Thursday, September 05, 2013 1:12:08 AM
Dental Implant Procedure – All-on-4
All four titanium implants are placed so that the bone will grow around and secure them in place. With only four implants, there is much less invasive and lengthy surgery.
Once the implants are in place, we will attach the abutments which the new replacement teeth will be secured.
The Restorative Dentist fits the replacement teeth on the abutments and adjusts the bite for comfort and a beautiful smile.
The All-on-4 Dental Implant Procedure uses four implants, with the back implants angulated to take maximum advantage of existing bone. Special implants also were developed that could support the immediate fitting of replacement teeth. This treatment is attractive to those with dentures or in need of full upper and/or lower restorations. With the All-on-4 Procedure, qualified patients receive just four implants and a full set of new replacement teeth in just one appointment—without bone grafts! The real appeal is how quickly permanent implants can be placed so that patients can leave the same day with fixed, non-removable replacement teeth.
Traditional approaches to restoring a full arch of teeth usually involved bone grafts, six or more implants, and as many as 18 months of treatment. That meant that a patient often would be without any teeth, or with ill-fitting temporary dentures for more than a year. Dr. Koyfman will always make sure that ALL patients leave with teeth!
With the All-on-4 Dental Implant Procedure, the patient has one or two visits to the office to allow Dr. Koyfman gather information for a treatment plan. Then the patient will return to their restorative dentist to have the teeth fabricated prior to surgery. Following this consultation, the patient is scheduled for surgery implantation and the new teeth are fitted and adjusted, all in one appointment (even when extractions are necessary). The patient comes to the office in the morning with unhealthy (or no) teeth, and leaves in the afternoon with a beautiful set of fixed, functional teeth.
The patient will return for occasional check-ups over the next several weeks and months. After almost six months, when the gums have fully healed and the implants are fused to the natural bone, your restorative dentist will take new impressions of the patient’s mouth and prepare a final, stronger, permanent set of teeth adjusted to a perfect fit.This helps ensure that the teeth will last for decades, and provide maximum support, beauty, and function to the patient.
Frequently asked questions section
How is the All-on-4 different from a denture?
The All-on-4 Procedure provides patients with new teeth that are firmly fixed in place, and look and function as close to natural teeth as possible.
A denture or partial denture is a removable appliance, and should be taken out every night for cleaning. Additionally, since a denture is not fixed in place, it will often slip or sometimes fall out, under even normal use. For this reason, a multi-billion dollar market for denture adhesives has developed, to try to hold dentures in place. Even with adhesives, many people find that eating, laughing, being active, and sometimes just talking can be a challenge with dentures.
All-on-4 provides the patient with a set of teeth that are connected to the implants, and are solidly fixed in place (what we call an implant-supported fixed bridge). They may only be removed by the dentist, are bushed and cleaned like normal teeth (though flossing is different), and are the closest thing possible to natural teeth in terms of look, feel and function.
The All-on-4 bridge also allows the patient to bite with much more force than dentures, since the stresses are transferred directly to the bone rather than to gum tissue as with dentures. This means that patients can eat almost any of their favorite foods without worrying about their teeth.
Will my implant supported teeth be uncomfortable and push on my gum tissue like a partial or a full denture does?
Absolutely not! And this is the best part of dental implant treatment vs. conventional removable dentures. Not only will your implant supported teeth be fixed in place, without slipping, lifting, rocking or needing to be removed for cleaning, but since your teeth are supported by the implants, they do not push down on the gum tissue and therefore do not create any of the discomfort common with dentures. In addition, since this pressure is eliminated, you also will not experience the destructive dissolving of the bone from underneath the denture. The implants will actually save your jawbone from dissolving away from under a non-implant supported denture.
What about the line between the new fixed bridge and my jaw bone? Can people see it?
This line will be hidden behind your lips so that when you smile it cannot be seen. During your initial examination I will evaluate your smile to determine where the junction of the fixed bridge and the jaw bone will be. During the procedure, I will actually adjust your “smile line” to ensure that your new smile is not too “gummy” and that the top (or bottom) of your bridge is completely hidden.
My friend had a full-arch procedure done at another dentist using 8 implants. Why does the All-on-4 Procedure with Dr. Koyfman use only 4 implants?
Research done shows that in most cases, 4 implants, specially placed with some angulated, are just as effective in supporting a full arch fixed bridge in either jaw as a 6, or 8 implant restorations. On rare occasions where bone is soft or severely worn down, additional implants may be needed, but these situations are the exception and usually only occur in the upper jaw.
