What if I want Permanent Teeth instead of Dentures?

Secure Bite “All-on-4™”

If you are missing all of your teeth, or you have “failing teeth”, the Secure Bite “All-on-4™” may be your best solution. The “All-on-4™” Procedure is a simple surgical technique, developed in the early 1990′s by a Portuguese doctor along with Nobel Biocare, a world leader in innovative aesthetic dental solutions. The Secure Bite “All-on-4™” Procedure allows the rehabilitation of the maxilla and/or mandible with fixed prostheses.

In this technique, 4 implants are placed in the anterior region of the jaw, which has the highest bone density. Implants in the front of the jaws also have the highest success rate, The Secure Bite “All-on-4™” Procedure allows the fitting of a fixed prosthesis with 12 to 14 teeth immediately on the day of surgery.

Through this technique, the rehabilitation of aesthetics and dental function can be achieved. Furthermore, the use of fewer implants simplifies and speeds up the surgical and prosthetic procedures while controlling cost with fewer implants and preventing the need for additional procedures such as bone grafts. Hygienic maintenance is also favored, thus increasing the longevity of the rehabilitation.

Description

The Secure Bite “All-on-4™” technique allows a full arch bridge to be place on four implants in the anterior region of the jaw. Two of these are off-centre at an angle of 30 to 45 degrees, thus allowing the maximum bone support.

The Secure Bite “All-on-4™” technique allows doctors to place implants in patients with poor bone levels, who would normally require a bone graft prior to implant placement. The use of the Secure Bite “All-on-4™” technique makes it possible for a dentist to achieve the complete reconstruction of a patients mouth, by fitting a dental prosthesis attached onto four points on implants.

During the procedure, a gum flap is raised and a small hole is drilled into the jaw-bone. This hole has exactly same length and width as needed to place the implant. The implants orientation must be very precise and it should be already determined before the surgery starts.

This procedure permits the patient to achieve the immediate functioning of the mandible and the maxilla and it will be done in two phases:

1st Phase

Surgical Phase. This phase usually takes 1 to 2 days and during this time the patient will undergo surgery where the remaining teeth are removed and a temporary full acrylic prosthesis will be applied to the maxilla and mandible. This temporary full acrylic prosthesis has a life expectancy of between 4 to 6 months. It is replaced with the final titanium bar/prosthesis during the 2nd phase.

2nd Phase

Prosthesis This 2nd phase usually takes place 4 to 6 months after the 1st phase is finished and the goal is to install the final prosthesis, which is titanium/acrylic.

Indications

The Secure Bite “All-on-4™” technique has been developed to maximize the use of the available bone and changes the original conception with regard to immediate loading for the edentulous patient. It is ideal for:

• Patients without any teeth
• Patients missing many teeth
• Patients with severe dental problems who desire a new bite and smile

From the surgical perspective, it is a simple and predictable procedure and it permits the patient to get the same teeth function as they would have with their natural teeth.

The Secure Bite “All-on-4™” technique permits Dr. Tye to place implants in patients who have poor bone levels and in those who would normally require a bone graft prior to an implant placement.

Using the Secure Bite “All-on-4™” technique makes it possible for your dentist and Dr. Tye to achieve the complete reconstruction of a patient’s mouth, which will be attached into four points on dental implants.

What Are The Potential Problems?

Although it is natural to be concerned about the pain that may be caused by these procedures, most patients do not experience severe or significant postoperative pain. Pain medication and antibiotics will be prescribed for you to make your recovery as easy as possible. Occasionally, some people develop postoperative infections that require additional antibiotic treatment. In addition, there is a chance that the nerve in the lower jaw, which provides sensation to your lower lip and chin, may be affected. If you are missing quite a lot of bone, it might be difficult to place an implant without infringing on the nerve space. Although we take great care to avoid this nerve, occasionally it is irritated during the procedure, resulting in tingling, numbness or a complete lack of sensation in your lip, chin or tongue. Although these altered sensations will usually resolve with time, they can be permanent and/or painful. If you notify us of postoperative numbness as soon as possible, it will allow us to manage your care in the most appropriate way.

How Long Will The Implants Last?

Implants last a long time. Of patients who were missing all of their teeth, long-term studies (more than 30 years) show an 80 to 90 percent success rate. For patients missing one or several teeth, six-year studies show a success rate of greater than 90 percent, which compares favorably with other areas in the body that receive implant replacement (such as hips or knees). However, if one of your dental implants either doesn’t heal properly or loosens after a period of time, you may need to have it removed. After the site heals (or on occasion at the time of removal), another implant usually can be placed.

What Happens After The Implants Have Healed?

In most cases, after four to six months of healing, your jawbone is firmly fused to the implants. The restorative phase of your treatment, when your missing teeth are actually replaced, is now ready to begin. Depending on a variety of factors, it may be possible to begin this phase of your treatment as early as six weeks after implant placement. We will review the most appropriate treatment sequence and timing for your particular situation.

