DENTAL IMPLANTS MADE SIMPLE By JONATHAN PENCHAS DMD MEd PA

Copyright © 2011 By Jonathan Penchas All Rights Reserved. Published in eBook format by eBookIt.com http://www.eBookIt.com ISBN-13: 978-1-4566-0319-9 Reproduction or translation of any part of this work beyond that permitted by section 107 and 10 – eight of the 1976 United States copyright act without permission of the copyright owner is unlawful. Requests for permission or for that information should be addressed to Jonathan Penchas DMD PA.

DISCLAIMER

The Information presented in this book is for educational and informational purposes only. The content is not intended to be a substitute for professional dental advice, diagnosis, or treatment.

Always seek the advice of your dentist or other qualified health provider with any questions you may have regarding a dental or medical condition. Never disregard professional advice or delay in seeking it.

The author and publishers of the book disclaim any loss or liability, either directly or indirectly as a consequence of the information presented herein, or the use and application of such information.

No guarantee is given, either expressed or implied, in regards to the accuracy or acceptability of the information. Patient’s results may vary from the information pertained in this book. Table of Contents

Overview The Problem(s) with Missing Teeth Causes of Adult Tooth Loss Conventional Options to Replace Missing Teeth: They Often Miss the Mark Why Dental Implants? Types of Implant Solutions Are You a Candidate for Dental Implants? Choosing the Right Implant Dentistry Solution Treatment Stages & What to Expect Ensuring Implant Success The Cost of Dental Implants Selecting an Implant Dentist Caring for Your Dental Implants Q&A Make the Call! Learn More ABOUT THE AUTHOR Overview

Let’s face it; teeth and dentistry are not at the top of the agenda for most of us. They usually only get our attention when they start hurting. And then zap – they get our attention in a big way.

Then you go to the dentist, who checks your teeth and gives you a long talk in an unknown language – “Dentaleze”. They flood you with information you don’t understand. What you usually understand is that it’s expensive and painful.

Dentists and physicians like talking in secret code. It’s the translation for the regular folks that was missing before this book.

If you try to do some research to make a decision about dental implants will find books written for dentists, or 300 page books written for consumers. You wouldn’t want to read books this big if you were deciding on open-heart surgery or mortgaging your life, let alone a decision about replacing a tooth.

This book is part of the “dentistry made simple“ series. These books allow you to master dentistry basics in a snap.

My goal is to make it simple – give you all the information you need to learn and make a decision about dental implants in less than one hour of reading. Dental implants: good for your smile, good for your life

Oral health is a hot topic these days. It’s no wonder. The condition of your teeth and gums impacts every aspect of your life. Good oral health encourages improved whole-body wellbeing and reduces the risk of developing serious medical conditions linked with oral disease. People with complete, healthy smiles enjoy certain advantages in the social and professional realms, as well. They often get the promotion, land the big job, and enjoy popularity with the opposite sex.

Let’s face it. A societal bias exists against people with missing teeth. An incomplete smile is often seen as a sign of poor oral hygiene and a lack of pride in your appearance. Although the reasons for tooth loss go far beyond neglect and may sometimes be beyond your control, negative character traits are often associated with missing teeth.

If You Have Missing Teeth, You’re Missing Out on Life

An incomplete smile diminishes quality of life. People with missing teeth or a denture that slips or clicks report feeling socially isolated. Part of this isolation is self-imposed, as these individuals choose to withdraw from friends and family rather than let others see the condition of their smile. Appearance suffers as jawbone tissue shrinks in response to a lack of stimulation by natural teeth. People with large numbers of missing teeth often look as if the area between the nose and chin is caving in. And, actually, that is what’s occurring. Cheeks sink in, too, without the support that teeth provide. Eating becomes painful, and speech clarity suffers. A Permanent Solution!

Dental implants restore incomplete smiles to transform the lives of people with missing teeth. They replace permanent teeth lost to disease, trauma, or neglect. The structure of an implant mirrors a natural tooth to provide all of the benefits of a complete smile. Implants improve the way a smile looks, feels, and functions. They help people regain control of their oral health and provide a wealth of benefits over traditional replacement teeth.

Implants are considered a permanent tooth replacement option because the titanium implant posts actually become a lasting part of your jawbone structure. People with implant-supported replacement teeth are able to enjoy active, healthy lifestyles due to the worry-free nature of dental implants. Simply put, they love their new smiles – and they love life again. The Problem(s) with Missing Teeth

A full set of healthy teeth is important socially, physically, and emotionally. Even one or a few missing teeth are cause for concern. Gaps in your smile caused by missing teeth impact occlusion (the way top and bottom teeth fit together) and jaw joint function. If a tooth doesn’t have “anchor” teeth on either side of it, it can begin to drift out of position, impairing the balance of your bite and causing uneven wear on teeth. Additionally, when the bite is misaligned, the temporomandibular joints can malfunction, causing headaches, facial pain, tingling in the fingers, and a jaw that clicks when opened and closed.

Diminished Quality of Life

Studies show that people with all of their teeth often enjoy a longer life than their peers with missing teeth. Additionally, the World Health Organization (WHO) determined that poor oral health contributes to the diminishment of what they define as the three main components of health: physical wellbeing, mental wellbeing, and social wellbeing. The health of teeth, gums, and jaw impacts quality of life and affects such things as sleep, diet, work, social interaction, and self-image. Causes of Adult Tooth Loss

The medical name for missing teeth is endentulism. This condition occurs in a large segment of the population. In fact, it’s estimated that 69% of adults have lost at least one tooth and that 50 million Americans have lost all of their teeth. Adult tooth loss occurs for many reasons, including gum disease, dental caries (cavities), and injury.

Gum Disease

Almost 70% of tooth loss is attributable to gum disease, also called periodontal disease. This bacterial infection attacks healthy gum, tooth, and bone tissue. If left untreated, the bonds that hold teeth and gums together are destroyed, resulting in tooth and bone loss. Periodontitis, the most severe form of gum disease, is a major contributor to tooth loss in adults aged 65 and older.

Tooth Decay

When plaque hardens on tooth surfaces, it produces acids that destroy tooth structure. Caught early, decay can be removed and the tooth restored with a filling or crown. Severe decay may cause extensive damage to tooth structure and invade the nerve tissue of a tooth. A root canal can resolve early-stage infection in the inner chamber of a tooth.

Left untreated, the infection only worsens and may result in tooth loss. Injury

Trauma to teeth from injuries to the mouth are another common cause of tooth loss. A fall, sports-related injury, automobile accident, physical trauma, or other damage may cause a tooth to come out or become damaged beyond repair and require removal by a dentist. Conventional Options to Replace Missing Teeth: They Often Miss the Mark

Traditional replacement teeth provide adults with missing teeth a way to regain oral function. However, conventional solutions such as dentures, partials, and bridges only address a subset of the problems associated with missing teeth. You may regain the appearance of a complete smile, but at a cost.

