BY MARTY W. LINDAHL, DDS
Dental Implants Today
A Modern Overview of Dental Implant Trends and Best Practices
by Marty W. Lindahl, DDS

As a cosmetically-minded dentist with a long history of smile design and restoration via veneers, crowns, and implants, I first regard the natural structure of my patient’s face when it comes designing the aesthetic appeal, and the functionality my patients aim to achieve. As a result, I try to think of myself as an “architect of the smile”, as most architects endeavor to honor form and function as the cornerstones of great design.

When restoring a patient’s mouth with implants, there are several foundations to consider in order to best support both the aesthetic desires and the longevity of comfort and health for the patient. Patient education is critical when it comes to ensuring long term results that the patient will best benefit from throughout the lifetime of their investment.

Although implants are used to replace single teeth, they are also utilized to reconstruct the dentition. In order to mimic nature as much a possible when it comes to these restorative enhancements, I often lean towards single-implants for full arch restorations because they’re the most comprehensive and desirable option for comfort, aesthetic, natural feeling, and longevity.

My goal is to deliver on these important aspects of patient’s’ expectations, and avoid common issues that frequently arise in terms of speech impediments, ill-fit, discomfort, and even bacterial issues, that put the patient’s quality of health at risk.

 

Utilizing 20 years of experiential foresight, I do my best to help circumvent failures, patient dissatisfaction, or the risk the patient carries of having to invest more in the future to remake a failed or ill-fitting prosthesis.

Acting on my patient’s best interests, I make a point to keep in mind all of the above, always considering the plausible flexibility and reversibility of the procedure, should any natural, or common issues arise.

Our mouths are living organisms that shift and adapt over time, so I always aim to establish awareness when designing for the longevity and performance of my patient’s smile.

“Our comprehensive customization range of implant options are what set us apart when it comes to patients who entrust us with their implant and restorative transformations.”

One of the cutting-edge procedures I’m most excited about involves utilizing zirconia. The latest advancements in modern dentistry are reaching for zirconia when designing  single implants, abutments, crowns, single teeth, multiple teeth, and full-mouth reconstructions.

Zirconia, (highly-utilized and endorsed by Southeast Oral Surgery) is European – it looks like Porcelain but is as strong as metal on the periodic table.

As continuing member of the Knoxville Oral Synergy Training Program (STP Residency) led by Southeast Oral Surgery, paneled by our surgery partners: Timothy P. McConnell, DDS; Otto W. Slater, DDS; Randall Napier, DMD; Jason R. Kennedy, DMD; Garren M. Petree, DDS; and  sponsored by Zimmer Biomet and other cutting-edge labs and product innovators; I make a consistent effort along with my team to benchmark the shared insights my fellow physicians, surgeons, specialists, branded product and lab partners, to stay abreast of current and emerging best practices in regard to all the latest tools and materials that are presently the most beneficial and advanced options when treating existing patient cases.

“More and more frequently, patients are opting for dental implants to replace missing teeth, as they are a long-term solution that most-closely resembles natural teeth. As a longtime member of the American Society of Implant & Reconstructive Dentistry (ASIRD)*, I am dedicated to utilizing all tools at my disposal when it comes to educating my patients about the latest and most beneficial implant options for their case.”

*Membership with ASIRD is by invitation only and restricted to dentists who meet a high standard of requirements.

The  importance of choosing an experienced surgeon-and-dentist team recognized for having a strong working relationship and a track-record of excellence is paramount when considering dental implant options. My goal is to have fellow dentists encounter my work and feel inspired that they can’t tell the implant from natural teeth.

“Intent on offering the industry-best to my patients, I continue to develop my relationships with like-minded professionals through associations such as the Knoxville Oral Synergy Training Program (STP Residency) who are a very important factor when it comes to record of success I’ve had with dental implant cases.”

The process begins with design, then moves to partnering with the best labs and surgical teams to place the implants in the optimal positions that suit the implant design as well as the patient’s comfort.

Individual crowns on implants and the streamline bone-grafting techniques utilized to house the implant, are the most selective premium option for mimicking nature. This type of restoration is the most natural-feeling available because the thinned shape of the tooth is the closest resemblance to a natural tooth, and it allows natural gum tissue support. This premium-standard option can take several months to execute.

