Understanding Dental Bone Grafts: A Comprehensive Guide - By Dr Amir Mostofi DDS , Dip (Ortho.), MSc (Implant.)

Understanding Dental Bone Grafts: A Comprehensive Guide

Dental bone grafting is a crucial procedure for patients experiencing jawbone loss, which can significantly impact oral health and the success of dental implants. It involves adding bone material to the jaw, which can be sourced from various origins such as the patient's own body, human or animal tissue banks, or synthetic materials. This procedure acts as a scaffold, allowing the patient's own bone tissue to grow and regenerate. Dental bone grafts are often essential for individuals who have lost teeth, are planning dental implant surgery, require dentures, or have suffered bone loss due to gum disease.

Types of Dental Bone Grafts

There are several types of dental bone grafts, each serving a unique purpose:

Socket Preservation: Performed immediately after tooth extraction to prevent socket collapse.

Ridge Augmentation: Enhances the jawbone's width and volume, particularly after long-term tooth loss.

Sinus Lift: Elevates the maxillary sinuses to allow for implant placement in the upper jaw.

Periodontal Bone Graft: Targets bone loss caused by gum disease, providing stability to loose teeth.

Procedure Details

Before the Procedure The process begins with a thorough oral examination and dental imaging to assess bone loss. Based on these findings, a personalized treatment plan is developed.

During the Procedure The procedure involves administering local anesthesia, making a small incision in the gums, and placing the bone graft material in the required area. A membrane may cover the graft for added protection. Finally, the incision is closed with stitches.

After the Procedure Post-surgery, patients might experience pain, swelling, and bruising, which are manageable with pain relievers and possibly antibiotics. It's normal to find small bone fragments in the surgical area during initial healing.

Pain and Sedation Dental bone grafts are generally low in pain. Sedation options vary, from local anesthesia to general anesthesia, depending on the case complexity.

Success and Failure The success rate of dental bone grafts is high, but smoking or certain medical conditions can increase the risk of failure. Warning signs include worsening pain, pus, gum recession, and lack of jawbone improvement.

Risks and Benefits

While generally safe, potential risks include infection, bleeding, nerve damage, and anesthesia complications. The benefits include increased eligibility for dental implants and restoration of jaw structure.

Recovery and Outlook

Recovery varies, typically taking three to nine months for complete healing. Most people can resume normal activities the day after surgery.

When to Contact Healthcare Providers

Patients should watch for severe pain, increased swelling, pus around the grafting site, or fever and contact their dentist if these occur.

Summary

Dental bone grafts are vital for restoring oral health and function in individuals with jawbone loss. They play a critical role in preparing for dental implants and combating the effects of tooth loss and gum disease.

Navigating the Misconceptions: Bone Grafting and All on 4 Dental Implants- By Dr Amir Mostofi DDS, Dip. MSc

 Navigating the Misconceptions: Bone Grafting and All on 4 Dental Implants.

By Dr Amir Mostofi DDS, Dip. MSc

The realm of dental implant technology has witnessed significant advancements in recent years, with All on 4 dental implants emerging as a pivotal solution for full jaw rehabilitation. This revolutionary technique has not only enhanced the efficiency of dental restorations but has also challenged common perceptions, particularly regarding the necessity of bone grafting.

Understanding All on 4 Dental Implants:

All on 4 dental implants offer a comprehensive solution for patients with significant tooth loss. This procedure involves the strategic placement of four implants in the upper or lower jaw, providing a stable foundation for a full-arch prosthesis. The technique is celebrated for its minimally invasive nature and its ability to deliver immediate results.

Debunking Bone Grafting Myths in All on 4 Implants:

Contrary to popular belief, All on 4 dental implants often do not require bone grafting. This misconception stems from traditional implant procedures where insufficient bone volume necessitated grafting. However, the innovative design and strategic placement of All on 4 implants typically bypass the need for such additional procedures.

The Science Behind No-Bone-Grafting in All on 4 Implants:

The key lies in the angulation and placement of the implants. By tilting the posterior implants, All on 4 takes advantage of the existing bone structure, even in cases where bone volume is limited, thereby eliminating the need for grafting in many instances.

Expertise Matters: The Role of Skilled Dental Professionals:

The success of All on 4 implants without bone grafting hinges on the expertise of the dental professional. Precision in implant placement is crucial, requiring an in-depth understanding of oral anatomy and advanced surgical skills. This expertise ensures optimal use of available bone and minimizes the need for grafting.

Advantages of Avoiding Bone Grafting:

Avoiding bone grafting in All on 4 procedures offers several benefits:

• Reduced treatment time

• Less invasive surgery

• Lower risk of complications

• Quicker recovery and healing

• Immediate improvement in functionality and aesthetics

Conclusion

All on 4 dental implants represent a significant leap forward in oral rehabilitation. By potentially eliminating the need for bone grafting, they offer a quicker, less invasive, and more efficient solution for full jaw restoration. However, the key to success lies in the hands of skilled dental professionals whose expertise can make a significant difference in the outcome. As with any medical procedure, it's essential for patients to consult with experienced dental practitioners to explore the best options for their specific needs.

Top 5 Sources of Dental Implant Pain When "There's Nothing Wrong with the Implant"- By Dr Amir Mostofi, DDs Dip MSc

If you've recently had a dental implant and are experiencing pain even though everything seems normal, you're not alone. This article aims to explain the top 5 reasons behind dental implant pain when there's no apparent issue with the implant itself, in a way that's easy for patients to understand.

1. Violations of the Inferior Alveolar Canal (IAC):

The IAC is a canal that houses the inferior alveolar nerve (IAN), which plays a crucial role in sensation for your lower jaw. Sometimes, the IAN takes a unique path, forming what's called an "anterior loop." Trauma to this area during implant placement can lead to sensory disturbances, bleeding, and pain. Recent research suggests that getting closer to the IAC may not be as risky as previously thought, as long as the nerve isn't directly affected.

2. Violations of Branches in the Mandibular Canal:

Traditionally, we've considered the IAC as a single canal to be avoided during implant surgery. However, it's now known that smaller branches can exist alongside the main canal, creating a network. If these branches are accidentally disturbed during surgery, it can result in pain. These branches are often missed because they aren't widely recognized, but they can show up on X-rays or CT scans.