My friend’s procedure involved bone grafting to “build up” the bone before the implants were placed. Does the All-on-4 Procedure involve bone grafting?
In most cases, even the most difficult ones, Dr. Koyfman is able to place only 4 implants and restore a full arch of teeth without the need for additional bone grafting. This is accomplished by the special placement and the angulation of the implants, taking maximum advantage of your available bone, without the need for additional grafting.
What is the success rate of the All-on-4 Procedure?
Published studies indicate a 98.2% implant success rate when using the All-on-4 technique in the lower jaw. Similar studies show a 97 to 98% success in the upper jaw for the same procedure.
Occasionally, an implant will fail. If this happens, I simply place a new implant in a slightly different position to take advantage of existing bone, and the fixed bridge is adjusted to align with the new implant.
What type of follow-up visits are necessary?
For the all-on-four procedure, the implants are placed the day of surgery and follow-up checks are done at one week, two weeks, two months and four months. At the end of the four month period, fabrication of the permanent teeth begins, and requires one or two additional visits over the next few months until the final teeth are delivered.
What will my diet be like after the All-on-4 Procedure? When can I eat solid food again?
Solid foods can be eaten by a patient that has undergone the All-on-4 Procedure that same day. However I need to define what is meant by solid foods. I am talking about a modified food diet, defined as foods that are soft enough to be cut with a fork. Examples of the modified food diet are scrambled eggs, meatloaf, mash potatoes, hamburger, fish & pasta.Please do not eat foods that require any tearing or biting with your front teeth i.e.: Pizza, sandwiches, and bagels. Also, avoid hard foods such as carrots, chips, apples, nuts and absolutely no gum chewing!
This modified diet is to be maintained until you receive your permanent prosthesis, usually about six months. Once your final bridges are made with the titanium frame as reinforcement you can resume a normal diet.
Why do I have to wear a provisional set of teeth and not my permanent new teeth right away?
On the day of your procedure Dr. Koyfman will place the implants and a new set of teeth called a “long-term provisional” prosthesis. This provisional set of teeth is fixed in place, is fully functional, and provides you with a beautiful smile. You will laugh, talk, play sports, and be normally active, without having to worry about your teeth.
This provisional set of teeth is made entirely of acrylic resin, which places less stress on your new implants during their first few months of use. We will ask you to be selective in the foods you eat the first few weeks following your procedure, but you will soon be back to a normal diet (without hard, tough, or brittle foods for a while longer).
Once your gum tissues have healed and the implants have become completely stable (usually about six months) your restorative dentist will fabricate a permanent bridge with acrylic or porcelain teeth, but this time with a titanium framework inside for strength. Think of the titanium as a reinforcement bar to give your teeth extra support and long-term strength. This permanent set of teeth is carefully adapted to your healed gum tissues and is adjusted to be sure we achieve an ideal fit in your mouth and that your bite and smile are perfect.
If I need both upper and lower full-arch replacements, do they both have to be done at the same time?
In many cases, where the patient has several broken or missing teeth or has an uneven bite, it is best to do both arches at the same time to avoid compromising the final result. This allows me to control the patient’s biting plane and bite. This way your “new” teeth will not be made to fit together with your existing teeth which may be severely crooked, uneven or have large spaces between them.
In some cases, treatment can be sequenced to meet the financial, health, or other individual needs of the patient.
Are some people not a candidate for the All-on-4 Procedure?
Very few people who need a full arch of replacement teeth are not candidates for the All-on-4 Procedure. However, each candidate is fully evaluated to determine the most appropriate plan of treatment to address their individual dental needs.
Importantly, Dr. Strout requires all candidates to be stable medically before entering treatment. That may entail contacting your physician about any existing medical conditions, and getting your doctor to provide medical clearance.
In some cases, the All-on-4 Procedure is not the indicated treatment approach. Based upon dental condition, some people are better off being treated with conventional dental procedures done by other dental practitioners. Dr. Strout and your restorative dentist will initially determine the appropriate treatment approach.
Posted by koyfmandental | 9/4/2013 6:12:08 PM
Wednesday, September 04, 2013 11:08:59 PM
Are you a candidate for sedation dentistry?
No one really likes going to the dentist, but many people are so fearful of dentists and dental procedures that they delay or avoid having necessary dental work done. The consequence of this range from cosmetic to serious overall health issues, because your teeth and gums can affect your entire body. An estimated 75 percent of American adults experience some degree of dental fear.
If you answer yes to one or more of the following questions, you may be a candidate for sedation dentistry.
- Do you have a fear of dental treatment or suffer from dental anxiety?
