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dental implant procedures

Indirect sinus lift procedure, a breakthrough technique performed by Clearwater periodontist Dr. Todd Britten to prepare patients for dental implants.

What is an Indirect sinus lift?

This procedure is less invasive than the direct sinus augmentation lift and is performed by preparing the bone for the dental implant as normal. Once the floor of the sinus has been reached, bone is gently packed in the preparation and pressed upward. This motion will tent the membrane of the sinus upward and create additional room for the full length of the implant.

As with the sinus augmentation graft or direct sinus lift, care will be taken not to damage the sinus and this procedure will have no effect on sinus pressure or affect people that suffer from seasonal allergies.

Britten Perio

Careful management of extraction sockets after a tooth is removed prevents unsightly bone loss and provides a better cosmetic outcome for tooth replacement. To increase the possibility of future implant placement, and to prevent more bone resorption, a ridge preservation procedure may be recommended. Without the use of a bone graft and collagen barrier at the time of extraction, studies show that 30­-40% of the jaw bone is immediately lost. This is because your body perceives that once the root is removed, the bone is no longer needed and your body absorbs or removes it, creating a ridge deformity.

These ridge deformities leave you with inadequate bone and tissue thickness for either bridge or dental implant restoration. The defects may have been caused by trauma, developmental defects, periodontal disease, the wearing of dentures, or through previous tooth loss.

Ridge augmentation procedures have been shown to greatly enhance the cleansability and appearance of your restorations. They increase your chance for long ­term successful dental restoration, both esthetically and functionally. Ridge augmentation procedures may be performed with gum tissue and/or bone grafting materials.

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3 Parts of a Dental Implant Clearwater Florida Periodontist Dr. Todd Britten

Jawbone is preserved through the pressure and stimulus of chewing. When that is removed through tooth loss, the bone “resorbs” (reabsorbs) into the body. In the first year after tooth extraction, normally 25% of jawbone is lost, and this bone loss continues on.

Careful management of extraction sockets after a tooth is removed prevents unsightly bone loss and provides a better cosmetic outcome for tooth replacement. To increase the possibility of future implant placement, and to prevent more bone resorption, a ridge preservation procedure may be recommended. Without the use of a bone graft and collagen barrier at the time of extraction, studies show that 30­-40% of the jaw bone is immediately lost. This is because your body perceives that once the root is removed, the bone is no longer needed and your body absorbs or removes it, creating a ridge deformity.

These ridge deformities leave you with inadequate bone and tissue thickness for either bridge or dental implant restoration. The defects may have been caused by trauma, developmental defects, periodontal disease, the wearing of dentures, or through previous tooth loss.

Ridge augmentation procedures have been shown to greatly enhance the cleansability and appearance of your restorations. They increase your chance for long term successful dental restoration, both esthetically and functionally. Ridge augmentation procedures may be performed with gum tissue and/or bone grafting materials.

For more information about periodontal regenerative procedures, ridge augmentation or dental implants, contact us today at 727-586-2681.

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Illustration from Britten Periodontics highlighting LAPIP technology used to save and treat failing dental implants

If you have dental implants, you’re expecting them to last a many years, or perhaps a lifetime. In most cases they do, giving patients a fully restored, beautiful, functional smile. Experts estimate between 3-20% of implants fail. This is often due to peri-implantitis – which is a threat to the lifespan of dental implants. Peri-implantitis is gum disease around an implant that is not reversible without intervention by a periodontist or dental implant specialist.

DISEASE AROUND IMPLANTS MIMICS PERIODONTAL DISEASE

There are two categories of complications with implants: Peri-Implant Mucositis and Peri-Implantitis.

Peri-Implant Mucositis:  This condition is similar to gingivitis around a natural tooth and does not include loss of attachment (bone or gum tissue) and is hopefully reversible at this stage.  Peri-Implant Mucositis is a reversible inflammatory reaction in the soft tissues surrounding a functioning implant.  Treating this condition as soon as possible will prevent peri-implantitis!

Peri-Implantitis:  This is a condition similar to periodontitis with loss of supporting structures (gum and/or bone) around a natural tooth.  Peri-Implantitis is a destructive inflammatory reaction affecting the soft (gingiva) and hard (bone).

Signs/Symptoms of moderate-advanced Peri-Implantitis

SWELLING IN THE GUMS

IMPLANT MOBILITY

BLEEDING GUMS

CHANGE IN GUM COLOR SURROUNDING IMPLANT

HIGH GUM SENSITIVITY

IMPLANT EXPOSURE (GUM RECESSION PREVENTS ADHERENCE TO THE IMPLANT OR CROWN SURFACE)

MILD TO SEVERE PAIN AROUND IMPLANT SITE

EXCRETION OF PUS FROM THE IMPLANTS SURROUNDING TISSUES

The good news is that peri-implantitis is treatable, especially if the infection is treated early. In order to help patients catch peri-implantitis, your Clearwater periodontist, Dr. Todd Britten is sharing what peri-implantitis is and how it can be treated with laser surgical therapy, or the LAPIP procedure.

Peri-implantitis is a bacterial infection of the gum and bone around the implant.

LAPIP® is a minimally-invasive method of laser gum disease treatment for implants that helps regenerate healthy tissue instead of destroying it. For most people who have dental implants, LAPIP® is simply the best solution for gum disease around implants, also known as “peri-implantitis”.

