Dental Implants

When Teeth are Lost…

…you may not feel comfortable eating, speaking or smiling. Traditionally it has been very difficult for dentists to create artificial teeth that look, feel and function like natural teeth. Until the mid-1980s even dental implants were plagued by failures.

Implants Can Help

Dental implants of today are designed to provide the foundation for replacement teeth that perform like natural teeth. The new generation of implants are tiny titanium posts that are carefully placed into the jawbone where teeth are missing. The bone bonds with the titanium by a phenomona known as Osseointegration. When this process is complete (it can take 4 months or more), a strong foundation has been created to which your Dentist can attach new teeth.

Are Dental Implants Right for You?

If you want new teeth that look and feel as though they’re really part of your mouth, implant dentistry may be the right choice for you. To help you decide, we ask that you undergo an evaluation that includes:

• A consultation to determine your specific needs
• A thorough review of you medical and dental history
• A dental examination that may in part be done by your Dentist and will include dental x-rays and models of your teeth
• A periodontal examination to determine whether there is disease in your gums and whether there is enough firm tissue to surround an implant as well as whether the height and width of your jawbone is adequate to hold an implant
• Special computerized panoramic and/or tomographic x-ray studies

When the evaluation is complete, your questions can be answered including the matters of fees, insurance, treatment time and schedule.

Since 1986 Dr. Mullin has received extensive training in Implantology and through ongoing continuing education, Dr. Mullin has continued to update his knowledge and skills in implant dentistry.

The dental implant system that Dr. Mullin utilizes is that of Nobel Biocare, the successor to the NobelPharma company that developed the original Branemark implants. Dr. Mullin has used the Nobel products for over 20 years. Though implant designs have evolved considerably in this time, Nobel continues to stock replacement parts and instruments for their original products. Their preeminent place in the market assures you that implants placed today will be supported in the future.

A Solid Foundation for Implants

Whether teeth are lost due to disease or trauma, their supporting gum and bone is lost as well. The longer a tooth has been missing, the more the foundation for an implant will have deteriorated. The majority of the patients Dr. Mullin treats benefit from preliminary surgery to prepare the site in their jaws where implants are to be placed.

Socket or Ridge Preservation

If a tooth is to be replaced by an implant, the tooth must be removed with skill, taking care to not damage surrounding gum and bone. Multi-rooted teeth must be sectioned and removed in pieces. Special care must be taken taken to close extraction sites with special suturing techniques. Bone fill can be enhanced by grafts, barriers and membranes placed in and around tooth extraction sites.

Immediate Implant Placement

It is easier to preserve gum and bone than to regrow it, so whenever possible Dr. Mullin will place an implant at the same time a tooth is removed. Advantages include reduced morbidity, cost and treatment time. In some instances, Dr. Mullin can fabricate or deliver a laboratory-made provisional crown for single implants before a patient leaves the office.

Guided Bone Regeneration

When bone cannot or has not been preserved, it must be regenerated to provide an optimum site for implant placement. Whenever possible, Dr. Mullin utilizes grafts of your own (Autogenous) bone, obtained from another area of the jaws. The donor site will naturally regenerate in a few months.

Larger defects require the use of banked bone products. Dr. Mullin utilizes human bone graft (Allogenic) products from the LifeNet Tissue Bank. LifeNet is the nation's largest nonprofit, full-service organ donation agency and tissue banking system and holds the longest running current accreditation by the American Association of Tissue Banks.

Since bone and gum are largely composed of collagen and calcium phosphate mineral crystals, these “raw” materials are often procured from animal sources (in highly refined and processed form). Occasionally entirely synthetic biologic materials can be utilized.

None of these products are “rejected” by the body and none transmit any disease.

To enhance the speed and completeness of bone regeneration, Dr. Mullin makes use of your own (Autogenous) growth factors in the form of Platlet-Rich Plasma. He utilizes the SmartPrep system developed by Harvest Technologies. Immediately before the operation, 20-60 cc. of your own blood is drawn; in less than 30 minutes an automated process is complete and the product is ready to use.

Small grafts are often needed around individual implants to allow ideal positioning and can be done at the time an implant is placed. Larger grafts are often needed to widen areas where multiple teeth are missing and are often done months before implants are placed. Often grafts will be extended into the sinus (above the upper back tooth area).

Dr. Mullin performs all of these procedures under local anesthesia; oral sedative medicines are prescribed as needed for about half of his patients.

Post-operative pain is only mild-to-moderate and of short-duration (afternoon & evening after operation). Swelling will always occur to some extent but is minimized by cold compresses and nutritional supplements.

Bone grafts must be allowed to heal for 4 months or more in the lower jaw and 6 months or more in the upper jaw before implants can be placed.

Soft Tissue Augmentation

Just as bone is often lost when teeth are lost, gum tissue is also often deficient. Again Dr. Mullin prefers to use your own tissue (thin strips from the back of the palate) whenever practical. If multiple grafts are necessary the palate renews itself in 2 months. Soft tissue grafts heal faster than hard tissue grafts, usually in 6-8 weeks.

Placement of Implants

While in concept no more difficult than carpentry, in practice it has taken decades to perfect the biotechnology to place implants safely and reliably. Strict sterile technique is followed in all manufacturing processes and operation procedures. Precision instruments include sterilizable minature electric drills with microprocessor controls. Gentle forces to minimize trauma and ultraslow drill speeds are employed to minimize heat (bone can die if heated just 1.5°C). Placement torque is controlled within a limited range; too little is bad but too much will crush bone.

Once placed the implants are not ready to anchor teeth until attachments called abutments are secured to the implants. This is sometimes done immediately but often must be deferred for 4 months or more. Sometimes a second minor operation is required to uncover the integrated implant to attach the abutment. With more innovations in implant surface technology, many of these steps can be combined, reducing surgery and healing time.

Coordination

While Dr. Mullin may place a provisional crown or other restoration on implants, your Dentist is responsible for your final restoration. Your Dentist must be involved in the process from start to finish, sometimes leading and sometimes following. The sequence should be determined from the outset.

Consultations and Communication

Planning any successful project is a time-consuming process. Many discussions go on “behind-the-scenes”. This is a large part of the cost of care, but well worth the investment.

Compliance

Implant dentistry is applied biotechnology. The “bio” is you. For the technology to work, you will have to work too. Keep all appointments as-scheduled and make payments on-time. Follow all post-operative instructions and take all medications as directed.