- Do you have a history of traumatic dental experiences?
- Are you embarrassed about your teeth but have avoided going to the dentist due to fear?
- Do you have complex dental problems or require dental surgery?
- Is it difficult for your mouth and gums to get completely numb for a dental procedure?
- Have you gone years or even decades without receiving professional dental care?
- Do you have a very sensitive gag reflex?
- Do you have difficulty opening your mouth?
- Have you denied you have dental problems until the pain becomes unbearable?
- Do you have extremely sensitive teeth?
- Do you make then cancel dental appointments?
Another group of people who may be candidates for sedation dentistry are those who have difficulty controlling their movements due to conditions such as cerebral palsy or Parkinson’s disease. Properly administered sedation can help these patients relax so that their involuntary movements do not impede dental work.
Tell your dentist about any medical conditions you may have, medications you are taking, and allergies to medications prior to a sedation dentistry procedure. Though sedation dentistry is usually reserved for patients who are 18 and older, there are pediatric sedation dentists who can treat children when circumstances are appropriate.
Posted by koyfmandental | 9/4/2013 4:08:59 PM
Thursday, August 15, 2013 8:10:35 PM
August 14, 2013 — Ongoing advances in tissue engineering are pushing the boundaries of what scientists can regenerate. Most recently, the development of tooth-like structures from stem cells in human urine has garnered international attention from lay and professional audiences alike (Cell Regeneration, July 30, 2013).
For the study, researchers from China utilized human induced pluripotent stem cells (iPSCs) for the first time in solid tissue or organ regeneration. More specifically, they used a form of stem cells derived from cells in the urine, called integration-free human urine induced pluripotent stem cells (ifhU-iPSCs).
This method is in contrast to isolation of various tooth stem cells such as dental pulp stem cells or gum stem cells for use in regenerating teeth. A major drawback of using isolated dental stem cells is “the absence of consistent sources of epithelial stem cells with odontogenic potential in the adult human individual,” the researchers noted.
This being said, epithelial substitutes from self-generating iPSCs seem to offer an improved solution to the problem. However, the question of “Why urine?” still seems to persist through mainstream media outlets. According to lead study author Jinglei Cai, from the Guangzhou Institute of Biomedicine and Health, the motivation behind using body waste was simple: “Urine is easy to collect,” Jinglei stated in an email to DrBicuspid.com. In addition, it also “would not cause any troubles for generation of patient-specific iPSCs, which is the first step of therapy using iPS techniques.” Thus, the ability to derive iPSCs directly from the patient appears to be an efficient avenue to avoid immunological complications.
Cai and her co-authors first obtained dental epithelia from ifhU-iPSCs using retinoic acid and bone morphogenic protein 4 in a medium. The resultant cells were passaged at 1:3 and grown in keratinocyte serum-free medium to become strong, flexible epithelial sheets at day 7 of growth. These sheets were recombined with mouse dental mesenchyme prior to being transplanted into the subrenal capsules of mice. Following three weeks of growth, tooth-like structures could be observed in the kidneys. After removing these structures from the fibrous cysts and surrounding bone, enamel, enamel space, dentin, and dental pulp could all be recognized, the researchers reported.
When asked how this technology might be applied in future dental clinics, Jinglei noted that several steps would need to be taken to achieve a more complete human tooth. First, mouse cells would need to be replaced with human cells using this model. Next, the tooth size and shape would need to be adjusted to proper proportions. After a complete oral cavity model for transplantation can be achieved, preclinical experiments could commence.
The need for craniofacial regenerative therapies is becoming crucial. According to the Centers for Disease Control and Prevention, by 2030 some 30 million people in the U.S. will be edentulous. What if we could somehow harness the regenerative powers of fish and reptiles to stimulate our adult teeth to regrow indefinitely?
The idea may not be too far-fetched. Earlier this year, an international team of researchers described the tooth renewal system of American alligators (Proceedings of the National Academy of Sciences, May 13, 2013). Alligator and human teeth are both well-organized; however, an alligator’s tooth has a lifelong system for renewal, while humans regenerate their teeth only once, the researchers noted. They concluded that it might be possible to pinpoint the regulatory network for tooth cycling. In adults who have lost teeth, we could stimulate latent stem cells in human dental lamina to re-establish a normal renewal process. In a patient with supernumerary teeth, we might also be able to terminate the spawning of an uncontrolled tooth.
Undoubtedly, additional robust research studies and improved grant allocations for labs are essential for a bright future in clinical stem cell-based therapies.