3. Inadequate Keratinized Tissue:

Keratinized tissue is the protective, tough tissue that surrounds your implant crown. Some studies suggest that not having enough of this tissue (usually at least 2 mm wide) can lead to pain, especially when you touch or use the implant, like when brushing or eating. Fortunately, this issue can often be resolved by adding more tissue through a soft-tissue graft.

4. Poor Bone-to-Implant Contact:

Even if an implant looks fine on X-rays and CT scans, it's possible that the bone around it isn't providing a secure foundation. This can happen when fibrous tissue forms around the implant instead of sturdy bone. This may not be visible in regular exams, but patients can still feel pain when using their implant, especially when it's fitted with a crown. A resonance frequency analysis machine can help diagnose this issue by measuring the strength of the implant-bone connection.

5. Predisposing Risk Factors:

Sometimes, pain after implant surgery can be linked to factors that exist within your medical or genetic makeup. Conditions like fibromyalgia, temporomandibular disorders, and depression/anxiety can make you more prone to experiencing pain. This type of unexplained pain often falls under the category of "peripheral painful traumatic trigeminal neuropathy" (PPTTN).

In summary, if you're feeling pain after a dental implant, even when everything looks fine, it's important to consider these factors before assuming it's psychosomatic. There are various reasons behind implant-related pain, and a thorough evaluation is essential to pinpoint the cause accurately. Your dental professional can help you identify and address the issue, ensuring your dental implant journey is as comfortable as possible.

All There to Know About Dental Implants: A Patient Guide

All There Is to Know About Dental Implants : A patient guide

In modern dentistry, dental implants have become the treatment of option for missing teeth.

What exactly is an implant?

A dental implant is an artificial tooth root that is typically composed of titanium. When applied with skill, they provide a highly reliable treatment. The primary objective of implant placement is to obtain immediate, intimate contact with the surrounding bone. Over time, additional bone growth on the implant surface improves the implant's stability.

In order to support replacement teeth, dental implants typically feature an internal screw thread or post space that permits the attachment of a variety of components. Once in place, these components provide long-lasting support for crowns, bridges, or removable dentures.

Who can receive dental implants?

Dental implants are appropriate for the majority of healthy adults. They can only be used once the jawbone has ceased growing, so they are typically not used on children. Habits such as excessive drinking or smoking can increase the number of complications associated with initial healing and may be detrimental to the gum and bone surrounding each implant in the long term. Smoking should be reduced or best still given up altogether. However, each case is unique, and if you have any medical issues, you should consult with one of our implant specialists prior to beginning treatment; in only a few instances do health issues completely preclude the use of dental implants.

Dental implants are appropriate for the majority of healthy adults.

How will you determine if you are a candidate for implants?

During your initial consultation, one of our specialist will determine whether implant treatment is feasible. We discuss your options and conduct an examination of your mouth and remaining teeth to determine the nature and extent of any existing dental issues. Typically, x-rays will be obtained and dental models will be fabricated so that these can be examined after your appointment. These x-rays and models will be used to determine the optimal position for an implant, the number of implants required to fill the gap, and the available bone grade and volume.

Establishing excellent oral hygiene is a crucial step in any treatment plan. At this initial consultation, you will be informed of which problems are essential and what treatment is necessary to stabilise any gum or tooth issues.

Must you maintain a wholesome mouth?

When you inquire about dental implants for the first time, it is frequently in response to ongoing dental issues or the recent loss of teeth. Before implant treatment, it will often be necessary to understand and treat the underlying cause of these issues.

If you have poor breath, loose teeth, or excessive bleeding, especially when your teeth are professionally cleaned, you may have gum disease.

Gum disease (periodontal disease) is a leading cause of bone loss, making dental implant treatment more difficult, but not impossible.

How lengthy is the treatment?

For routine cases, the duration between implant placement and the placement of the first tooth/teeth can range from three to six months. The availability of higher-quality bone can be used to reduce treatment time, whereas inferior bone requires more time and care, which can extend treatment times beyond six months.

What should you understand before beginning treatment?

You will receive a written summary of your discussion regarding treatment planning, emphasising your current dental condition and any alternatives to dental implants. This summary also provides an overview of the anticipated treatment stages and provides an estimate of the expected duration, number of implants, and cost. There may be additional issues unique to your case, and they will be addressed accordingly.

How long do implants typically last?

Once the implants and surrounding soft tissues are deemed to be healthy and the new teeth are deemed to be comfortable and properly aligned, the quality of your oral hygiene and willingness to attend regular maintenance reviews will have the greatest impact on their longevity.

Similar to neglected natural teeth, implants will develop a layer of hard and porous deposits (calculus and plaque) if they are not properly cared for. These deposits, if left untreated, can cause gingival infection, bleeding, soreness, and general discomfort. Implants could be said to have the same longevity as natural teeth. Implants that are well-maintained and placed in sufficient bone can potentially last a lifetime if cared for properly. However, just as you would anticipate traditional crowns, bridges, and fillings to require occasional restorations or replacements, implant-supported teeth may also require similar maintenance over time.

How many teeth can dental implants support?

Dental implants can be used to replace a single tooth or an entire arch of teeth. Dental implants can support all prevalent forms of tooth replacement, such as bridges and dentures.

If you are missing a single natural tooth, one implant will typically suffice to provide a replacement. However, larger spaces created by two, three, or more missing teeth may not require one implant per tooth; the precise number of implants will depend on the grade and quantity of bone at each potential implant site.

Patients with a propensity of clenching or grinding their teeth (bruxism) may be at risk of implant overload. Bruxism occurs during sleep for most individuals, so they are typically unaware of it. The most common clinical indications of bruxism are excessively worn or flattened teeth, chipped enamel edges, and/or the frequent breakage of filling fragments. During treatment planning, the effects of bruxism must be considered, and they can be compensated for by placing additional implants, selecting appropriate restorative materials, and providing a nighttime bite guard to secure the new teeth. This will be covered in your initial consultation and treatment plan.

Implant retained prostheses

What is the therapy?