Full Dentures

Full dentures replace complete upper and/ or lower arches of teeth. A plastic base that floats on your gum tissue and jawbone ridge holds the prosthetic teeth in place. But without the chewing forces of natural teeth, gum tissue and jawbone mass shrink over time, causing dentures to loosen. Full dentures can be relined to accommodate gum and bone shrinkage, but this solution is only temporary. Bone and gum tissue will continue to diminish, and dentures will continue to shift, click, and cause problems with eating and speaking. Denture wearers may resort to using large amounts of adhesive to keep their teeth intact. With the scare involving zinc in over-the-counter denture paste, this method of stabilization is far from perfect and may be harmful. Additionally, dentures minimize chewing capacity by 80% when compared to natural teeth. The base of an upper denture may completely cover the roof of the mouth, restricting your ability to fully taste food.

Partial Dentures

This restorative solution is often used to replace missing teeth scattered throughout an upper or lower row of teeth. Partials are held in place with clasps that attach to healthy existing teeth. These clasps, often made of metal, can wear away at natural tooth structure, compromising the health and stability of these “ a n c h o r ” t e e t h a n d increasing the risk of tooth decay and gum disease.

Crown & Bridgework

The least beneficial way to deal with missing teeth? Ignore them! If you choose this route, you’ll likely experience pain, impaired oral function, a diminished appearance, and more tooth loss. Research shows that if a missing tooth isn’t replaced, up to 20% of adjacent teeth will be lost in the next 4 to 8 years. One missing tooth sets in motion a downward spiral of events that negatively impacts the quality – and potentially the length – of your life. Ignoring the Problem

The least beneficial way to deal with missing teeth? Ignore them! If you choose this route, you’ll likely experience pain, impaired oral function, a diminished appearance, and more tooth loss. Research shows that if a missing tooth isn’t replaced, up to 20% of adjacent teeth will be lost in the next 4 to 8 years. One missing tooth sets in motion a downward spiral of events that negatively impacts the quality – and potentially the length – of your life. Why Dental Implants?

Dental implants are simply the most natural tooth replacement method ever created. They provide people with missing teeth an attractive and long-lasting solution to combat the damage of tooth loss and regain strong, healthy smiles. Dental implants look and feel like your own teeth, so no one will know that you ever suffered from tooth loss. Implants provide innumerable benefits over traditional replacement teeth and boast an impressive success rate – up to 98%.

This innovative method to restore incomplete smiles is backed by over 40 years of research and enjoyed by millions of people around the world. Dental implants are quickly becoming the preferred method of tooth replacement by people who desire strong, stable, lasting smiles.

Dental Implant Structure

Designed to imitate the structure of a real tooth, implants contain three parts: a small, surgical-grade titanium post topped with an abutment (an attachment device) and a dental prosthetic. When placed in your jawbone tissue in the socket of a missing tooth, the post functions as a substitute tooth root. The jawbone doesn’t see the post as a foreign body. Instead, it readily accepts the post and begins a process called osseointegration in which the jawbone grows tightly around the post to form a bond similar to that of bone tissue and natural tooth root.

A small fixture, called an abutment, placed atop an implant post secures one or more replacement teeth. Your new smile may require individual implant crowns secured to single dental implant posts, or a dental prosthesis similar to a denture or bridge attached to two or more posts. Individual implant crowns are fixed in place; prosthetics containing multiple teeth may be fixed or removable.

A Wealth of Benefits

The list of advantages provided by dental implants over traditional replacement methods seems endless! Here are a just a few of the benefits you’ll enjoy with dental implants:

• A smile that looks and feels completely natural

• A lifetime of healthy smiles if you take proper care of your implants

• A restorative solution with a success rate of 95 to 98%

• No more jawbone loss

• A more youthful appearance • The ability to fully taste food and to eat any food you want – crunchy, chewy foods are no longer off limits

• You won’t have to remove your teeth to clean them (if you choose a fixed prosthetic)

• No slipping, clicking, or foul odor that often occurs with dentures

• You’ll never buy denture adhesive again

• Clear speech

• Existing teeth stay in position to ensure optimal bite alignment and comfortable jaw function

• Retention of natural tooth structure (no grinding down to apply crowns to secure crown and bridgework)

• A proven solution backed by research and practical application

The History of Dental Implants

An Ancient Origin In the 1930s, archeologists discovered what is considered the first evidence of dental implants. A jawbone fragment of a young Mayan woman contained tooth-shaped pieces of shell in the sockets of three missing teeth. While once believed that these shell fragments were placed posthumously, a Brazilian dental academic concluded in 1970 that bone had grown around two of the “implants,” indicating that they were placed during the woman’s lifetime. The Start of Modern Implant Dentistry

A Swedish orthopedic surgeon named Per-Ingvar Branemark was studying bone healing and regeneration when he discovered that bone tissue adhered tightly with titanium implanted into it. Branemark’s original focus on knee and hip surgery soon evolved into using titanium in tooth replacement.

He coined the term “osseointegration” to describe the process of bone bonding with titanium, and he placed his first dental implant into a volunteer patient in 1965. Concurrently, research into using dental implants to replace missing teeth was occurring in the United States and Italy.

Implant Dentistry Today

Branemark continued his research into dental implantology and, in 1978, partnered with a Swedish defense company to produce and market his dental implants. Out of that partnership came the company we know today as Nobel Biocare, one of the leading manufacturers of quality dental implants.

Over 7 million Branemark System implants have been placed to date. Other companies adopted the technology and produce quality implant systems to help patients regain stronger smiles and richer lives. Types of Implant Solutions

Dental implants replace the root of a tooth to imitate natural root function and secure one or more replacement teeth. They type of implants used today are called root-form endosseous implants. This simply means that they take the form of a root and are placed into the bone. Within the realm of traditional dental implants, different types exist to meet the diverse needs of people with missing teeth. Your dentist may recommend mini implants, short implants, or thin implants to address your unique tooth replacement requirements.

Mini Dental Implants

As you would expect, mini dental implants, or MDIs for short, are smaller than traditional implants. They’re used primarily to stabilize loose dentures in patients who either can’t withstand traditional implant surgery or who have a narrow jawbone ridge. Placing MDIs is a minimally invasive procedure that can be completed in a single office visit. The smaller size of the implant lends itself to rapid healing so that it can immediately support replacement teeth. A special fixture attached to your new or existing denture snaps on to the implants for maximum stability.

