Implant Restoration

The Dental Implant

The procedure is technically known as an endosseous implant.

The implant behaves like an artificial root on top of which a new artificial porcelain tooth can later be screwed in or cemented.

The implant is serted surgically in the existing jawbone and can remain in place for years.
The procedure to place the implant is a minor, two-step surgical process.

While some people express concern at undergoing minor surgery, the procedure is actually less invasive than having a tooth removed.

There is another significant, therapeutic benefit to implants: They prevent further bone loss and help maintain ridge form.

Mini Implants

Here are the recent patient questions on dental implants:
Q = Question ; A = Answer

Q: What are my options for implants?
A: The cheapest and uncomfortable would be denture.

Q: How long do dental implants last?
A: As to the longevity of dental implants, honestly at the present time we cannot answer this question.

Q: How much does mini implant cost?
A: About $2500.

Q: Can i use my medisave to pay for it?
A: No. Unless you go for conventional implant.

Q: What is the dental implants procedure?
A: The first step in the decision for dental implants is to make an appointment with a qualified dentist for an evaluation. Dentist will examine your mouth and teeth and take a thorough medical and dental history. X-ray will be taken on the consultation day which will give the dentist a good idea of your bone density and the shape of your jaw. Dental implants is a process generally performed in the office with local anesthesia or light sedation to help make the patient more comfortable. Using precise, gentle surgical techniques, the implants are placed into the jawbone for 3 to 6 months while osseointegration takes place. This helps ensure a strong, solid foundation for replacement teeth. During this time, temporary bridges or dentures may be used to minimize any cosmetic or chewing inconvenience.

Q: Can i choose the type of anesthesia for dental implant surgery?
A: There's MUST on local anesthesia. But if you're require for general anesthesia, we will provide it for you too.

Q: Am i going to hospitalization?
A: Not necessary.

Q: What is the long-term success rate?
A: The simply answer to the long-term success rate of dental implants are that dental implants can fail, but fortunately very infrequently. Failure rates vary depending on the site in the mouth, whether they are placed into natural or grafted bone and whether the patient smokes. The overall success rates in natural bone is 95%, though this falls to between 85 and 90% in grafted bone. If a patient smokes it has been shown that they are statistically two and a half times more likely to have an implant fail than a non-smoker.


In order to better understand how mini implants work, it will be helpful to read about the history and current status of standard dental implants.

http://www.osseonews.com/standard-implants-vs-mini-implants-for-lower-overdenture/

Immediate & Conservative

Immediate implant placement after extractions has numerous advantages.

1. Implant placed immediately after extraction, so no extra surgery for the patient.
2. Bone and soft tissue preservation.
3. Option to do conservative flapless surgery.
4. Faster healing.

Biggest disadvantage:
Outcome highly dependent on skill of the surgeon. It is very difficult to drill into an extraction socket and place the implant in an ideal position.

This technique is also not suitable for teeth which show signs of chronic infection (cysts etc).

The middle aged female patient had a fractured post crown, upper left central incisor. A Flexite immediate denture was prepared for her on the day of the extraction.

Flexite denture on the cast.

Another view of the Flexite denture.

The crown was separated from the root.

We then extracted the root. It was difficult as we had to make sure that no bone was lost or damaged during the extraction.

The socket had excellent bone walls on all sides.
No chronic infection.
Conditions for immediate implant placement were fulfilled.

Dr Chan placing an Osstem GSII 4.5x10mm implant.

Good primary stability meant that we could place a healing abutment on top of the implant.

It's a bit closer to the lateral than the central, but the xray shows that the position was acceptable.

The temporary Flexite denture was tried in the mouth.
Note that no scalpels were used for this surgery.
We expect minimal pain, swelling and faster healing.

The implant should be ready for loading in 2-3 months.
Both bone and soft tissue should be well preserved for an aesthetic outcome.

Crouching Tiger Hidden Dragon @ New Age

A young and attractive childcare teacher cum part-time model turned up at our clinic with an interesting problem.

Her main complaint was tilted right incisor. She could not put on braces as it would affect her modelling assignments.

Apart from a tilted incisor on the right side, she also has a retained baby tooth in the canine position.

The tilted tooth affects her smile very significant.

An xray solves the mystery. The patient's permanent canine decided to lodge itself in the upper jaw bone directly above the right incisor. The "hidden dragon" pushed the root of the incisor backwards (palatally), tilting the crown of the same tooth forward (labially).

For those who are not familiar with xrays, we'ce traced the buried canine out for you.

The "hidden dragon" was surgically removed and the defect was filled with bone graft. The patient was pain free from the second day after surgery. We proceeded to do a root canal on the tilted tooth.

Here's the tooth with fibre post and composite core built up.

Shade matching was a challenge. We didn't want to follow the colour of her other teeth too closely as she may want to do something about the unsightly spots soon. She may also wish to extract her baby tooth and replace it with an implant.

And here is the temporary crown.

Stay tuned to see our emax crown when it's ready.

If You Have The Gummy Smile...

What is gummy smile?

A smile is considered a 'gummy smile' if a significant amount of gums can be seens as a person smiles. Below

The gummy smile (1)

The gummy smile (2)

The gummy smile (3)

I personally think that a person's appearance, 70% is depending on the smile. Or you might say that if she/he looks ugly or so so... i would say that people's are rely on make-up or garment dressed. In this world, no one is ugly. Everyone has a good looking.

Correcting gummy smile can be accomplished by one oof two possible simple surgical procedures. The first procedure is called a gingivetomy. Gingivectomies are performed when the amount of gum reduction necessary is minimal such as in mild gummy smiles. During a gingivetomy, a minimal of gum tissue is removed. The procedure is painless, requires no sutures, and the gum tissues usually heal within two weeks.

More advanced gummy smiles require more extensive tissue reduction. This is performed by a procedure known as crown lengthening. During this painless procedure, the gum tissues are contoured around each individual tooth. The tissue is lifted off the bone and placed in a desired new position. The tissues are sutured into place and allowed to heal for 7 - 10 days. After initial healing, the sutures are removed. The newly repositioned gums are allowed to heal for an additional 5 - 7 weeks before any final restorations can be placed. Following a crown lengthening procedure, further treatment with either porcelain veneers or porcelain crowns will be required to achieve a beautiful new smile. These final restorations can be completed in just two visits.

More Emax

This middle aged lady had a couple of discoloured and root canal treated front teeth. She wanted the aesthetics to be improved.

2 discoloured teeth.
Alignment is also slightly off.

Emax crowns tried in the mouth.

Colour and alignment have been corrected.

Emax crowns cemented.

Time to do scaling and a new denture for her back teeth.

Out With The Old In With The New

This middle aged lady has an obvious problem. Her 2 old crowns have come loose and her dentist failed to replace them in their original positions - which is understandable because they have detriorated so much.

We advised her to redo her PFM crowns with emax. After seeing what we have done for her daughter, she agreed.
The 2 old PFM crowns have deteriorated so much, it was impossible to seat them proper after they were dislodged.
Notice the gap between the crowns as well.

Her original crowns were also protruding. She didn't have a choice of a better system back then.

Definitely warrants a redo.

We removed her old PFMs, masked the underlying colour
Impressions were taken.
The stumps were temporarily covered with temporary crown material.
Emax crowns.

A veneer on the lateral incisor would be perfect