Like I said last blog, we’ll cover implant supported teeth where the teeth are removable when the patient wants to remove them. We’ll cover the two basic types.
Removable Prosthesis (Teeth)
There are two kinds of implant supported removable prosthesis. In one option the support for the teeth is much more rigid.

2A. Is supported completely by the dental implants not the soft tissue. The prosthesis is rigid (doesn’t move at all) which a titanium bar that is attached to the implants supports.
Usually 5-6 implants in the mandible (lower jaw) are needed to support the bar. 6-8 implants are required in the maxillae to support the supporting bar. When the prosthesis is in place it is extremely rigid. When it is removed to clean, the patient brushes and cleans the bar that it fits on to. The removable prosthesis is made of denture teeth, acrylic and a metal substructure.

2B. Overdenture-the prosthesis is supported by implants and soft tissue and is not rigid.
This is the most common type of removable prosthesis because of the fee involved. Even though it is a substantial investment, it is not close to the cost of the 2B completely implant supported prosthesis. Implants support varies from 2-3-4 depending on available bone and available funds of the patient. Of course 4 implants support the overdenture better than three implants. Of course three implants support better than two implants.
Advantages of overdentures when compared to 2A.
1. Reduced cost over all other implant prosthesis choices.
2. Gives support and comfort that could never be achieved by conventional.
3. Many times (not always) be upgraded in the years to come to a more complete treatment. As years pass and patient’s financial situation improves, implants can be added. To have a fixed result or 2A result, the existing overdenture has to be replaced.
Disadvantages of overdentures when compared to fixed prosthesis or 2A.
1. Bone (jaw) will continue to shrink and resorb in the areas where there are no implants.
2. Relines and added cost every few years are to be expected.
3. Bite adjustments and doctor checks are required more frequently.
4. Attachments in overdentures will wear. They will need replacement with associated costs.

Even though these disadvantages are real, the benefits of overdenture treatment are life changing for most people. The suffering that people endure with full upper and lower dentures has been discussed.  This is a wonderful treatment.

I have been a Quincy dentist since 1978.  It is hard to believe the advances in dental health today.  I attended the Misch Surgical Institute and achieved Fellowship status in the International Congress of Implantology.

Dr Steve

 

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Options For People with No Remaining Teeth-Full Edentulism

Today is on teeth that are supported by dental implants.  These teeth are non removable by the patient.  They are permanently in the patients mouth like real teeth.

1. Fixed Prosthesis (Teeth)-NON-REMOVABLE TEETH
This is the most desirable treatment because it’s the most natural and stops the shrinkage of the jaws.
Depending on many factors, 6-8 or more implants are required to support a non-removable fixed prosthesis. There are many possible solutions depending on the amount of shrinkage of jaws and soft tissue that has already occurred. I will be able to recommend the specific type of fixed prosthesis as I study your situation.
1A. Fixed Bridge-Material of choice is porcelain to noble metal alloy. In general this is the same material used in a fixed bridge that is supported by natural teeth. It will give the best cosmetic results in most cases. There are times due to greater shrinkage that this is not possible.
1B. Fixed Hybrid-Material of choice is denture teeth , acrylic and metal base.
In general this must be utilized when more shrinkage has occurred. This allows me to give you the lip support while decreasing stress on existing implants.

It is impossible to give complete descriptions in this book. It would take a textbook to explain. That is not the purpose of this book.
Tomorrow I will talk about removable option. That are teeth that are supported by dental implants but are removable to clean.
I have been a dentist in Quincy since 1978. I have been restoring dental implants since 1978. I attended the Misch Surgical Institute and have achieved Fellowship status.
Dr. Steve

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Advantages of implant supported Teeth for totally edentulous people

1.   Improved quality of life.

2.  Greatly improved ability to chew.  Many people can create as much force with their implant supported teeth as with their own natural teeth.  Within 2 months of completing treatment reported over an 85% increase in chewing ability.  After three years of completing treatment, most people showed over a 300% increase in chewing ability from when they had full 

chewing ability from when they had full dentures.

3.  Look younger.  Facial dimensions were lost while they had full dentures not supported by implants.  It is life a natural facelift. 

See Chapter 8 on Facelift dentistry.

4.  Feel younger.  Over 85% of people with implant-supported teeth reported their psychological condition greatly improved.

5.  Implants stop the shrinkage of their face and jaws too keep that youthful look.

6.  Adhesive and denture pastes not needed to hold teeth in place.  Of course the number of implants used to support the teeth vary.  The greater the number of implants used increases the stability.  See more later.