Short Dental Implants

This type of dental implant is often used in patients with limited bone height. A traditional dental implant requires sufficient jawbone depth and mass to successfully integrate. A bone graft can enhance bone mass in preparation for dental implants. Short dental implants, however, negate the need for a bone graft and allow the dentist to place the implant posts without fear of damaging the maxillary sinus or the inferior alveolar nerve.

Thin Dental Implants

Thin implants feature a one-piece design that combines the implant post and the abutment. These implants are used for immediate load, which means that replacement teeth can be attached immediately following the surgery to place the implants. Thin implants are used between closely spaced teeth and in jaws that are narrow but have sufficient depth. They work well in dense and soft bone tissue.

The bottom line? There’s likely an implant solution that’s right for you, no matter your bone structure, density, or depth. Are You a Candidate for Dental Implants?

Why is it so important to replace missing teeth?

Replacement of missing teeth is important as they play a huge part in supporting the cheeks and lips, and missing teeth will cause a change in facial appearance. The best way to prevent this change is undoubtedly to have another dental implant, as this also protects against bone loss in the upper and lower jaws, which in turn provides support for facial appearance. Bone loss occurs when teeth are removed as the roots stimulate the bone. Dental implants act in the same way as natural tooth roots and stimulate the bone so that it is preserved.

Dental implants provide an attractive replacement tooth alternative for almost anyone with missing teeth or an ill-fitting prosthetic. With the different types of dental implants available and the myriad implant dentistry solutions, you’re sure to discover the solution that best addresses your specific needs and expectations.

To find out if dental implants are right for you, answer these questions:

• Do you have one or more missing teeth?

• Is your denture painful or loose?

• Has your bridge caused the teeth that hold it in place to decay or degrade?

• Are you tired of not fully tasting food?

• Is it difficult to chew?

• Do you dislike using denture adhesive? • Are you embarrassed about the condition of your smile?

• Do you dislike having to remove your teeth to clean them?

• Are you concerned about the jawbone loss that occurs when teeth are missing?

If you answered yes to just one of these questions, then you owe it to yourself to discover the benefits of dental implants. Chances are, though, that you replied yes to several of these questions because they’re all common complaints voiced by people with missing teeth or a traditional prosthetic that hasn’t lived up to expectations.

Determining Candidacy

Ideally, dental implant patients should have good overall health and good oral health. At your implant dentistry consultation, the doctor will review your medical history, discuss medications you may be currently taking, and perform a thorough dental exam. Conditions such as gum disease must be addressed prior to implant surgery to promote optimal results.

A CT-scan or X-rays of your jaw will provide information about bone density, mass, and depth. Procedures to increase jawbone volume include bone grafts and sinus lifts. Different types of implants are also available – the mini, the thin, and the short – to accommodate your specific jawbone structure.

Conditions that Affect Implant Success

Certain medical conditions and lifestyle choices impact the success rate of dental implants. However, if you suffer from one of these conditions or engage in a habit listed below, that doesn’t necessarily mean that you’re not a candidate for dental implants. • Uncontrolled diabetes slows the body’s healing response. Since implant placement is a surgical procedure, delayed healing may hinder implant success. If your diabetes is controlled by medication, though, you’ll enjoy a good long-term prognosis regarding the success and longevity of your implants.

• Smokers may want to consider quitting before undergoing dental implant surgery. Smoking decreases bone quality and delays healing. While smoking doesn’t automatically preclude you from implant candidacy, it does lessen the chances of long- term success.

• Practicing good oral hygiene is a critical success factor. Proper brushing and flossing, as well as regular visits to the dentist are vital to achieve a good level of oral health compatible with implant success and will go a long way toward increasing the longevity of your implants. In fact, your implants may last a lifetime with proper care.

• Oral bisphosphonate drugs used to treat osteoporosis may interfere with implant success. Dental implant patients are sometimes advised to discontinue use of these drugs prior to and for a period of time following implant surgery.

• Bruxism, or teeth grinding, may damage the implants during the healing process and lessen the longevity of replacement teeth.

• Advanced age is not a factor in implant success. On the opposite end of the spectrum, however, dental implants are not recommended for young patients whose jawbone growth and development is not yet complete. Choosing the Right Implant Dentistry Solution

Dentists today use dental implants in several situations. You may have an individual missing tooth that needs to be replaced with a single implant post and crown, or you may be a denture wearer who has suffered for years with a painful, life-limiting prosthetic. No matter your needs, there’s an implant dentistry solution that’s right for you.

Dental Implants to Replace Individual Teeth

A single implant post placed into the jawbone where a natural tooth once existed anchors a custom-made implant crown. The crown will be designed to match the appearance and dimensions of your missing tooth in order to preserve bite alignment and keep existing teeth from drifting out of position. The alternative to a single implant post is to grind the adjacent teeth down and place a bridge with a dummy tooth on the real teeth. (Illustration No. 5 shows both options)

Dental Implants to Replace Multiple Teeth

Depending on your unique situation, gaps in your smile may be filled with individual implant posts and crowns – a one-for-one replacement. Alternatively, an implant bridge can be created to restore multiple missing teeth in a row. (Illustration No. 6)

Instead of attaching the bridge to healthy existing teeth ground down to receive crowns, an implant-supported bridge leaves healthy tooth structure intact. Two implant posts placed in the jawbone where teeth are missing stabilize the bridge to restore harmonious function, optimal comfort, and a natural appearance.

Implant supported bridges can be an excellent way of replacing several missing teeth. The advantages of having a bridge fitted over the implants are that it can save thousands of dollars, and if properly placed the implants should be able to handle the extra load. This is because well placed dental implants will successfully transmit the extra load from the bridgework to the bone, without creating stress on the implants.

Teeth in a Day with All-on-4 Dental Implants

This innovative procedure uses four dental implants to fix in place an entire arch of teeth. The implant surgery is performed and replacement teeth in the form of a bolted-down bridge known as a hybrid denture are attached the same day. Called immediate load, the design and placement of the implants allows the teeth to immediately support natural chewing forces just like real teeth.

With traditional implants, a waiting period exists between surgically placing the posts and attaching replacement teeth. The All-on-4 dental implants procedure eliminates this waiting period to let you experience a functional, new smile right away. You’ll often hear this implant dentistry method called teeth in a day or teeth in an hour. (Illustration No. 7)

Word of caution – having complete top and lower permanent teeth on implants has some risk involved. Breakage of teeth on these bridges is more frequent than previously thought. This is because the upper and lower teeth are so rigid, and have no feeling, and they bump into each other with greater force then even regular teeth.