Posted by koyfmandental | 8/15/2013 1:10:35 PM
Tuesday, August 13, 2013 8:31:19 PM
Those who don’t brush their teeth regularly may be putting themselves at greater risk of contracting pneumonia.
Samit Joshi, a postdoctoral fellow in infectious diseases at the Yale University School of Medicine, presented a study at the Infectious Diseases Society of America’s annual meeting in Boston, claiming that changes in the types of oral bacteria can have a significant impact on the risk of developing pneumonia. Joshi cited poor oral hygiene as one of the most common risk factors for pneumonia, with the risk doubling if a person has severe gum problems.
The study analyzed the oral health of 37 subjects, from a variety of age and health backgrounds, over the period of one month. Though only a small percentage of the patients developed pneumonia, those who did acquire the disease also saw significant increases in the number of oral bacteria associated with pneumonia.
“Our findings might improve the way we prevent pneumonia in the future by maintaining [the types of] the bacteria which live within our mouths,” Joshi said in an interview with the Global Medical News Network (GMNN).
While the study was not designed to demonstrate the direct relationship between pneumonia and these bacteria, Joshi told the GMNN that he hopes his experiment will be replicated by larger independent studies to determine a causal link.
Upon hearing the findings of the study, the British Dental Health Foundation, an oral health charity, issued a press release stating that poor oral hygiene may lead to the development of pneumonia.
“During the winter months we’re all susceptible to colds, coughs and chesty viruses due to the drop in temperature,” Nigel Carter, the foundation’s chief executive, said in an interview in The Telegraph. “What people must remember, particularly those highlighted as vulnerable, is that prevention can be very basic.”
Carter added that links between gum disease and overall health have been well-documented, and that keeping up good oral health can help stave off illness.
Sheldon Campbell, a professor of microbiology at the Yale School of Medicine who was not affiliated with the study, said that while he was not surprised by Joshi’s findings, they are significant because they place an even greater emphasis on oral hygiene. While there are many variables that might affect the development of a disease, poor oral hygiene will likely negatively affect patients, Campbell said.
“Most of the bacterial organisms that cause infections are neighbors of the oral floor,” he said. “There are too many variables to accurately say, but it’s likely that oral microbodies probably impact the development of certain diseases.”
Approximately 3 million Americans are infected with pneumonia annually.
Posted by koyfmandental | 8/13/2013 1:31:19 PM
Monday, August 12, 2013 8:27:38 PM
Four Reasons to Get All on 4 Dental Implants
Every day, many people are struggling with the discomfort and difficulty that comes with lower dentures. Why? Most people are told that dentures are the only solution for their problem so they end up going through their lives feeling stuck dealing with this aged technology. Well, that’s just not true. Here are four reasons to stop struggling with dentures and start living comfortably with All on 4 Dental Implants.
- You can finally eat all those foods you’ve been struggling to eat with dentures. Eating foods like corn on the cob or apples is made hard with dentures. As you eat certain foods, the dentures tend to shift around and can even pop out. With the All on 4 implants, your teeth will sit securely just as your own natural teeth.
- The procedure takes just one day. Yes. One day. Unlike other implant procedures that can take up to 12 or 18 months, the All on 4 procedure takes just four hours to put a bridge over four implants and is completed in just one day.
- There is no expensive bone-grafting necessary. The All on 4 treatment uses angled implants to avoid bone-grafting by using whatever bone is available.
- There is normally no cost to you. Most dental insurance plans cover the All on 4 treatment which means no cost to you!
If you have been struggling with uncomfortable dentures, you don’t have to feel stuck with them any longer. KoyfmanDental can provide you with the comfort and security of the All on 4 dental implants in just one day. Call us today to set up your consultation.
Posted by koyfmandental | 8/12/2013 1:27:38 PM
Thursday, June 20, 2013 2:59:20 AM
Quite often, I see patients who suffer from teeth grinding, otherwise known as bruxism. While most people experience mild cases of teeth grinding – which typically includes jaw clenching –in other cases, bruxism during sleep can be serious and may cause other health issues.
Why can’t I sleep through the night? What can I do about it?
Studies have shown that teeth grinding is a major indicator for obstructive sleep apnea (a chronic condition that disrupts your sleep) – and your dentist can help you uncover it. According to a recent article on CNN Health:
The simple dental health screening that can improve the quality of your sleep and — because almost everything boils down to a good night’s sleep — even save your life, begins with asking your dentist, “Do I grind my teeth?”