7.  Speech greatly improved.

8.  Self-esteem greatly improved.

9.  Social events and time with family is again enjoyed.  Dinner either in their own home or in restaurants is again a pleasure.  I can’t tell you how many times people tell me how they will not go out to dinner with 

their kids and especially grandchildren because of embarrassment

10.  Patients are happier.

I have been a dentist in Quincy since 1978.  I have been restoring implants since 1978.  I attended the Misch Surgical Institute and have achieved a Fellowship status.

Dr Steve Matarazzo

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ALSO IT IS MY 60TH BIRTHDAY TODAY, HOORAY.  JOANNE AND I ARE GOING TO VISIT OUR FAVORITE BEACHES.  BEACHCOMBER AND WHITE CREST BEACHES IN WELFLEET.  SUN SHOULD BE OUT, BOOGIE BOARDS READY FOR THE SURF, GOING TO SAL’S ITALIAN SATURDAY NIGHT.  WHAT A WEEKEND PLANNED.  I AM PICKING UP MY NEW CANNON REBEL VIDEO AND STILL CAMERA TODAY.  I’LL BE USING IT IN THE PRACTICE AND FOR FUN.  WILL SHOW YOU SOME PHOTOS SOON I HOPE.

No Remaining Teeth-Full Edentulism

Due to dental phobias, anxiety, lack of concern by patient and or doctor, an incredible number of adults are completely without natural teeth.

What can be affected by the lack of natural teeth?

1.  Overall health is diminished.

2.  Digestive problems from lack of ability to chew food properly.  Ask someone with dentures to bite your finger, don’t worry it won’t hurt.  Their ability to create chewing force is so diminished you would feel sorry for them.

3.  Self-esteem is damaged in most people.  If most trusted you enough to share with them their feelings, which most won’t, they will tell you what psychological damage has occurred.

4.   Too many people are robbed of the joys of living, laughing and loving life that could be theirs.

5.  Too many people shorter lives, diminished lives because of dental disease.

6.  Embarrassment and hopelessness are common feeling for these people.

7.  Over 80% of patients report difficulty speaking.

8.  Over 65% of people reported pain and sores from trying to wear dentures.

9.  Over 20% report they never wear their dentures.

10.  17% reported they could chew better with their dentures out of their mouth than in their mouth.

11.  Over $200,000,000 was spent in the U.S last year on dental adhesives and pastes.

12.  Unpleasant taste and frequent reapplication of adhesive during the day

The more decades they wear their dentures the more the damage occurs in all these areas.  People are not going to share these thing with you because they are so personal.  If you are reading this, you most assuredly know what I mean.  If you are the spouse, family, friend or significant other this may come as a surprise to you.  Your loved one is embarrassed and doesn’t want to share this.  Many women have never told their husbands or been seen by them without their dentures in place.

A conservative estimate of numbers of people in the Unites States of America that have one-or-two arches of missing teeth is staggering.  Over 30,000,000 people or about 17% of the U.S. population is living or putting up with this condition.  I have been a dentist in Quincy since 1978 and also restoring implants since 1978.  I attended the Misch Surgical Institute and achieved Fellowship status in the International Congress of Implantology.

Dr Steve Matarazzo

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Multiple Missing Teeth-Partial Edentulism

The use of dental implants for patients who are missing multiple teeth is rapidly growing.  When multiple teeth are missing there are two basic ways (other than dental implants) to choose from.  A fixed-bridge whose span an even greater than a three-unit bridge and is under more stress and danger.  For example, a patient with two missing teeth, a four-unit fixed bridge is going to fail even quicker and easier than a three-unit bridge.  If those two supporting abutment teeth are lost then the patient has four missing teeth rather than two.  The other replacement option is a removable partial denture.  Yuck.  Removable partial dentures to replace missing teeth has one of the worst patient acceptance rate of almost anything.  The only thing accepted less is when the patient has full removable dentures with no implant support.  Its been reported that 60% of patients don’t wear their partials within a 5 year time period.  When patients actually wear their removable partial dentures bad things usually happen to the supporting teeth.  The teeth that support the partial, you know, the ones with the ugly metal clips that show when you smile get damaged.  These teeth become loose, broken, decayed and worn.  Eventually they become so damaged that they must be sacrificed and extracted.  These supporting teeth show significant bone loss, which leads to these teeth becoming loose and eventually extracted.  Again, dental implants have become the most predictable and preventative treatment available to most patients.  I have been a dentist in Quincy  since 1978.  I have been restoring implants since 1978 also.  After attending the Misch Surgical Institute, I achieved Fellowship status in the International Congress of Oral Implantology.