While not the end of the world, when the teeth break off and need to be replaced, it’s a nuisance. These problems are most common when the dentist is not an expert and does not plan and design the bite for such heavy forces. It can be avoided by meticulous planning and design of the teeth.

Dental Implants to Replace a Complete Row of Teeth

A complete row, or arch, of teeth can be replaced with an implant- supported denture – either a removable denture or a permanent denture, known as a hybrid denture.

A removable denture must be taken out once a day for cleaning. Traditional posts strategically placed within the jawbone stabilize the custom-fitted replacement teeth. (The All-on-4 dental implants technique described below may also be used.)

The implant-supported removable denture can be used in the lower and upper jaws – where traditional dentures are notorious for losing their secure fit and slipping. Special attachments in the denture snap on to a metal bar or ball-shaped fixtures atop the implant posts. (Illustration No. 8)

Upper dentures supported by dental implants don’t have a bulky plastic base covering the roof of the mouth. Instead, the base hugs the jawbone ridge, without irritating it the way traditional dentures can. Your palette is exposed, so you’ll fully taste your food again. Dental Implants to Replace Complete Top and Bottom Rows of Teeth

Implant-supported dentures can restore complete upper and lower rows of teeth. Traditional dental implants stabilize permanently attached or removable replacement teeth to revitalize a smile with no natural teeth intact. Two or more implant posts placed in the lower and four or more implant posts in the upper jawbones can be fitted with clip attachments or a bar. Replacement teeth contain a reciprocal fixture that snaps on to these attachments and provides a stable, secure fit. (Illustration No. 8)

Remember, while dentures with clips are a huge improvement over regular dentures they still have some movement and are never as comfortable as dentures or bridges that are permanently locked in. They are best used if you had dentures before, want to save on cost, and don’t mind some movement of your teeth.

Alternatives to dental implants

Yes, there are alternatives to using dental implants. But they are usually not as comfortable or better when compared to dental implants. They are only better if you cannot have dental implants, or if implants are too costly. Think of them as the old alternative dentists invented before implants were available.

Although dentures replace missing teeth and help support the facial structure, they can accelerate bone loss as they press down on the gums and underlying bone causing it to be reabsorbed. This can happen relatively quickly after tooth extraction or removal of implants. Wearing a partial denture that is held in place with metal clasps can also help accelerate bone loss, as well as weakening the adjacent teeth so that they eventually loosen and fallout. An alternative to replacing just a few teeth is to have a bridge fitted. This process involves grinding down the healthy teeth either side of the missing teeth in order to support bridge. While this treatment is perfectly viable it does involve the removal of healthy tooth structure. Although the teeth that have been ground down are protected underneath the bridge, there is a likelihood that over time the bridge may leak allowing bacteria to enter, causing decay.

Implants act like natural teeth

One of the major reasons for choosing implants over a bridge is that it stimulates the bone in the area where the tooth is missing and prevents reabsorption from occurring. A bridge doesn’t do this and there is the risk that bone will be gradually reabsorbed underneath the bridge which could lead to an unsightly gap occurring over time.

Implants help save the bone as they act like natural tooth roots, and every time a load is placed on the implant it stimulates the bone the same way the natural teeth used to which helps maintain bone density and quality. Without this stimulation bone loss occurs, and this means that if a patient chooses to have an implant placed at a later date they may well need a bone graft to ensure that there is sufficient density and that the implant can be placed at the correct height.

Implants look more natural

Dental implants create much better esthetic results as the replacement tooth is seen to be emerging from the gum, just as natural teeth do, whereas the pontic region of the bridge which replaces the missing teeth merely sits on the gum and cannot give such a natural result.

There is no denying that the process of having dental implants is much more involved than having a bridge, but it's well worth putting up with the extra time and cost involved for a long-lasting and natural result that is much better for oral health.

So Many Advantages

Each of these solutions provides freedom from the problems associated with traditional replacement teeth. You can eat what you want and enjoy an active lifestyle without worrying about your smile. Because implant-supported replacement teeth look completely natural, no one will know that you ever experienced the hardships of tooth loss. You’ll experience an end to the bone shrinkage associated with missing teeth and rediscover the joys of smiling!

How Do I choose? – Your Dentist is your advocate

Your dentist will recommend the implant dentistry system that works best for your unique circumstances. For example, the combination of a fixed hybrid denture to replace teeth in the upper jaw and a removable overdenture supported by a bar and clip in the lower jaw provides optimal esthetics and guards against the failure that may occur when fixed prosthetics replace upper and lower rows of teeth. Treatment Stages & What to Expect

So you’ve decided to restore your smile with dental implants. Congratulations! Here’s what you can expect at every stage of the process, although your actual experience may differ slightly depending on your unique set of circumstances.

Stage 1: Consultation & Examination

At your implant dentistry consultation, you and the dentist will discuss your needs and expectations, and you’ll undergo a comprehensive examination of your teeth and gums. The doctor will likely take an impression of your smile to create study models. X-rays and computer tomography (CT) scanning technology will provide detailed images of your jawbone to determine bone quantity and quality, as well as the location of nerves and the sinus. The doctor will use the study models and images to determine the type of implant dentistry solution that’s right for you and to identify the optimal location for maximum implant stability and success.

Stage 2: Treatment Planning

Following an analysis of the results of your exam, the dentist will present recommendations and discuss whether you require any pre- treatment procedures, such as a bone graft or sinus lift, to ensure successful integration of the implant posts after placement. At this point, costs will be discussed, and you’ll receive information on the steps involved in your procedure. It’s important that you ask questions about anything that you don’t understand so that you leave the doctor’s office armed with knowledge and feeling good about your decision. Stage 3: Dental Implant Surgery*

On the day of your implant surgery, a specialist (typically an oral surgeon, periodontist, or prosthodontist) will insert one or more implant posts into your jawbone. The number of implants you receive depends on the number of teeth you are having replaced, the type of prosthetic that will replace your missing teeth, and the implant dentistry solution determined by you and the doctor. If it was determined that you require a sinus lift and/or bone graft to provide adequate jawbone tissue to support implants, the doctor may perform one or both of these procedures at this time. (Alternatively, these procedures may have been performed earlier in the process.) You may also receive temporary replacement teeth to wear during the healing phase that occurs following surgery.

After your implant surgery, you may be surprised at how good you feel. Many patients report little or no discomfort and quickly resume normal activities.

*If you undergo the All-on-4™ dental implants procedure, the doctor will attach your replacement teeth immediately following the placement of your implants.

