Boca Raton Periodontist Has High Dental Implant Success Rate

Periodontists have advanced training in placing dental implants and they use the latest 3D CT technology to help ensure high success rates for dental implants.

We have an approximately 98 percent success rate for dental implants in our Boca Raton periodontal and dental implant practice.  Worldwide, that number is probably closer to 94 percent.  We bat ahead of the curve.  The success rate on dental implants worldwide is actually dropping right now, primarily because there are so many general dentists that are getting into the mix.  Right now about 50 percent of all implants in the world are being placed by general dentists, which means that they just do not have as much training or experience in placing implants and doing bone grafts.

As a specialist in periodontics, a critical part of my formal training was learning to diagnose, treatment plan, and then place dental implants along with bone grafts.  That is not something that is formally taught in dental school.  With regard to dentists who have decided to go back and learn how to place dental implants, most of them have done some type of very brief training, whether that means a few weekend courses or, perhaps, what they call mini residences, which are sometimes a week or ten days long.

With this type of limited training, dentists do not have opportunity to experience formal training with instructors over a period of years and years.  My training was a one-year hospital residency, followed by a three-year specialty residency, always under the tutelage of mentors who had many years, if not decades, of experience.

I have been personally placing implants for about 19 years and would estimate that I have placed around 13,000 implants at this point.  In my opinion, there are a number of very important factors that lead to successful outcomes with implant dentistry.  One of them is adequate diagnosis and treatment planning.  That requires a thorough examination with the patient, often with a 3D image like a CT scan.  Many dentists do not have CT scan technology in their office and they may not be as comfortable or familiar reading a 3D image.  It is important to remember that 2-dimensional images like a panorex or a regular dental X-ray, called a periapical radiograph, often has 20 to 25 percent distortion, which means that they are not accurate for determining the optimal placement of a dental implant.  3D technology like a CT scan does not have that distortion.

Patients should ask questions about training, experience, and equipment when they seek dental implant treatment.


IMG_3490_lowDr. Frederic J. Norkin
South Florida Center for Periodontics & Implant Dentistry

Who Needs a Frenectomy?

Before the “who”, let’s start with the “what”— what’s a frenectomy? The short answer: a frenectomy is a minor dental procedure where excessive gum tissue is removed. Specifically gum tissue around the gumline. A frenectomy can be performed on one of two areas in the mouth: the lingual frenum or the labial frenum. Both are common and highly effective.

Lingual Frenectomy

The lingual frenum is beneath the tongue. Depending on growth, you’re likely just fine or may be a bit tongue tied. This is when the lingual frenum is tight enough to impede speech, and is really most common in children. In cases like these, having a lingual frenectomy will loosen your tongue to a greater range of motion allowing for clearer speaking. In some cases, it will also improve appetite if the excessive tissue was hindrance when eating.

Labial Frenectomy

The second type of frenectomy is on the labial frenum. It is much more visible as it’s the skin that’s attached to the middle of your upper gums. If there’s excess, it will pull your gums away from the bone. This often causes a gap between the two front teeth along with gum recession. If you’re undergoing orthodontic treatment, you may be recommended to have a frenectomy to help close gaps in your smile zone. While denture patients may consider the procedure to have a more secure fit, as the frenum may rub against the prosthetic causing discomfort.

Am I A Candidate for a Frenectomy?Frenectomy - image

A frenectomy is a quick procedure that can take as little as 15-minutes to fix a life-long problem. As with any dental treatment, we can only be sure you’re a candidate based on your unique case. If you’re tongue tied, feel like your tongue has limited range of motion, getting ready for orthodontic treatment, or if you have dentures, call for a consultation.



index_dr_ganales-xsDr. Jeffrey Ganeles
South Florida Center for Periodontics and Implant Dentistry
Boca Raton, FL
New Patients Welcome

Florida Periodontist Discusses New Technology

Florida Periodontist Dr. Frederic J. Norkin discusses new technology such as digital x-rays, Tekscan, and high resolution digital photography to plan treatment for patients.

We use a number of tools for diagnosis and treatment.  Those include digital radiography that allows us to take X-rays that are at the lowest possible radiation dose for our patients.  We are also able to use what’s called a “T” scan, a Tekscan, and that essentially is a tool that we use to digitally check a patient’s occlusion—in other words, their bite.

Most dentists use what is called articulating paper that just makes marks on teeth but does not tell much about the biting force.  Particularly when we are dealing with patients with implants, bite and biting force are critical.  It is not just a matter of seeing where the patient bites but, most importantly, how hard and whether the bite is balanced properly.  We can use this digital technology, the “T” scan, to make sure that we can deliver a balanced and protective occlusion for our patients.  This technology really improves our treatment outcomes, particularly when dealing with patients with full arch and full mouth restorations.