Using dental implants to anchor removable prostheses is a significantly more effective method than using adhesives, pastes, or powders. With only two implants or four mini implants in each jaw, dentures can be clipped into position and held securely, but are simple to remove for cleaning and sleeping. Implants also provide a number of aesthetic advantages, including the preservation of bone in the jaw and the maintenance of facial structure, as well as the restoration of lost lip support to reduce wrinkles around the mouth. Approximately 15 minutes of the 90-minute procedure are devoted to actual surgery. It is a quick and economical alternative to a complete arch of dental implants.

What alternative treatments are available?

Implant-retained dentures are a significant improvement over traditional removable dentures, which are inconvenient, sometimes uncomfortable, and restrict your diet. Full arch dental implants are an even better alternative to removable dentures; we are one of the few practises in East Anglia with the expertise to conduct this procedure. It's a life-altering, permanent solution.

Is it essential to replace an entire set of lacking teeth?

Multiple tooth loss can have a profound effect on one's quality of life. In addition to having a significant influence on your ability to speak and eat, it can also alter your appearance. Without teeth to support the lips and cheekbones, wrinkles develop more quickly and the cheeks become hollow. Many individuals with this type of tooth loss believe they appear older than they are, which can be detrimental to their self-esteem.

A summary of the implant procedure

Typically, implant treatment consists of several phases that occur over a period of three to nine months. Although there are numerous implant treatment methods, a typical procedure typically involves the following:

Assessment and planning for treatment:

At the initial consultation, after a thorough discussion of all potential alternatives, we will determine whether implant treatment is feasible. If necessary, x-rays will be obtained and models of the teeth will be created. Then, a written treatment plan detailing the treatment sequence and associated costs will be created.

Implant placement:

Implant implantation is a relatively straightforward minor surgical procedure that can be performed in a dental office under sterile conditions.The procedure is performed under local anaesthesia and, if necessary, sedation. If, during evaluation, it is determined that the underlying bone is deficient, there are several options for bone regeneration. Depending on the needs, bone regeneration is typically performed at the same time as implant placement.

Transition period:

It can take between six weeks and six months for implants to integrate with a patient's bone. During this period of integration, temporary dentures or bridgework may be worn as needed. In certain instances, temporary teeth can be affixed to the implants in a procedure known as "immediate loading" while the implants integrate.

The Recuperative stage:

Once implants are incorporated, they can be restored with a variety of new teeth (definitive restorations) including a single crown, small or large bridge, or removable overdenture. We collaborate closely with a laboratory that creates these permanent restorations.

Maintenance:

Following conclusion of implant treatment, the patient must clean the new teeth (restorations) according to the instructions. A dental hygienist may also provide guidance on the care and upkeep of restorations and natural teeth. Regular visits to the dentist are required so that the health of the soft tissues, bone levels, and restoration can be evaluated.

How can you determine if you have sufficient bone for dental implants? Normal dental x-rays display a great deal of detail, but only in two dimensions. From these views, it is typically possible to determine the height of available bone for implant placement; however, sometimes more advanced imaging techniques are required to determine the equally crucial bone breadth.

Dental CBCT Scans – there are now a number of sophisticated x-ray techniques that enable a three-dimensional examination of the jawbone. CBCT (cone beam computed tomography) scans are the most precise and widely available. Images obtained by CBCT scanning will typically display all of the necessary bone information, including quantity and quality, but most importantly the presence of structures that must be avoided.

What may result in bone loss?

When a tooth is lost or extracted, a significant portion of the bone that once encompassed the remaining root may be lost. This loss is referred to as "bone resorption" and can be especially rapid during the first few months. Despite the fact that the rate and quantity of bone resorption is highly variable between individuals, it will always occur to some degree unless special precautions are taken to mitigate its effects.

Many patients report that their dentures gradually become looser and no longer fit as well as they once did. Initially, the observed worsening of denture fit is a result of the increased rate of bone loss following tooth extractions.It is the direct effect of gnawing forces that causes the gradual deterioration of supporting bone over time. Therefore, the longer prostheses are worn, the less available bone there is for dental implants.

What anatomical structures must be avoided during dental implant placement?

As long as the implants remain within the bone that once supported your natural teeth, there are no significant risk areas in the upper mandible. If you are missing upper back teeth, you can be shown the contour and location of the area above the roots (maxillary sinuses). Since the maxillary sinuses are visible on the majority of x-rays, they are generally avoided.

The 'inferior dental nerve' is the most vital anatomical structure to avoid in the lower mandible. This nerve begins behind the wisdom teeth, travels under the back teeth (molars), and emerges on the epidermis of the face where the middle teeth (premolars) are or were. This is the reason why a normal dental anaesthetic numbs the lip even when the needle is inserted in the very back of the mouth. If this nerve is irritated or damaged during dental implant implantation, it can result in temporary or permanent numbness or altered sensation. This is an uncommon but significant complication.CBCT scans are typically the most accurate method for pinpointing the location of this nerve, allowing implants to be implanted with confidence. CBCT scans are more expensive than standard dental x-rays, but the information they provide is often invaluable for complex treatment planning and determining the location of vital anatomical structures. If a tooth is inadvertently damaged by the implantation of a nearby implant, any resulting issues can typically be treated with root canal therapy, in which the tooth's nerve is removed.

Can dental implants preserve bone?

This is one of the most essential characteristics of dental implants. Once in place and supporting teeth, daily functional forces (eating, smiling, speaking) stimulate the adjacent bone, causing it to become denser and stronger. As with all things, there are limitations to the amount of labour an implant can perform. We will discuss this in greater depth as it pertains to your specific situation.

Can replacement teeth be worn while undergoing implant treatment?

If the teeth being replaced by dental implants are in a highly visible area of the mouth, it is probable that you will need to have some teeth present during the procedure. This can be accomplished in a variety of methods, ranging from simple plastic dentures to removable bridges. If replacement teeth are used during treatment phases, it is vital that they do not exert uncontrolled pressure on the implants. You should anticipate a number of visits for minor adjustments to any temporary teeth after the implants are inserted and before they are activated. They might not be as visually appealing as your final restoration.

Are dental implants compatible with natural teeth?

Dental implants are routinely inserted adjacent to natural teeth, and this procedure is generally very safe. The only exception to this rule would be if the natural root was extremely curved or inclined in the proposed implant path. This could cause the implant to damage the root, but this is typically avoidable through meticulous pre-operative planning.