Stage 4: Healing

As your jawbone tissue heals, a process called osseointegration occurs in which your bone grows tightly around the implant posts to fully integrate with your jawbone. This process typically takes 2 to 6 months, depending on the type and number of implants you receive. Usually, osseointegration occurs faster in the lower jaw. Stage 5: Dental Implant Restoration

Attaching your replacement teeth is called restoring your implants. Now is the time you’ll receive your custom-made implant crown (s), denture, or bridge. You can begin enjoying your new smile right away! Ensuring Implant Success

Dental implants create strong, natural-looking smiles and deliver exceptional durability and longevity. Successful implant placement and proper integration of bone tissue with the implant posts occurs up 98% of the time – an extremely high success rate. As with any medical or dental procedure, however, certain side effects and risks may occur.

Risks Associated with Dental Implants

• Nerve damage in the jaw may occur that causes numbness or a pins-and-needles sensation along with numbness in the lips, jaw, and gums.

• The implant may fail to integrate with the bone tissue, which can cause a replacement tooth to come out or a prosthetic to loosen.

• Peri-implantitis, which is an inflammatory condition of the gum tissue and/or bone surrounding an implant, may occur. Smoking, poor oral hygiene, diabetes, and thin tissue around the implant contribute to the development of peri-implantitis.

• Infection may be introduced during implant surgery or as a result of poor oral hygiene.

• Sinus problems can arise.

These side effects are rare but should be taken into account when considering dental implants. Many of these conditions may be resolved by dental implant removal and replacement. Who Should Not Get Dental Implants?

Typically, dental implants are not recommended for people who:

• Have insufficient jawbone mass and aren’t candidates for a bone graft or placement of mini or short dental implants.

• Have uncontrolled diabetes or heart disease. This is because medical conditions can affect the health of the gum tissue, and the gums of smokers and diabetics are less able to fight off any infections such as periodontal disease. Their condition can cause vascular changes to the gum tissue which inhibit its ability to receive sufficient nutrients and thus less make them less able to repair and produce the necessary antibodies to fight bacteria.

• Take intravenous or oral bisphosphonates for certain forms of breast cancer or osteoporosis. These drugs may increase the risk of developing osteonecrosis, which is a delayed healing syndrome. (Users of oral bisphosphonates for osteoporosis may be advised to discontinue the use of the drug for a period of time before and after dental implant surgery.)

• Have undergone radiation therapy to the head or neck.

• Heavy smokers are more likely to suffer implant failure. It’s quite likely that smokers may be recommended to give up the habit if they wish to have implants that last a lifetime.

Don’t give up hope! Only your dentist can determine for certain whether dental implants are right for you. At your implant dentistry consultation, tell your doctor about your medical history, current conditions, and medications you take, if any. After an honest discussion and thorough examination, the dentist can prescribe the appropriate restorative therapy to revitalize your smile and improve your oral health.

Implant Failure

A tiny percentage of dental implants may fail, or patients may feel pain at the site of the implant making it necessary for the dental implant to be removed. Removal of an implant is quite straightforward and is done using a special drill that fits around the implant. Once it has been removed then it’s quite likely that a bone graft will be necessary. Patients can choose to have another implant and crown fitted or an alternative type of dental restoration. In any case there should be no significant change to facial appearance after removal provided the missing teeth are replaced in some way.

Luckily the chances of a dental implant needing to be removed are incredibly small, as they have a success rate of at least 95% in natural bone, and between 85% and 90% in grafted bone. Much of the success lies in picking an experienced surgeon who is used to placing at least several implants every week.

Preventing Failure

Proper care on your part can help prevent dental implant failure. Adhering to the doctor’s instructions for caring for your smile immediately following your implant surgery and after attachment of your replacement teeth puts you on a firm footing for a lifetime of healthy smiles.

Another crucial component involves your doctor’s due diligence in assessing your candidacy. Jawbone tissue of sufficient quality to integrate with implants is a primary success factor. Resolving oral conditions such as gum disease prior to implant surgery creates a hospitable environment for dental implants. Getting chronic health conditions, such as diabetes, under control and stopping smoking increases your chances of implant success and encourages better overall wellbeing.

Can the Metal Used for Implants Cause Allergic Reactions?

The dominant element in the dental implants is commercially pure titanium which is generally available in four grades which depend on the amount of iron and carbon included in the alloy, although some alloys also contain a small amount of aluminum and vanadium. However titanium is much more resistant to corrosion than aluminum and vanadium, which is important in the mouth. Titanium is also used because it is extremely biocompatible with living tissue and is completely inert to all human body fluids, and in fact this biocompatibility is so great that it actually stimulates bone growth which makes this element ideal for dental implants. This also means that patients are extremely unlikely to suffer an allergic reaction.

Titanium is widely accepted as being the best material for any surgical appliance that is required to integrate with the bone. This is because most metals have the potential for corrosion, and when metals corrode they release metal ions into the body that could potentially cause an allergic response. It would be extremely rare to find any kind of allergic reaction to a dental implant, and there have been only a few reported cases of allergic symptoms for millions of implants –and these have tended to be for hip implant or orthopedic appliances. In short, the chances are so rare you need not worry about it. The Cost of Dental Implants

Dental implants do cost more initially than other replacement tooth methods. However, implants represent a wise investment in your smile and one that may save you time, money, discomfort, and aggravation in the future. When you choose dental implants to restore your smile, you’re selecting a long-term solution to improve your oral health – and good oral health is crucial to quality of life and overall wellbeing. Most dental implant patients consider the cost of implants a small price to pay for the countless advantages implants provide over traditional replacement teeth.

Remember, dental implants require no alteration of surrounding tooth structure, and they remain strong and sturdy for the long term. Plus, implants are the only tooth replacement option that stops jawbone loss. Other life-changing benefits of dental implants versus traditional replacement teeth include:

• A completely natural look and feel • You’ll once again speak with clarity • No diet restrictions – eat what you want • The potential to last a lifetime • A success rate up to 98% • No slipping, loosening, or shifting • Much more!

Cost Comparison: Dental Implants vs. Conventional Crown & Bridgework

To illustrate the value of dental implants, let’s compare the cost of implants to crown and bridgework. A dental implant to replace a missing tooth costs about the same as a traditional bridge secured to teeth prepared with dental crowns. However, a bridge only lasts an average of 10 years before it must be replaced. If you opt for bridgework over an implant, you’ll be paying for a new bridge over and over again throughout your lifetime, and you may need to re-restore the teeth anchoring the bridge. As this scenario illustrates, it doesn’t take long for the cost of replacement bridges to surpass your initial investment in an implant.

Insurance & Dental Implants

Some dental insurance companies now cover the cost of dental implants, and it’s hoped that this trend continues.

