Services

Dental Implants

When you lose a tooth it usually is best for your oral health to have it replaced. Missing teeth compromise your “bite” and decrease your ability to chew properly. Missing a tooth, or several teeth, can also increase the burden on your remaining teeth. Depending on the location in your mouth, a missing tooth can also have a very negative impact on your smile and appearance. Fortunately, missing a tooth is not a life-threatening process and you have time to consider what replacement option is best for you. At your consultation appointment we will closely examine the area, explain all your replacement options, make recommendations, and most importantly, answer all your questions. It is extremely important to us that you are well informed and that you understand all your options.

What Are My Tooth Replacement Options?

If you are missing one or more teeth and choose to have them replaced, there are several treatment options available to you:

A “flipper” is a removable plastic tooth device. It is fragile and is meant only to last for a short period of time. Flippers are usually only worn by patients on a temporary basis for esthetic purposes while they are waiting for more definitive and permanent treatment.	"Flipper"
A cast partial denture is also a removable device. It is precision cast in metal for increased strength and longer service. Wire clasps are commonly used to hold it in place. These wire clasps are frequently visible when you smile and unfortunately will also commonly damage the remaining supporting teeth.	Cast Partial
A fixed bridge is cemented into place using crowns or “caps” on the teeth adjacent to the open space for support. Crown placement usually requires removing or reducing the outer layer of the adjacent teeth. Fixed bridges have been made by dentists for their patients for decades. Unfortunately, bridges have many significant disadvantages: The average “lifetime” of a bridge is 12 years, meaning that most bridges will need to be replaced every 12 years. Frequently, replacing a bridge means making it longer because the original supporting teeth are no longer useful. Bridges are very difficult to clean under, which results in decay of the teeth supporting the bridge. Often, patients are not aware of the decay until it is too late. Teeth do not like to be “drilled (whittled) down”. A full 10% of teeth supporting a bridge will have to under go root canal treatment sometime in the future. Root canal treated teeth are prone to fracture, which further contributes to the early demise of a fixed bridge.	Fixed bridge
Full dentures or “plates” are the traditional solution for people who have lost all their teeth in one or both jaws. The success and fit of a full denture depends upon the patient’s jaw shape and size, their oral habits, and their adaptability. Some people adapt well to their dentures, while other patients are not able to adapt at all. Dental implants can be used to provide support for the replacement of one tooth or all the teeth. After years of research and clinical trials, we can now provide this option, in addition to the traditional treatments listed above. Implant supported teeth and dentures are often a wonderful option. Implant supported teeth and dentures can be made attractive, stable, and comfortable for many patients.	Dental Implant

Are Dental Implants An Option For Me?

If you are considering dental implants, we will examine your mouth and oral structures thoroughly. We will review your dental and medical history to ensure that dental implants are appropriate for you. And we will evaluate your jawbones with sophisticated digital x-rays to determine if you are a good candidate for dental implants.

Exactly What Is A Dental Implant?

The best way to explain a dental implant is to compare it to a natural tooth. A natural tooth consists of a root and a crown. The part of the tooth you see and eat with is called the crown. Beneath the crown is the root. The root of the tooth anchors the tooth through the gum tissue to the jawbone. When you lose a tooth, you lose both the root and the crown. To replace a tooth, we first have to replace the root. A dental implant is essentially a new root. This specialized titanium root (implant) is fitted into a socket that we create in your jaw, replacing the lost root of your natural tooth.

Once an implant has been placed in the jaw, the bone around the implant will fuse, or integrate, to the implant. The process of integration typically takes from 2 to 4 months depending upon the quantity and quality of the jawbone. Once the implant has integrated (fused) to the jaw bone, a support post, called a final abutment, will be placed into the implant itself. The abutment actually protrudes up through the gum tissue and serves as a post to which a new crown can be cemented. If all your teeth are missing, a variety of treatment options are available to support and greatly increase the stability, strength, and retention of your dentures.

How Are Implants Placed?

The office procedure to place a dental implant usually takes about an hour for one implant and no more than two or three hours for multiple implants. The placement process consists of the following steps:

• For the patient’s comfort, we normally recommend IV sedation during the procedure. Once you are sedated, a local anesthetic is administered to numb the area where the implant is to be placed.
• Then an incision is made into the gum tissue and the gum tissue is reflected back to reveal the underlying bone.
• Using specialized instruments, a socket is then carefully created within the jaw bone.
• The titanium implant is then inserted into the socket within the jawbone.
• A healing abutment, or healing cap, is placed onto the implant after it is inserted into the bone. The gum tissue is then brought around the healing abutment and held in place with dissolvable sutures.
• Once the implant has integrated, an impression is made of the implant by the restorative dentist and a final abutment and crown is fabricated. The healing abutment is removed for the last time; the final abutment is placed into the implant, and the crown (tooth) is cemented to the final abutment.