Are the replacement molars fused together?

When numerous implants are inserted, they are typically connected in the same manner as a bridge supported by natural teeth. When teeth supported by implants are joined together, they are mechanically sturdier than the sum of their parts.

If sufficient implants are available, it is frequently simpler and just as effective to construct several smaller bridge sections, each supporting a few teeth. The overall effect in the mouth is identical, and if you ever need to repair one of the minor sections, this can be accomplished much more easily. Again, the quality of the bone, as well as the number and placement of the implants, will determine which option is most suitable for you.

Is it unpleasant when implants are inserted?

The majority of patients will be familiar with the anaesthetics used in routine dentistry and will be aware of their efficacy. The same anaesthesia is used to insert implants. Depending on the complexity of your case, the procedure could last anywhere from 30 minutes for a single implant to several hours for complex bone augmentation and implantation of multiple implants. Expect some minor swelling and occasional discoloration after surgery. For the majority of patients, fundamental over-the-counter pain relievers will suffice for several days. If you continue to experience discomfort, contact your healthcare provider, who can prescribe a stronger medication.

Generally, healing is uncomplicated, and sutures are removed within a week to ten days. During the initial few days, you should disclose any unanticipated pain or swelling so that it can be evaluated. Always seek advice when in doubt, as early detection of a problem often leads to a simplified solution. You may also be prescribed antibiotics and asked to perform some basic procedures, such as rinsing your mouth with salt water or an antiseptic mouth rinse. It is essential that you follow these directions.

If the implant surgery will require a long time, is sedation an option?

Although it is relatively simple to provide effective pain management during surgery, the majority of patients will be apprehensive. There is no need to suffer in silence, as there are numerous highly effective ways to attain a state of relaxation.

Conscious sedation – For more complex procedures, it may be recommended that you have a more regulated method of relaxation and comfort during the surgical phases. This is known as 'conscious sedation' and is distinct from a anaesthetic because you are awake enough to respond to simple instructions that may be helpful to the surgeon; however, you will recall almost nothing of the treatment phase. It is especially advantageous for procedures lasting more than an hour that do not require hospitalisation; this is likely the case for the majority of dental implant treatments.For routine "conscious sedation," a sedative is administered via an arm or hand vein for the duration of the procedure. An anesthesiologist continuously monitors your pulse rate and oxygen levels during this extremely safe procedure. A standard dental local anaesthetic is injected around the proposed implant sites under conscious anaesthesia. By the time the dental anaesthetic is administered, the anaesthesia has already taken effect, so most patients do not recall this phase. For procedures requiring oral or conscious anaesthetic, you may be asked to refrain from eating or drinking for at least four hours prior to surgery, and you will be required to make arrangements for an adult to drive you home. Additionally, you will be instructed not to operate any apparatus for at least 24 to 36 hours.

What can be done if there are insufficient bones?

Up to this point, we have covered the fundamentals of routine implant placement. This has included the initial examination and diagnosis, special x-rays such as CBCT scans, anaesthetic during surgery, and what to expect following the placement of implants. However, for some individuals, bone loss following tooth extraction or loss prevents the placement of an implant. There are actions that can be taken if this occurs:

It is possible to increase the height of available bone in the upper jaw above the back molars by creating new bone in the sinus.This process is known as a "sinus augmentation." Without the widespread success of this technique, numerous patients would be unable to receive dental implants in a region of the mouth where tooth loss is so prevalent.

There are numerous methods for adding bone, but one of the simplest is to remove a piece of bone from another location and attach it as a "onlay graft" to a deficient area. The new piece of bone will gradually fuse with the underlying bone, and an implant can be implanted in a more favourable position once it has healed and matured.

Where can additional bone be obtained?

Bone can be harvested from a variety of locations, but most commonly from the back of the lower mandible or the chin. Occasionally, it is extracted from the hip or tibia. When using your own bone to create new bone in another area of the mandible, you will experience discomfort at both the donor site and the surgical site. As your own bone is typically regarded as the 'gold standard,' many people feel that the additional discomfort is well worth it.

Alternatives to your own bone for augmentation There are other sources of bone, such as bovine (derived from cows), porcine (derived from pigs), and synthetic materials that have been specially processed to make them acceptable for use in humans, for those who prefer an easier but slightly slower solution. All of these materials, including your own bone, are merely scaffolds into which new bone will grow in a few months in preparation for dental implant placement.

It can take anywhere from three to twelve months for new bone to be suitable for dental implants. Do not rush to advance to the next stage. A larger quantity of bone will take longer to mature than a smaller quantity. Each surgeon will have a preferred technique for producing new bone. Many of them will additionally employ a technique known as "guided tissue regeneration." By placing a barrier material between slow-moving bone cells and the fast-moving cells of the soft tissues lining the mouth, this technique allows slower-moving bone cells time to occupy a space. This is a "resorbable barrier" that will dissolve spontaneously after a few months of performing its function.

Does bone augmentation impact treatment duration?

If you require bone augmentation, it may lengthen the duration of your treatment; however, when performed successfully, it will significantly enhance the outcome of the implant(s) placed. When used in the front of the mouth, it can also enable the construction of much more aesthetically pleasing results.

Regardless of the method selected to increase bone density, the time, effort, and expense are generally worthwhile.

How do you care for your implants?

To increase the longevity of your implants, it is imperative that you maintain excellent oral hygiene. Cleaning your implants is straightforward. For the majority of implant-supported teeth, you will be able to brush and floss around each supporting implant just as you would around natural teeth and tooth-supported bridges. Maintaining excellent oral hygiene may require special floss, interdental toothbrushes, and other cleaning aids in some areas.

If you wish to maintain optimal implant health, it is reasonable to anticipate that some daily maintenance procedures will be more complex than those performed around your natural teeth, and that you will need to devote more time than in the past.

During the first few months following implant placement, your dentist may request that you visit them more frequently; however, once they are satisfied that your treatment is proceeding according to plan, your ongoing dental care will be comparable to that of a patient with natural teeth.

What options exist if an implant fails?