In some cases, depending on the density or hardness of your bone, it is helpful to gradually increase the work on your implants. Various types of temporary replacement teeth are used during this phase. Information we obtain at the time of implant placement will help us to determine what is the most appropriate approach for you.

The dental work required to complete your treatment is complex. It is, however, considered more comfortable and more pleasant than conventional dental care. Frequently, most of the work can be done without using even local anesthesia.

Your restorative treatment begins with specialized impressions that allow us to produce a replica of your mouth and implants. We will also make “bite” records so that we see the relationship of your upper and lower jaws. With this information, we will make the abutments (support posts) that attach your replacement teeth to your implants. Various types of abutments exist. Frequently, we can use “off the shelf” abutments. Other times, custom abutments must be made of gold or a tooth-colored ceramic material. As you can imagine, these custom-made abutments add to the cost and treatment time involved. Which abutment to use is a decision that often cannot be made until after healing is complete and impressions have been made.

The number of appointments and the amount of time required for each appointment is different for each patient. No two cases are exactly the same and regardless of the number of teeth replaced, the work must be completed with great precision and attention to detail. If you are having only a few teeth replaced, as few as three short appointments may be required. Between appointments, we will need time to complete the necessary lab work to make your replacement teeth.

If your final restoration is a removable denture, you will need to come to as many as five office appointments (although it may be fewer) over the following several months. During these appointments, we will perform a series of impressions, bites and adjustments in order to make your new teeth, as well as the custom support bars, snaps, magnets, or clips that will secure your teeth to the implants. During this period we will make every effort to make certain you have comfortable temporary replacement teeth.

In general, once your implants are placed, you can expect your treatment to be completed anywhere from two to 12 months. For these reasons, it is difficult for us to tell you exactly how much the restorative phase of your treatment will cost, although you should receive a reasonable estimate of costs . It also is difficult to give you a specific time frame for completion of your treatment until after the implants are ready for restoration.

How Do I Clean My Implants?

As with natural teeth, it is important that you clean implant-supported restorations regularly with toothbrushes, floss and any other recommended aids. You also should visit your dentist several times each year for hygiene and maintenance. As with regular dentures and other tooth replacements, your implants and their associated components are subject to wear and tear and eventually will need repair, including clip replacement, relines, screw tightening, and other adjustments.

Will One Doctor Do Everything?

No, Dental Implants require a team approach. One dentist places the implant(s) and performs any other necessary additional surgical procedures while another dentist provides the temporary teeth and restores the dental implants after healing is complete. Both doctors are involved in planning your dental treatment. Also, depending upon a variety of factors, different dental specialists will help with your dental care.

What Do These Services Cost?

Before treatment begins, every effort will be made to give you an accurate estimate of all the expenses involved in placing and restoring your dental implants. This includes the implant placement itself plus any bone and soft tissue grafting procedures that are needed. In many cases, there is an initial charge for the diagnostic work-up, including study models, x-rays, and the fabrication of a surgical template to ensure the best possible result. You also will be charged for the abutment or support post(s), plus the crown, dentures, or anything else that will be placed over the implants, including temporary restorations, as well as for periodic maintenance such as hygiene visits, tissue conditioners, denture relines and other repairs.

We will try to assist you in estimating what your actual payments will be after we evaluate your insurance coverage or other third party payments, if any. Your ultimate restorative choice should be guided by your sense of what is best for you based on the information we have provided you. You also should consider the financial impact of each treatment option as some insurance companies provide no or limited coverage. If different doctors are involved, they will charge you separately for their services.

Why would you select dental implants over more traditional types of restorations?

There are several reasons: Why sacrifice the structure of surrounding good teeth to bridge a space? In addition, removing a denture or a “partial” at night may be inconvenient, not to mention that dentures that slip can be uncomfortable and rather embarrassing.

Are you a candidate for implants?

If you are considering implants, your mouth must be examined thoroughly and your medical and dental history reviewed. If you mouth is not ideal for implants, ways of improving outcome, such as bone grafting, may be recommended.

What type of anesthesia is used?

The majority of dental implants and one graft can be performed in the office under local anesthesia, with or without general anesthesia.

Do Implants need special care?

Once the implants are in place, they will serve you well for many years if you take care of them and keep your mouth healthy. This means taking the time for good oral hygiene (brushing and flossing) and keeping regular appointments with your dental specialists.

Dental implants are changing the way people live. They are designed to provide a foundation for replacement teeth which look, feel and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything, knowing that teeth appear natural and that facial contours will be preserved they can smile with confidence.

What are Dental Implants?

