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The Gum Disease Michigan Blog Has Moved!

In an effort to consolidate numerous blogs into one comprehensive, all-inclusive blog, we've moved our blog.  It now resides at http://blog.drnemeth.com .  Please visit us at our new address and re-subscribe to stay up to date on all the latest news from Michigan Periodontists and Dental Implant Specialists, Drs. Joseph Nemeth and Amar Katranji.  We will look forward to seeing you there!

Joseph R. Nemeth, DDS and Associates Now Offers All-on-4 Dental Implant Treatment

Are you a patient who has lost all your teeth and are fed up with ill-fitting dentures that slip around and cause constant sore spots on your gums?  Have your dentures been relined over and over again while you continue to lose height and width of your jawbone?  Is your face starting to look "sunken in" because your dentures don't fit well, prematurely aging your face?  Are you tired of not being able to eat the foods you love because your dentures don't fit?  Have you been told that alternative treatments involving implant-retained dentures are too expensive?

The All-on-4 Dental Implant Concept may be the answer you've been looking for.  A proven and successful concept for edentulous patients, the All-on-4 technique allows Southfield Periodontists, Drs. Nemeth and Katranji to provide patients like you with an efficient and effective, more permanent restoration using only four implants to support an immediately loaded full-arch prosthesis, like an implant-retained denture or bridge.

Angled posterior implants
During the procedure, the two dental implants toward the back of your mouth are tilted, allowing the surgeon to use longer implants in minimum bone volume, thereby increasing bone-to-implant contact.  This reduces the need for vertical bone to be built through bone grafting processes, often reducing the cost of surgery.  In addition, the angled posterior implants can be anchored in the better quality bone near the back of the jaw, improving support of the prosthesis by reducing cantilevers (prosthetic with an unsupported end).

Good clinical results
Biomechanical measurements show that tilted implants, when part of prosthetic support, do not have a negative effect on the load distribution.  The angulation of implants has been used in clinical practice for more than ten years and has shown positive results.

Overall published data on the All-on-4 concept shows cumulative survival rates between 92.2% and 100%.  The concept is supported by good clinical outcomes from studies using protocols in which four implants have been placed to support a full-arch prosthesis.

Planning with NobelGuide
All-on-4 can be planned and performed using the NobelGuide treatment concept, ensuring accurate diagnostics, planning and implant placement.  The NobelGuide Software allows for comprehensive diagnostics including the detection of available bone, virtual implant placement according to your anatomy and restorative needs, and the ordering of distinctive surgical templates custom made for each patient.  NobelGuide works with minimally invasive techniques as well as surgical techniques utilizing mini-flaps and full-flaps, with the surgical template ensuring exact implant placement through a guided surgical technique.

All-on-4 in Summary

• Enables the Michigan periodontist to restore your entire upper or lower dentition with only four implants
• Reduces the need for the dental implant surgeon Michigan to complete expensive bone grafting procedures
• Allows for immediate placement of prosthetics without the wait time associated with two-stage dental implant procedures
• Facilitates the placement of fixed or removable final prosthetics
• Diminishes the stress patients face because the results are documented and proven effective

Would you be interested in learning more about the All-on-4 dental implant concept or other dental implant procedures?  Visit Michigan Periodontists, Drs. Nemeth and Katranji on the web at http://www.drnemeth.com or call 248-357-3100 to schedule a consultation appointment today.  Don't wait another minute to take the necessary steps to having the beautiful smile you deserve!

*source: NobelBiocare, Inc.

Placement of Dental Implants Michigan Results in Minimal Bone Loss

Source: Chicago- May11, 2009 

The American Academy of Periodontology 

www.perio.org/consumer/implant-placement.htm

According to the American Academy of Periodontology (AAP), Michigan Dental implants, frequently used as a replacement for missing teeth, can actually help prevent bone loss.  Dental Implants Michigan can be used not only as a replacement for missing teeth in or order to restore the patient's tooth function but also to improve a patient's appearance.  Previous research shows that placing a dental implant disrupts the host tissue in the area of the implant, so Michigan oral surgeons often focus their treatment planning to carefully maintain the patient's bone and gum tissue surrounding the implant.  A more recent study published in the Journal of Periodontology discovered that most of the bone remodelling occurrs in the time between when the implant is placed and when the final restoration is seated.

Close observation of the same patients in the five years following the implant placement showed little bone change, regardless of the type of restoration or implant length.  This study, conducted at the University of Texas Health Science Center at San Antonio, evaluated 596 dental implants placed in 192 patients over the age of 18.  Patients were screened for adequate oral hygiene and bone volume.  Exclusion criteria included heavy smoking, chewing tobacco use, drug abuse, and untreated periodontal disease, amongst others.

Study author Dr. David Chochran, DDS, PhD, Chair of the Department of Periodontics at the University of Texas Health Science Center at San Antonio, and President of the AAP, believes that this study provides additional supporting evidence for the use of dental implants Michigan to replace missing teeth.  Because the patient's host tissue surrounding the dental implant largely remains uncchanged in the five years following placement, the dental team is free to focus on periodontal assessment and treatment of other areas in the patient's mouth, confindently knowing that the Dental Implants Michigan are doing their job of acting as a viable substitute for that patient's natural tooth.

When Your Sinus Gets in the Way of Successful Implant Placement

When Your Sinus Gets in the Way of Successful Dental Implant Placement

Successful placement of implants in the posterior maxilla could potentially be compromised by the lack of vertical dimension between the alveolar crest and the floor of the maxillary sinus. Typically, 10mm of vertical bone is required for predictable implant success (Misch 1987) although success can be achieved with less than 20 mm (Fugazzoto 2007). Moreover, bone density in the posterior maxilla is often poor, which could lead to complications during implant fixation. To address these problems, maxillary sinus elevation surgery was developed to increase the amount of bone available for implant placement.