The average success rate for dental implants is approximately 96%; you should discuss how the loss of an implant could affect your treatment plan. A dental implant can fail for a variety of reasons, including smoking, poor oral hygiene, and systemic disease. In these particular high-risk groups, one would anticipate a much higher failure rate. If an implant does not integrate well with the surrounding bone, it will ultimately lose its ability to support replacement teeth and become loose. Commonly, a failing implant does not cause discomfort, and if there are sufficient residual implants, it may not be necessary to replace it.

It is essential to discuss the potential complications that may arise.

Various implant procedures

One-stage implant – The implant is inserted into a fresh, healing, or healed extraction site where the original tooth was extracted, and is immediately visible above the gum. This technique has the advantage of not requiring a second surgical stage to expose the implant. Typically, the implant will not be able to sustain a tooth for several weeks or months.

This is the first stage of a two-stage implant, in which the implant is inserted into a fresh, healing, or healed extraction site and then concealed by a layer of gum tissue. At the second stage, weeks or months later, the implant is uncovered and components are added, bringing it to the surface of the gum so that a new tooth can be attached.

Same-day implants necessitate meticulous planning prior to the actual day of surgery. A few hours after the placement of multiple implants, a full arch of temporary or permanent teeth can be affixed. If temporary dentures are used, they are typically replaced with a permanent bridge after a sufficient period of healing. Not all patients are appropriate candidates for this method of treatment.

In this procedure, a tooth is extracted and an implant is placed promptly into the extraction site. Depending on the local bone and soft tissue conditions, implant surgery may be performed in one or two stages. Not all patients are candidates for this treatment.

Immediate implant placement and early loading – This is dissimilar to immediate implant placement. It is essentially a one-step procedure in which the implant is inserted into a fresh, healing, or healed extraction site and a replacement tooth is attached at the same appointment. This first tooth will typically be kept out of direct contact with opposing teeth for more than three months, following which it will be restored. This procedure is more prevalent in areas of the mouth where aesthetics play an essential role. Again, this approach is not suitable for all patients.

Frequently asked questions:

Will I be able to consume my favourite foods afterwards?

Patients should be able to consume a normal, nutritious diet with little to no difficulty upon completion.

What are the costs associated with implant treatments?

The price can vary based on the required level and extent of treatment. A written treatment plan therefore explains and confirms the total cost.

How much time will it take?

Implant treatment typically requires multiple appointments over the course of several months. In certain instances, implant procedure can be completed much more quickly.

How lengthy is its duration?

Regular dental hygiene and regular checkups should ensure that implants last for many years after treatment is complete.

Am I too elderly to receive implants?

There is no upper age limit for patients undergoing implant treatment, so long as they remain in reasonable health.

Is the procedure painful?

Patients are frequently astonished by the lack of pain they experience during and after implant procedures.

Glossary:

-Abutment

Abutment is the component that connects the implant to the permanent tooth restoration.

-Barrier membrane

A membrane that is draped over a bone defect or bone implant to prevent the infiltration of soft tissue, which could compromise the healing process.

-Bone augmentation

This is the insertion of natural or synthetic bone material in a deficient area of natural bone. This procedure may be performed concurrently with implant implantation, or as a separate procedure prior to implant placement.

-Bone resorption

Resorption of bone is the loss of bone height and/or width in the upper or lower mandible. This process continues throughout life, but is accelerated in areas where teeth have been lost.

-Bridge

A bridge is a method for replacing one or more missing teeth with artificial teeth that are bonded to adjacent natural teeth or dental implants. Bridges may be glued in position (adhesive bridges) or supported by crown preparations (conventional bridges) and constructed from a number of different materials.

-Bruxism

The act of clenching or grinding one's teeth when not chewing.

-Calculus

Sometimes referred to as tartar, tartar is a hard deposit that forms on teeth. Calculus is the result of the calcification of debris around the teeth, and it can be avoided by practising meticulous oral hygiene. Once calculus has formed, it is difficult to eradicate, and requires the services of a dental therapist or hygienist in most cases.

-Absolute arch

A complete arch refers to the teeth of the upper or lower mandible in their entirety.

-Consultation

A dental consultation to evaluate potential treatment options. Appointments may include an examination, x-rays, and photographs, as well as a frank discussion and explanation, if necessary.

-Crown

Crowns can be manufactured from a variety of materials, including porcelain, porcelain fused to metal, and gold. The majority of crowns that are not visible in the mouth are white in pigmentation.

-CBCT scan

Cone Beam Computed Tomography is a sophisticated x-ray technique that generates three-dimensional images of the mandible. Due to their three-dimensional nature, these images can only be observed on a computer screen.

-Definitive refurbishments

The definitive restoration refers to the ultimate implant-supported crown, bridge, or denture fabricated during the treatment process. The restoration will require routine maintenance and may require replacement.

-The administration of dental anaesthetics

Anaesthesia (Greek: ) means without sensation, which includes pain. The majority of dental anaesthetics are administered via injection into the affected area. Rarely, procedures may be performed while you are unconscious; this is known as a general anaesthetic.

-Dental implant

An implant is an artificial "tooth root." The majority of implants are composed of metal, with titanium or titanium alloys being the most prevalent. Implants are surgically inserted into the jawbone in order to support crowns and bridges or to stabilise dentures.

-Dentures

Dentures are removable, custom-made replacement teeth. Typically, they are composed of acrylic or acrylic and cobalt chromium.

-Extraction

Extraction of teeth is the removal of teeth.

-Extraction position

The space left after tooth extraction.

Effective implantation

A functioning implant is one or more implants that are capable of supporting a dental restoration, such as a crown, bridge, or denture, and biting.

-Therapeutic tissue regeneration

A procedure that promotes the regeneration of soft tissue (gums) and may be used to improve the aesthetics around teeth or crowns.

-Gum disease

Soft tissue disease surrounding teeth. Gingivitis is the common name for gingival inflammation; it is a response to the deposition of plaque and, in most cases, can be treated with rigorous oral hygiene.

-Periodontal disease

Gingivitis can develop into periodontitis, a more severe form of gum disease, if left untreated. Periodontitis causes bone loss and can threaten the survival of a tooth or teeth.

-Immediate loading

Providing a temporary crown or bridge concurrently with implant implantation. Not all patients are appropriate candidates for this treatment.

