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
www.flsmile.com

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
Periodontist
South Florida Center for Periodontics and Implant Dentistry
Boca Raton, FL
New Patients Welcome
www.flsmile.com

Implant Dentistry Advancing Rapidly—Robotic Assisted Surgery Coming Soon

Implant dentistry is advancing so quickly that soon almost all patients will have same-day teeth and robotics will help make surgery less invasive.

 In general the trends in implant dentistry have been placing implants in more difficult places or more difficult circumstances, using less drastic procedures, having them heal faster and look better.  It was considered a crazy idea 20 years ago to think that patients could walk out of an office with teeth the same day of treatment.  We do that routinely now.

In the future, we will be able to do that even more frequently than we do now.  We probably can do it three quarters of the time today based on the circumstances of the case.  I imagine we will be doing it 90% of the time in a couple of years and replace almost any tooth and load it immediately, which means it will be functional that same day.

There is also a trend toward doing fewer bone grafts because shorter and smaller implants seem to be as successful as longer and wider ones which require more bone.  In a sense, we are developing the ability to do more with less.

Some of the challenges we have had in the past, particularly in terms of complications with dental implants, have been cement getting stuck around implants and causing bone loss and infections.  We are going to see different attachment mechanisms that no longer require screwing a crown or cementing a crown to an implant.  We are just going to snap them into place, which is going to be quicker, simpler, and more trouble free.

On another exciting front, I am involved with a company that is developing robotic guidance in order to place implants extremely precisely using a very minimally invasive approach.  It is computer assisted surgery and it is similar to what is being done in orthopedics.  This new robotic approach will be on the market probably a year from now and although its first generation is rather large, the second and third generations of that unit will be much smaller.  This process is also going to allow us to prepare a temporary restoration in advance so that everything is a little bit faster and more streamlined in the treatment process.

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

Replacing Missing Teeth with Dental Implants Provides Numerous Advantages

According to periodontist Dr. Jeffrey Ganeles, replacing teeth with dental implants protects adjacent teeth, preserves bone, and keeps the bite intact.

The advantages of replacing a single tooth with a dental implant are that you can avoid touching or damaging the adjacent teeth.  If you want to replace that tooth then an implant stands by itself and it does not require any preparation of the adjacent teeth, and that is really a huge benefit.

Once you put a cap on a tooth there is a certain lifespan to a cap or crown.  For instance if you needed to make a conventional bridge, which means that you are going to prepare teeth on either side, then the average lifespan of that bridge is about seven years.  So instead of using an implant, if you used a fixed bridge, then you would have to commit to changing or replacing that bridge roughly every seven to ten years.  Every time you replace a crown or a bridge you typically run into other problems such as root canals or fractures. If you use an implant, you can avoid all those complications and all that future treatment.

Another advantage of an implant is that once you lose a tooth the bone tends to atrophy or shrink in that area.  If you place an implant, then it tends to maintain that bone so that it does not shrink.  The dental implant actually stimulates the bone around it so it maintains the volume and the integrity of the jaw bone.

If the missing tooth is the back of the mouth, then the advantage of replacing it is that you basically create more surface area for chewing and it maintains the bite better.  If you lose all your back teeth, then you start overworking the front teeth.  The front teeth can move, they can flare out, and they can develop more bone loss on their own.  For these reasons, keeping a bite intact tends to be very important and that is another significant benefit of dental implants.

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

Second Opinion Leads to Simpler, Easier Dental Procedure

Dr. Jeffrey Ganeles relates the story of a patient he saw for a second opinion who needs much less dental treatment than she was told by another doctor.

I saw a patient recently for a second opinion, a 37-year-old woman who had an upper molar removed in another office.  The original surgeon she saw had this crude drawing on an x-ray and told her she needed to have a sinus lift, which is a procedure that is done to create more bone in the upper jaw in order to place a dental implant.

She did not like that opinion for a variety of reasons.  First, she really did not want someone doing a procedure on her sinuses. It may be a safe procedure but it is not one that anyone would volunteer for unless it is really necessary.  She is also a vegetarian, and the surgeon was talking to her about using a cow derived bone to put into her sinus.  She said she has never had meat products, so she certainly did not want to have cow derived material in her mouth.

She came into see me and we were able to take a scan, which is a 3D x-ray of that area.  The other surgeon was only looking at a two dimensional x-ray, so he really did not have a full understanding of the available bone.  It turns out that she did not need a sinus lift, so we did not have to have the conversation about cow products or additional surgical procedures.  She is scheduled to have an implant placed soon in a relatively simple, straightforward fashion.

