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Dental CT scans the new standard of care

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Dental CT Scans: The new standard of care for dental implants

 

IT IS A DENTIST’S RESPONSIBILITY to provide reasonable and ordinary care, skill and diligence as other dentists in good standing in the same neighborhood provide, and deviations from these standards that produce untoward results constitute malpractice."

They are not the standard of care for every implant case. But I consider it a standard of care when treatment planning complex cases such as multiple implants in the posterior mandible, to obtain more accurate information. But in other cases, I want what's best for my patients, even if it does cost the 200-300 dollars for a scan, its piece of mind and accurate treatment planning. Also gives the patient visual evidence of the limitations of treatment with their anatomy. Its an educational and treatment planning tool.

The radiation dose is not significant. If a patient can afford to have an implant placed, they can afford to have it placed by a dentist who has the information they need to place it safely and usefully

Do you need a CT scan for every implant case? Of course not - but when they are safe, cheap and easily accessible you'd be a fool not to get one for complex cases or where the usual fun anatomical structures are close to the proposed implant site.

Will it make implant treatment more expensive? When I get a scan for a complex case, I often get a Simplant-planned drilling guide (Surgiguide) made from it

The radiation dose far exceeds the potential risk of surgical complications without a CT Scan, especially in the complex cases where treatment planning is very important

CBCT (Cone Beam CT) is a powerful tool, however it needs to be coupled with a implant placement program (i.e. Simplant) to be really useful

The more you plan and the more data you have to do it, the better the case. Just be open-minded and use the technology when appropriate.

CT scans are a valuable aid in implant dentistry. They are indicated whenever they will help provide a better treatment outcome for your patient, ie, more accurate implant placement or reducing risks such as nerve injury.

it is the most important tool for us to appreciate the patient's anatomy.

The trouble is, and the law says, that we have a greater responsibility than providing the best dental care we can possibly give our patients.We need to make them aware of the best possible care that exists in the local community when compared to services provided in our offices. That is not anything most of us are comfortable doing, yet that’s what "standard of care" is all about.

Going the extra mile for more information can no longer be considered a "standard of excellence" that separates one clinician from another. Getting all the information necessary—in this case, 3-D imaging—to make an informed decision should not be glossed over

 

What exactly is a Dental Implant?

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What exactly is a Dental Implant?

A natural tooth has a crown - the part which shows above the gumline,

and a root - the anchor hidden below the gumline.

When a tooth is missing, a dental implant takes the place of the missing root

and a prosthetic crown replaces the natural crown.

Read more...
 

Dental Implant Complications, Maintenance and Care

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Dental Implant Complications, Maintenance and Care

As with every surgical procedure, complications may arise with any step of the entire implant reconstruction sequence. This can range from immediately postoperative complications to ones that surface many years after the implants have already been in function. Either way, often we can resolve some of these problems if we diagnose them early and initiate appropriate corrective measures. In order to avoid complications once the implant is in function (with a prosthesis on top) proper maintenance and care on the patient's side is a must.

Complications:

Complications can usually be divided into three different categories:

  • Post Surgery Complications
  • Integration Time Complications
  • Post Prosthetic Complications

Post Surgery Complications are complications that occur within the first few days after the placement of implants or a grafting procedure. These usually include swelling, pain, nausea, bleeding, possible infection, or partial numbness in certain areas. Swelling, pain, nausea and some minor bleeding are, to a certain extent, fairly normal responses to general surgical invasion of tissues. Pain can usually be reduced with proper medication. Swelling will usually dissipate after a few days, although one can use ice packs immediately post-surgery to reduce the swelling somewhat. Nausea is usually a side effect of medications (usually narcotic in nature) given I.V. during surgery or taken post-operatively. Minor Bleeding can be controlled with moderate pressure to the area utilizing gauze pads (one can also wrap a moist tea bag into the gauze pads-the tannic acid in the tea will help constrict some of the blood vessels). Infections are usually not a big occurrence, because most patients are on an antibiotic regimen for some time after surgery. If an infection persists nevertheless, your doctor will usually pursue more aggressive methods of infection control. Partial Numbness can sometimes occur after surgery in the lower jaw. This usually involves the lower part of the lip and chin area or one side of the tongue. This can be very short lived or extend over long periods of time (may even be permanent, depending on the procedure). This is usually due to either temporary fluid pressure on the nerve or some form of mechanical manipulation of the nerve.