	Healing Cap
Final Abutment	Final Crown

Two to four months is typically the amount of time required for the implant to integrate to the jawbone. We will follow you closely during this time. Once we have determined that the implant has healed to your jaw, the final abutment and crown will be made by your restorative dentist.

Dental implant therapy can vary greatly from patient to patient. It certainly is not a “one size fits all” form of treatment. That is why clinical expertise and judgment are so critical to implant success. Dr. Muse has the clinical experience and academic background to assure that your implant restoration is highly successful. Dr. Muse will present and discuss with you in great detail all your treatment options, the individual steps along the way, and the expected outcome. We promise to work closely with your restorative dentist and most importantly, as a team; we will make sure that all your implant questions have been answered prior to proceeding with treatment.

What Does It Feel Like After An Implant Is Placed?

Modern instrumentation and anesthesia techniques allow us to place implants in a pain free fashion. Implants are typically placed under IV Sedation, which provides a safe, comfortable, pain-free and memory-free experience. Afterwards, recovering from implant surgery is very similar to recovering from having a tooth removed. Most patients take a combination of Motrin and a mild narcotic medication for the first 24 to 48 hours after their surgery. By the third to fifth day, the area is still sore, but usually the pain has subsided. The residual soreness is usually completely gone by the end of the second week. Almost all of our patients tell us that healing from dental implant placement is easier, and less bothersome, than healing from having a tooth removed.

Can I have a tooth removed and an implant placed at the same time?

Immediate implant placement into an extraction socket does not work well for larger, multi-rooted, posterior teeth. In this case, the tooth is removed and the socket is grafted in order to preserve the bone for future implant placement. The graft material turns into bone after 3 to 4 months, and then an implant can be placed.

What is a socket graft?

Our jaw bones exist to hold the root of a tooth. Once a tooth is removed the bone in that area is no longer needed and the bone begins to atrophy, or “melt away”. If the plan is to eventually replace that missing tooth with an implant we want to preserve all the bone in that area that we can. By placing a graft material in the socket when the tooth is removed the bone is preserved and a future foundation is laid for implant placement. Lost bone can always be rebuilt, but reconstructing a deficit bony area is always more difficult, more time consuming, and more expensive than preserving the bone that you already have.

The graft material is not design to be a part of your body forever. The graft serves as a scaffold for your own bone cells (osteoblasts) to grow into. The graft is resorbed and your own bone is laid down in the area.

What is the graft material made of?

There are many different types of graft materials. Some are synthetic (alloplasts), others come from different species (xenografts), while others come from the same species (allografts), such as cadaver bone. All of these graft materials are extremely safe and can be used in different situations to accomplish different goals. If we feel grafting is needed prior to your implant surgery, or in conjunction with your implant treatment we will discuss with you which type of grafting material we feel is best in your particular case.

Can I have a tooth (crown) placed on the implant the same day as the implant is placed in my jaw?

Yes, placing an implant and securing a temporary tooth to it the same day is possible. This type of treatment is typically limited to the upper front teeth where esthetics is important. Although immediate tooth placement on the implant (immediate temporization) sounds “neat” and “flashy” it carriers certain risks that sometimes are not worth taking. If we think you are a candidate for immediate temporization of the implant we will review the nature of the treatment in great detail with and thoroughly discuss the pros and cons of such treatment.

I have heard about “Teeth in a Day”. What does that mean?

Teeth in a Day refers to the placement of multiple implants (usually 5 or more) either the upper or lower jaw bone and teeth are immediately connected to the implants. The patient therefore walks out of the office that day with implants in place and new teeth attached to them.

Dental Implant Post-Operative Instructions

1. MEDICATIONS:

   Antibiotics (Amoxicillin, Clindamycin)
   Antibiotics are normally prescribed following implant surgery. Be sure to follow the directions on the label and take the antibiotics until gone. Please remember that antibiotics can alter the effectiveness of oral contraceptives.
   
   Anti-Inflammatory Medications (Motrin, Advil, Tylenol)
   These medications help prevent inflammation and relieve mild to moderate discomfort. They are very effective in relieving the mild discomfort associated with most implant procedures. They may be taken in conjunction with narcotic medications if needed, since they relieve pain along a different pathway. They are most effective when taken on a regular basis for several days, rather than sporadically, or “every now and then”.
   