Peri-implantitis is an infection that has much in common with periodontitis, or advanced gum disease. With both diseases, the gums and supporting structures in your mouth are infected and become inflamed. As these diseases progress, pockets of bacteria form below the gum line, creating protected spaces which harbor bacteria and debris, exacerbating the infection. Severe cases of both peri-implantitis and periodontitis lead to bone loss, which can compromise the stability of your teeth or your implant.

If you think you have gum disease, you will need to seek treatment, since both periodontitis and peri-implantitis are progressive diseases which cannot be treated at home. The same daily hygiene used to avoid gum disease can be used to protect against peri-implantitis. You should brush and floss every day, and schedule regular checkups with your dentist, dental implant specialist and periodontist. Finally, certain lifestyle choices, like tobacco use, can increase the risk of gum infections.

Periodontal disease is common, peri-implantitis is less common, occurring in around 1 out of 10 implant recipients. Peri-implantitis is also different from periodontitis because it’s harder to diagnose early. Many patients don’t know they have an infection until serious symptoms develop. More often, peri-implantitis is detected through an x-ray during a regular checkup.

There are several treatment options for peri-implantitis. Surgery or laser procedures are the most common, and of the two, laser treatment is by far the least invasive. LAPIP is similar to LANAP, the procedure used to treat periodontitis. LAPIP, however, is designed to target infection around dental implants.

First, a laser is inserted beneath the gums at the base of the implant, where it targets and destroys bacteria and infected tissue. Ultrasonic tools are then used to remove any remaining bacteria and to make sure the implant is 100% free from dangerous debris. The laser is inserted below the gum line one more time to eliminate any surviving bacteria, and the gums are encouraged to heal around the implant again.

LAPIP treatment offers many important benefits. First, it is less invasive than surgery and does not destroy any healthy gum tissue. The laser is specifically designed to only target infected tissue. This treatment is also quick and effective. Finally, the laser works to stimulate gum and bone growth, allowing your natural bone to increase in both density and mass without a bone graft, protecting the security of your implant for years to come.

Sometimes, the gum tissue surrounding an implant can become thin, and expose the threads of the implant surface below. In this case, Dr. Britten has developed a state-of the-procedure which combines use of the PerioLase laser to destroy bacteria, decontaminate the implant surface and surrounding tissues, and reduce inflammation. Dr. Britten can then perform a procedure to graft tissue around the implant in such a way as to cover the exposed portion of the implant, however, the main objective is to re­establish the protective barrier or layer of the gum around the implant.

If you have implants and think you have peri-implantitis, please contact us immediately. We at Britten Periodontics are committed to providing our patients with the highest level of care available.

Dr. Todd Britten at Britten Periodontics employs advanced technology for bone grafting to prepare for dental implants

Dental implants are often used to replace teeth, but when there is not enough jaw bone to hold the implants, a dental bone grafting procedure may have to be done first.

“After the loss of a tooth, the jawbone recedes, or becomes indented. Bone grafting allows us to fill in this space to have enough bone to place a dental implant.”

For patients with missing teeth who need additional jaw bone support for the placement of dental implants, a periodontal regenerative procedure, or bone grafting must first be performed. Dr. Britten, an implant specialist and periodontist in Clearwater, Florida, also provides the latest technology and techniques in ridge augmentation, ridge preservation, sinus lift or sinus augmentation procedures for patients missing teeth to be able to have dental implants.

Dental bone grafts can come from multiple sources. Autogenous grafts come from the patient, allografts are taken from a bone bank where human bone from cadavers has been donated, and xenografts are taken from animal bone. Local anesthesia is all that is needed in most cases. The new bone is surgically placed in the jaw area where it is deficient in bone and transplanted where the dental implants will be located.

Sometimes Leukocyte Rich Platelet Rich Fibrin is used in addition to bone grafting. (L- PRF) is a by-product of a patient’s own blood that can help healing after dental procedures such as a tooth extraction, as well as promote healing around bone or tissue grafts and dental implants. L-PRF treatments are often used for greater success for necessary procedures for dental implant placement, including socket bone grafts, sinus lifts, ridge augmentation, correcting peri-implantitis, block bone grafts and extraction sites prior to implant placement. Dr. Britten provides both of these technologies in his Clearwater, Florida periodontal practice.

The dental bone graft, or periodontal regeneration procedure, must be allowed to heal completely prior to other procedures, such as the placement of dental implants. This will generally take about four to six months. Once the area has completely healed, the patient can be reevaluated for the placement of dental implants.

Britten Periodontics & Implant Dentistry is a periodontal practice offering patients personalized dental care in implant dentistry in Clearwater, Florida. Dr. Todd Britten received his Bachelor of Science & Doctorate of Dental Surgery from University of Florida, a Master’s Degree and Certificate in Periodontology and Implant Dentistry; and completed extensive training at the Institute of Advanced Laser Dentistry. He is one of the only board-certified periodontists in Pinellas County. He is a member of the American Academy of Periodontology, American Dental Association, Florida Association of Periodontists, Upper Pinellas County Dental Association, Hillsborough County Dental Association, Hillsborough County Dental Research Association and Florida West Coast Dental Association.

Patients interested in these procedures can get additional information by calling 727-586-2681.

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