The other interesting part of this consultation was that the patient did not have a lot of bone in this area.  However, I knew that there was enough bone based on my experience, because I have dealt with short implants for a long time, and if you can use a short implant then you typically need less bone to hold that implant in place.

Many surgeons are not comfortable with short implants because they have not dealt with them over the years and they are also not familiar with the current information on short implants.  I happen to be very much on top of the latest scientific information on short implants because I gave a lecture in Colorado recently, and I know with certainty that the success rate of short implants is equivalent to that of long implants.

There is an old prejudice that persists among many surgeons that you need to have really long implants to be successful.  I know that this thinking is not valid, so I was able to tell this patient with confidence that a short implant is going to work very well.  The patient is 37 now, and when she is 67 that implant will still be there and it will still be fine.

 

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

Dental Implants Can Last a Lifetime with Professional and Home Care

Dental implants can last a lifetime if patients see their dentist regularly and practice proper home care, according to Dr. Jeffrey Ganeles.

The success rates for implants have been tracked in some studies up to 20 years and almost 90% of the implants of a certain group were fine at 20 years.  These results mean that some of those implants did have problems, but the vast majority of them are fine.

In theory implants should last a lifetime.  There is no inherent reason why they should deteriorate, breakdown, be rejected, or become infected.  In reality implants can have problems after time just like natural teeth do.  They are also subject just like natural teeth to changes in a patient’s health, so if someone gets an implant at age 40 when they are healthy, but then they have chemotherapy when they are 75, or the patient has other health problems as they age, then it is certainly possible that the implant could have a problem, too.

We encourage patients to stay on a professional maintenance program.  If the patient has had periodontal disease in addition to implants, then we like to keep them in our office for cleanings with our hygienist at least once or twice a year.  They generally go back to their dentist for the other cleanings.

If they have not had any periodontal disease and perhaps lost a tooth because of trauma, or because a tooth cracked, and they are really not at risk for periodontal disease, then we will check on the patient every year but have them go back to their dentist to continue professional maintenance.  Regardless of who does the cleaning, patients should continue to get them done professionally because implants like teeth can have problems if they are not cleaned properly, and the best way to do that is to see a hygienist at least twice a year and also do proper daily oral care at home.

When I place implants I expect them to last a lifetime and we educate our patients to help them achieve that goal.

index_dr_ganales-xsDr. Jeffrey Ganeles
Periodontist
South Florida Center for Periodontics and Implant Dentistry
Boca Raton, FL
New Patients Welcome
http://www.flsmile.com

Dental Implants Can Last a Lifetime with Professional and Home Care

Dental implants can last a lifetime if patients see their dentist regularly and practice proper home care, according to Dr. Jeffrey Ganeles.

The success rates for implants have been tracked in some studies up to 20 years and almost 90% of the implants of a certain group were fine at 20 years.  These results mean that some of those implants did have problems, but the vast majority of them are fine.

In theory implants should last a lifetime.  There is no inherent reason why they should deteriorate, breakdown, be rejected, or become infected.  In reality implants can have problems after time just like natural teeth do.  They are also subject just like natural teeth to changes in a patient’s health, so if someone gets an implant at age 40 when they are healthy, but then they have chemotherapy when they are 75, or the patient has other health problems as they age, then it is certainly possible that the implant could have a problem, too.

We encourage patients to stay on a professional maintenance program.  If the patient has had periodontal disease in addition to implants, then we like to keep them in our office for cleanings with our hygienist at least once or twice a year.  They generally go back to their dentist for the other cleanings.

If they have not had any periodontal disease and perhaps lost a tooth because of trauma, or because a tooth cracked, and they are really not at risk for periodontal disease, then we will check on the patient every year but have them go back to their dentist to continue professional maintenance.  Regardless of who does the cleaning, patients should continue to get them done professionally because implants like teeth can have problems if they are not cleaned properly, and the best way to do that is to see a hygienist at least twice a year and also do proper daily oral care at home.

When I place implants I expect them to last a lifetime and we educate our patients to help them achieve that goal.

 

Dr. Jeffrey Ganeles
Periodontist
South Florida Center for Periodontics and Implant Dentistry
Boca Raton, FL
New Patients Welcome
http://www.flsmile.com