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The Dental Implants & Aesthetics Center
Dr. Riad Abu Saleh & Dr. Rawad Abu Saleh
המרכז להשתלות שיניים ואסתטיקה
ד"ר ריאד אבו סאלח וד"ר רואד אבו סאלח
The Information Center
Basal Implants
Basal Implants are an advanced implantology system which utilizes the basal portion of the jaw bones for the retention of the dental implants. Basal implants are made of Titanium metal, uniquely designed to be accommodated in the basal (cortical) bone areas. The basal bone area provides excellent bone quality for the retention of these unique and highly advanced implants.
The teeth are usually situated in less dense bone portions of the jaw bones called the alveolar or crestal bone of the jaw. This less dense alveolar or crestal bone area gradually starts getting resorbed and recedes once the teeth are lost. The bone which ultimately remains after regression of the alveolar bone following loss of teeth is the basal (Cortical) bone which lies below the alveolar bone.The basal bone is less prone to bone resorption and infections. It is highly dense, corticalized and offers excellent support to implants.
Basal implants are used either for teeth replacement or as an anchor for different types of removable dentures such as All in 4 and All in 6. However, the usual aim of the procedure is a fixed structure to replace as many as 12 teeth on each jaw. Basal implants are considered to be the best choice for individuals with moderate or severe atrophy of the jaw and can possibly avoid the need for bone augmentation.
With Basal implants, the final prosthesis (crown) is fixed on the titanium post within 24 hours, saving time and costs considerably. This procedure is called “Immediate Loading”. With Basal implants the need for a second surgery to fix the abutment and the need of interim/provisional dentures is totally eliminated.
Another major advantage of Basal implants is the fact that they can be successfully placed in smokers or diabetic patients, or in individuals with chronic or destructive periodontitis.
Basal implants are fast, safe and painless:
- Single piece implant system (screw and abutment in one)
- Minimally invasive and less traumatic
- Immediate loading (24 Hrs.)
- Avoidance of bone grafting
- Basal / Cortical strong bone support
- Good solution for unfavorable bone situations
- Extremely high success rate
- Virtually no incidence of infections or Peri-implantitis
- Affordable and cost effective
Same Day Implants
Same Day Implants help you replace your teeth in one day. If it is determined that you are an appropriate candidate for these procedures, replacement teeth ranging from a single tooth restoration to a full arch of teeth can be delivered on the same day as the dental implants are placed. These procedures can oftentimes be accomplished successfully even if your natural teeth have to be removed on the same day. After an initial consultation and examination, a dentist should use state of the art technology to plan your dental implant procedure, including the design of your replacement teeth. This technology enables dentists to place your implants, and fabricate and place your replacement teeth the same day!
Advantages of Replacement Teeth in one day:
- Easy, safe and predictable
- Minimally invasive procedure
- Less or no time missed from busy life
- No healing time required prior to functioning
- Complete range of prosthetic possibilities
Immediate Loading
Immediate load dental implants are implants that have teeth fixed to them within 24 to 48 hours of being inserted. This is different to normal procedure. Normally, a dental implant is allowed to heal on its own for 3 to 6 months before a tooth is fitted to it.
It is important to understand that immediate load dental implants can not be achieved the same as any other implants. For example, Basal Implants are perfect for immediate loading procedures (unlike regular implants)
Immediate loading has shortened the transitional period between implant placement and implant restoration considerably. Benefits for the patient include reduced overall treatment time, reduced number of visits to clinicians, comfort during the healing period and improved aesthetic and phonetic aspects.
Dental Aesthetics
Dental Aesthetics is also known as "Cosmetic Dentistry", and is generally used to refer to any dental work that improves the appearance (though not necessarily the functionality) of teeth, gums and/or bite. It primarily focuses on improvement dental aesthetics in color, position, shape, size, alignment and overall smile appearance. Many dentists refer to themselves as "cosmetic dentists" regardless of their specific education, specialty, training, and experience in this field. This has been considered unethical with a predominant objective of marketing to patients. The American Dental Association does not recognize cosmetic dentistry as a formal specialty area of dentistry. However, there are still dentists that promote themselves as cosmetic dentists.