In many instances, we also use digital impressions, so that we can take accurate impressions of our patients without having to necessarily take conventional impressions that require us to fill trays and sometimes trigger the gagging reflex in patients.  Digital impressions are appropriate in some instances but not, unfortunately, in every instance yet. When we use it, however, it is exceedingly accurate.

We also photograph many of our cases. Diagnostically, photographs are tremendous for us to be able to observe a patient’s lip line and smile.  A photo lets us see where we are starting from and, very importantly, it allows us to share this information with the patient.

Many people have guarded smiles, particularly when they have a broken down dentition, and we try to retract the teeth and see areas that they do not ordinarily see.  Digital photography with high resolution and magnification allows us to have a clear indication of how to rebuild their smile their confidence.

We are always on the forefront of these new technologies to better serve our patients.




Dr. Frederic J. Norkin
South Florida Center for Periodontics & Implant Dentistry

New Dental X-Rays Offer Great Advantages

CT scan technology combined with new computer programs allows periodontists to plan dental cases in advance, get better results, and shorten treatment time.

We have been using CT scan technology in our practice now for about a decade.  It is perhaps the single most important tool that we have in our office.  It literally lets us see through the bone, very much the way I would take an apple, cut that apple in half and be able to open it up and look inside.  With the CT scan, I have that same ability to take an image of your jaw, cut it in half and look at the inside of your jaw.  In doing so, we have so many advantages.  Diagnostically, we can find certain types of lesions that are related to root canals or failing root canals that we may not ordinarily see on regular dental X-rays.  We can certainly see the anatomy much better.  We can find where the sinuses are with great accuracy.  We can find where certain nerves are located, so we can avoid them during surgery.

We also have planning software that works with these images that allows us to use our computer to plan out an entire case in advance, whether it is for a single implant or for many implants and make sure that we place the implant in the most ideal position.  That planning lets us do a much better job, more accurately, more efficiently when it comes to doing the actual surgery.

Beyond that, in many instances, we then mill guides that allow us to take our plan that we made on the computer and with tremendous accuracy replicate t through a CAD cam, meaning a computer-assisted design, computer-assisted milling process.  We mill a guide and replicate our plan that we made without the patient there and then deliver  on the day of treatment the same exact plan that we designed in advance.

This process allows us to do certain procedures that may require going around a nerve or a sinus much more accurately and safer than we would ordinarily.  It also allows us the opportunity to maximize what little bone some patients may have remaining.  It also lets us place implants in the most ideal position.  Finally, with high-tech x-rays and software, we work much more efficiently and we can do less invasive procedures.  By taking advantage of CT scan technology, we minimize chair time for the patient.

In sum, we are able to take CT scan information, combine it with computer planning ahead of time, and then ultimately deliver a superior outcome for our patients.


IMG_3490_lowDr. Frederic J. Norkin
South Florida Center for Periodontics & Implant Dentistry

After Dental Implants, Mom Has First Photo With Son In 13 Years!

After dental implants, a mom gained the confidence after 13 years to have her photo taken with son—only the second photo since the day he was born.

Dental implants have many benefits.  Essentially, a dental implant is a tooth root replacement. Dental implants can support one new individual tooth, a full arch, or even a full mouth of teeth.  The teeth that are affixed to dental implants are fixed and not removable, except when dental implants support dentures that literally snap in, like a snap on a shirt.

Dental implants also have the advantage that they help to maintain bone.   When a tooth is missing, the bone shrinks.  It literally reabsorbs over just a few months.  As much as 50 percent of the bone can literally shrink away to nothing.  However, when bone is under pressure, whether from having a natural tooth or a dental implant, the bone is stimulated.  This process is analogous doing weight-bearing exercises for the rest of your body which help to maintain strong. healthy bone.

There are also psychological advantages that go along with dental implants.  Studies show that using dental implants can make patients feel more confident psychologically because they are  not worried that a denture, for instance, is going to fall out of their mouth in social situations.

We can also use dental implants to literally take care of years of dental problems for patients whom we often describe as a dental cripple and change their lives.   I have a patient who came in with what appeared to be a very pleasing smile, but all of her teeth were loose.  Her tooth concern was that she really could not eat—at least that is what she told me.