As evidence amasses attesting to the benefits of dental implants and their long-term cost-effectiveness over other replacement tooth methods, perhaps more and more insurance companies will cover the cost of implants. For now, most dental insurance plans contain a Least Expensive Alternative Treatment (LEAT) clause, which states that they will pay for the costs incurred to replace a tooth with the least costly restorative solution.

Additionally, the bulk of dental insurance companies view dental implants as a cosmetic dentistry procedure, and cosmetic dentistry isn’t typically covered. Although dental implants do contain an esthetic component in the appearance of the custom-made replacement teeth, implants are a restorative dentistry treatment that improves oral and overall health.

The companies that do provide coverage for dental implants may impart a lengthy waiting period before you can apply your benefit amounts to implant placement and restoration. Be sure to review your policy closely to determine whether you are covered and what, if any, limitations apply. Find a Dental Insurance Company in Your Area

For a list of insurance companies offering dental insurance in your state, you can visit the National Association of Dental Plans (www.napd.org). The information provided on this site only lists the names and contact information of insurance companies, not whether they provide coverage for dental implants.

Third-Party Financing

You may choose to finance your dental implants. Many reputable companies exist that offer no- and low-interest plans to cover the cost of implant dentistry. Typically, these lending institutions charge no upfront costs, no prepayment penalties, and no annual fee. You can apply online or over the phone and find out if you’re approved in seconds. Many dentists have teamed with third-party financing companies to help patients defray the cost of cosmetic and restorative dentistry treatments. Selecting an Implant Dentist

Choosing a doctor to restore your smile is an important decision. You’ve probably seen ads in the newspaper and online or heard radio commercials for dentists offering dental implants. But how do you know which doctor to choose? It’s crucial to select someone with experience, skill, integrity. Someone who is dedicated to excellence and stays current with leading implant dentistry through continuing education and training. You want a doctor that makes you feel comfortable, who answers all of your questions, and who instills trust and respect.

Factors to Consider

Does the person performing my implant surgery have advanced training in implant dentistry?

Dental specialists, including periodontists, prosthodontists, and oral surgeons, are typically the types of doctors who perform the implant surgery. They’re required to attend additional training following dental school to attain certification in their respective areas. Each of these three types of specialists has undergone rigorous postgraduate study in areas pertaining to gum and jaw surgery and/or tooth replacement, and they have the expertise to perform all types of restorative dental surgery. A specialist may team with general and restorative dentists who create and attach the replacement teeth following the surgical procedure to insert the implant posts. How many dental implant procedures has the doctor performed?

Don’t be afraid to inquire about your doctor’s experience. You may want to see some before-and-after pictures to get a feel for the esthetics results a doctor provides, and feel free to ask questions about the procedure, the team, the doctor – anything at all – to make sure that you have total peace of mind about your decision.

Does the doctor stay current with leading implant dentistry trends?

Advancements in implant dentistry are evolving at a fast pace. A doctor who doesn’t value continuing education can miss out on tools, techniques, or materials that may greatly benefit patients. Asking about your doctor’s focus on continuing education will provide a glimpse into his or her dedication to the advancement of implant dentistry and restoring your smile.

Where is the dental implant surgery performed?

Some doctors perform the surgery in a hospital, some in their dental operatories, and some in an in-office surgical suite. If the surgery will be performed in a doctor’s office, ask to see the location so that you feel comfortable and assured.

Who will assist the doctor in performing the implant surgery?

Often, you’ll deal closely with the team of professionals assisting your implant dentist. Ask about their experience with implant dentistry and the focus of their continuing education. These people will be caring for you and restoring one of your most valuable assets – your smile! It’s important that you feel safe, secure, and comfortable.

It’s Your Smile – Take Charge of It!

It’s OK to feel like you’re interviewing your doctor. In essence, you are! Most doctors are happy to answer your questions and provide all of the information you need to feel good about the decisions you make. It’s your smile, and your need to know that you’re choosing the doctor you feel is the best person to address and resolve your specific needs. Caring for Your Dental Implants

Before you leave the dentist’s office with your new smile, you’ll receive information on how to care for your dental implants at home. Diligent homecare is crucial for implant longevity, and you’ll need to attend regular checkups and cleanings at your doctor’s office.

Gum tissue bonds more strongly with natural teeth than with dental implants, so it’s important to maintain the health of that tissue. You’ll likely need more frequent professional cleanings than a person without dental implants. The hygienist may use special instruments specifically designed to clean dental implant restorations.

Twice daily brushing and daily flossing will help prolong the life of your implants. The dentist will show you the proper way to perform these activities and may suggest using a special brush to ensure maximum effectiveness.

If your prosthetic is removable, be sure to clean your replacement teeth as recommended by the dentist and to floss around the implant abutments. Every few years, individual implant crowns may need to be removed by the dentist for cleaning, and then placed back onto the implant posts. Q&A

Why are implant posts made of titanium?

The surgical-grade titanium used to create the implant posts is biocompatible. Bone tissue readily bonds with it and integrates it as it would a natural tooth root. Additionally, the strength and durability of titanium makes it ideal for dental implants.

Is everyone a candidate for All-on-4 dental implants?

Each patient’s needs, concerns, and expectations are different. Luckily, there’s an implant dentistry solution for almost everyone! The All-on-4 dental implants method involves placing implant posts in the jawbone and attaching replacement teeth the same day – a process called immediate load. It’s not the right solution for everyone.

Your doctor will discuss your specific situation to determine if All- on-4 is the best solution for you.

Is It True That I Can Get Dental Implants Finished in a Week?

There are some types of dental implants which can be immediately functional, and which can be used within a week or even the same day. They usually have temporary teeth put on them, until permanent teeth can be made a few months later. studies have shown that these implants have a similar success rate to conventional implants which cannot be loaded until a healing period of between three and six months has elapsed. That’s the good news, but the reality is that only a small percentage of patients are suitable for this procedure, and that most would benefit from using the more conventional implant procedure as the results are much more predictable and safer.

The benefits of having implants that are functional within a week are pretty obvious in that it gives a much better patient experience and can be less traumatic. However there must be sufficient bone to support the dental implants and the patients must be in very good general health and cannot be smokers or suffer from any systemic diseases such as HIV or diabetes that could compromise their immune system.

This system is also unsuitable for anybody who has severe grinding or bruxism as this would place too much pressure on the implants. They also need to be prepared to take extremely good care over their oral hygiene. In addition people having this procedure may need to follow a soft diet for between eight and twelve weeks after the surgery. The dentist must do a thorough assessment of someone’s suitability for this procedure to ensure it is really the best course of treatment.