The implants themselves are tiny titanium posts, which are inserted into the jawbone where teeth are missing. These metal anchors act as tooth root substitutes. They are surgically placed into the jawbone. The bone bonds with the titanium, creating a strong foundation for artificial teeth. Small posts are then attached to the implant, which protrude through the gums. These posts provide stable anchors for artificial replacement teeth. Implants are more conservative than bridges in that implants do not require the filing down of normal tooth structure. Implants also stimulate the growth of bone and prevent the atrophy or shrinking of bone that happens after teeth are lost. Dental implants are an ideal method of replacing missing teeth. Coordination is required between your Oral and Maxillofacial Surgeon who places the implant(s) and your Restorative Dentist who places the crown over the implant(s) after the healing phase.

Implants also help preserve facial structure, preventing the bone deterioration that occurs when teeth are missing.

The Surgical Procedure

Implants are first placed within your jawbone during a sterile surgical procedure. For the first three to six months following surgery, the implants are beneath the surface of the gums gradually bonding with the jawbone. You should be able to wear temporary dentures and eat a soft diet during this time. At the same time, your dentist is forming new replacement teeth.

After the implant has bonded to the jawbone, the second phase begins. Dr. Tye will uncover the implants and attach small posts, which will act as anchors for the artificial teeth. These posts protrude through the gums. When the artificial teeth are placed these posts will not be seen. The entire procedure usually takes six to eight months. Most patients experience minimal disruption in their daily life.

Surgical Advances

Using the most recent advances in dental implant technology, Dr. Tye is able to place single stage implants. These implants do not require a second procedure to uncover them but do require a minimum of six weeks of healing time before placing artificial teeth on them. There are even situations where the implants can be placed at the same time as a tooth extraction further minimizing the number of surgical procedures. Advances in dental implant technology have made it possible in select cases, to extract teeth, and place implants with crowns at one visit. This process, called “immediate loading” greatly simplifies the surgical process.

Who actually performs the implant placement?

Implants are a team effort between an Oral and Maxillofacial Surgeon and a Restorative Dentist. While Dr. Tye performs the actual implant surgery, and initial tooth extractions and bone grafting if necessary, the restorative dentist (your dentist) fits and makes the permanent prosthesis. Your dentist will also make any temporary prosthesis needed during the implant process.

What types of prostheses are available?

A single prosthesis (crown) is used to replace one missing tooth – each prosthetic tooth attaches to its own implant. A partial prosthesis (fixed bridge) can replace two or more teeth and may require only two or three implants. A complete dental prosthesis (fixed bridge) replaces all the teeth in your upper or lower jaw. The number of implants varies depending upon which type of complete prosthesis (removable or fixed) is recommended. A removable prosthesis (over denture) attaches to a bar or ball in socket attachments, whereas a fixed one is permanent and removable only by the dentist.

Dr. Tye performs in-office implant surgery in a hospital-style operating suite, thus optimizing the level of sterility. Inpatient hospital implant surgery is for patients who have special medical or anesthetic needs or for those who need extensive bone grafting from the jaw, hip or tibia.

Why dental implants?

Once you learn about dental implants, you finally realize there is a way to improve your life. When you lose several teeth – whether it’s a new situation or something you have lived with for years – chances are you have never become fully accustomed to losing such a vital part of yourself.

Dental implants can be your doorway to renewed self-confidence and peace of mind.

A Swedish scientist and orthopedic surgeon, Dr. Per-Ingvar Branemark, developed this concept for oral rehabilitation more than thirty-five years ago. With his pioneering research, Dr. Branemark opened the door to a lifetime of renewed comfort and self-confidence for millions of individuals facing the frustration and embarrassment of tooth loss.

Why would you select dental implants over more traditional types of restorations?

There are several reasons: Why sacrifice the structure of surrounding good teeth to bridge a space? In addition, removing a denture or a “partial” at night may be inconvenient, not to mention that dentures that slip can be uncomfortable and rather embarrassing.

Other benefits include:

• Healthy teeth are not destroyed or ground down
• Implants do not require clasps secured to healthy teeth
• Can be used regardless of the quantity & structure of remaining teeth

Denture patients will benefit with:

• Confidence in knowing your dentures are secure
• Improved speech and denture comfort
• Improved biting pressure which also improves diet, overall health and allows you to eat any food with confidence
• No need for denture adhesives

Are you a candidate for implants?

If you are considering implants, your mouth must be examined thoroughly and your medical and dental history reviewed. If you mouth is not ideal for implants, ways of improving outcome, such as bone grafting, may be recommended.

What type of anesthesia is used?

The majority of dental implants and on lay grafts can be performed in the office under IV Sedation.

Do Implants need special care?

Once the implants are in place, they will serve you well for many years if you take care of them and keep your mouth healthy. This means taking the time for good oral hygiene (brushing and flossing) and keeping regular appointments with your dental specialists.

Dr. Tye offers a variety of Dental Implants to suit each individual patient’s needs.