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Single Tooth Missing Loss
A three-unit fixed bridge is the most common treatment of choice for the replacement of one missing tooth. Treatment time is one to two weeks and many times can be satisfactory when it comes to function, speech, and cosmetics. Major disadvantages with this popular treatment are that the supporting teeth must be “drilled” and compromised to accomplish this. Root canals, root canal failures, decay, and tooth fractures are common reasons why these three-unit fixed bridges fail. Now the supporting abutment teeth are severely damaged or lost and the problem has become significantly worse. These supporting abutment teeth are lost about 30% of the time within 14 years. On average over 80% of abutment teeth used to support a bridge have no fillings or decay or minimally restored. Doesn’t it sound like a great idea not to subject your good healthy teeth to decay, root canals, fractures and extraction if you don’t have to. Yes, yes, yes!

Single-Tooth Implants
The option of utilizing a single dental implant to replace a single missing tooth eliminates the risks to your perfectly good healthy teeth. Many times dentists and or patients are swayed by insurance companies to accept a three-unit fixed bridge to replace the missing tooth. Reduced treatment time as I stated can be attractive until those abutment teeth are lost and treatment time multiplies and treatment cost multiplies.
Single implant use to replace a missing tooth is by far the most predictable method to replace a missing tooth. Cosmetics many times are greatly improved because the natural adjacent teeth are untouched. Even in the case where adjacent teeth required root canals or crowns, the implant use to replace the missing tooth is far better because we haven’t tied the entire success together. Single tooth implant represents the treatment of choice to replace a single tooth.
I have been a dentist in Quincy since 1978. I graduated Misch Surgical Institute and achieved Fellowship status int he International Congress of Oral Implantology.
Dr Steve

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With modern science improving in diagnostic ability and the ability to successfully treat so many diseases that used to be a death knell, people are living longer and longer. I am not talking about just existing. Today it seems like everyone is exercising either at a gym, at home or outside enjoying themselves. Bicycle riders and joggers are everywhere. Look at people’s supermarket carts when they are checking out. It seems like 95% of everything is healthy, fresh and not processed. Ok, an occasional quart of ice cream or a bag of Peanut Butter cups like our friend Barbara, from Eastham loves but it’s the exception not the rule.
Decrease in smoking is huge. Everyone, especially the smokers now know what damage it does. Even most men do not ignore discovering you have high blood pressure anymore. A pre-diabetic diagnosis is met with fear, which leads to determination to not succumb to diabetes. Every age is involved. We have met people in their 80’s snow boarding and skiing.
Social pleasures and dating is becoming not just a young persons life. With dating on line and so many second and third and fourth marriages, (thank God Joanne and I are on number one), that looking good and as young as possible is essential.
Remember Billy Crystal from Saturday Night Live? It’s better to feel good than look good, and you look marvelous!” Well that’s half true now. It’s not just good enough to look good. It is desirable for all to be as healthy as one can be. Now if you are old enough to know Billy Crystal and Saturday Night Live, then I know you are probably about my age. No I’m going to let you guess. I might guess that if your reading this chapter on Dental Implants, either you or a loved one is missing some or all their teeth. Dental implants and associated bone grafting, sinus grafts, and socket regenerations are some of the most predictable procedures we can do today. Who cares about procedures? We just want our teeth and to eat well and look well.
A healthy 65-year-old man or woman has over a 50% chance to live to 88 years old and a 25% CHANCE TO LIVE TO 94 YEARS OLD (OR YOUNG). IS IT WORTH IT TO ME TO SPEND $20,000 TO $30,000 TO $80,000 DOLLARS TO FIX MYSELF AT AGE 65? THIS IS NOT AN UNUSAL QUESTION THAT IS ASKED BY OUR PATIENTS AND SIGNIFIGANT OTHER. EVERY PERSON MUST ANSWER THAT QUESTION FOR THEMSELVES. I BELIEVE THE POSITIVE APPROACH IS ESSENTIAL. IGNORING THE PROBLEM OR JUST DOING NOTHING ONLY INSURES THE PROBLEM WILL GET WORSE AFFECTING THE PERSON’S OVERHEALTH AND SELF-ESTEEM.
One of my mentors kiddingly said, “ If you have this restorative implant treatment and live 20 more years you will be thrilled. If you have this restorative implant treatment done and die next year, you won’t care.” He was kidding but in reality isn’t it true?

