Bringing confidence to your smile. Dental Implants. Patient Information

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1 Dental Implants Patient Information

2 Our area expertise is dental implants and this is an area about which our team are both passionate and highly trained. We work closely together with your dentist to provide the highest standards of treatment and care. Collectively we ensure that all the different treatment options are available to you. We have over 40 years experience in our field of dentistry are here to provide the clinical treatment for you as our patients, training for the profession through our institute (ICEi), and support and mentoring for our practitioner partners through our association (ICEa). We are very privileged to be work as part of your dentist s team. The fundamental principles of ICE are: 1. Provide the highest quality of care in all aspects of Dental Implant related treatments. 2. Raise the quality of life of our patients. 3. Provide full and continuous clinical support to Dentists and their team members. There are many partners and professionals that make up the ICE family. The Clinical Faculty at your local ICE clinic are led by: Prof Cemal Ucer, BDS, MSc, PhD, Oral Surgeon Cemal Ucer first established an implant referral centre in He is a Fellow of the International Team for Implantology (ITI), Editor-in-Chief of the ARK- the ADI on-line Education Programme. He is a member of the editorial board of JOMR (Journal of oral & maxillofacial research) and the editor of the Implant Dentistry Today. Cemal is Professor and Clinical Lead of the Diploma/ MSc programme in dental implantology at Salford University and a member of the Faculty of Examiners of the Royal College of Surgeons of Edinburgh in Implant Dentistry. Cemal is the President of Association of Dental Implantology (UK). Dr Simon Wright, MSc PGDip Dental Implantology BDS PGCTLCP FHEA Simon completed the Trafford One Year Implant Course in 2004, and has gone on to complete his Diploma in Implant Dentistry, and his MSc in Dental Implantology. Dr Wright is a Senior Lecturer in Implantology at the University of Salford, and an Honourary Lecturer at the University of Manchester, but also lectures nationally and internationally for Astra Tech, Straumann, the ITI, Mersey Deanery, and on the MSc courses at Manchester, Cardiff and Sheffield. He has a keen interest in teaching dentistry and is a trainer for young foundation dentists and nurses. He has written many courses for nurses and dentists, and has been gained a Fellowship to the Higher Education Academy. Dr Dave Speechley, MSc.BDS DMI RCS Edin PGDip Implant Dentistry. David restored his first implant in 1990, well before they were mainstream, predictable, and affordable. At that time there were few (if any) recognised training pathways in dental Implantology. In 2003 David gained his diploma in medical informatics from the Royal College of Surgeons Edinburgh, and became a part time lecturer at both Liverpool University Dental School, and Liverpool University Medical School. More recently he has become a postgraduate dental tutor for the North West (Mersey) Deanery, the Dental representative for Lever s Ethics Committee, member of the Local Dental Committee, and Treasurer of the Association of Dental Implantology. David has lectured for a number of commercial companies, including Straumann, and Astra, and on MSc. David is a member of the Faculty of Examiners for the Royal College of Surgeons England. Who are ICE?

3 Treatment Options The loss or absence of teeth; be it through dental disease, accident or congenital defect, not only affects your appearance and confidence, it can also hinder your speech and the ability to eat and enjoy food. For almost 40 years, dental implants have offered a scientifically proven means of replacing one or more missing teeth or to anchor dentures securely. Implants are just one option to replace a missing tooth, these are: 1/ Do nothing and accept the gap. There are many advantages to doing nothing, and this may be a consideration in the back of the mouth, however there are also some disadvantages these are: Appearance Ability to eat effectively, this will also affect your diet and general health Your teeth help you form sounds, so your speech may be affected Oral Comfort Your jaw bones start to dissolve away as the teeth are gone, this will start to affect your facial profile. 2/ Dentures Dentures are metal or plastic removable devices that ideally need to removed at night. They rest on the soft tissues of the mouth, and may also be clipped around the teeth. Dentures are good, cost effective way to replace many teeth, however they may become loose and need changing as your mouth changes with time. 3/ Bridges A bridge restores one or more missing teeth using one or both teeth either side of the gap. The bridge may need either minimal or extensive shaping of the teeth either side of the gap. This means that these teeth need to be in good condition and you have to accept that it may reduce the life span of these supporting teeth. 4/ Dental Implants There are many options for the restoration with dental implants, and these are explained fully as we go through this booklet. What is a Dental Implant? A dental implant is a small screw made of medical-grade titanium which is inserted into the jawbone which then bonds to the implant surface over 6 to 12 weeks. After the healing period the tooth replacement in the form of a crown, a bridge or a denture is secured to the implant. How long do implants last? Nowadays implants have a very good long-term outlook and many, with the right care and attention, will never have any complications. The research certainly demonstrates that over 95% of implants placed are healthy after 10 years. The way that you look after your implant is fundamental to the long-term success of the treatment, there are a number of risk factors that may make the implant more likely to have problems. Usually these can be removed or reduced to a minimum. Your dentist will discuss how these risk factors will affect your individual case. The main ones are: A history of gum disease; this makes it more likely to get gum disease around the implant. Uncontrolled Diabetes; If your Diabetes is uncontrolled you are more likely to get an infection. Oral Hygiene; Poorly cared for implants are more likely to have complications A heavy bite or tooth grinding. Stress Smoking; the research demonstrates that smoking is a significant risk factor, so we would urge you to give up smoking. The less you smoke the less of a problem that it becomes. Drinking; social drinking does not affect the process particularly; however drinking above the recommended weekly intake may have an effect.