If the patient doesn’t have the optimum bone density needed to place individual implants per tooth, or should the patient prefer a faster restoration option, then I will often recommend a zirconia restoration.

Zirconia restorations are an ideal emerging technological material that has a high potential for adjustment if needed over time that far out-performs the “all-on-four”, or “teeth-in-a-day” method. In my professional opinion, zirconia is the future and I’m excited to champion this material and method as it continues to perform extremely well as an ideal advancement in modern dentistry that is gaining positive support.

One of the things to consider when utilizing zirconia as an alternative to the teeth-in-a-day method, is that this type of restoration method is not a “one tooth problem”, meaning that in the rare possibility it breaks, the entire case may have to be re-crafted. It is always desirable to keep repairs to a minimum for convenience to the patient. Another consideration to keep in mind, is that as an emerging technology, it is important to monitor the individual patient to see how their natural biology takes to this type of implant. Due to the resilient strength of zirconia material, it is wise to monitor to ensure there is no threat to the individual patient’s potential bone loss or implant wear, but the future looks amazing, so I am presently studying ways to evolve this option in light of its outstanding potential.

Sometimes when designing implants, I come across a case where the patient wants the best individual implant crown and smile design, but doesn’t have the optimal bone structure to place a full mouth of implants. In this situation, I will often introduce a concept known as the “copy mill bar” that includes individual crowns. With this method, a custom bar is fitted on fewer implants, and the patient can add natural-looking pink gums where needed, alongside individual crowns that imitate a beautiful full-mouth restoration. This way, should any of the individual crowns need to be replaced, it is a “single-tooth problem”, meaning, in terms of time and investment it is relatively simple to repair. This provides the most natural way to replicate a single-implant, full-mouth rehabilitation for patients whose bone structure can only support a limited number of implants.

Through the years, I have done numerous “hybrid” teeth-in-a-day restorations to repair prior work patients have undergone. As with all dental restorative cases, I do my best to troubleshoot; however new patients coming to my practice for teeth-in-a-day or all-on-four, restorations often express their disappointment and frustration that their all-on-four teeth wear out and break. Even though they can be fixed, this issue is still an emotional and financial nuisance for the patient because of the substantial investment they already made in the all-on-four method. Teeth-in-a-day hybrid restoration cases most frequently do not show a natural transition, so this method often feels bulky and thick in the mouth, which can cause the patient embarrassing impaired speech issues and a host of other discomforts.

Being able to provide an upgrade to the hybrid all-on-four method in order to reduce the frustration of patients seeking relief from these issues is important to me.

To help patients access this often overlooked and much-needed enhancement, our practice designed an in-house RHD Advantage Plan to make this elective restorative treatment more accessible to patients desiring relief from these symptoms.

The dental implant options I strive to provide are more hygienic, longer-lasting, virtually unbreakable, and more natural-feeling.

For the popular teeth-in-a-day hybrid; the surgery or temporary “teeth-in-a-day” happens in one day, and the restoration of the permanent teeth generally takes 5 or more appointments to complete the implant as the “final bar” hybrid-supported prosthesis.

“One major advantage I am able to offer my patients through my strategic relationships with top surgical and lab partners, is the Genisys method of “overnight teeth”: the option to complete their hybrid case in as little as 1-2 appointments without compromising quality, but rather increasing implant healing and decreasing implant failures.”

 

This is an excellent solution to provide to patients who are weary of coming in for numerous appointments.

The beauty in all these systems is that in order to meet any patients specific needs, all are made possible in the most beneficial way, by the right team, dedicated to studying and implementing both the technology and best practices that ensure the most expedient turnaround of the highest-quality. These benefits are a huge convenience in light of today’s demand. At Rolling Hills Dental, my team strives for perfection so that together, we can settle for excellence. We look forward to the opportunity to serve you in light of your dental implant needs.

If you are preparing for Dental Implants in Eastern Tennessee, Knoxville, Maryville, Alcoa and surrounding areas, here are some excellent tips to help you educate yourself and your loved ones on the treatment preparation options available to you.

Preparing for Dental Implants
While dental implants stand as the gold standard for dental reconstructions, there are certain factors that can keep patients from receiving more immediate treatment. Issues like gum disease, bone density, and teeth clenching complicate the healing process and long term success of dental implants. However, at Rolling Hills Dental, we want you to consider the following pre-implant treatments that can help qualify you to receive a dental implant.