Cosmetic dentistry may involve:
- The addition of a dental material to teeth or gums (bonding porcelain veneers/crowns/gum grafts)
- The removal of tooth structure or gums (enameloplasty/gingivectomy)
- Adding nor removing dental materials, tooth structure, or gums (teeth whitening /gum depigmentation)
- Straightening of teeth accompanied by improvement in appearance of face (Orthodontics)
Orthodontics
Orthodontics, also known as Orthodontia and Dento-facial Orthopedics, is a specialty field of dentistry. An orthodontist is a specialist who has undergone special training in a dental school or college after they have graduated in dentistry. The specialty deals primarily with the diagnosis, prevention and correction of mal-positioned teeth and the jaws.
For comprehensive orthodontic treatment, metal wires are inserted into orthodontic brackets (braces), which can be made from stainless steel or a more aesthetic ceramic material. The wires interact with the brackets to move teeth into the desired positions. Invisalign or other aligner trays consist of clear plastic trays that move teeth. Functional appliances are often used to redirect jaw growth.
Orthodontia is the specialty of dentistry that is concerned with the treatment of improper bites and crooked teeth. Orthodontic treatment can help fix the patient's teeth and set them in the right place. Orthodontists usually use braces and clear aligners to set the patient's teeth. Orthodontists work on reconstructing the entire face rather than focusing only on teeth. After a course of active orthodontic treatment, patients will typically wear retainers (orthodontic devices), which help to maintain the teeth in their improved positions while surrounding bone reforms around them. The retainers are generally worn full-time for a period, anywhere from just a few days to a year, then part-time (typically, nightly during sleep) for as long as the orthodontist recommends. It is possible for the teeth to stay aligned without regular retainer wear. However, there are many reasons teeth will crowd as a person ages, whether or not the individual ever experienced orthodontic treatment; thus there is no guarantee that teeth will stay aligned without retention. For this reason, many orthodontists prescribe night-time or part-time retainer wear for many years after orthodontic treatment (potentially for life). Adult orthodontic patients are more likely to need lifetime retention.
Hollywood Smile
Hollywood Smile is a smile makeover. It's a Supra Natural White, perfectly aligned attractive looking teeth. It takes in consideration the skin color, the gum position, the front teeth color and size, and of course the position of the upper teeth with the lower lip.
Benefits of a nice smile:
Higher self esteem
Nothing to hide while smiling
Attractive flashy smile
Simple, painless cosmetic procedures.
Hollywood Smile is achieved with the help of the following dental treatments:
- Whitening/ Bleaching
- Ceramic Veneers (thin laminates of ceramic. Beautiful durable and very natural looking)
- Composite Veneers (Lower quality and shorter term smile enhancement)
- Crowns (3/4 crowns, or full 360 crowns made with the full ceramic materials)
- Orthodontics
- Gum Surgeries (for Irregular uneven or Gummy smiles)
Porcelain Veneers
Dental veneers (sometimes called porcelain veneers or dental porcelain laminates) are wafer-thin, custom-made shells of tooth-colored materials designed to cover the front surface of teeth to improve their appearance. These shells are bonded to the front of the teeth, changing their color, shape, size, or length.
Dental veneers can be made from porcelain or from resin composite materials. Porcelain veneers resist stains better than resin veneers and better mimic the light reflecting properties of natural teeth. You will need to discuss the best choice of veneer material for you with your dentist.
Veneers are routinely used to fix:
Discolored teeth - either because of root canal treatment, stains from tetracycline or other drugs, excessive fluoride or other causes, or the presence of large resin fillings that have discolored the tooth
Worn down teeth
Chipped or broken teeth
Teeth that are misaligned, uneven, or irregularly shaped (for example, have craters or bulges in them)
Teeth with gaps between them (to close the space between these teeth)
Veneers offer the following advantages:
- They provide a natural tooth appearance.
- Gum tissue tolerates porcelain well.
- Porcelain veneers are stain resistant.
- The color of a porcelain veneer can be selected such that it makes dark teeth appear whiter.
- Veneers offer a conservative approach to changing a tooth's color and shape
- Veneers generally don't require the extensive shaping prior to the procedure that crowns do, yet offer a stronger, more aesthetic alternative.
Zirconia Crowns
A zirconia crown is a popular type of all-ceramic crown, which is worn to improve the appearance of a tooth which has become stained or disfigured over the years. They are durable, easy to wear and long lasting.
Zirconia crowns have a translucent appearance which means that they are indistinguishable from your own teeth. It is hard to spot a zirconia crown amongst natural teeth. This type of crown is made from zirconia, a very strong material which is compatible with the human body. Zirconia is used in many other medical applications such as artificial joints and is known for its strength and durability. Zirconia is a type of crystal which is long lasting and indestructible.