4 Implant Related Options Dental implants can be used for many different types of treatments. They can be used to replace on single tooth unit, to support an implant retained bridge, or to retain a removable denture. We will thoroughly investigate which type of treatment is most appropriate for you. This is based on the number of teeth to be replaced, the condition of any remaining teeth, the amount of bone support, the way you bite together, and your desired outcome in terms of appearance and oral comfort. Replacing one or more teeth Problem Single tooth gap Solution Implant-supported single crown Looks and functions just like a natural tooth No need to damage adjacent healthy teeth Continued use (loading) prevents resorption shrinkage of the underlying bone Implant-supported tooth prevents lateral movement (drifting) of adjacent teeth and over-eruption of opposite tooth Very high and predictable long-term success (98 percent). Alternatives Leave a gap Conventional bridge Denture Replacing several missing teeth, a failed bridge of a partial denture. Problem More than one tooth missing Solution Permanently fixed bridge or crowns supported by implants Eat anything you choose Looks and works just like natural teeth Fixed in place, no need to remove it to clean No need to damage adjacent healthy teeth Prevents shrinkage of underlying bone Alternatives Replacement tooth-supported bridge Larger tooth-supported bridge Partial denture Leave a gap Replacing all your Teeth Problem All teeth missing Loose, uncomfortable or poorly fitting conventional complete denture Solution Implant-supported fixed or removable complete arch bridge Implant-supported permanently fixed porcelain bridge Removable (clip-retained) denture Conventional denture located with two implants Alternatives Continue with a complete conventional denture Implant Options

5 Treatment Process There are a number of stages to dental implant treatment. This is to ensure that you receive the treatment that is appropriate for you and you get the end result that you expect. 1. Patient Info You will be given all the information that you need to make an informed decision about your treatment options. 2. Treatment Plan Your dental team will develop a treatment plan with you. For this you will need to have a full examination, and some xrays. Sometimes the bone in your jaw may have shrunk away, if this is the case we may request a 3-D scan to give us a computerised image of your jaw bones. At the end of this appointment you will be given a written summary of your treatment planning discussion and you will be given the expected cost of your treatment. 3. Surgery Before this appointment you would have had any routine treatment and your teeth and gums would have been cleaned. You may be asked to carry out some tasks around the time of this appointment these may include: Taking some antibiotics Rinsing with a mouthwash Not driving your car Bring a friend or relative with you. The surgery is usually a simple and minor procedure. It is carried out under sterile conditions and is totally painless - you usually have the same anaesthetics that you do when having a filling. Depending on each individual case it may take 30 mins for a single tooth, upto several hours for a whole mouth operation. After the surgery you may get some bruising and swelling, however this is usually adequately controlled with normal painkillers. It is very important that you follow the instructions given to you after the surgery these are detailed in the Post operative information stage. You will need to have your mouth checked a couple of times to ensure your healing is uneventful. One of these may be to remove the stitches after about 10 days. The bone will now fuse with the implant, this is known as integration. This normally takes between 6 weeks, but may be as long as 6 months if bone grafting is needed. 4. Restoration Phase After period of integration, where the bone heals onto the implant, the restoration can fitted. This usually involves one or two appointments. The first involves have a mould or a digital impression taken of your mouth. This is then sent to a technician to fabricate your teeth. The final appointment is to fit the restoration. Sometimes we build in more restorative appointments if we need to change the shape of you gums, or check the appearance. 5. Maintenance and Follow-up. You will need to look after your implants and have then checked every 6 months.

6 Bone Grafting Sometimes people do not have enough bone to secure the implant into. In these cases we need to carry out additional procedures to augment the bony ridge. This is usually done at the same time that the implant is placed, and it makes very little difference to the treatment or how long it takes. However if the bone is very deficient then you may need an entirely separate procedure to regenerate the bone. There are many ways to regenerate bone, the most common way is to create a scaffold into which new bone can grow. This can be done using animal, synthetic or your own bone. This is called Guided Bone Regeneration. The animal products are safe to use in humans, however your dental team will give you some specific information about the products that they use if you ask them. In the upper jaw we can simply grow new bone in the sinus, this is known as sinus augmentation and is highly predictable. The Nervous Patient Most procedures are simple and normal anaesthetics are adequate, however if you are more anxious then there are several effective techniques to help you relax. These include: Relative Analgesia: - This is a mixture of laughing gas (Nitrous Oxide) that you inhale through a mask. It is similar to what you have when giving birth. Oral Sedation:- We can give you some medication to help you relax, usually Tamazepam. Conscious Sedation: - This is a sedative that is administered into a blood vessel. You are awake, but rarely remember the procedure. General Anaesthetic:- In very exceptional circumstances we may decide it is best for you to be asleep. Temporary Devices There may be a time during the treatment that you have gap. This can be temporised to ensure that you always have teeth. You will be able to work and live as normal with these temporary devices. Sometimes your dentist may want you to leave the temporary device out of your mouth. If this is the case you team will tell you with plenty of notice. A number of provisional devices are available: Restore the implant straight away Denture Bridge Essex guard this is a clear guard lips over your teeth Your dentist will help you decide which is best for you.

7 ICE, 28 Rodney Street, Liverpool L1 2TQ

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