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

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

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
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