Integration Time Complications are usually not very extensive and for our purposes we will only mention two: Exposure of surgical site (implants, grafts, membranes, etc.) and Rejection of the implant.

Exposure of the surgical site needs to be distinguished between the gradual showing of the top of the implant through the gums or the exposure of a grafted site. If you see the top of the implant coming through your gums after a while, it is usually not a problem at all (although you should have your doctor check it to make sure), since many times implants are actually placed and left exposed through the gums immediately post surgery. This usually eliminates the Uncovery procedure. If, on the other hand a graft site becomes exposed this may pose a more dangerous problem and you should contact your doctor immediately.

Rejection of the implant statistically happens approximately one out of twenty times. The true reason for this is sometimes not known, however, there are several etiologic factors that we know may be responsible for that. The most prevalent is disturbance of the implant during the healing time. Try to baby the implant as much as possible during the first four weeks. If your doctor advises you to not wear certain removable appliances (dentures, partials, etc.) during that time, you must follow his advice, or you may risk loosing the implant. Also, smoking increases the chance of rejecting the implant. The reason for this is still unclear, but it is hypothesized that the nicotine, being a fairly strong vasoconstrictor, limits blood supply to the surgical site and thus compromising the healing and osseointegration process. Lastly, poor surgical technique (overheating the bone during preparation, etc.) may sometimes be the cause.

Post-Prosthetic Complications encompasses everything that happens to either the implant or the prosthesis after the implant is in function. However, before I elaborate on that it should be mentioned that sometimes everything can go well with the surgery and healing and, as you can see below, the making of a final prosthesis can be the beginning of a long-lasting nightmare.

 

 


This can usually be avoided by doing your research about the doctor(s) placing and/or restoring your implants Assuming, that the implant(s) is (are) successfully connected to a prosthesis, things might still go wrong in the future. The implant(s) may experience extensive bone loss over a certain period of time. This can be due to excessive load on the implant. Chewing or grinding too heavily on the implant crown(s) spells disaster for the future survival of the implant. Beyond the potential bone loss around the implant(s) this can also fracture some of the components, if not the implant itself. If this is the case, the crown(s) need to be adjusted and/or a night guard should be worn. Compromised oral hygiene may also be a factor, although this seems to be less and less an etiologic factor, according to latest research (which does not mean one can neglect oral hygiene around implants all together-on the contrary).

All other problems are usually linked to the prosthesis on top of the implant(s). This may include screw loosening, fracture of porcelain or acrylic, etc. These problems can usually be corrected, since most implant systems are based on a screw-retained platform, which makes the prosthesis usually retrievable (but not necessarily repairable). This however does not endanger the implant fixtures. On a good note, decay or cavities will never be a problem.

Maintenance and Care:

As already mentioned above, care of your implants is an important factor. Oral hygiene should be performed on a daily basis, as explained to you by your dental professional. Usually it does not involve any more care than your natural teeth need. Forceful water picks and harsh tooth brushing should be avoided.

 

If you still have questions or for more information or comments e-mail me at:

 

Come in for a free consultation today.

 

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Why do dental implants cost so much?

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Why do dental implants cost so much? How can I afford them?

Dental implants are NOT expensive, when one evaluates the return on the investment and the long range benefits that come from having secure, functional, attractive teeth and a winning smile. Unlike all the rest of the human body, the virtual "youth" of dentition can be preserved by dental specialists right on up through the age of a hundred. For some who prioritize dental health, the concept of eating well until death is an significant motivation to implant treatment.

Dental implants in New York City are a costly treatment to provide for a number of reasons. First, an entire team of highly skilled professionals are necessary in order to deliver the most perfect result that we can for each individual. With the exception of meticulous sterile detail and attentive, thorough home care instructions, there is nothing routine about dental implant treatment. Each patient receives a highly customized treatment plan that takes into consideration their overall health needs in conjunction with the esthetic and functional requirement to achieve a long-lasting smile.

Read more...
 

$500 Dental Implants. The scam.

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Recently there has been a hash of dentists offering dental implants for the bargain basement price of $500. These dental implants are sub-standard implants usually imported from China or India

We use FDA certified, approved and inspected titanium dental implants. Which are guarenteed to last you for the rest of your life. Yes our dental implants don't cost $500. That is because they are made from the finest materials and come with our 5 year guarantee against failure. This guarantee is also backed by the companies that manufactures the implants.

You get what you pay for.

 
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