With advancing technology, today’s dental implants offer far better results compared to the legacy systems of the past. Mississauga dental patients want dental implants to provide a natural smile that is strong and functional. One critical factor of a well done dental implant is the gum tissue must attach or integrate to the collar of the implant. In other words, we don’t want our implants to look like implants. We want them to look like teeth natural coming out of the bone and gum tissue. Both dentists and patients wish to have implants that help preserve the surrounding bone. Bone loss around implants was a big issue in the first generation of implants years ago. Dr. Hawryluk uses fundamental techniques and materials that maximize the preservation of this bone. Modern implants must also offer a stable ‘restorative connections’ with options to attach different types of ‘abutments’ or crowns to, suited for your individual needs.
Dr. Hawryluk Jr. can place your dental implants based on a fully computer-guided solution, which brings the patients issue into a ‘digital workflow.’ Now implants can be predictably planned to meet the patient’s expectations, and Dr. Hawryluk makes all significant decisions before the surgery. At the time of implant placement, Dr. Hawryluk executes what he designed in the digital workflow. In this process, Dr. Hawryluk will often review your case with both the radiologist and the dental technician who fabricates your porcelain crown. All details of your dental care will be figured out in advance, so the dental work end product will seamlessly fit. Decisions such as what materials are the best (ie, zirconia versus titanium) take place before the implant placement as opposed to being an afterthought.
Before your implant placement, Dr. Hawryluk can present your implant plan to you on the computer. He can explain how the protocol designed for you maximizes safety and predictability. By the time Dr. Hawryluk is ready to place your implant, he has already done it 2-3 times digitally. The result is a quicker and more comfortable implant installation for you.
The first step of planning your dental implant is to take a digital CT scan, digital model, and do a virtual wax-up of your ideal tooth position. From this, we can see your tissue thickness, how close we may be to a nerve or sinus, how close we are to the adjacent teeth, and the best depth of your planned implant.
One aspect is your implant plan, which is Dr. Hawryluk carefully considers is the correlation between tissue thickness and bone loss in placed implants. In general, a thin ’tissue biotype’ will lose more bone after implant placement than a thick tissue biotype. Bone undergoes remodeling after implant placement. The human body naturally creates a 3mm buffer between the implant site and the outside. It will do this at the expense of taking the bone away. In a thin biotype, more bone would have to be naturally resorbed to create this buffer. We do not want our implants to experience bone loss as the body’s systems typically make a ‘biologic width.’ The body will make this biologic because it needs a 3-4mm of the tissue thickness. As a general rule, Dr. Hawryluk feels that 4mm of tissue thickness is best to protect your implant from crestal bone loss. This width formation occurs with or without bone resorption. To prevent resorption, Dr. Hawryluk will place your implant 3-4mm away from the gingival margin (gum line). To achieve this, sometimes implants are placed below bone level or ‘subcrestal.’
Dr. Hawryluk furthers the accuracy of our implants by only using Certified BioHorizons implant parts. With these, the gap between components is only 1 micron. In contrast, non-certified parts can have up to a 40-micron space. Bacteria are much smaller than 40 microns, so it is easy to see how non-certified parts could cause problems. Pieces not fitting well can cause peri-implantitis, which leads to bone loss and implant failure. The nice thing about BioHorzons implants is you will see beautiful gum health around the implants and long term stability of the bone.
Another planning consideration Dr. Hawryluk makes is whether or not an implant should be ‘immediate.’ An immediate implant is when the implant is placed the same day as tooth removal. Also, sometimes, a temporary crown can be placed on the implant right away or ‘immediately loaded.’ For this to be possible, Dr. Hawryluk will have to verify the ‘buccal bone’ (bone around the tooth socket facing the cheek) is intact after the tooth removal. If it is not, then sometimes the placement may have to be delayed.
As the famous author Stephen Covey said, ‘we need to begin with the end in mind.’ Dr. Hawryluk Jr. takes this approach with treating a patient. If you live in the Mississauga area and are looking for a dentist, please call us.
References: Nobel BioCare: Predictable and esthetic implant results – tools for success 2017.