Multiple Tooth Implants

Multiple tooth implants may be placed if you need or desire to permanently replace an extracted or lost tooth. Titanium implant bases are placed into the jawbone to replace the job of the tooth roots. We allow a period of time to allow for the jawbone to heal over the bases before fitting for a crown. Next, abutments are screwed into the bases of the implants to allow crowns to be attached. Finally, custom fabricated crowns are placed over the abutments and will function like a real tooth.

1. Eliminates the need to "cut down" the neighboring teeth to make a bridge.
2. Maintains the jawbone structure.
3. Feels and functions like natural teeth.
4. Does not rely on other teeth for support.
5. Replaces partial plates and may be used to secure loose dentures.
6. Cleaned and flossed like a natural tooth.

In many situations it is possible to remove the diseased and/or loose teeth and replace them with dental implants at the same time. In almost all situations simultaneous bone grafting is completed. This method of treatment reduces the number of surgical visits. It also speeds up the entire process enabling the implants to be ready to receive (caps/crowns) more quickly.

Eligibility Consultation
i-CAT 3D CBCT (cone beam)
During your initial no-risk consultation your health status and jawbone vitality will be evaluated to decide your eligibility for the revolutionary All-On-4® procedure.

Your oral exam will include a 3D CT-scan of your jaw that will be used to generate three-dimensional images of your teeth, soft tissues, nerve pathways, and bone. The highly accurate 3D radiographic images will support your diagnosis, planning, and treatment.

If your eligibility is confirmed a custom treatment plan and sequence will be formulated. The fee will be determined and the financial information will be reviewed.

Sedation and Implant Placement
During surgery, you are fully sedated.
Your comfort is a priority, we provide sedation for a comfortable anxiety-free procedure.

Any failing teeth that remain will be extracted and then you will be prepared for implants to be placed. Two straight implants in the front and two implants tilted up to 45º in the back of your jaw.

At the close of the procedure patients meeting criteria for immediate loading of the implants will receive a fixed provisional bridge. In other words, if you meet the requirements, you will leave with teeth.

Post-surgical Care
After a few days, you return for the permanent denture.
The typical All-On-4® choice is an acrylic denture built around a titanium framework.

The All-On-4® treatment concept is a cost-efficient, graftless solution that provides patients with a fixed full-arch prosthesis on the day of surgery.

Treatment Offers:

• Full-arch rehabilitation with only four implants:
  Two straight anterior implants and two implants tilted up to 45º in the posterior
• Immediate Function: (fixed provisional bridge)
  For patients meeting criteria for immediate loading of implants
• Graftless procedure:
  Bone grafting is avoided by tilting the posterior implants, utilizing available bone

Gary Ackerman, DDS will evaluate your current requirements and needs to determine if the All-On-4® procedure is right for you. There are many different tooth replacement options available, and in some cases where All-On-4® might not be the best, we will pair you with the best dental implant option to restore your smile.

If you have slipping dentures and are tired of being self-conscious about the thought of losing them at an inopportune moment, a full arch implant might be the solution for you. Dental implants that can be placed to accept a full arch of teeth. This is done by strategically placing implants along the upper or lower jaw and attaching a denture-like attachment over abutments on the implant posts. Once placed, a full arch using implants will feel and perform like natural teeth. You will be able to chew with confidence and never have to worry again about losing your dentures.

This implant technique, is the optimal solution for those who have lost or are about to lose all of their upper and/or lower teeth. It's a procedure that comes closest to having a new set of permanent teeth.

There are actually two phases to implant dentistry.

Phase 1: Using very accurate surgical techniques, an incision is made in the gum tissues and implants are placed into dimensionally controlled sites (depth and width) in the jawbone.

First, the gum tissue is opened and the jaw bone is tapped with a small drill and then drilled with a wider drill. The implant is inserted into place. The gum tissues are then closed and the healing phase begins. This may take anywhere from 3-6 months to ensure a strong base.

Phase 2: An abutment is secured to the top of the implant placing a new tooth crown onto the implant abutment. Implants can replace a single tooth, several teeth or your dentures.

Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There will be a metal healing abutment protruding through the gingival (gum) tissue.

BLEEDING. Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding can be controlled by biting on a gauze pad placed directly on the bleeding area for 30 minutes. If bleeding continues please call the office for further instructions.

SWELLING. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon as it is the body's normal process in repairing itself. Swelling does not always appear immediately. It may take 12 to 24 hours before swelling becomes apparent. Swelling may not reach its maximum until 2-3 days post-surgery. Swelling may be minimized by the immediate use of ice packs post-surgery. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 36 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days call the office.

DIET. Drink plenty of fluids. Avoid hot liquids or hot food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed.

PAIN MEDICATION. You should begin taking pain medication as soon as you feel the local anesthetic wearing off. For moderate pain, 1 or 2 Tylenol or Extra Strength Tylenol may be taken every 3-4 hours. Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen, bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken every 3-4 hours as needed for pain. For severe pain, the prescribed medication should be taken as directed. Be sure to take the prescribed antibiotics as directed to help prevent infection. Do not take any of the above medication if you are allergic, or have been instructed by Gary Ackerman, DDS not to take it.

HOME HYGIENE CARE. The night of surgery, use the prescribed Peridex Oral Rinse before bed. The day after surgery, the Peridex should be used twice daily, after breakfast and before bed. Be sure to rinse for at least 30 seconds then spit it out. Warm salt water rinses (teaspoon of salt in a cup of warm water) should be used at least 4-5 times a day, as well, especially after meals. Brushing your teeth and the healing abutments is no problem, but be gentle initially with brushing the surgical areas. Good oral hygiene is essential to good healing.

PHYSICAL ACTIVITY. Keep physical activities to a minimum immediately following surgery. Physical activity could cause throbbing or bleeding of the surgical implant area.

WEARING DENTURES. You will always have teeth during your recovery period. Temporary partial dentures or full denture arches should not be used immediately after surgery and for at least 10 days.

Before making the decision in going the implant route, ask yourself if there is another option. We offer many different implant alternatives.

The different alternative options to implants that we provide are:

• Tooth Supported Bridge
• Removable Partial Denture
• No Treatment