GERALD L. KAISER D.D.S.
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Dental Implants                    call: 480-767-0058
   

Subperiosteal Implant (Subs)

These are saddle shaped implants that are placed between the gum and bone.  Although very successful in the lower jaw, the success in the upper jaw is questionable.  Therefore, Dr. Kaiser no longer places subs on the upper, due to the unacceptably high failure rate.  Dr. Kaiser continues to place subs on the lower, but only in cases of extremely narrow bone ridges that cannot be predictably treated with other types of dental implants. Very few dentists have experience with subperiosteal implants. 

 

Endosseous Implants (Root form)

 

This is the type of implant commonly used today.  These implants can be used to support a single tooth, or serve as anchors to support multiple teeth, or even support and stabilize complete dentures. 

 

This type of implant is extremely successful, and the best way to replace missing teeth.  Dental bridges anchored on natural teeth are no longer the standard of care, because of the higher incidence of problems and poorer long term prognosis compared to bridges anchored by implants.

 

There are three parts to what is commonly termed a dental implant.  There is the implant body, the abutment, and the tooth, teeth, or denture supported by the implant-abutment complex.

 

The Implant Body

 

The implant is made from titanium, a biologically compatible material that is not rejected and is very strong (Dr. Kaiser has never had an implant break in function).  The implants we use are tapered screws.  Dr. Kaiser has settled on this particular implant for reasons beyond the scope of this brief review.  The dental literature is quite clear that no implant type or design is more successful than another, when successful healing and long term health is evaluated.  The fact is titanium is still just titanium, no matter what the various implant companies contend.  However, the implant connection to the abutment is a different story altogether.  The abutment is a post which both screws and locks into the implant. This abutment-implant connection is the weak link, and loosening or breakage of this connection is the leading cause of implant related problems.  Most of the dental implant companies have modified this connection to significantly reduce these problems, as long as the dentist follows the manufacturer’s recommended instructions.

 

The Abutment

 

The abutment connects the tooth or teeth to the implant body. The abutment is also titanium, but in the past few years, Zirconium has been used because its white color may be more esthetic and less noticeable should there be an unexpected gum recession.  Abutments come in three types:  prefabricated, custom fabricated, and computer designed and computer manufactured (Cad-Cam).  The Cad-Cam abutment, while only marginally more expensive, creates a form that most closely resembles a natural tooth, facilitating brushing and flossing and limiting the problems of trapped foods.  Dr. Kaiser strongly believes that these computer designed abutments should be used in every case.

 

The Crowns and Bridges

 

The crowns and bridges on implants are just like the ones dentists have been placing on teeth for decades, except they fit better, don’t ever decay, or need root canals.

 

The Hybrid Denture (Teeth in a Day concept)

 

Dental implants were originally developed to support complete dentures. The loose fit, the poor function and almost every problem associated with the denture is eliminated or mitigated with implants.

 

Single Tooth Replacement

 

Replacing a single rooted missing tooth with a dental implant is the most common implant procedure and is considered the standard of care. The course of treatment for replacing a single tooth varies depending upon whether or not a tooth needs to be extracted or has been missing for some time.  When a single tooth is extracted, Dr. Kaiser prefers, if at all possible, to place the implant on that same visit.  This saves both time and money without any reduction in success.  When the tooth that is lost is visible when the patient smiles, Dr. Kaiser use the Immediate Tooth- Implant technique described elsewhere on this site. 

 

When a molar tooth, or a multi rooted tooth is extracted, Dr. Kaiser’s 30 years of experience has demonstrated that it is best to wait without any socket grafting for approximately ten to twelve weeks before placing the implant.  Of course, if there is excessive bone loss sometimes

grafting is required, but this is uncommon. 

 

Multiple Teeth Replacement

 

Dental implants are also used to replace several lost teeth which results in a long edentulous (toothless) space. In this case a dental implant is placed on each end of the space and a dental bridge suspended between the implants.  Some dentists prefer placing a dental implant for each missing tooth, but there are disadvantages (and not just cost) to this type of treatment plan. 

 

Replacing several missing teeth with dental implants will give you new, unparalleled strength and stability which will allow you to eat what you want.  It will also preserve your jaw bone and facial appearance.

 

The usual treatment time varies between 1 and 2 hours but can be longer in complex cases.  The majority of these cases are accomplished in Dr. Kaiser’s office under local anesthetic.  Also the patients are usually able to resume normal activities that same day.  Oral and intravenous conscious sedation is also available. 

 

Cost

 

Patients will usually have more options in these complex cases. There will usually be a significant difference in time and cost depending on the option which you choose.  Sometimes the most expensive and time consuming option may only make a minimal or no difference in the quality of the outcome. Dr. Kaiser’s 30 years of experience has resulted in a thorough understanding of the cost-risk equation in implant dentistry.  He will spend all the time you need to understand your options in these complex cases.   

 

 

Alternative to an Implant Supported Fixed Bridge

Long Span Fixed Bridge Anchored on Natural Teeth

 

The large bridge has a poor long term prognosis when compared to a bridge supported by dental implants, in part because the longer bridge is more prone to dental decay, and ultimately  the need for root canals.  With teeth that are crowned end up requiring root canals, the cost differential of implant supported bridges and tooth supported bridges can rapidly disappear

 

Removable Partial Denture

 

This is an alternative which is often perceived as uncomfortable, and a bit complicated to use.  Function cannot be compared to that of a bridge.  The denture is made of plastic and metal which may affect its appearance.  However, the installation process is simple, and natural teeth are usually spared. 

 

All Teeth Missing

 

A fixed dental bridge or hybrid denture anchored to dental implants is the best solution but many times a over denture supported by implants is selected due to decreased cost. These two solutions are both far superior to a non-implant supported denture.  In fact, dental implants were originally developed for this particular situation. Treatment times vary depending upon the treatment selected 

As with all procedures in Dr. Kaiser’s office treatment is usually accomplished with only local anesthetic.  Oral and IV conscious sedation is available upon request.

 

 

 

 

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