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Dental Implants in Brooklyn, New York

By Dr. Robert Mikhli and Dr. Theodore Goff

 

Missing even one tooth can result in an unsightly gap in our smile or the loss of chewing in an area of the mouth.  While these consequences are esthetically displeasing, or at the least inconvenient, these are the least of the significant problems resulting in the loss of a tooth.  What is of greater concern is the bone loss that inevitably follows tooth loss. The placement of a dental implant will ultimately result in the implant fusing with the bone, preserving your jaw bone, improving chewing function and enhancing or restoring the esthetics of the smile.

 

Dental implants have revolutionized the replacement of teeth in the field of dentistry.  In the last fifty years the technology for dental implants has rapidly developed and improved.  Today, dental implants may be your best option for the replacement of a tooth, multiple teeth, or the entire dental arch. 

 

What are dental implants? 

 

Dental implants are becoming the new standard in tooth replacement. They are a popular and effective long-term solution for people who suffer from missing teeth or chronic dental problems.  Unlike dentures, bridges and crowns, dental implants act as artificial tooth roots that integrate into the jawbone, providing a long-term base for secure, stable and comfortable tooth replacement.

One of the biggest strengths of dental implants is their durability. Each implant is typically made from medical-grade materials like titanium, acrylic, porcelain and zirconia. This means you get a natural-looking tooth, without the same issues of decay, traditional gum disease and root canal therapy you get with your natural teeth. In fact, when properly cared for, dental implants can last a lifetime.

 

Dental implants are a more modern tooth replacement solution than dentures or bridges. They’re designed in a way that they will integrates with the bone of the jaw. This forms a strong, durable, long-term anchor for your new teeth while keeping the bone itself from deteriorating. It also ensures there’s no slippage or other uncomfortable movement that can sometimes happen with dentures.

One of the things people love most about dental implants is how real they look and feel. Because the connection with the jawbone is so strong, they actually become a part of your mouth, functioning like natural teeth. Imagine waking up and smiling in the mirror, chewing your favorite foods again and laughing out loud with friends, all without the daily chore of dentures. 

 

Dental implants consist of three components: the dental implant itself, an artificial tooth root that serves to replace the root of the tooth – the portion of the tooth that is below the gumline, a dental abutment, or mechanism to allow attachment between the dental implant and the crown, and a dental crown, or artificial tooth.  

 

Figure 1: Dental Implant, Abutment, and Crown. https://www.aaid-implant.org/dental-implants/what-are-dental-implants/

 

 

 

 

 

 

Benefits of dental implants? 

Replacing damaged or missing teeth with implants is more than another dental procedure.  Implants can transform your oral health and help you reclaim what you have been missing.  The benefits are beyond a new smile.

Unlike older, short-term tooth replacement technologies like dentures or bridges, dental implants are made of durable, stable materials like titanium, which do not require repetitive maintenance and replacement.  Dental implant treatment has a 95% or higher success rate, when properly placed, making this the preferred tooth replacement solution for so many people.

Chew, Talk, and Smile with Comfort

One of the things people love most about dental implants is that they feel and function like real teeth. You will be able to brush, floss, eat, talk, and smile with comfort and confidence. There’s no slipping, readjusting, reapplying adhesives, or taking them out every night. With dental implants, it is as if you were born with them.

Improve Your Overall Health

Dental Implants can help improve more than just your oral health. Dental health is scientifically linked to heart health. The removal of infected teeth and the placement of dental implants can help address gum and heart disease, together. Also, when you are able to eat healthier foods, like raw fruits and vegetables, you can enjoy a healthier, well-balanced diet.  If you have been dealing with chronic dental issues, over time they may have affected more than just your dental health — like the simple act of laughing without reservation, kissing your spouse, smiling for family photos, or interacting with coworkers. Many patients find that one of the most valuable benefits of dental implants is regaining the confidence to reclaim the life they want and reconnect with others.

Look as Young as You Feel

As soon as teeth are lost, bone loss in the jaw starts. Over time, this causes a sunken-in look that may contribute to looking older. Because dental implants naturally become part of your mouth, they not only keep your jawbone strong and healthy, but also help you maintain the natural shape of your face, helping you look more like you.

 

Although the entire treatment process takes more than one day, you will experience a noticeable transformation on the day of your procedure. If you are restoring your entire arch, that morning, you will walk into Precision Implant Care and leave later that day with a beautiful new smile that you can start sharing right away.