-Inferior dental nerve

This nerve, sometimes known as the inferior alveolar nerve, travels through a bony canal in the lower jaw and provides sensation to the lower teeth, before emerging from bone as the mental nerve, which provides sensation to the lower lip.

-Combination toothbrushes

A small interdental brush with typically a single tuft of filaments. This can be used as an alternative to dental floss for cleansing between teeth and around implants.

-Maximum sinus

A hollow, air-filled space located just above the upper premolars. This varies in size from person to person and grows throughout one's lifetime.

-Molars

The upper and lower third molars on both sides of the mandible.

-Onlay anastomosis

When bone is taken from another area of the body, such as the hip (rarely), jaw, or behind the molars, and grafted to a deficient area.

-Osseointegration

Osseointegration is the bonding or fusion of an implant and bone, which typically takes several weeks to months.

-Plaque

Plaque is a soft, sticky, colourless film of bacteria that forms continuously on teeth and gums and can harden into calculus if not removed daily by practising good oral hygiene (brushing, flossing, etc.).

-Premolars

The two teeth located on both sides of the mandible in front of the molars.

-Reline procedure

During a relining procedure, a soft or firm material is used to correct the fitting surface of a denture following an extraction or surgery.

-Removable overdenture

A removable denture that is supported by implants but can be removed by the patient for cleansing.

-Restorations

The restoration may consist of a filling, a crown, a bridge, or a denture. It restores the tooth or teeth to full functionality.

-Rejuvenating phase or appointment

This phase follows the surgical phase of the treatment plan, typically a few weeks to a few months after a sufficient degree of recuperation. In the majority of instances, this will involve obtaining impressions so that the technician(s) can fabricate the definitive restoration.

-Sinus augmentation

A surgical procedure in which bone regenerative material is inserted into the sinus to stimulate the formation of new bone in order to enhance the available bone height for implant placement.

-Sterile conditions

In this context, sterility refers to the absence of bacterial contamination. We can never achieve absolute sterility, but we must always strive to achieve as near as possible to a sterile working environment. This includes the use of autoclaves to sterilise all nondisposable instruments as well as drapes and robes to isolate working surfaces and personnel.

-Titanium

This biocompatible metal is used to manufacture implants. Titanium has been utilised for decades in medical procedures, including hip replacements.

-Treatment scheme

A report outlining the patient's dental implant procedure, including the proposed treatment timeline and expenditures. The purpose of this guide is to provide an overview of standard dental implant treatment. Each individual's treatment plan for dental implants will be customised by Norfolk Dental Specialists in terms of cost, duration, and method of care delivery.

Diet Advise following Full Jaw Implant Surgery.

All-on-4 implant surgery is a thorough and successful treatment for periodontal disease and tooth decay, in cases where an entire upper or lower arches are missing or irreparable. Before the benefits of All-on-4 implant surgery take full impact, you can anticipate certain adverse effects after surgery. Possible symptoms include:

• Minimal oozing
• Swelling
• Tense jaw and facial muscles
• Sore throat and/or trouble swallowing
• Site-specific pain

If you experience adverse effects, they are transient and often subside after one week. Any pain or discomfort can be alleviated with over-the-counter drugs such as Paracetamol, Aspirin, or Ibuprofen.

It is very imortant to rest for the first three to four days. After that period of time, and as tolerated, you may resume normal activities and exercise.

However, dietary limitations last longer. These constraints can be divided into two time categories:

• First three weeks after surgery
• From three to six weeks after surgery

Knowing which foods are acceptable to eat following the surgery are crucial, as they will help you with the following;

• Reduces the impact of any pain and/or swelling
• Promotes a rapid recovery
• Maximise the benefits of your All-on-4 operation

If you already have dietary restrictions due to a medical condition (such as diabetes), you should visit a physician or trained nutritionist for advice.

Blender for soft food diet - after surgery, a blender will be your best buddy.

3 Weeks Post-Surgery: Eating on a Liquid Diet

Your mouth, jaw, and throat are likely to be painful for either a few days or up to three weeks after surgery, however any pain or swelling will progressively lessen. As a result, eating might be unpleasant or challenging. During this time a liquid diet without chewing is required.

Here are some considerations to make during this time period;

• The majority of pain post surgery is felt immediately after the surgery. It may be challenging to open your mouth and swallow. If your jaw feels rigid, making it difficult to open your mouth, try massaging it with an ice pack.

• Liquids can be consumed shortly after surgery. In the first 48 hours, you should only consume cool liquids. If you intend to consume something hot, do so until after the anaesthetic has worn off and all bleeding has ceased. It is best to avoid hot or spicy liquids until the third or fourth postoperative day.

• Hydration is key! It's important to consume a great deal of fluids, but in tiny quantities and often throughout the day. Once the anaesthetic has worn off and you feel comfortable enough, you should consume clear fluids shortly after surgery. Fluids will restore and maintain the tissue's moisture for optimal healing, regardless of whether there is drainage following the procedure.

• You will experience hunger as a result of consuming just liquids and avoiding solid foods for the first three weeks following All-on-4 implant surgery. In addition, optimal nutrition is necessary to avoid illness and accelerate recovery. Ensure that the fluids you consume during the day are nutrient-rich and that you consume them often. Given that you have just undergone oral surgery, it is expected that your intake would be lower than usual. However, you must bear in mind that nourishment is essential to healing, and without it you may experience a delay. Following is a list of foods that can be consumed during the first one to two weeks following surgery.

Important - do NOT use a straw when consuming liquids or liquidised food. The sucking movement might loosen blood clots, causing more bleeding and delaying the healing process.

What foods may I consume during this time?

There are numerous liquid foods that can be consumed during the first three weeks following All-on-4 implant surgery. The following are examples of consumable liquids;

• Soup broths (bouillon - beef, poultry, and vegetable)
• Creamy soups (without solids)
• Coconut liquid
• Kefir drinks
• Fruit juices
• Tea/coffee
• Warm cocoa
• Milk, including all forms of cow milk, from fat-free to whole
• Milk derived from nuts or peas
• Milkshakes
• Yogurt drinks
• Meal substitute shakes
• Protein shakes
• Smoothies
• Sodas
• Gelatine (e.g. Jelly)
• Custard
• Ice cream
• Frozen fluids, like fruit ices or popsicles
• Frozen yoghurt

When consuming milkshakes, yogurt drinks, fresh fruit jucies, smoothies and protein shakes, the consistency should be light enough for easy sipping. As the days pass and you feel you can stomach it, you can consume heavier shakes.

