Dental ImplantsThere is hope if you lose one or more teeth due to periodontal disease, or some other cause. Dental implants truly are changing the way people live. They are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. If you have missing teeth, dental implants will give you the ability to eat virtually anything and can smile with confidence, knowing that teeth appear natural and that the implants preserve your facial contours. Patients with dental implants can smile with confidence.
What Are Dental Implants?
Dental implants themselves are tiny titanium screws that Dr. Noraian surgically places into the jawbone where teeth are missing. These metal anchors act as tooth root substitutes.
Your jawbone grows up to the implant and bonds with the titanium, creating a strong foundation for artificial teeth. Dr. Noraian then attaches small posts that protrude through the gums to the implant. These posts provide stable anchors for artificial replacement teeth. Dental implants also help preserve facial structure, preventing the bone deterioration that occurs when teeth are missing.
If, like many others, you feel implant dentistry is the choice for you, Dr. Noraian will recommend a review of your health history, complete a periodontal examination, and obtain a low dose cone beam CT scan to understand the 3-D bone architecture available for implant placement. Once you complete these procedures, Dr. Noraian will review your case with you, using special 3-D software to explain your treatment options.
- For minor cases, you may complete your consultation in one visit.
- For major cases, Dr. Noraian may need to
consult with your restorative dentist before finalizing your options for review
so you may need two or more visits to finalize your treatment plan.
During your consultation, Dr. Noraian will address your specific needs and considerations. Your questions and concerns are important to Dr. Noraian and his staff, and they will work with you very closely to help you decide which option is best for you and to assist in making your procedure a success.
Dental Implant Presentation
To provide you with a better understanding of dental implants, we have provided the following multimedia presentation. Many common questions pertaining to dental implants are discussed.
The Surgical Procedure
There are a variety of surgical procedures used for dental implant placement and Dr. Noraian is well-versed in these methods. The preparatory procedures for dental implants are presented on previous pages. Once the bone is ready
for implant placement, and Dr. Noraian gets a surgical guide fabricated from the 3-D model of your case made from Simplant or Anatomage Software or your case has been evaluated in 3-D, he may place the implants as follows:
Immediate Implant Placement – Once the jaw is numb, and a tooth has been extracted, Dr. Noraian will place a surgical guide over the extraction site and the remaining bone will be prepared to receive an implant. If the bone is sound enough, then an immediate implant may be placed. If the bone is not sound enough, then Dr. Noraian will repair the ridge using bone graft and soft tissue graft material. He will save the surgical guide for future use in a few months for implant placement.
- One Stage Surgery – Once the jawbone is numb, Dr. Noraian uses the surgical guide to map out the incision which might be a small tissue punch, which is a round circle slightly smaller than the diameter of a mechanical pencil eraser, if you have enough attached gum tissue to support the implant. To preserve attached gum tissue, he may use a straight line incision over the ridge. Dr. Noraian places the surgical guide in the teeth, or jaw to size a hole through the soft tissue which will receive the implant. Dr. Noraian will place the implant and place a healing post, or healing abutment, in the top of the implant to train and maintain the soft tissue shape. If Dr. Noraian used a straight line incision, the soft tissue will require sutures to secure the soft tissue adjacent to the healing abutment. Suturing is not required for the tissue punch technique. Whenever possible, this method is preferred as it eliminates the need for additional surgery. You may need an occasional minor revision of the soft tissue. In rare cases, an immediate implant may be placed using this method.
- Two Stage Surgery – Once the jawbone is numb, Dr. Noraian uses the surgical guide to map out the incision. To preserve attached gum tissue, he may use a straight line incision over the ridge. Dr. Noraian places the surgical guide over the teeth, or jaw to size a hole through the soft tissue which will receive the implant. He will place the implant, and place a cover screw that is flush with the top of the implant to keep soft tissue from growing in the top of the implant. Dr. Noraian closes the soft issue over the implant and cover screw with sutures, and the implant will heal for several months before you need a second surgery to expose the cover screw for removal and place the healing abutment. While this method was the original implant placement method, Dr. Noraian will use the other option more often with immediate implants and cases where bone grafting around the neck of the implant is necessary based on what is shown by the cone beam CT scan.
