The COVID-19 Lockdown Has Given Opportunities to Learn More

During the dental office lockdown, I had a chance to take numerous courses online. Most of them were on implant, ClearCorrect Aligner (like Invisalign system using clear invisible trays to make teeth straight), oral lesions including cancer, and sleep appliance for sleep apnoea.
In the area of implant surgeries and restorations, I have gained some new pointers and techniques.

Dental Implant Education

During an implant surgery, when there is not enough bone to place the implant in, dentists normally would graft bone in the area to improve the dimensions and quality of bone. The bone normally comes from another human being (processed bone from cadavers which had been tested to be non-pathogenic). I have learned that the extracted teeth of the patients can be used as bone graft material after they are cleaned, disinfected and grinded up with a special machine. There are multiple benefits of using the patients’ own extracted teeth for bone grafting: 1) they are from themselves and not from another dead person, 2) there are no chances of getting someone else pathogens, 3) the healing will be faster due to intrinsic growth factors and healing enzymes existing in the teeth 4) there is no additional cost for the allograft (someone else bone), 5) the extracted teeth can be saved for later days to be used for the same patient, 6) the process of preparing the teeth for grafting only takes about 15 minutes and therefore the grafting can be done during the same appointment.

The other thing that I have learned about implants is the refined technique of doing immediate implant placement after the extraction of a hopeless or broken tooth. Again, there are multiple benefits of doing immediate implant placement if the conditions and circumstances allow: 1) it saves time and trouble of having multiple visits, 2) it also promotes superior preservation of bone and healing where the tooth was extracted, 3) the patient can have a crown/tooth immediately without having to wait for a long time, 4) the gums around the implant and the supported crown will look a lot more natural with less gum recession.

There are many different types of implants but not all of them are made the same way. Implants that have been treated with acid to make their surfaces rough tends to require shorter time for the bone to grow into the porous spaces and hence more shorter time to heal. The emergent profile of the implant above the bone but within the gum tissues also plays a role in how well the soft tissues (gum tissues) form a nice seal around the implant and stay healthy with nice aesthetics.

The colour of the implants and the structures that connect to the implants can be electroplated to have different colour – pink or gold instead of the traditional greyish colour of titanium alloy. The pink and gold colour can allow the gum tissues covering the implants and the supporting structure look pink and natural instead of looking greyish in colour in many other implant cases.

Another technique is indirect sinus lift for upper molar and premolar regions. We normally need at least 10 mm of bone in order to be able to place an implant that will be stable and strong. There are numerous times that the thickness of bone below the sinus is less are 10 mm. Indirect sinus lift technique allows me to gain more bone height below the sinus. Sometimes, the sinus lift surgery can be performed simultaneously with implant placement. Indirect sinus lift technique is a relatively simple, conservative procedure to gain more bone height for implant placements.
The use of digitally designed and milled surgical guides is a breakthrough in implant dentistry. The jawbone where the implants are going to be placed can be visualized by having a cone beam computed tomography (CBCT) taken. The digital images from the CBCT can be viewed in 3-dimensions at different angles and orientations. The distance, shape, width, quality and thickness of the tissue in interest can be determined. The images of the patient’s teeth can also be captured digitally and be superimposed onto the CBCT images. Even the face can be digitally photographed and be incorporated with all those images. With all those reconstructed images and hence the knowledges gained, dentists can plan what type and size of implants to be used, where their locations are and how the orientations going to be. A surgical stent can then be produced by a 3-D printer to allow the surgeon to place the implants precisely to achieve optimal outcomes.

The COVID-19 Lockdown has left people with uncertainty. If you have a dental question regarding how our office is handling dental safety from the lockdown please call Dr Wong at Affinity Dental Care at (289)-861-5111.


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