I took out all of her teeth and placed a number of implants in both the top and lower jaw What I didn’t know until much later on was that this patient had never had a picture taken with her then 13-years-old son after he was born.  She had one picture taken when her son was born.  Even though her teeth looked good when she smiled, she lacked confidence due to her loose teeth, and she did not have any more pictures taken until, literally, the day that we delivered, not only her implants, but her immediate fixed teeth, meaning we took the teeth out in a single visit, placed the implants and made temporaries for her right away that we screwed in place.

That was actually the first time in almost 13 years that she had a picture with her son.  I had no idea that we were making that kind of an impact.  I thought I was simply helping a woman who was having trouble chewing due to failing dentition.  The implant dentistry treatment gave her confidence and changed her life in more ways than one.




Dr. Frederic J. Norkin
South Florida Center for Periodontics & Implant Dentistry

Boca Raton Periodontist Explains Board Certification

Boca Raton Periodontist Dr. Fred Norkin explains the rigorous board certification process and how it makes him a better clinician.

After completing dental school at Tuft University, in Boston, Massachusetts, a general practice residency at the Miami Veterans Administration Hospital, in Miami, Florida, and a periodontal residency at Nova Southeastern University in Fort Lauderdale, Florida, I went on to become board-certified.  Becoming a board certified periodontist is essentially a two-step process.  First, you take and pass a written examination, and the next step is an oral examination.  At that point, the periodontist is board certified and becomes what is called a “diplomate” of the American Board of Periodontology.

Many people are surprised to learn that only about 50 or 60 percent of all practicing periodontists become board-certified.  Every seven years diplomates must be recertified in our specialty through a written examination.  This is the process we use to maintain our board certification.

The value of this voluntary and prestigious credential is that it forces us, as periodontists, to hone our specialty knowledge and make sure that we are current on all of the recent studies and scientific literature.  We need to show that we are able to weave that knowledge into thoughtful, sensible treatment plans and outcomes for our patients.

There may be many ways to treat a patient or an individual problem, and I may not agree completely with another colleague.  The board certification process essentially makes sure that different potential treatment plans put forth by various periodontists for particular case plans make sense.  By constantly challenging ourselves to think through all the treatment issues in depth and be prepared to defend our conclusions in front of our colleagues, we help ensure that patients are getting the best we have to offer.

I know from experience that my commitment to board certification has caused me to sharpen my skills and stay on the leading edge of periodontal and dental implant treatment.



Dr. Frederic J. Norkin
South Florida Center for Periodontics & Implant Dentistry

Sinus Lift: what is it and do you need one?

A sinus lift is recommended when there is not enough bone height in the upper jaw or not enough room between sinuses for dental implants to be placed. The surgery adds necessary bone to the jaw and the sinuses on either side of your nose to build a stronger foundation in preparation for dental implants. The sinus membrane is lifted by a dental specialist (oral surgeon, endodontist or periodontist) to make room for the bone transplant.

Do I Need a Sinus Lift? Maybe…

You may be a candidate for a sinus lift if you have bone loss due to periodontitis or resorption of bone after a prolonged period of having missing teeth (sunken jaw). It’s often necessary in these circumstances to augment the existing bone in the jaw in preparation for dental implants. The donor bone may come from your own body or other medically appropriate substitute. If the bone comes from your own body, it is most often taken from your hip or tibia. You will have x-rays taken to determine the anatomy of your jaw and sinuses, as well as a CT scan to accurately measure the height and width of your existing bone.

How’s a Sinus Lift Done?

The actual sinus lift procedure starts with your dental specialist creating an incision in the back of your mouth to reveal the bone, raising the sinus membrane up and away from your jaw. Then a small, circular shaped hole in the bone is opened. Granules of the bone graft are packed into this hole, and the tissue will then be closed with stitches.

don't sneezeAftercare Instructions for Sinus Lift

After the procedure it is important to avoid blowing your nose or sneezing forcefully. These place you at risk for loosening the graft and stitches. You’ll have a saline wash to keep the inner lining of your nose wet, as well as an antimicrobial mouthwash that helps prevent infection at the incision site. Pain meds will be prescribed as will antibiotics. Be sure to complete the full round of antibiotics.

After a sinus lift, contact us if swelling or pain gets worse over time. Should bleeding not stop after two days or if the blood is bright red and continuous, your bone graft may have become dislodged, call us immediately. Also let us know if you develop a fever as this could be a sign of infection. The healing process generally takes between four to nine months. This allows the bone graft to mesh with your bone, and after it’s healed, you will be ready for your dental implants.

If you are interested in dental implants or have questions about the sinus lift procedure, call us today at (561) 912-9993

index_dr_ganales-xsDr. Jeffrey Ganeles
South Florida Center for Periodontics and Implant Dentistry
Boca Raton, FL
New Patients Welcome