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

Raton Periodontist Provides Long-Term Commitment to Dental Implants

Boca Raton periodontist Dr. Jeffrey Ganeles provides a long-term commitment to repair or replace dental implants as needed as long patients do their part.

We are certainly committed to maintaining the patient’s health, and we have an office policy that says if you lose an implant within ten years we will take some responsibility for that and make sure that we credit you towards replacing the implant.  For instance if you lose an implant within the first two years we will replace it for you. We essentially own that as long as you meet certain criteria.  Those criteria are that we have to check the final cap and you have to maintain professional cleanings at a dentist’s office.  The cleanings do have to be done in our office, but the patient needs to have those cleanings done professionally in the dental office of their choice.

If the patient has the cleanings done in another office, then we like to see x-rays on these patients periodically.  We often get x-rays on patients whom we have not seen for a while and it gives us a chance to check and to make sure that everything is fine.  If for some reason there is  a problem, then we can always call a patient back and say we got an x-ray from your dentist and the implant does not look as good as it used to.  We can ask the patient to please come in so we can take a look and resolve a small problem before it becomes a big concern.

After two years or between two years and ten years, we will give you a percentage or will credit you a percentage of the value of what you paid for that procedure toward any replacement or toward correcting a problem around that implant.  We feel this is a very fair policy, because we are accepting some long-term financial responsibility for the implant.

 

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

Periodontics and Untreated Cavities in the US

Mother Daughter BrushingWith the vast advancements in the dental field this last decade, it may be surprising to learn that untreated cavities stemming from gum disease are still a prevalent and persistent issue for many people in the United States. More than one in five Americans has untreated cavities and periodontitis, according to Dr. Bruce Dye, an epidemiologist at the U.S. Center for Disease Control and Prevention. “It appears that we haven’t been able to make any significant strides during the last decade to reduce untreated cavities” (Dye.)

How do cavities relate to periodontal health?

shutterstock_14313997Bacterial plaque continually accumulates on your teeth at the gum line. The same bacterial acids that destroy tooth enamel can cause an infection of your gum tissue and the bone surrounding your teeth. When the plaque is not fully removed, it hardens in to tartar – giving the bacteria a place to thrive, in turn leading to cavities and gum disease that gradually breaks down tooth and bone.

You can reduce your odds of developing gum disease and cavities through engaging in healthy lifestyle choices. Practicing good dental hygiene by regularly brushing and flossing is essential.   Limiting sugary drinks and unhealthy snacks that feed the bacteria that lead to tooth decay and periodontitis is another controllable element in cavity and gum disease prevention.  Regular periodontal cleanings are also paramount. When problems are identified and treated early, it prevents the necessity for further costly and invasive procedures.  If you are experiencing sensitivity or pain, schedule an appointment today.

flsmile-wordpressDr. 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 Lasers Provide Minimally Invasive Treatment and Much Faster Healing Time.

Periodontist and implant dentistry expert Dr. Jeffrey Ganeles uses different lasers for treatment that is minimally invasive and comfortable.

We have different lasers that we use.  One is called the diode laser and we use that one simply to do small surgical procedures where we are just trying to trim tissue.  The advantage is there is virtually no discomfort, there is no bleeding, and the treated area heals very quickly.

The other kind of laser that we have is called a YAG laser and that has a number of special properties associated with it. This laser specifically destroys the bacteria in the gum that causes periodontal disease.  The YAG laser seems to be able to distinguish or selectively treat diseased tissue and leave healthy tissue alone, which is specific to the wavelength of the YAG laser.  Other lasers do not have this capability and that is the reason that this one is FDA approved for that purpose while other ones are not.

The YAG laser also seems to stimulate the healing process so that the cells that are involved in repair get turned on as a result of stimulation by the specific wavelength of this laser.  In addition, the YAG laser was just FDA approved for their claim of periodontal regeneration, which means that it stimulates new bone and attachment to root surfaces that have been damaged as a result of periodontal disease.  We have observed this process occasionally and somewhat inconsistently but it certainly is a possibility.

Another advantage of using lasers is they cause the patient virtually no discomfort.  One of the other properties of lasers is that they tend to seal off the nerve endings associated with pain.  This means that we can do a fairly aggressive procedure with a laser and patients may only need to take a Tylenol or an Ibuprofen afterwards, because the nerve endings have been treated by the laser and discomfort is greatly reduced..

The YAG laser also appears to be helpful in treating problems around implants.  We are very enthusiastic about this property because some implants can develop problems, including infections around them.  The laser destroys the bacteria and promotes healing in the gum around the implant.  The beauty of this again is that there is virtually no discomfort associated with it.

The procedure we used to do to accomplish the same thing was a much more invasive surgical procedure that required healing time, a lot more expense in terms of materials that were used, such as bone grafting materials, and we were not getting any better results than we get with a laser.  So the laser allows us to do more with a minimally invasive approach, much faster patient healing time, and no surgery

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

Do You Have a Dental Disorder?

Dentist Looking Glass TeethThe range of possible dental disorders is wide and many and some are more easily recognized than others. It could be a bit perplexing to consider you may have a dental disorder without realizing it, but it’s actually more common than you might think. Some disorders have obvious symptoms that may have you running to our office. Others can be more subtle. Do you feel tired, easily irritable, or have difficulty focusing? Do you have facial soreness or pain? Surprisingly, these may be the result of a dental disorder. Our goal is to educate our patients on common and uncommon symptoms that may be a sign to visit our office and receive the required care to remedy these conditions.

A dental disorder is a disruption of your body’s natural process relating to your oral health. Despite its origins, it is important to understand symptoms may be experienced elsewhere in the body. For this reason, many suffer from ailments they don’t consider relevant to tell their dentist. However, as we are a medical provider we encourage you to share things that may not seem related – you never know!

shutterstock_115032628-VECTORRedness and swelling of the gums may indicate the presence of gingivitis, or early-stage gum disease. Left untreated, it can progress into full blown periodontitis that can threaten your smile and even cause tooth loss. Bleeding from the gums, tooth mobility, and soreness are all signs of periodontitis and should be checked.

We understand some conditions may seem complex. Rest assured we are here to work with you to find a solution to your unique needs. If you feel one or more of these conditions may apply to you or a family member, call our office to begin seeking relief today. We are here for you.

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