What types of dental implant procedures are available?

 

One of the reasons why dental implants are becoming the new standard in tooth replacement is their versatility. Whether you are looking to replace a complete row of upper and lower teeth, multiple teeth, or a single tooth, dental implants can address a wide range of tooth replacement needs. If you’re not sure which type is right for you, Dr. Robert Mikhli or Dr. Theodore Goff will examine your condition and help you decide during your consultation.

Missing a single tooth

If an individual is missing a single tooth, the options to restore their smile are:

  • A partial removable denture to fill in the gap

  • A dental bridge

  • A dental implant.

 

A removable partial denture is held in place by small clasps.  The partial is made of acrylic, and sometimes a metal bar, and it will come in and out of the mouth.  Many patients find this option unacceptable due to the movement of the partial denture and the fact that it can be taken out of the mouth.

 Figure 2: A partial removable denture to fill the gap.

A dental bridge restores the missing tooth by “bridging” a replacement tooth, called a pontic, between the two opposing teeth, called “abutment teeth”.  To bridge teeth, the dentist will prepare the two abutment teeth for dental crowns.  A special dental laboratory will fabricate a three unit restoration called a dental bridge.  This restoration will be cemented over the abutment teeth and form a “bridge”, replacing the missing tooth.  Many patients do not prefer this method of replacement because the two teeth prepared have to have tooth structure removed to accommodate the bridge, the bridge is one unit and each tooth cannot be flossed, and the price for a bridge is nearly the same price as a dental implant system. 

 Figure 3: A bridge to fill the gap.

A dental implant system restores the missing tooth as a single tooth.  Once completed, the dental implant appears just like a natural tooth.  Dental implants consist of three components: the dental implant itself, an artificial tooth root that serves to replace the root of the tooth – the portion of the tooth that is below the gumline, a dental abutment, or mechanism to allow attachment between the dental implant and the crown, and a dental crown, or artificial tooth.  When properly placed, a dental implant system is the ideal treatment for a missing tooth or missing multiple teeth.  The system looks just like a natural tooth when you smile, there is no visible difference.  A dental implant and the dental crown attached to the implant does not decay like a natural tooth can, meaning your dental implant crown will not get a cavity and require a filling, and the bone around the dental implant will not deteriorate as it would if the missing tooth root was not replaced. 

 Figure 4: A dental implant to replace the missing tooth and tooth root.

Missing multiple teeth

If an individual is missing multiple teeth, the options to restore their smile are:

  • A partial removable denture to fill in the gaps without any implant retention or stabilization

  • A dental bridge or several bridges cemented over prepared teeth

  • Dental implants individually placed to replace teeth or spaced appropriately to create anchors for dental bridges.

As with a removable partial for a single tooth, there are partial dentures for multiple teeth.  These are fabricated to fill in the missing teeth in any area within the arch.  With multiple missing teeth, bridges are still an option, however the number of pontic teeth will increase.  

 

In many instances, dental implants can stand in place of two missing teeth, reducing the span of a dental bridge, eliminating the need to remove tooth structure of other teeth, and replace missing roots of teeth, subsequently reducing bone loss. 

 

 

 

 

 

 

 

 

 

 

 

 

Figure 5: Dental implant replacing 3 missing teeth

 

Full Mouth Rehabilitation

When all of the teeth in the mouth or within a single arch are too damaged to be saved, full mouth or arch rehabilitation is the ideal option to restore function to the mouth. When a full arch or mouth rehabilitation is necessary, the options are:

 

  • A complete removable denture or dentures without any retention with implants

  • Removable implant stabilized overdentures for each arch

  • Fixed, implant retained prosthetics for each arch, the All-on-4 procedure

 

Removable dentures are fabricated to fit over the gums and can be adhered to the tissue with temporary gel or paste that acts as a sticky glue like substance to help hold the dentures in place during the day.  Dentures are removed from the mouth every night.  Many patients object to dentures due to their movement when speaking and eating, the potential for sore spots on the gums, large amounts of plastic across the palate and into the gum tissue, and the long term loss of jawbone.