Lateral Window Sinus Lift: A Sinus Augmentation Technique

Implant placement can be performed simultaneously with the sinus elevation procedure or following a healing period that can last

6-9 months. Immediate placement during sinus elevation reduces overall healing time and eliminates another surgical procedure, which can be desirable to patients. The decision to place an implant during sinus augmentation is dependent on the presence of adequate bone volume and quality to provide for initial stability of the implant. Rosen and colleagues (1999) recommended at least 5mm of native bone for immediate implant placement during sinus augmentation. However, more recent studies have found that implant stability can be achieved with less than 5mm (Peleg 2006).

Lateral Window Sinus Augmentation: The lateral approach involves a modified Caldwell-Luc operation to gain access to the sinus cavity. A bony window is created in the lateral maxillary wall, the Schneiderian membrane is elevated, and bone grafting material is a combination of autogenous bone and allograft. An absorbable collagen membrane is placed between the bone graft and the membrane as well as over the bony window.

This technique is usually the preferred method of sinus elevation in situations of poor bone quality and minimal residual bone height because it allows for direct visualization and accurate bone placement and volume at the position of the implant. Also, tearing of the membrane can be easily treated, minimizing contamination of the graft during healing.

For more information about Sinus Augmentation (Lift) procedures or Dental Implant Procedures, contact Joseph R. Nemeth, DDS and Associates at 248.357.3100 or via email at jodi@drnemeth.com. You may also want to visit the practice website at http://www.drnemeth.com.

Dental Implant Composition

Dental Implant Composition

A dental implant is a man-made tooth root constructed from titanium. Titanium is a lightweight, soft, noncorroding metal. The surface of the titanium forms a natural ceramic coating when exposed to oxygen which enables bones cells to attach to it (a process called osseointegration). Since bone cells react better to titanium surfaces that are rough, most implants are put through a roughening process by the manufacturer.

To enhance bone healing, implants are sometimes coated with a calcium derivative found naturally occurring in human teeth and bones to jump start the osseointegration process called hydroxyapetite.

Implants are often threaded. In order to enhance implant placement and stability, thread shape and pitch are carefully calculated to help transfer biting force to the surrounding bone.

To learn more about Michigan Dental Implants, call Drs. Nemeth and Katranji at 248.357.3100 or email jrn@drnemeth.com or visit us on the web at http://www.drnemeth.com.

Ridge Modification Prior to Dental Implant Placement

The American Academy of Periodontology (AAP)
http://www.perio.org/

The AAP Reports:

Deformities in the upper or lower jaw can leave you with inadequate bone in which to place dental implants. This defect may have been caused by periodontal disease, wearing dentures, developmental defects, injury or trauma. Not only does this deformity cause problems in placing the implant, it can also cause an unattractive indentation in the jaw line near the missing teeth that may be difficult to clean and maintain.

To correct the problem, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or bone substitute to build up the ridge. Your periodontist can tell you about your options for graft materials, which can help to regenerate lost bone and tissue.

Finally, the incision is closed and healing is allowed to take place. Depending on your individual needs, the bone usually will be allowed to develop for about four to 12 months before implants can be placed. In some cases, the implant can be placed at the same time the ridge is modified.
Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come. Ridge modification can enhance your restorative success both esthetically and functionally.

To learn more about Michigan dental implants, call Joseph R. Nemeth, DDS and Associates at 248.357.3100 or visit us on the web at http://www.drnemeth.com/. You can also visit the AAP website at http://www.perio.org/.

Michigan Dental Implant Impression Comparisons

Taking an impression is the first step in producing a model to indicate the positioning of Michigan dental implants and/or abutments in a patient's mouth. A device which facilitates the replication of implant positions on the study models is called and impression coping and is often required during the impression stage of placing dental implants.

Impressions may be taken in one of two ways: at the implant level or at the abutment level. Placement of an implant analog, a device which mimics the implant on the study model, must occur during an implant-level impression, while abutment level impressions require placement of an abutment analog or a device which mimics the abutment.

Which impression technique is used depends on the preference of the restorative dentist and also varies by implant system. With nonfriction implant systems, impressions can be taken at either the implant or abutment level. With internal friction abutments, delivery of the abutment to its final position is necessary before the final impression is taken.

Comparison of Implant-Level and Abutment-Level

	Implant-Level Impressions	Abutment-Level Impression
Ease of localization	Requires subgingival placement of copings	Easier, because margins are often supragingival
Impression copings	Necessary	Conventional impression without copings is available in some cases
Abutment selection and preparation	On a model in the laboratory	Can be done in the mouth, chairside
Abutment modification	Not needed once delivered	May be needed in the mouth
Custom abutment	Available	Not available (unless an implant-level impression was taken first).
Interim and final crown fabrication	Can be performed in the laboratory, together with the abutment selection and preparation	Chairside relines of provisional restorations and final impressions often necessary

*Source: http://online.lexi.com

Implant-level Impressions

Implant-level impressions are similar for any type of prosthesis. There are two main types of impression copings – closed tray and open tray. Closed tray or transfer impression copings remain on the implant complex after the impression is removed and need to be placed into the impression manually. Open tray or pickup impression copings are automatically retained in the impression after removal. This usually requires the manipulation of a long screw that is not present in transfer copings.

For more information on implant impression comparison, call (248) 357-3100 and talk to an implant specialist. If you're a general dentist who would like to see a demonstration of taking implant impressions in the Oakland, Wayne, or Macomb County Michigan area, feel free to contact Joseph Nemeth, DDS & Associates by phone or email jrn@drnemeth.com. Also look for us on the web at www.drnemeth.com.