Implant Dentistry

 

There are many implant dentists in Colorado Springs... so, what makes our team at Silverstone Dental the place to go for your Colorado Springs Implant Dentistry needs? I believe it comes down to experience, education and knowing when to refer. 

 

Most dental schools don’t teach dental implant placement to students in non-residency positions. At Nova Southeastern we were thoroughly taught about implant restoration (treatment planning, placing crowns and dentures on implants) but next to nothing on the surgical procedures, which is more than most dental schools! So, most non-specialty dentists (ie. Oral Surgeons, Periodontists and some Endodontists) are left to rely on continuing education to learn these procedures. There are a few quality dental school and hospital based mini-residencies which teach a comprehensive approach to implant placement and restoration at enormous cost to the dentist. These programs are typically a year in length and require the dentist to travel 2-3 times per month to take the course. Both NYU and USC have great programs but travel and cost are prohibitive for many dentists. Because of these constraints most dentists placing implants rely on in-office continuing education by implant companies that teach a crash course on implant placement surgery in as little as two days! These courses are little more than marketing techniques by individual/small implant companies that care little about the success of the implants placed and more about the number of implants sold. Needless to say, as a dentist I have seen many misplaced implants that put in jeopardy both the success of the treatment and patient satisfaction. A well placed implant should act and feel very similar to a natural tooth.

 

While at Yale I was able to learn from some of the best surgeons and restorative dentists on implant placement and restoration to optimize the life, comfort and function of your implant tooth or denture. The invaluable skills of treatment planning, placement and restoration of multiple implant systems and designs was paramount in my year-long residency at Yale.

 

    Treatment Planning: Arguably the most critical step in the implant process is what happens before the first incision is even made. Critical planning is necessary for overall success of the treatment. Angulation, spatial relationships to adjacent teeth and consideration for future treatment are all important to a patients ability to adapt naturally to an implant restoration. Diagnostic impressions for planning have proven to be very important as it allows the dentist(s) placing and restoring the implant to visualize the treatment necessary and in some cases to prepare a surgical stent that will guide the surgeon to place the implant in the optimal position.

 

    Placement of the Implant: The surgical portion of implant restoration is a very technical and requires a certain amount of finesse to complete properly. Having surgical stents, appropriate x-rays (which may include CT scans) and a sound knowledge of surgical protocol is key to implant body success. If an implant is placed well and your body is given a solid chance to heal, implants have a 96-98% success rate. As stated earlier if it is placed well it should feel and act very similar to a natural tooth. You should be able to floss, brush and chew normally with minimal complications like food getting stuck between the teeth and infection around the implant. 

 

    Restoration of the Implant: There are many types of implant restorations. The most common one is to replace a tooth or teeth. The benefits of using implants to restore missing teeth is to avoid the use of a bridge or a removable partial denture. Treatment planning for the restoration of an implant is a very important concept for a dentist to master. If the implant is too close to an adjacent tooth it can cause bone loss and possible failure of the implant. If there isn’t enough space from the gums to the tooth above or below it, it may require crowning and possible root canal treatment of the tooth that it comes in contact with. If an implant is being used to retain a denture it may be necessary augment the bone or to place the implants in an area with future plans in mind. 

 

    Appropriate Referral: As eluded to earlier some implants may be more difficult to place due to location in the mouth, proximity to other anatomical landmarks like the sinuses. large nerves, or amount and quality of bone in certain areas. In these cases it may be appropriate to see a specialist. Periodontists have 3 year residencies and Oral Surgeons have 4-6 year residencies where they spend tremendous amounts of time honing the skill necessary to optimally place implants. They learn cutting edge techniques for bone grafting, sinus lifts and tissue maintenance that improve the success of implant treatment and the over all esthetic result. At Silverstone Dental we place a number of implants but I am cautious and know my limits. We never hesitate to refer treatment if it is going to be in the best interest of our patients. The Oral Surgeons and Periodontists that I refer to are extremely qualified and hand selected based on the results we get from them. 

 

So, with all that said... what is a dental implant? Dental implants have been around for 60+ years. They resemble screws. They are threaded and are carefully placed into a strategically prepared area of bone called the “implant bed” or osteotomy. They are made out of titanium and are sometimes coated with different proprietary materials by implant companies. Some have super absorbent materials coated to them that allow the tissues and fluid to penetrate them. Others have sand-blasted surfaces that provide greater surface area for the bone to grow around. There are some with holes in them and even trabeculated patterns to mimic cancellous bone, allowing the bone to grow through them. Implant design has become highly technical and each design has a boat-load of research touting its superiority over the last design. All in all though they are just titanium bone screws. Titanium is a very inert metal that is super bio-compatible. It has been used in medicine for years for joint replacement, fixation of broken bones and as plates to reenforce fragile bone. It is highly researched and accepted for its various uses and has one of the lowest allergenicities of any material used in dentistry or medicine. Bone grows around it with no problems which makes it an ideal material for dental implants. The ability of bone to grow around it is known as “implant integration.”  Once an implant is “integrated” it has a 96-98% success rating in single tooth restorations. The numbers only go slightly down when multiple implants are placed as in bridges or implant supported prosthesis like dentures, all on four or “round house” implant bridges. Implants are easily the most successful treatment known to dentistry and, when done well, provide the most patient friendly results.