.
WHAT IS THE PROCESS?
Doctors will usually recommend multiple sessions (3-5), usually space four weeks apart, to achieve the best results. While there is no real downtime, patients may experience the following after the treatment: redness, swelling, peeling and a slight “sunburnt” look
Post-treatment, patients will be advised to moisturise liberally to hydrate the skin and encourage the healing process. They can use a product they already own, or, if they do not have a suitable moisturiser, we can also recommend them a specific product for post treatment from the range we carry. Patients are also advised to use sunblock to minimise the chances of post-inflammatory pigmentation. They may also use mineral based concealers and/or makeup on D2 post-treatment if desired.
WHY CHOOSE FRAXEL?
Fraxel ® Dual Laser System unique use of two different laser wavelengths allow doctors to tailor treatments individually.
Technical Details
Fraxel 1550nm wavelength erbium laser is used when deeper treatment is required, in significant lack of skin tone; skin resurfacing procedures; more extensive age spots, melasma, acne and surgical scars.
Fraxel 1927nm wavelength thulium laser is used for more superficial skin laxity, treatment of mild sun damage and pigmented lesions, specifically age spots, sun spots, and freckles.