When you need to increase your calorie intake, put the following foods in your shakes:

Whites of powdered eggs, milk powder products, instant breakfast mixes (e.g., instant oatmeal), butter, margarine, or oil, sugar, syrup, or honey, or brewing yeast.

Sample Menu for first three Weeks After Surgery

Following is an example of a one-day menu for a fluid diet immediately following All-on-4 surgery. It is vital to note that you should have snacks to ensure that you receive the necessary nutrients and calories for recuperation.

Breakfast

• Fruit juice or smoothie
• Cup of tea or coffee
• Yogurt
• Glass of water

---

Breakfast Snack

• Glass of fruit juice
• Glass of water

---

Lunch

• Meal replacement drink
• Cup of broth
• Jelly
• Glass of water

---

Dinner

• Cup of broth or soup that has been strained
• Cup of fruit juice
• Yogurt
• Glass of water

---

Evening Snack

• Ice cream or frozen yogurt
• Warm cocoa
• Glass of water

---

3 weeks to up to 6 weeks after surgery; A soft food diet

After the pain subsides, you will feel more capable of transitioning from a liquid diet to a soft food diet. During the weeks and months following surgery, it is vital to remember that your jaw is still mending and the implants are attempting to integrate.

The process by which the jaw creates a biological bond with the implant screws is known as osseointegration. To ensure that this occurs correctly, you must continue to monitor your diet.

During the inital three months, you MUST avoid consuming meals that are - heard, chewy or crunchy and that require less chewing.

What foods may I consume during this time?

After three weeks, the following are examples of things you can add to your diet;

• Anything that is mashed or puréed, such as - mash potato, fruits, vegetables
• Everything soft, such as - bananas and melons
• Everything in a can and lacking skin and seeds
• Anything baked or cooked to a tender texture
• Soft breads, cakes
• Cooked pasta (soft)
• Noodles
• Quinoa, cous cous
• Eggs - poached, scrambled
• Pureed sauces

Example Menus for three weeks to six weeks:

This is a sample menu for a one-day soft food diet after surgery. It is vital to note that you should have snacks to ensure that you receive the necessary nutrients and calories for recuperation.

Breakfast

• Scrambled eggs on soft bread
• Fruit juice or smoothie
• Cup of tea or coffee
• Yogurt
• Glass of water

---

Breakfast Snack

• Bowl of soft fruit
• Glass of fruit juice
• Glass of water

---

Lunch

• Soup
• Stir fry with soft vegetables and noodles
• Jelly
• Soft fruits
• Glass of water

---

Dinner

• Meat cooked to a tender texture with mashed potato
• Cup of fruit juice
• Soft cake wirh custard or cream
• Glass of water

---

Several Important Suggestions for the Recuperation Period

Utilize a food blender or processor. If you can combine some of your favourite foods, you can better appreciate the fluid/soft food diet restrictions during the first several weeks of recuperation.

If you enjoy your food, you are more likely to consume sufficient calories and nutrients to help the healing process. Take initiative. When you decide to undergo this procedure, begin investigating what foods you can and cannot consume. This can include recipes for various shake and smoothie varieties. This can also help you stock up on food before surgery so that you are prepared to eat after you get home to recover.

Observe your body. Adjust your intake if you ever feel like you are not getting enough or are perhaps getting too much. Ask relatives for support. And get ~plenty of rest.

How about...

What about unmentioned details? You have learnt primarily what meals you can eat and a small amount about those you should avoid. But there are certain foods and beverages that we are commonly questioned about;

• Do not consume nuts or similar items - these will be far too hard and crunchy for your jaw
• Avoid hot and spicy liquids 24 to 48 hours after the surgery
• During the recovery phase, excessive alcohol consumption should be avoided, as alcohol consumption can impair the dental implants.

You can always consult the dental surgeon should you have any enquiries.

A budget alternative to fixed full jaw implant prosthesis is a snap on denture (overdenture) starting from £2500. By Dr Amir Mostofi DDS, Dip. , MSc.

A budget alternative to fixed full jaw implant prosthesis is a Snap-on denture (overdenture) starting from £2500.By Dr Amir Mostofi DDS, Dip. ,MSc.

Here, I would like to explain about a cheaper alternative that our practice, Clinic for Implant and orthodontic dentistry is providing. A budget alternative to fixed full jaw implant prosthesis is a snap on denture (overdenture) whith the cost starting from £2500 in UK (at the time of writting). Some patients would like to have a full jaw implant restored fixed prosthetics. However, the cost of such treatment is beyond their reach. The cost of fixed dental implants for a full jaw restoration can vary depending on several factors, such as the number of implants needed and the experience level of the surgeon. However, on average, a fixed full jaw restoration with fixed dental implants can cost between £12000 to £25000 in UK. A practical alternative is option of overdenture (snap on denture). The cost of Snap-on dentures for a full jaw restoration is typically less expensive. The cost can vary depending on the number of dental implants needed and the materials used for the denture. However, on average, the cost for a full jaw restoration with a Snap-On denture can range from £2500 to £12000 in United Kingdom. This cost is more affordable for many patients.

Snap-on dentures, also known as overdentures, are a type of denture that snaps onto a small number of dental implants in the jaw bone. This type of denture offers a number of benefits over traditional dentures, which rest on the gums and are held in place by suction or adhesives.

One of the main benefits of snap-on dentures is improved stability and retention. Traditional dentures can slip and move around in the mouth, causing discomfort and making it difficult to speak and eat. Snap-on dentures, on the other hand, are securely attached to the dental implants, which anchor them firmly in place. This means that snap-on dentures do not slip or move around in the mouth, which greatly improves the ability to speak and eat.

Another benefit of snap-on dentures is that they provide a more natural-feeling bite. Traditional dentures can change the way the jaw and teeth align, which can cause discomfort and even jaw pain. Snap-on dentures, however, are anchored to the jaw bone, which helps to maintain the natural alignment of the jaw and teeth. This can help to reduce discomfort and jaw pain.