   Narcotic Medications (Darvocet, LorTab, Percocet)
   These are strong medications prescribed for the relief of moderate to severe pain and are often not needed for very long following routine implant procedures. Narcotic medications are design to be taken in conjunction with anti-inflammatory medications, not as a replacement. In other words, anti-inflammatory medications and narcotics can be taken together. The need for narcotics typically subsides after a few days, depending on the type of procedure preformed, and then any anti-inflammatory medications can be stopped a few days later. Narcotic medications can and do have side effects, such as drowsiness, decreased appetite and nausea. You should not drive while taking narcotic medications, nor should they be combined with alcohol.
   
   Anti-emetic Medications (Phenergan, Tigan, Zofran)
   Nausea and vomiting is uncommon following implant surgery. We frequently give these medications during IV sedation as a prophylactic measure and will prescribe them post-operatively if needed.
   
   

2. PAIN – Most patients do not experience severe pain following implant surgery, but some mild discomfort can be expected for a few days. Any discomfort should easily be controlled with the pain medications that we have prescribed for you. If you experience severe pain, which is not controlled with pain medications please call us.
   
   
3. BLEEDING – Post-operative bleeding is not common following implant surgery. You may experience some minor oozing from around the healing abutments or the operative site in general. Placement of gauze in the area and gentle pressure is usually all that is needed.
   
   
4. PHYSICAL ACTIVITY – Limited physical activity during the first 24-48 hours following implant surgery is usually best. Trying to do “too much, too soon” may lead to post-operative bleeding, increased discomfort, and a prolonged recovery.
   
   
5. SWELLING – Swelling and bruising following implant surgery is possible. Swelling can increase for the first two to three days and then usually subsides over the next 7 to 10 days. If we think you will experience some swelling we will give you a special ice pack to place over the surgical area. Keeping your head elevated by sleeping on 2 to 3 pillows for the first week following surgery will help minimize and resolve any swelling. Anti-inflammatory medications, such as Motrin or Advil, also help to decrease swelling.
   
   
6. MOUTH RINSES: Do not rinse your mouth the day of your surgery. On the second day begin rinsing with warm salt water (1/2 teaspoon salt in a glass of warm water) 4 to 5 times a day for several days. It is very important to keep the implant healing abutment (cap) clean while the implant integrates to your jaw bone. Initially, rinsing well be enough. After a few days, when to soreness has decreased, begin gently cleaning the abutment with a Q-tip or wet gauze. Usually, after 7 to 10 days all the soreness will be gone and you can gently brush the area with a toothbrush. Mouthwashes, such as Listerine and Scope, as well as toothpaste, will not hurt the healing site. We will review good oral hygiene measures with you at your follow up appointment.
   
   
7. FLUIDS: Fluid intake is important following your surgery. It is best to start with clear beverages such as Ginger Ale, 7-Up, or Sprite. Gatorade, tea, broth, or juices also work well. Avoid drinking a lot of water at first. Once your stomach has settled, you can advance to other fluids such as milkshakes, but remember to avoid a lot of dairy products until your stomach has settled, especially after IV sedation. Avoid hot liquids until the numbness has worn off and any oozing has stopped. It is very important to stay well hydrated while healing from surgery, so be sure to drink plenty of fluids.
   
   
8. DIET: Chewing a normal diet, especially during the first few days following your surgery, will be difficult, but maintaining a good level of nutrition throughout your recovery is very important. Food selection is largely a matter of choice. Be patient and start initially with soft, easily digested foods such as soups, Jell-O, milkshakes, and mashed potatoes. Coarser foods can be added as your healing progresses. Do not chew directly on the healing abutments. This could lead to the implant failing.
   
   
9. TEMPERATURE: It is not uncommon to have a slight elevation in temperature following even minor oral surgery procedures. Rest, medications (Tylenol or Motrin), and plenty of fluids will hasten a return to a normal temperature.
   
   
10. SUTURES: Sutures are sometimes placed around the healing abutments to help reposition the tissue, promote healing, and decrease post-operative bleeding. These sutures are dissolvable and will typically disappear 3 to 10 days following your surgery. Sutures may also cause a “drawing” or tight feeling in the area. This tight feeling is normal and will be relieved when the sutures release and dissolve.
    
    
11. PHYSICAL ACTIVITY: Limited physical activity during the first 24 to 72 hours following oral surgery is usually best. Trying to do “too much too soon” may lead to persistent oozing, increased discomfort, and a prolonged recovery.
    
    
12. SMOKING: Don’t. Nicotine decreases blood vessel diameter and thus impairs blood flow to the surgical area, which delays healing. The heat from smoking destroys immature tissue, dissolves blood clots, causes increased post-operative discomfort, prolongs your recovery, and could lead to implant failure.

Please remember that we are at your service and are here to help.

Call us if you have any questions.

404-378-2331

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