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.
What Are Serology Tests?
Serology tests are specialised blood tests that can detect the antibodies which our body generate as part of our immune response. While our immune system is complex and many factors team up as part of our total defence system, serology remains the practical measurable solution to estimate the strength of our defence against COVID-19 virus.
什么是血清学检测？
血清学测试是检测身体的血液测试，可以检测我们身体在免疫反应中产生的抗体。虽然我们的免疫系统很复杂，而且许多因素共同构成我们整体防御系统的一部分，但血清学仍然是评估我们对 COVID-19 病毒防御强度的实用可衡量解决方案。
Different Types of Antibodies
When challenged by a virus, our body produces antibodies and other types of protective cells. While the presence of N antibodies or the quantity of S antibodies alone does not indicate that the person is immune against infection, it does provide a sense of how our body has responded or is still responding to the vaccine. In addition, a specific type of antibodies that can block viral entry, called neutralizing antibodies (NAb), has been shown to be a good correlate of immune protection.
不同类型的抗体
当我们的身体接触到病毒时，我们的防御或免疫系统会通过产生各种称为抗体的保护性蛋白质以及其他保护性细胞来自然地做出反应。虽然 N 抗体的存在或 S 抗体的数量本身并不表明该人对感染具有免疫力，但它确实提供了我们的身体对疫苗的反应或仍然对疫苗有反应。
另一种可以阻止病毒进入的特定类型的抗体称为中和抗体 (NAb) ，它已被证明是免疫保护的良好关联物。
Conclusion
Serology tests are useful tools to assess our immune response to the vaccines. While serology guides major pharmaceutical companies when designing vaccine protocols or making vaccine recommendations at the population level designing, it can also shed light for our individual decision making process too.
结论
血清学测试是评估我们对疫苗的免疫反应的有用工具。虽然血清学指导主要制药公司在人群层面设计疫苗方案或提出疫苗建议，但它也可以为我们的个人决策过程提供启示。
Available Serology Tests 血清学测试服务
Anti-N: tests for antibodies against “N” protein unique to the SARS-CoV-2 virus / inactivated vaccine.
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Can tell if your body mounted a wide spectrum antibody response to the SARS-CoV-2 virus / inactivated vaccine (Sinovac or Sinopharm)
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If you were infected by SARS-CoV-2 virus for individuals who received mRNA vaccine
Anti-N：检测针对 SARS-CoV-2 病毒/灭活疫苗特有的“N”蛋白的抗体。
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可以判断您的身体是否对 SARS-CoV-2 病毒/灭活疫苗（科兴或国药）产生了广谱抗体反应
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如果您因接种 mRNA 疫苗的个体感染了 SARS-CoV-2 病毒
Anti-S: measures total antibodies against the "Spike" or "S" antigen.
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How successful our immune system reacted to the "S" protein antigen
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Anti-"S" is ability of individual to mount antibodies to recognize "S" antigen of SARS-CoV-2 virus or COVID-19 vaccines
Anti-S：测量针对“Spike”或“S”抗原的总抗体。
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我们的免疫系统对“S”蛋白抗原的反应有多成功
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抗“S”是个体产生抗体以识别 SARS-CoV-2 病毒或 COVID-19 疫苗的“S”抗原的能力
cPass™️: test for presence of neutralizing antibodies that can block virus entry into our cells.
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Neutralizing antibodies can be first line immune defense to prevent infection
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Neutralizing antibodies are widely accepted as a good correlate of vaccine protection
cPass™️：测试是否存在可以阻止病毒进入我们细胞的中和抗体。
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中和抗体可以作为预防感染的第一线免疫防御
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中和抗体被广泛接受为疫苗保护的良好关联物