Figure 6: Upper and lower dentures to replace a full arch of missing teeth.  No implants are involved

 

 

Implant stabilized dentures are also removable dentures, however they are stabilized with two to four implants. The denture itself is removed each night, however the implants remain in the mouth indefinitely.  Many patients prefer an overdenture over a removable non-stabilized denture because the implant stabilized denture is more secure when chewing and talking, there is no need for any adhesion gel or glue, the amount of plastic over the palate and into the gumline is significantly reduced and the placement of some implants allows the jawbone to have some structure to attach to, thus reducing the amount of bone loss. 

 

 

 

 

 

 

Figure 7: Implant stabilized denture (over denture). The denture is removable, but secured by implants to improve stability and balance 

 

Fixed, implant retained prosthetic arches are the state-of-the-art dental prosthesis for full arch rehabilitation.  Also known as the All-On-4 Procedure or Hybrid Prosthesis, the fixed, implant retained prosthetic is the ideal treatment for full arch or full mouth rehabilitation.  A hybrid prosthetic is retained in the mouth by four to eight implants.  The prosthetic is secured to the implants by the dentist and can only be removed in a dental office.  The prosthetic is very thin and appears like natural teeth.  The base is custom fit to the contours of the patients gums so there is a very tight fit, minimizing any food getting lodged beneath the prosthetic.  Patients are especially keen on the hybrid prosthesis because it is very thin and does not extend into the gumline or over the palate. 

 

 

 

 

 

 

 

 

 

 

 

 

 

Figure 8: Implant retained prosthesis. The prosthetic can only be removed by your dentist.  

 

What is the process when receiving a dental implant?

Dr. Robert J. Mikhli or Dr. Theodore Goff will follow routine procedures to evaluate each patient for their candidacy for a dental implant.  The patient’s medical status and general health will be evaluated, the dental implant site will be carefully evaluated, the way the patient bites will be considered, and the esthetic concerns will be carefully evaluated.  A special scan, called a Cone Beam Computed Tomography (CBCT), will be administered so the dentists can have a 3-D representation of the patients teeth, skull, and nerve location.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Figure 9: CBCT for Implant Planning.  https://cdeworld.com/courses/4804-Clinical_Applications_of_CBCT_and_CAD-CAM_Data_Integration?c=133

The use of the CBCT allows the dentist to assure that the underlying bone is thick enough to retain a dental implant and to evaluate ideal implant placement to avoid placement of the dental implant into nerves or sinus cavities.  Upon completion of a thorough planning process, the patient is ready to have their dental implant placed.

 

Dental implant surgery is generally a very comfortable process performed under local anesthesia.  Most patients say that they feel minor vibrations from the hand piece when preparing the implant site.  Upon completion of the surgery there are no open wounds and very little, if any post-operative discomfort.  In most cases, the dental implant will remain under the gums for 4 or 5 months to fully integrate into the bone.  Once the implant is fully integrated into the bone, the implant will be uncovered and prepared for the dental crown.  The implant uncovery is performed under local anesthesia with a small incision made into the gum above the dental implant and a small cap (healing abutment) placed onto the implant to properly contour the gums in preparation for the dental crown. Most patients experience very little discomfort following the uncovery procedure.  Over the course of one to three visits, following the uncovery, the patient will receive their final crown, and the implant procedure is complete.

The placement of an implant requires expert knowledge for proper surgical planning, proper implant placement and proper attachment of the crown.  Dr. Robert Mikhli, owner and operating dentist, as well as Dr. Theodore Goff, operating dentist, of Precision Implant Care in Brooklyn, New York have extensive experience and training in implant dentistry.  Dr. Robert Mikhli and Dr. Theodore Goff are top-rated dentists offering dental implants and oral surgery at Precision Implant Care.  They utilizes state-of-the-art surgical approaches and technology to restore oral health and enhanced aesthetics to patients with damaged, diseased or missing teeth.  

Today, the dental implant system is a commonly used procedure to replace a single missing tooth, multiple missing teeth, or to aid in the rehabilitation of the entire arch.  While there are several dental procedures to replace missing teeth, dental implants are the most effective procedure to restore your smile, your chewing functions, your confidence, and most importantly, stop the loss of jaw bone surrounding your teeth.  A dental implant system can look and feel almost as natural as your own tooth and in the long run, can be the most cost effective procedure necessary to restore your mouth to the most optimal state of health.  According to the American Dental Association (ADA), more than 5.5 million dental implants are placed annually in individuals by dentists in the United States.

During your consultation, the doctors at Precision Implant Care will discuss the various options available to replace your missing tooth or teeth.  

 

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