INTRODUCTION TO WORLD OF IMPLANT DENTISTRY (Reading this is very important if you are considering implant therapy as one of your options. Dr.Bonnick visited the facility in Germany on February 16-20, 2008 to observe the actual production of implants and can assure you there is no lead in these implants. He was part of a VIP contingency from North America invited to see the latest in research at the University in Frankfurt and in Bonn.)

In 1917 a general dentist by the name of Bob Greenfield from Wichita Kansas obtained the first patent for a tooth replacement system in the USA. Between that time and the mid 1980's dentists who placed implants were considered to be practising with a very unpredictable mode of therapy, and majority of these specialty dentistry programs did not sanction the use of implants.

The tide turned when a physician from Sweden studying bone repair happened to notice that the bone cells liked to grow around titanium. For twenty years they researched on their population and came of with protocols for what they called "osseointegration." These findings were presented at a North American Conference and the companies started to sell the system to hospitals as most of their protocols were hospital driven. The hospitals used the protocols and started to train oral surgeons to place implants, and Periodontists (treat diseases of the gum and associated support tissues) and Prosthodontists (replacement specialists for missing facial structures) started incorporating implant training into their dental programs. A US dentist by the name of Geral Niznick decided to patent his own system of titanium implants and started to sell them to and train general dentists to place them. In recent times Endodontists (root canal specialists), and Orthodontists ( braces and other devices to straighten teeth) have started adopting implant placement into their general protocols.

I was fortunate enough to work with the surgical team that first started using implants from Sweden and spent some time with the team at Long Island Jewish Medical Center as the voluntarily treated injured patients from the freedom fighters in Afghanistan as they fought against the Russians in 1987.

There a certain advantages for a patient who need implant therapy as well as cosmetic rehabilitation, root canal and bridges as well as dentures in going to an office that can provide all those services during the same appointment when it is feasable. In our office we "start with the end in mind." We design the anticipated smile results and instead of just giving a patient some implants, we place the implants in the best position to facilitate the end result. We have a great relationship with our dental specialists and often utilize them when we have advanced periodontal disease or if patient has lost so much bone that they require procedures like a "hip graft." The American Dental Association has voted against having "Implantology" as a specialty so far, but it is agreed that placement of implants requires specialized training. (See About Dr. Bonnick)

As the general population becomes more educated about the benefits of having dental implants, the demand will exceed the dental community's ability to fill that need. People realize that loss of teeth will eventually lead to loss of bone in the jaw that not only affects the looks of a patient but severely limits their ability to process nutritional food. To help offset the problem our office is not only dedicated to providing dental implants to patients, we are dedicated to help educate our colleagues in implant dentistry. We continually update our education with staying current with the literature as well as staying abreast by maintaining our credentials with the American Academy of Implant Dentistry.

 

 

 WHAT ARE COMBINATION CASES?

Our office prides itself in our ability to take care of multiple problems in a reasonable period of time with or without sedation. Over the last few months we had several cases that involved sinus surgery. With our current technologies we are able to assess the amount of bone that exists in the upper jaw before we encounter the membrane of the sinus. The sinus membrane is very forgiving and can repair itself in six weeks. If there is enough bone 7mm or more we can use blunt instruments to lift up the membrane like a blanket and insert bone grafting before placing the implant. If the amount of bone left is 7mm or less I may elect a two stage technique.

In the two stage technique bone is grafted below the sinus, by displacing the membrane upward through a small hole made in the side of the bone. The membrane is then protected by a collagen liner and bone graft is packed leading to a new bone growth of 10-20mm. 6 months later implants from 10-15mm are placed and allowed to integrate as the grafted bone continues to mature. After integration of the implants an implant supported teeth are placed. The patient does not go without teeth because they wear transitional prosthesis while they wait on the body to heal.

In our office we use several systems of implants depending on the results we are trying to achieve. Sometimes we have to do extractions, bone grafts, root canals, fillings, gum treatments, place implants, or place transitional appliances all at the same visit. If the case warrants it we can use mini-implants to hold initial appliances secure until the long term implants heal. A lot of prior planning goes into providing these treatments for combination cases.

Some patients from another state can even have a CT Scan made and e-mailed to us so we can do the virtual surgery and have all the supplies needed to do their case before they arrive at our office. If you are any of your friends are thinking about having extensive dental work done we would be happy to do a consultation for you.

 

 

AREA DOCTOR RECEIVES TRAINING IN CUTTING EDGE PROTOCOL

FORT WASHINGTON, PA, (June 2006) – At Viewpoint, a cutting edge research and teaching center for dental medicine, Drs. Thomas Balshi and Glenn Wolfinger, directors of Prosthodontics Intermedica, debuted implant dentistry’s newest and most patient-friendly protocol for healthy smiles, Teeth In An Hour. Eight doctors from across the globe experienced computer generated technology that permits a patient with not a single remaining tooth to have a fully functional and esthetic third set of teeth in less than an hour.

Local General Dentist, Bertrand Bonnick, participated in this training, following the new product launch at Nobel Biocare’s World Conference in Las Vegas last year. The new surgical technology, which begins with a brief but comprehensive scan, permits the doctor to accomplish virtual surgery on a computer model, thus creating optimum guided surgical technique, minimally invasive for the patient.

Dr. Bonnick, will be among the first in your area certified in the Nobel Biocare process of guided surgery. Their clinical facilities are located in Greensboro.

Prosthodontics Intermedica, at the Institute for Facial Esthetics, specializes in the replacement of missing, periodontally hopeless and severely decayed teeth. The center offers advanced solutions like zirconium CAD/CAM crowns and bridges, but focuses primarily on Nobel Biocare’s Branemark System of dental implants. Implant procedures are supplemented with genetically engineered growth factors to accelerate the healing process. Patients enjoy immediate function with implants following either the Teeth In A Day™ or Teeth In An Hour™ protocols. The Institute in Fort Washington is a major teaching center and source of research information about dental implants.

