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

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 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

Gum Reshaping: Simple Procedure that Dramatically Improves Smile

Gum reshaping is a relatively simple procedure performed by Dr. Jeffrey Ganeles to reveal tooth structure and give patients a better smile.

Gum reshaping is a procedure that we do when patients have too much gum covering their teeth.  The problem is not so much that they have short crowns but some patients appear to have small, square teeth when they smile, or when they smile they just show a lot of gums and very little white teeth.  When that happens it is often a condition called “altered passive eruption,” which is a fancy term for saying that the gums simply are overlapping the teeth too much.  As a result, the patient has a less than desirable smile.

The patients who have too much gum tissue often think that their teeth are the problem and they assume that very little can be done to make their teeth larger or less square.  However, the problem may just be that the surface of the teeth are hidden by too much gum.

To solve this problem, we reposition the gum so we can expose all the natural tooth structure that is there.  This procedure is used commonly for adolescents after orthodontics, and we create really dramatic results for patients when we can reposition their teeth.  We call it a “gum lift,” even though it is not a very accurate term, but gum reshaping is a quick and simple one that we do routinely in our periodontal office and it brightens up a patient’s smile immediately.

Gum reshaping is one of the most gratifying procedures we do in our office and it is not too uncomfortable, it is certainly not very involved, and the patient’s recovery time is very quick.  This procedure provides a huge cosmetic advantage for many patients.  Many patients are pleasantly surprised that such a simple procedure provides them with a dramatic esthetic benefit.

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

Dental X-Rays and Your Health

X-rays, otherwise known as dental radiographs, are a staple of quality dental care. While x-rays bring undeniable advantages when it comes to identifying and diagnosing potential health issues, some may harbor reservations regarding the risks of exposure to radiation.  Fortunately we can ease those concerns and serve as a resource for understanding radiography, so you can feel confident receiving excellent care.

Why Do I Need Dental X-Rays

X-rays are an essential tool in the dental community (and medical community at large) as they provide valuable insights that we would not otherwise be able to access with visual inspection alone. Our team, with the help of x-rays, is able to see between, inside, and under your teeth. In doing so, we have the ability to check a variety of important health factors. This includes the presence of cavities, the health of your tooth roots, the bone structure surrounding the tooth, the status of developing teeth, the health of your jaw bone, and many more conditions that we would not otherwise be able to monitor. X-rays are instrumental when there is a known issue; with them, we are better able to understand the full scope of the situation and design an appropriate treatment plan for the beauty and health of your smile.

Radiation Exposure from X-Rays

Radiography technology has come a long way, and your exposure to radiation is negligible amounts in terms of risk – in fact, the risk you assume by forgoing x-rays can create long-term damage that could otherwise have been identified and treated. We understand some patients have concerns about radiation exposure, and it’s important to understand we are all consistently exposed to radiation each and every day. It’s high levels of exposure that are the true cause for concern. Our x-ray machines operate on a micro-scale that simply don’t compare. We assure you receiving x-rays is one of the single most beneficial processes capable of saving your health by identifying small problems before they progress into serious conditions.

If you have any unaddressed concerns, in regards to x-rays or other dental procedures, our knowledgeable staff is happy to share answers with you. We want you to feel relaxed in our office, and confident that you are receiving the best care possible!

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

Dental Root Coverage Procedures Leave Patients Smiling

Root coverage procedures are used to correct gum recession and give patients better smiles, according to Boca Raton periodontist Dr. Jeffrey Ganeles.

People frequently lose gum on the outside of their teeth and this is called recession.  Factors that predispose someone to gum recession include previous orthodontic treatment that the patient may have had in years past or teeth that are crowded and are perhaps in need of orthodontic treatment.  When the gum is stretched thin on the outside of the root of the tooth, it is very often susceptible to abrasion by a toothbrush, or there is thin gum around the tooth and the gum simply moves up an upper tooth or down a lower tooth.  The result is that more tooth surface is exposed and the patient’s smile is compromised.

What root coverage is means is doing a fairly simply procedure with an emphasis on esthetics.  We move the gum or create gum to cover over that exposed root and also focus on reversing the process that originally caused gum loss in the first place.  So if you have a wide smile and all of a sudden the root is exposed on one of your teeth, it can usually be covered.  The result can be a very significant cosmetic improvement.

The procedures to cover roots are generally considered relatively minor in scope and there are a lot of different ways to do it and also many materials that we use.  In the past most people associated covering roots with taking gum from the palate.  Periodontists do not do that very often any more, because most of the time it is not necessary.  We have newer ways to accomplish root coverage.  We tailor the treatment to the individual depending on the particular situation and patients comment all the time that they are very pleased with the results.

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