There is no fear from the body rejecting zirconia or displaying an allergic reaction to it. It is safe to use and preferred by many people to porcelain fused to metal crowns.
There are three advantages to zirconia crowns:
Strength: zirconia crowns last longer than other types of crowns.
Aesthetics: these crowns have an attractive translucent colour which blends in well with the other teeth.
Retain more of the existing tooth: minimal preparation is required which means more of the original tooth is preserved. This is useful if the crown needs to be removed.
Zirconia crowns are a good choice if you are looking for a strong, long lasting and visually appealing crowns. They are ideal at covering signs of damage or staining, as well as helping to maintain the function of the tooth.
Dental Care
Basic dental care involves brushing and flossing your teeth regularly, seeing your dentist and/or dental hygienist for regular checkups and cleanings, and eating a mouth-healthy diet, which means foods high in whole grains, vegetables and fruits, and dairy products.
The advantages to practicing basic dental care:
- Prevents tooth decay.
- Prevents gum (periodontal) disease, which can damage gum tissue and the bones that support teeth, and in the long term can lead to the loss of teeth.
- Shortens time with the dentist and dental hygienist, and makes the trip more pleasant.
- Saves money. By preventing tooth decay and gum disease, you can reduce the need for fillings and other costly procedures.
- Helps prevent bad breath. Brushing and flossing rid your mouth of the bacteria that cause bad breath.
- Helps keep teeth white by preventing staining from food, drinks, and tobacco.
- Improves overall health.
- Makes it possible for your teeth to last a lifetime.
How to keep your teeth healthy:
Keeping your teeth and gums healthy requires good nutrition and regular brushing and flossing.
Brush your teeth twice a day-in the morning and before bed, and floss once a day. This removes plaque, which can lead to damaged teeth, gums, and surrounding bone. Use a toothpaste that contains fluoride, which helps prevent tooth decay and cavities. Ask your dentist if you need a mouthwash that contains fluoride or one with ingredients that fight plaque. Look for toothpastes that have been approved by the American Dental Association. Avoid foods that contain a lot of sugar. Sugar helps plaque grow. Avoid using tobacco products, which can cause gum disease and oral cancer. Exposure to tobacco smoke (secondhand smoke) also may cause gum disease as well as other health problems. Practice tongue cleaning. You can use a tongue cleaner or a soft-bristle toothbrush, stroking in a back-to-front direction. Tongue cleaning is particularly important for people who smoke or whose tongues are coated or deeply grooved. Schedule regular trips to the dentist based on how often you need exams and cleaning.
Proper Teeth Brushing
Brushing your teeth is an important part of your dental care routine. For a healthy mouth and smile it is recommended to:
- Brush your teeth twice a day with a soft-bristled brush.
- The size and shape of your brush should fit, allowing you to reach all areas easily.
- Replace your toothbrush every three or four months, or sooner if the bristles are frayed.
- A worn toothbrush won’t do a good job of cleaning your teeth.
The proper brushing technique is to:
- Place your toothbrush at a 45-degree angle to the gums.
- Gently move the brush back and forth in short (tooth-wide) strokes.
- Brush the outer surfaces, the inner surfaces, and the chewing surfaces of the teeth.
- To clean the inside surfaces of the front teeth, tilt the brush vertically and make several up-and-down strokes.
Dental Care During Pregnancy
It's important for you to take good care of your teeth and gums while pregnant. Pregnancy causes hormonal changes that increase the risk of developing gum disease which, in turn, can affect the health of your developing baby.
Try to make a dental appointment before getting pregnant. That way, your teeth can be professionally cleaned, gum tissue can be carefully examined, and any oral health problems can be treated in advance of your pregnancy.
Tell your dentist (and doctor) if you are pregnant. Routine dental care can be done any time during pregnancy. Any urgent procedure can be done, as well. All elective dental procedures, however, should be postponed until after the delivery. Before you have your dental appointment, check with your obstetrician to see if she has any special precautions/instructions for you.
Tell your dentist the names and dosages of all drugs you are taking – including medications and prenatal vitamins prescribed by your doctor – as well as any specific medical advice your doctor has given you. Your dentist may need to alter your dental treatment plan based on this information.