Repairing Gum Disease
The effects of the first stage of gum disease—gingivitis—are reversible, and can be treated through routine cleanings and good at-home maintenance, allowing you to return to proper gum health. With later stages of gum disease—periodontitis—the damage done to the supporting bone structure and gums is permanent. If you exhibit advanced levels of gum disease, scaling and root planing can help you to achieve the healthy gums necessary to receive dental implants. There are even options available if you have lost bone density due to periodontitis.

Restoring Bone Density
Dental implants rely on a certain level bone density to support the integration of the implant post into the bone. This process of osseointegration relies on the jaw bone to be able to fully integrate biocompatible titanium rods to ensure that your implant is secure, and acts like the root of a natural tooth. However, if you have experienced bone loss due to the loss of teeth or periodontitis, there are treatments that will enable you to support implants. Bone grafting procedures will bolster your jaw strength, allowing you to support implants that can properly integrate into the bone. Procedures like sinus lifts will enable patients without the right amount of bone structure for implants to be placed, to expand the available bone by their molars, and restore balance to their bites.

Relieving Clenched and Grinding Teeth
If you clench your teeth at night or during the day, you run the risk damaging an implant before it heals, or breaking the teeth surrounding an implant that has been placed. While the crowns of implants are generally able to withstand the pressure of a bruxism, this can complicate the healing process and will slowly wear on the shape of the restoration, as it would with natural teeth. If you know that you are a habitual tooth grinder, or clench at night, look into getting a night guard, or a guard for daytime teeth clenching. This can not only help you to qualify for dental implants, but will help you maintain the health and aesthetics of your natural teeth.

Prepare for Your Dental Implant Today
If you are looking to begin restoring your smile with dental implants, contact our Rolling Hills Treatment Coordinator to schedule your examination today (865) 983-4444.

Dr. Marty Lindahl, and the Rolling Hills Dental staff are proud to offer innovative implant solutions to patients from in and around the Maryville, Knoxville, Alcoa, Blount County, Knox County, and surrounding areas.

LINKS OF INTEREST

The following websites are provided as a resource for patients. This page contains hyperlinks to World Wide Web sites that are created and maintained by other organizations. We have included these links because we think that our patients may find them of interest. Keep in mind that Marty W. Lindahl, DDS and Rolling Hills Dental do not necessarily endorse the views expressed on these websites. Also, we do not guarantee the accuracy or completeness of any information presented on these sites.

DENTAL LINKS

WebDental – American based dental database

 

RESEARCH AND LIBRARY LINKS

University of Tennesse Medical Center

MedicineNet – Content-rich commercial site includes interactive groups, ask-the-doctor feature, medical dictionary, comprehensive drug information, medical news, disease-specific information, and links.

Medscape – Searchable commercial collection of full-text articles from such useful sources as the National Institutes of Health and the Centers for Disease Control and Prevention.

Oncolink – Huge collection of cancer information and links based at the University of Pennsylvania. The best starting place found for cancer information.

Healio – Physician maintained commercial database of annotated health links. Oriented toward medical professionals, but accessible to an educated lay person. A keyword search gets you to a subject index, from which you navigate to the links you want.


JOURNALS

American Journal of Oral and Maxillofacial Surgery

British Medical Journal

New England Journal of Medicine

American Dental Association

 

PROFESSIONAL ASSOCIATIONS

Academy of Osteointegration

American Academy of Dermatology

American Academy of Restorative Dentistry

American Association of Oral & Maxillofacial Surgeons – find information about oral and maxillofacial surgery including cancer, dental implants, sports safety, jaw surgery, and more.

American College of Oral and Maxillofacial Surgeons

American College of Prosthodontics

American Dental Association – ADA Online – access to news, publications, and products and services related to dental health.

American Medical Association – another useful site with links to consumer health information, searchable database of more than 650,000 physicians

American Society of Dentist Anesthesiologists

Center for Reconstructive Jaw Surgery

International Association of Dental Research

Second District Dental Society

Tennessee Society of Oral and Maxillofacial Surgeons

 

IMPLANT MANUFACTURER LINKS

Astra

BioHorizons

Keystone

Nobel Biocare

Straumann

Zimmer Dental