 

 

DID GRANDMA DIE EARLY BECAUSE SHE DID NOT HAVE IMPLANTS?

In a few months it will be ten years since my grandmother passed away at the age of 79 on the way to work. She was a firm believer in “If you are not sick you should have a job.” She also had a great sense of adventure and often accompanied me on my mission dental trips, or visiting somewhere new in the world. Although we had arranged for her to live with my mom and dad, she insisted on “turning her own key in her own door.”

Grandma like a lot of those born in the 1920’s got her denture early and like a lot of people she did not like her bottom denture because it had no suction. I was not insistent on her having implants because she wanted to save her money to support her independence. In retrospect this might not have been the best long term decision because not having implants meant she could not crush her food properly in order to receive the best nutrition. Studies show that dentures are about 30% efficient at crushing food, implant supported dentures around 70% and natural teeth around 90%.

Grandma complained about loss of appetite, stomach pains, and irregular bowel movements. She had medication that needed to be taken with meals to prevent further stomach irritation. On that fateful morning her lack of appetite meant she skipped her medication and her increased blood pressure led to a stroke from which she did not regain consciousness.

I miss my Grandmother and wished I could have done more for her. I have committed myself and practice to the promotion of the benefits of having dental implants because I think it can make a difference in people’s lives. No amount of money saved was able to keep Grandma with us for additional years, but money properly invested in making sure she could eat more than soups and “mush” might have given me additional years with her. So don’t brush us off when we talk to you about implants it means your prevention program was not successful for the teeth lost. Listen to us with an open mind, my Grandma would have wanted me to give you an option I did not give her.

 

 

 

LOSING TEETH CAN MAKE YOU LOOK OLDER

When I was a child a lot of people over forty years old looked old to me. Most of them had dentures and I thought dentures were a rite of passage as you crossed age 40. I did not know at the time that the thing I was looking at was lower face collapse. Yes the first time the denture was made was the best fitting denture because the patient still had a lot of alveolar bone (bone associated with the roots of the teeth). As the alveolar bone shrunk the denture settled further into the soft tissue and eventually the lower face shortens.

If you note the distance between the base of the nose and the tip of the chin in a more attractive person you will see that that dimension is not as shrunken as that in a person with a more aged look. Loss of a first molar or canine tooth compromises the chewing and facial support and presents a lot of challenge to restoring a beautiful smile.

Implants provide dentists with the ability to replace the roots of teeth that are lost. Replacing teeth in the front of the mouth presents the unique challenges in making the persons smile look real. Specially trained dentists can help patients by augmenting bone through various bone grafting techniques.

Animals with teeth generally die shortly after losing all their teeth. Human beings are the exception because they have dentists to provide artificial teeth. Back teeth provide the support for biting forces while front teeth are made to incise or cut. Eye teeth or canines the pointy one provide the transition from front to back, as well as protecting the back teeth from being ground down when one chews side to side.

Loss of back teeth leads to more pressure on the front teeth and the resulting spacing as people age, as well as the collapse of the face. So next time you have a broken back tooth resist the temptation to say “it just a back tooth, pull it out!” No future plastic surgery can help recapture attractive facial features with a collapsed lower face. Prevention in dentistry is always better easier and causes less discomfort than expecting a magical cure.

 

 

TEN REASONS FOR CONSIDERING DENTAL IMPLANTS

Dental implants come in many different forms. There are subperiosteal implants, ramus frames, blades, and root form implants. The subperiosteal implant is mostly used for area where the bone is not of sufficient height to accommodate root form implants, and is mostly used in shrunken lower jaws. The ramus frame and blade implants are mostly used in the lower back jaw when the patient is not an ideal candidate for advanced bone grafting techniques. The most common type of implants used most of the time are root form implants that mimics the root of the tooth. The reasons given are addressed primarily to the root form implant.

1. The implant consists of a titanium alloy that is biocompatible to bone and encourages the bone to form around it holding it in place. The healing process is referred to as osteointegration.
2. Once the implant becomes osteointegrated it helps to preserve alveolar bone. Approximately 60% of the bone in your jaws grew in response to the erupting teeth. When a tooth is extracted you go through a process of losing bone in that area that can last a lifetime. An implant helps to preserve this bone structure.
3. It helps to prevent malocclusion. When you lose a back tooth you set up shifting in the other teeth. Teeth adjacent tend to move into the space and the teeth opposing drift up or down into the newly formed space. Some spaces become “food traps” and contribute to bad breath and periodontal disease.
4. Implants can slow facial atrophy. Roughly 150 Newton of force is applied on normally functioning back teeth while only 50 Newton are applied on the front teeth. Non-pathological forces on the back teeth contribute to the preservation of facial muscle tone, hence our “looks”.
5. Digestion is vastly improved with properly functioning teeth because the ability to crush food is enhanced.
6. People without teeth spend approximately 17% more on drugs. The Mayo Clinic studies also show that having teeth added approximately 10 years to your life expectancy.
7. There is an increased risk to the aspiration of food if you have no teeth. Aspiration of food is one of the causes of death in the elderly that hardly gets mentioned except in CPR courses.
8. Save money on denture adhesives. In America about $148million are spent on denture adhesives every year.
9. Complete lower dentures usually move about 10-12mm during function and contribute to diet modifications that are less than nutritious. Many denture wearers develop anti-social tendencies because they are unwilling to go out for a meal.
10. A dental implant with abutment and crown costs about the same as a three unit bridge replacing a single tooth. A Catscan guided program allow us to do the virtual surgery on the computer with you present so we can help you decide if you are a good candidate for this treatment.