Dental X-rays can be done during pregnancy. Your dentist will use extreme caution to safeguard you and your baby, such as shielding your abdomen and thyroid. Advances in technology have made X-rays much safer today than in past decades.
Don't skip your dental checkup appointment simply because you are pregnant. Now more than any other time, regular periodontal (gum) exams are very important, because pregnancy causes hormonal changes that put you at increased risk for periodontal disease and for tender gums that bleed easily – a condition called pregnancy gingivitis.
Pay particular attention to any changes in your gums during pregnancy. If tenderness, bleeding or gum swelling occurs at any time during your pregnancy, talk with your dentist or periodontist as soon as possible.
Follow good oral hygiene practices to prevent and/or reduce oral health problems.
Sinus Lift
A sinus lift is surgery that adds bone to your upper jaw in the area of your molars and premolars. It's sometimes called a sinus augmentation. The bone is added between your jaw and the maxillary sinuses, which are on either side of your nose. To make room for the bone, the sinus membrane has to be moved upward, or "lifted." A sinus lift usually is done by a specialist. This could be either an oral and maxillofacial surgeon or a periodontist.
A sinus lift is done when there is not enough bone height in the upper jaw, or the sinuses are too close to the jaw, for dental implants to be placed. There are several reasons for this:
- Many people who have lost teeth in their upper jaw, particularly the back teeth, or molars, do not have enough bone for implants to be placed. Because of the anatomy of the skull, the back of the upper jaw has less bone than the lower jaw.
- Bone may have been lost because of periodontal (gum) disease.
- Tooth loss may have led to a loss of bone as well. Once teeth are gone, bone begins to be resorbed (absorbed back into the body). If teeth have been missing for a long time, there often is not enough bone left to place implants.
- The maxillary sinus may be too close to the upper jaw for implants to be placed. The shape and the size of this sinus varies from person to person. The sinus also can get larger as you age.
The bone used in a sinus lift may come from your own body (autogenous bone), from a cadaver (allogeneic bone) or from cow bone (xenograft). If your own bone will be used in the sinus lift, it will be taken from other areas of your mouth or body. In some cases, the surgeon removes bone from your hip or tibia (the bone beneath the knee). You will need X-rays taken before your sinus lift so the dentist can study the anatomy of your jaw and sinus. You also may need a special type of computed tomography (CT) scan. This scan will allow the dentist to accurately measure the height and width of your existing bone and to evaluate the health of your sinus.
Bone Grafting
For classic/regular dental implants to be successful, the jawbone must have enough bone to support them. Tooth loss often leads to more loss of bone over time.
If the bone under your gum is not tall enough, not wide enough or both, you will need a procedure to add bone to your jaw before implants can be placed.
Bone grafting, or bone augmentation is a term that describes a variety of procedures used to "build" bone so that dental implants can be placed. These procedures typically involve grafting (adding) bone or bone-like materials to the jaw. The graft can be your own bone or be processed bone (off the shelf) obtained from a cadaver. After grafting, you have to wait several months for the grafted material to fuse with the existing bone. "Off–the-shelf" grafted materials either cause surrounding bone to grow into the graft or cause cells around the graft to change into bone. A graft from your own bone transplants bone cells or a block of bone that fuses to the jaw.
Several different procedures can be used for bone augmentation. Your dentist will select one depending on the type, location and number of implants to be used. If you need a bone graft, it is important that you and your dentist discuss all of the options available to you. After bone augmentation, dentists usually wait four to nine months before placing implants.
Most bone augmentation procedures involve the use of bone grafts. An excellent choice for a bone graft is your own bone. This most likely will come from your chin or ramus (the back part of your lower jaw). If your dentist cannot get enough bone from these areas, he or she may need to get bone from your hip or shin bone (tibia) instead. The hip is considered to be a better source because the hip bone can provide a large amount of bone. The marrow from either the hip or shin (tibia) contains bone-forming cells. However bone taken from your hip requires a hospital stay and general anesthesia.
If you don't like the idea of having bone removed from your body to be placed in your jaw, other excellent options are available. Your dentist can use materials made from the bone of human cadavers or cows. Synthetic materials also can be used for bone grafting. Newer products, such as bone morphogenetic protein-2 (BMP-2), also are available. BMP-2 stimulates certain body cells to turn into bone, without grafting. This protein occurs naturally in the body. The dental material is produced using DNA technology. You should discuss your options and their risks and benefits with your dentist before any procedures are done.