- Split Ridge Technique – Once the jawbone is numb, Dr. Noraian will make a soft tissue incision over the ridge to expose the bone which has undergone disuse atrophy. He primarily uses this method for missing lower molars that you have not had replaced. Next, he makes a bone incision with the dental hand piece, and gently spreads open the bone. Dr. Noraian makes the hole which will receive the implant, and he places the implant followed by the cover screw and fills any gaps with bone and soft tissue graft material. Dr. Noraian closes the soft issue over the implant and cover screw with sutures, and the implant will heal for several months before you need a second surgery to expose the cover screw for removal and place the healing abutment. This method is one of the most innovative ways to replace lower back teeth when the ridge is too thin to use the one or two stage techniques mentioned above.
For the first three to six months following the surgery, dental implants are located beneath the surface of the gums, gradually bonding with the jawbone. You may be able to wear some type of temporary tooth replacement over the implant like a flipper, an Essix retainer with replacement teeth, a Snap-On Smile Appliance, or a removable complete or partial denture. Dr. Noraian will review the option that is best for your particular situation. Regardless of the replacement option it is important to eat a soft diet at this time. At the same time, your restorative dentist designs the final bridgework or denture that will ultimately improve both function and aesthetics.
Once Integration is Complete
After the implant has bonded to the jawbone, preparation for the restorative phase begins. Dr. Noraian may need to uncover the implants and attach a small healing collar if one is not already in place. Once Dr. Noraian clears you after about two weeks, he will provide your restorative dentist with the appropriate components that he used for the laboratory component of your case. To start making your new teeth, your restorative dentist must take an impression. Then Dr. Noraian can connect the posts or attachments to the implants. He then makes the tooth replacements over the posts or attachments.
How Long is the Whole Process?
The entire procedure may take four to eight months to receive your final restoration. Dr. Noraian is working hard to shorten that timeframe. One method is with the OssTell Stability Meter which helps him determine how stable the implant is at any given point during your treatment. Once the stability meter reaches a certain mark, he may clear you to proceed with the final restoration sooner. Most patients do not experience any disruption in their daily life.
What Types of Prosthesis are Available?
Dr. Noraian uses a single prosthesis (crown) to replace one missing tooth – each prosthetic tooth attaches to its own implant. A partial prosthesis (fixed bridge) can replace two or more teeth and may require only two or three implants. A complete dental prosthesis (fixed bridge) replaces all the teeth in your upper or lower jaw. The number of implants varies depending upon which type of complete prosthesis (removable or fixed) Dr. Noraian recommends. A removable prosthesis (over denture) attaches to a bar or ball in socket attachment, whereas a fixed prosthesis is permanent and removable only by a dental professional.
Where is the Procedure Done?
Dr. Noraian performs in-office dental implant surgery using a surgical operating suite, optimizing the level of sterility and providing him with the latest equipment for your comfort and safety.
Why is Implant Maintenance Important?
Dr. Noraian has the patience to help you when you experience an implant problem. He knows it is just as important to support your implant as it is to place it. Once Dr. Noraian places your implant, he wants you to have it for a long time. By keeping up with regular implant maintenance which may include a cleaning, x-rays, and periodontal charting, Dr. Noraian will help you to get the most longevity for your investment. His maintenance program is so good, that he has patients who received their implants elsewhere, but start seeing Dr. Noraian to maintain their implants because they know he will treat them like he placed the implants for them.
What Implant Systems Are Supported?
If you have an implant from a system not on the list, or if you have no idea what type of system you have, Dr. Noraian will try to help. Below is a list of the systems Dr. Noraian currently supports with components he has on hand or readily accessible:
Providing The Latest in Proven Periodontal and Dental Implant Therapies
One of the hallmarks of Dr. Noraian’s practice is his experience with many implant systems. Over his years in practice, new technology phased out some implant systems, other companies aquired some implant systems, and some companies continue to improve upon and innovate their systems. Of course during his tenure, Dr. Noraian has developed personally preferred implant systems, but his diverse background with implants allows him to even provide support to people to whom he did not place implants. Implants, like teeth, require maintenance. Even when you use good maintenance habits, your implant may be ailing or failing for a host of reasons. Hopefully, you reach Dr. Noraian before your implant fails since he does have methods to shore up an ailing implant. If your implant does fail, he may have options for you to consider another implant.
Dr. Noraian has received extensive training in Dental Implantology in addition to Periodontology. Through continuing education, Dr. Noraian is up to date with the most current information on implant dentistry and periodontics.