Immediate load implants require the tooth that needs to be removed to be removed effectively without removing any bone after which the implant can be placed in the extraction hole and its stability tested by the application of suitable force using a torque wrench. After this an immediate abutment and temporary tooth can be placed. The temporary tooth is purely for cosmetic purposes and is adjusted to ensure no load can be applied to the implant under normal circumstances. This is to enable Osseo integration to take place over the next two or three months. After the process is completed an x-ray is taken to confirm the implant is successful.

Once the implant has fully integrated then a permanent crown can be fitted. While one advantage of this type of implant is the convenience of not being without teeth or having uncomfortable temporary fitted, and another advantage is that the tissues and gum surrounding the tooth are less likely to recede. In traditional implant surgery the gum is allowed to heal for several months before the implant is placed and there is always the risk that delayed placement can allow the gums to recede which may affect the gum line on the finished restoration.

Is the implant process painful?

The dental examination and pre-treatment diagnostics are comfortable and non-invasive. Sedation administered during the surgical procedure to place the implants into jawbone tissue ensures your complete physical and mental relaxation. Following dental implant surgery, most patients report little or no discomfort. Your doctor may recommend taking an over-the-counter analgesic or prescription pain medicine if you experience any tenderness or swelling at the site of your implant placement.

What’s a bone graft, and why would I need one?

A bone graft involves the use of artificial or donor bone to increase bone mass. Bone quality is a key component contributing to implant success. If the doctor determines that you have a shallow jawbone, because of your unique physical makeup or resulting from bone diminishment following tooth loss, a bone graft will augment your natural bone tissue to provide adequate depth to hold implant posts in place. A bone graft may be performed prior to or at the same time as dental implant placement.

How long do implants last?

Studies point to implants lasting as long as 40 years. Depending on your age and the care you take of your implants, they may last your entire lifetime. These factors include a person’s medical health and also their daily oral hygiene routine. If there is a question mark over either of these aspects then an implant could fail at some later date. It also depends on how good the quality of the bone was at time of placement. Most implants have a very high rate of success and should last a considerable amount of time, especially as the materials and expertise have increased.

Avoiding periodontal disease

Periodontal disease can affect the gums and the site of the implants in the same way that it affects the gums around natural teeth, so it’s important to ensure that any signs of the disease are eliminated before implant placement, and that care is taken to avoid periodontal disease in the future. The best way to ensure this is to visit the dentist regularly and to schedule cleanings with the hygienist at least every six months. The hygienist is the best person to clean the implants thoroughly which will lessen the chance of gum disease. They will also check that you are cleaning your teeth correctly.

Good oral hygiene helps prolong the life of implants

Anyone who has had implants should be prepared to take extra care of them, and this includes having regular dental check-ups as well as following an oral hygiene routine.

Teeth should be brushed after every meal, and a small toothbrush or interdental brush used to clean the abutments. Floss can also be used to clean around the gums and abutments and prosthetic teeth. Removable prosthesis should be taken out of the mouth so that the abutments can be cleaned and flossed thoroughly, while fixed prosthesis should be cleaned as thoroughly as natural teeth, and the interdental brush and floss can be used to clean in between and around the abutments.

I’ve been told I can get Mini Implants for my denture – is it permanent?

Mini dental implants are sometimes recommended by dentists as a permanent solution for loose dentures. This sounds good because the cost is low, and the procedure fast and easy.

For the dentist recommending this, it’s an easy and profitable procedure. The dentists recommending this will usually not send you to a specialist such as a surgeon or Periodontist. This is because the specialists will seldom use these implants as a permanent solution.

In most people these implants do not last long, do not hold the dentures well and have many problems.

As the saying goes “if it’s too good to be true – It is.”

I’ve been told that my jawbone is shallow. Can I still get implants?

An implant dentistry solution exists for almost every patient. To shore up jawbone mass, you may be a candidate for a bone graft. Alternatively, the dentist may recommend thinner or short dental implants to secure your replacement teeth.

The All-on-4™ Technique: Can This Be Used for Partial Tooth Loss?

The All-on-4 technique is especially suitable for patients wishing to replace all their natural teeth. It is also good for patients who have a few remaining natural teeth which need to be removed, but it’s not particularly suitable for people who have remaining teeth that are in good condition and which do not need to be removed. People who have experienced partial tooth loss but whose remaining teeth are viable would find normal implant techniques a much better means of tooth replacement, even though conventional dental implants take longer to place and have to be left for longer so that they can integrate with the bone.

The All-on-4 technique is an excellent solution for patients who need to wear full dentures, as it gives the stability of an implant- supported bridge using just four strategically placed implants. In some cases it may be necessary to use six implants in the upper jaw to ensure complete stability.

This technique minimizes the need for bone grafting, and in the vast majority of cases a same day bridge can be made for fitting immediately after the implant placement procedure, which is why it is often referred to as the permanent teeth-in-a-day procedure.

One of the reasons why it is unsuitable for patients who have only partial tooth loss is that four dental implants need to be placed at specific angles in a particular location at the front of the mouth. This is to ensure that the best use is made of the available bone as it often has a higher density in this region. This procedure is beneficial for patients who do not have good bone density, and who would have difficulty having conventional implants without extensive bone grafting procedures. Patients who have lost all their teeth often suffer from considerable bone resorption, especially if the teeth have been missing for quite some time. Wearing dentures accelerates bone loss over the years as the dentures place pressure on the bone.

Patients who have suffered partial tooth loss can potentially have less extensive bone resorption as the tooth loss is more likely to be recent, and could more easily have conventional implants without the need for bone grafts. While the all-on-four technique is excellent for patients needing to replace all their natural teeth, and is an extremely quick procedure, there is some concern that unless an experienced surgeon is chosen for the procedure there could be a higher risk of implant failure. As with all dental procedures the need to choose a highly experienced surgeon cannot be stressed enough.

Will Removing a Dental Implant Cause a Change in Facial Appearance?

A tiny percentage of dental implants may become loose or patients may feel pain at the site of the implant. We call this a failure of an implant. When an implant fails it’s necessary for the dental implant to be removed. Removal of an implant is quite straightforward and is done using a special drill that fits around the implant. Once it has been removed then sometimes a bone graft will be necessary to replace the implant. Patients can choose to have another implant and crown fitted or an alternative type of dental restoration. In any case there should be no change to facial appearance after removal provided the missing teeth are replaced in some way.

If I Smoke Can I Get Dental Implants?