Another benefits of snap-on dentures is that they do not require adhesives to hold them in place. Traditional dentures rely on adhesives to keep them in place, which can be messy and unpleasant to use. Snap-on dentures, on the other hand, are anchored to the jaw bone and do not require adhesives to stay in place. This makes them more convenient and comfortable to wear.

In addition, snap-on dentures can help to preserve the jaw bone. Traditional dentures rest on the gums and rely on suction to stay in place. Over time, this can lead to bone loss in the jaw, which can cause the dentures to fit poorly and make the face appear sunken. Snap-on dentures, however, are anchored to the jaw bone and help to preserve bone and maintain a more youthful appearance. Snap-on dentures, also known as overdentures, are a more cost-effective option for full jaw restoration compared to fixed dental implants. While both options can provide a secure and stable solution for missing teeth, the cost of fixed dental implants can be significantly higher.

Another factor to consider is the maintenance costs. Fixed dental implants require regular check-ups and cleaning like natural teeth, but snap-on dentures are easy to clean and maintain, which can save patients on additional costs in the long run.

It's worth noting that the final cost of the treatment will depend on the individual case, and it's important to consult with a dental professional to get an accurate estimate of the cost. In conclusion, Snap-On dentures offer a number of benefits over traditional dentures, including improved stability and retention, a more natural-feeling bite, greater durability, no need for adhesives, preservation of jaw bone, more budget friendly and easy to clean. While they may require more upfront costs, snap-on dentures are a more secure, durable, and comfortable option for those in need of dentures.

"Dental Bite Splints: A Comprehensive Guide to Relief, Protection, and Improved Oral Health" - By Dr Amir Mostofi DDS, Dip. MSc

What are dental bite splint?

A dental bite splint is a small, detachable device worn over the teeth to assist reduce pain and suffering brought on by bruxism, TMJ disorders, and other abnormalities with the bite. These splints can be tailored to fit a person's mouth and are often constructed of acrylic or other hard plastic materials.

Bruxism is a condition in which a person unintentionally clenches or grinds their teeth, frequently when they are asleep. Numerous issues, such as tooth deterioration, jaw pain, migraines, and facial muscle pain, may result from this. In order to reduce pressure and strain on the jaw muscles and joints, which can cause pain and discomfort, bite splints work by giving the teeth a smooth, even surface to rest on.

The jaw joint and the muscles that govern the jaw are both impacted by TMJ disorders. These conditions can make it difficult to bite and chew, as well as create pain and discomfort in the jaw, cheeks, neck, and shoulders. By helping to stabilise the jaw and redistribute the power of biting and chewing, bite splints can assist to reduce these symptoms.

Bite splints come in a variety of designs and forms, each with a distinct function. Hard splints, soft splints, occlusal guards, and orthopaedic splints are the most popular varieties. Hard splints are designed to offer a sturdy surface for the teeth to rest on and are composed of acrylic or other hard plastic materials. They are typically worn at night and can aid in reducing bruxism and TMJ disease symptoms. On the other side, soft splints are created to be more comfortable to wear and are constructed of softer materials like silicone or rubber. They are typically worn during the day and offer a temporary fix for people who have dental work or missing teeth, as well as relief from the signs and symptoms of bruxism and TMJ disorders. In order to protect the teeth from harm when participating in sports or other physical activities, occlusal guards are similar to hard splints. Orthopedic splints, on the other hand, can be worn for a longer amount of time and are intended to assist address misaligned bites or other abnormalities with the bite.

Each patient's bite splint is normally constructed specifically for them by a dental practitioner. To identify the root of the patient's bite issues, the procedure starts with a dental examination and bite analysis. The dentist will then make a model of the patient's mouth using impressions of the patient's teeth. The bite splint is then created using the model as a guide and materials and methods tailored to the patient's requirements.

The usage of a bite splint has several advantages, including the reduction of pain and suffering brought on by bruxism and TMJ conditions, defence against teeth grinding and clenching, stabilisation of the jaw and correction of misaligned bites, and enhancement of sleep. However, using a bite splint has some potential drawbacks as well, such as initial discomfort while getting used to wearing the splint, difficulty speaking or eating while wearing the splint, the need for routine cleaning and maintenance of the splint, and the potential for tooth movement or changes in the bite if the splint is not properly fitted or maintained.

A dental bite splint is an effective tool for people who suffer from pain and discomfort brought on by teeth grinding, TMJ disorders, and other bite-related problems. These splints can offer comfort, safeguard teeth, and enhance general dental health. If a biting splint is the best course of therapy for you, it's crucial to speak with a dentist who can also correctly fit and maintain the splint to maximise its effectiveness.

While bite splints can frequently help with the pain and discomfort brought on by bruxism and TMJ issues, it's crucial to treat the underlying issue if you want to experience long-lasting relief. This may entail dietary adjustments, stress reduction measures, or the application of additional therapies like mouthguards or dental appliances.

It's critical to maintain appropriate dental hygiene while wearing a biting splint in addition to treating the underlying causes of bite issues. To do this, you should frequently brush your teeth, floss them, and visit a dentist for cleanings and checkups. To ensure their efficiency and durability, bite splints should also be frequently cleaned and stored in a safe place when not in use.

If any discomfort or problems develop while using a bite splint, it is extremely crucial to speak with a dental expert. If the splint is not offering the required relief or if it is causing any discomfort or problems, it may need to be changed or replaced.

Although bite splints can be a beneficial therapy choice for many patients, they might not be appropriate for all patients. Before beginning use of a bite splint for treatment, it is crucial to discuss any worries or queries with a dental practitioner.

Bite splints can improve general oral health in addition to reducing pain and discomfort. Bite splints can assist to prevent tooth damage and maintain the health of the teeth and gums by shielding the teeth from clenching and grinding. Additionally, they can aid in jaw stabilisation and bite alignment correction, enhancing the mouth's overall functionality and attractiveness.

In general, bite splints can be a helpful therapy choice for those who are in pain or uncomfortable due to teeth grinding, TMJ disorders, or other bite-related problems. Although utilising a biting splint may have some downsides, for many people, the advantages of comfort and better oral health may outweigh these concerns. To ensure the success of the bite splint, it is crucial to work closely with a dental professional to choose the best course of treatment and to properly fit and maintain the appliance.