Whether patients are stressed due to financial hardships, personal or job-related pressures, a trip to the dentist for a screening may help detect reasons they have trouble sleeping through the night. Do you have earaches, sensitive teeth, jaw soreness or constant headaches? Don’t forget to mention these symptoms during your next dental visit so that your dentist can examine your jaw for signs such as flattened teeth. In severe cases, teeth grinding may loosen or fracture the teeth, sometimes resulting in tooth loss or hearing loss.
If I am grinding my teeth, what can be done about it?
Your dentist can fit you with a mouth guard to wear while you sleep, to protect your teeth from the grinding motion of your jaws. A dental visit might also be a good opportunity to find out how to reduce stress and get tips to help stop teeth grinding, such as relaxing before going to bed, and cutting back on drinks that contain caffeine.
If you think you have symptoms of teeth grinding, I encourage you to ask your dentist about it on your next visit!
Posted by koyfmandental | 6/19/2013 7:59:20 PM
Thursday, May 16, 2013 10:42:41 PM
Bad breath is medically known by a variety of names such as Halitosis or fetor orid all of which imply the same. Bad breath affects a large number of people over the world. There are various causes of bad breath. Approximately, 90% of the causes originate from the oral cavity; while very few are from extra-oral sources.
The seven most common causes of bad breath are:
1. Accumulation of Food Debris:
It is the most common cause for bad breath which is mainly due to collection of food particles/debris on or between the teeth or even on surface of the tongue. This occurs mostly in people who do not maintain good oral hygiene. The accumulated food particles act as food for bacteria which results in bacterial respiratory products which are responsible for the characteristic rotten egg smell.
2. Tooth Decay: Tooth decay can be responsible for bad breath in some cases. Tooth decay, medically known as dental caries causes putrefactive action of bacteria on the teeth which leads to demineralization of the tooth and bad breath.
3. Dryness of mouth (Xerostomia): Dryness of mouth may sound harmless, but it is one of the most common causes of bacterial. Saliva inhibits growth of bacteria in the oral cavity. Reduction in salivary secretion favors bacterial accumulation and growth leading to bad breath.
4. Gum Diseases: Periodontal diseases are often accompanied by bad breath.
5. Smoking: Smoking, apart from its innumerable harmful affects also contributes to bad breath which is due to accumulation of nicotine, tar and other odor producing substances in the mouth. Bad breath due to smoking is typically known as smoker’s breath.
6. Severe Dieting: Starvation resulting from excessive dieting can cause a condition known as ketoacidosis which can cause bad breath.
7. Extra-oral sources: In very few cases, the cause of bad breath does not lie in the oral cavity. Some examples of these conditions are infections of respiratory tract, diabetes, kidney dysfunction, gastric reflux.
Another important aspect of bad breath that needs to be mentioned is delusional halitosis. Delusional halitosis is people who do not actually have bad breath but, they think they do. This affects about 25% of people who seek professional treatment for bad breath.
Read more: http://www.sanedentist.com/bad-breath.html#ixzz2TTEkf58v
Posted by koyfmandental | 5/16/2013 3:42:41 PM
Tuesday, May 14, 2013 8:46:12 PM
Dentists are frequently asked questions about chipping a tooth—“Is it that big a deal? Doesn’t it depend on how big the chip is? I mean if it is just a little chip, it can’t be that bad…can it?” The answers to these questions are variations of the same theme. Yes, chipping a tooth means you have lost valuable tooth structure and potentially laid the foundation for additional chips and cracks. Or you may need a root canal if the chip is close to the pulp containing the nerve and it doesn’t heal properly from the trauma.
As for repairing a chipped tooth, your dentist can usually fix minor chips with modern bonding techniques using tooth-colored filling materials. For larger chips that involve more tooth structure, your dentist may suggest a crown (cap) or a veneer. The most important thing to remember is that if you chip a tooth, you need to see a dental professional for a proper evaluation and treatment remedy.
Posted by koyfmandental | 5/14/2013 1:46:12 PM
Tuesday, May 14, 2013 8:35:39 PM
As a parent or caregiver, you want to do whatever is necessary to protect your children. And when it comes to your child’s oral and dental health, you should feel no different. One technique for protecting teeth from tooth decay is through the use of sealants. By allowing your dental professional to seal your children’s teeth—the little nooks and crannies where the toothbrush can’t reach—with pit and fissure sealants, you may dramatically reduce the development of tooth decay thus saving you money and future dental visits. Of course your child’s oral hygiene, regular dental visits, fluoride, and sugar consumption are important factors too when promoting good oral health.
Posted by koyfmandental | 5/14/2013 1:35:39 PM
Wednesday, February 27, 2013 11:11:51 PM
Posted by koyfmandental | 2/27/2013 3:11:51 PM