Studies have shown that smoking can affect the integrity of dental implants and that they are more likely to fail than implants in a non-smoker, and in fact the failure rate can be as high as 16% among smokers compared to 1.4% in non-smokers over a five-year period. This is partly because people who smoke are at greater risk of infection following the implant surgery and may heal more slowly. Smoking affects the healing process because it narrows the arteries, lessening the flow of blood to the bone and tissues around the gums and teeth. This means vital nutrients are less able to reach the site of the surgery so that the gum cells, or gingival cells lack the necessary energy to heal and they are less able to produce antibodies to fight any infection. Smokers are more likely to be deficient in vitamin C which is an essential nutrient and antioxidant and is especially important in healing wounds. This vitamin cannot be manufactured by the body.

In addition smoking has also been shown to be a risk factor for gingivitis and periodontal disease which is one of the main causes of tooth loss in adults. Periodontal disease results from a build-up of plaque around the teeth, which in turn creates the right conditions for dental decay to occur. Significant reabsorption of the alveolar ridge has also been found to be more prevalent amongst smokers; this is the bony ridge that supports the teeth, and it is necessary for the bone to be of sufficient density and quality in order to support dental implants. As smokers are more prone to losing teeth they are also more likely to be candidates for dental implants, which creates a vicious circle that could be broken by giving up the habit.

It is of course still possible to have dental implants and continue smoking, but it’s important to be aware of the implications of continuing with a tobacco habit. Even if you cannot give up smoking, it’s probably best to abstain from smoking, at least during the healing process, with the first 6 to 8 weeks being most important as the implant integrates with the bone. Integration is vital so that the implant has the necessary strength to support a crown and the resulting load.

It goes without saying that anyone intending to have dental implants and who wishes to continue smoking needs to be extra vigilant over their oral health. This includes scheduling regular check-ups and cleaning, and also having an excellent daily oral hygiene routine. Smokers should also take extra care to select the very best implant surgeon they can find to help minimize the risk of implant failure.

Why Should I Choose an Implant over a Bridge?

The prospect of having an implant as opposed to a bridge may seem scary due to the surgery involved, and some patients may also be deterred due to be extra cost, but in the long run it can be much more cost efficient and better for oral health to choose implants over a bridge. This is because the dental implants should last a lot longer than a bridge provided they are looked after correctly. There are several reasons for this:

• Dental bridges can place stress on the adjacent teeth which can weaken them over time and may lead to further tooth loss. This is avoided by having dental implants.

• It’s much easier to floss and use interdental brushes on a single implant than to floss thoroughly around a bridge.

• Dental bridges involve grinding down healthy tooth structure which can never be replaced. Over time a bridge may begin to leak which allows bacteria to enter these ground down teeth which may result in decay.

• Implants actually integrate with the bone and effectively become an inert part of the body whereas bridges are just a dental appliance. Make the Call!

Now that you have the information – It’s time to take the next step and discover the smile you were meant to have! Call the right dentist office today to schedule an appointment and regain your smile and your life through modern implant dentistry. Learn More

More information about dental implants is available at:

• Dr. Penchas website at Midtown dentistry – www.midtowndentistry.com

• Academy of Osseointegration – www.osseo.org

• American Academy of Implant Dentistry – www.aaid- implant.org

• American Academy of Periodontology – www.perio.org

• American College of Prosthodontists – www.prosthodontics.org

• International Congress of Oral Implantologists – www.icoi.org

• Osseo News – www.osseonews.com

• All-on-4™ – Is a trademark of Nobelbiocare inc. – www.nobelbiocare.com ABOUT THE AUTHOR

!"#$%&'()*&%#$+'Made Simple' Dr. Jonathan Penchas DMD Med PAABOUT THE AUTHOR Dr. Jonathan Penchas DMD Med PA

Strange as it sounds, Dr. Penchas knew he wanted to be a Strange as it sounds, Dr. Penchasdentist knew when he was he 16. wanted to be a dentist when he was 16. His education was obtained throughout the world. He attended schools in London, Jerusalem, Boston, Louisiana, His education was obtained throughoutand Texas. He attended the dental school world. at Hebrew HeUniversity attended schools in London,in Jerusalem, Jerusalem, Israel where he received Boston, his D.M.D. degree. Immediately thereafter, he completed his specialty in Louisiana, and Texas. He attendedProsthodontics at dental Louisiana State schoolUniversity in New atOrleans. Hebrew University in Jerusalem,During the same Israel time, Dr. Penchas where earned his Masters he degree received his D.M.D. degree. in Education at The University of New Orleans. In Houston, Texas he completed a fellowship in Dental Oncology (cancer dentistry), and Immediately thereafter, he completedMaxillofacial Prosthetics his specialtyat M.D. Anderson Cancer in Center. Prosthodontics at Dr. Penchas served as a full-time Clinical Assistant Professor of Prosthodontics at the Louisiana State University in NewUniversity Orleans. of Texas in 1995 through 1996. He is a dental examiner for WREB, a dental examination board.

During the same time, Dr. PenchasDr. Penchas published earned his !rst article hisin the Journal Masters Of Dentistry For degree Children during inhis senior year in dental school. He has since continued to publish articles and routinely Education at The University of Newparticipates Orleans. in giving seminars to dentists, technicians, and the general public.

In Houston, Texas he completedDr. a Penchas fellowship is the founder of in midtown Dental dentistry -aOncology successful private dental (cancer of!ce with special emphasis on dental implants and cosmetic dentistry in Houston Texas. dentistry), and Maxillofacial Prosthetics at M.D. Anderson Cancer Dr. Penchas’ has three children: ben, Jordan, and shai. His hobbies include beekeeping and Center. scuba diving.

He can be reached at: Dr. Penchas served as a full-timeJonathan Penchas Clinical DMD PA Assistant Professor of Prosthodontics at the UniversityMidtown of DentistryTexas in 1995 through 1996. He is a 315 Westheimer Rd., Houston, TX. 77006 dental examiner for WREB, a dentalE Mail: [email protected] examination board. Tel: 713.807.9877 Fax: 713.807.0501 Online: www.midtowndentistry.com Dr. Penchas published his first article in the Journal Of Dentistry For !"#$%&'()'&#*+&,)'-#./.#/01#*2 Children during his senior year in dental school. He has since continued 35 to publish articles and routinely participates in giving seminars to dentists, technicians, and the general public. Dr. Penchas is the founder of midtown dentistry -a successful private dental office with special emphasis on dental implants and cosmetic dentistry in Houston Texas. Dr. Penchas’ has three children: ben, Jordan, and shai. His hobbies include beekeeping and scuba diving. He can be reached at: Jonathan Penchas DMD PA Midtown Dentistry 315 Westheimer Rd., Houston, TX. 77006 E Mail: [email protected] Tel: 713.807.9877 Fax: 713.807.0501 Online: www.midtowndentistry.com