Dr Steve Matarazzo

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Why are more and more people accepting dental implants to help restore them to normal cosmetics, function, comfort, speech, and health?
The top 10 reasons
1. People are living much longer lives.
2. Failure of conventional dental work.
3. Shrinkage of face and jaws as a result of losing their teeth.
4. Dislike of removable prosthesis whether it be full dentures or partials.
5. Lost or loose teeth as a result of wearing a removable partial.
6. Psychological impact of having no teeth.
7. Predictable long-term success of dental work supported by dental implants.
8. Less damage to existing natural teeth.
9. Advantages of not having to remove your teeth.
10. The ability to look and feel younger.
Hooray!
People are living longer! How many years are you planning to be healthy, enjoying yourself and your loved ones?
With modern science improving in diagnostic ability and the ability to provide excellence in care, dental implants have continually grown in our Quincy dental practice.
Thanks
Dr. Steve Matarazzo

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Dental Implants
Who wants them? Who needs them?
Who wants dental implants? No one. Who needs them? Sometimes any one who has anywhere from one missing tooth to 32 missing teeth.

Goals of modern dentistry
Our goal of modern dentistry is to return our patients to oral health. We must do this in the most predictable fashion. Everything we do with and for our patients must have this in mind no matter how many teeth are remaining or how many teeth are missing.

What is a dental implant? A dental implant is simply a replacement for a tooth root. The primary function of an implant is to act as an abutment for a prosthesis or support to something similar to a tooth. We are not sharks that can replace missing teeth throughout their lifetime. SO implants allows your dentist to use the implants to support missing teeth whether its one, two, three, ten, or 30. Implants are titanium root forms that are place into you jaws basically the same place your tooth used to be. The implant will fix it self to your living bone in a process that is called osseointegration. The use of dental implants to treat complete and partial edentulism has become an integral part of our ability to restore our patients to as natural and predictable situation as possible.
Implant survival rate have been reported any where from 96% to 99%. No report has ever stated the loss of adjacent teeth. The rarely failed implant can almost always be retreated keeping the adjacent natural teeth healthy and untouched.

Let me tell you a story about from 1978. I had just graduated dental school and like I said, I was at the beginning of my continuing education career. My brother John who was in college at the time, called and said that he had one of his front teeth “knocked out” in soccer game. The tooth was long gone and was going to come right down to have me fix it. John had a beautiful smile. He never had a cavity in his life. So as I was trying to figure out what to do I had to think? I knew I did not want to make him a removable partial denture, which is a plastic tooth, attached to metal and plastic that John would have to take in and out forever. I knew I didn’t want to take my drill and shape his front teeth for a non-removable bridge because even though I knew I wasn’t experienced enough to do a fabulous work that would endure the test of time, I knew in my heart it would have been a shame to damage two perfectly good teeth. Thank God I knew this as in experienced as I was. I did refer John to a periodontist whom I had met previously. He placed a dental implant where the tooth was missing from. I later placed a crown on the implant. It came fabulous. That was 1978 and as of today August 2012, John’s smile is perfect. The implant and crown are just as healthy as the day they were finished.
When do you think the first dental implant was placed?
Answer: 1952
I attended the Misch Surgical Institute and achieved Fellowship status in the International Congress of Oral Implantology.
Dr Stephen Matarazzo

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Hi, this is Dr. Stephen Matarazzo again.  Many times when people come to us they don’t like their smile.  They may have been to other dentists in Quincy and didn’t go ahead with treatment.  Sometimes they come in because they did go ahead with cosmetic treatment and they are disappointed at the results they received.  Its critical we look together with you at many photographs of yourself.  We will let you look at a portrait photos, close ups of you smile when your lips are relaxed, closeups of your smile when you give the biggest smile you can imagine.  When our patients see what they really look like, it helps them clarify to me what they really want to look like.  I can even show you what you will look like with our imaging software.  I encourage all of you to ask to see many before and after pictures of patients cosmetic work.  I will show you other patient’s with similar problems to you that we solved.  You are welcome to speak with our patients who have completed similar treatment.  You could also view video testimonials of patients that had similar problems solved.

Here are just a few questions for you to consider.  Take a good look in the mirror and make some notes.  We’ll look at all your photographs and work together to create the smile of your dreams.  Let’s wave a magic wand and create the new you!

Smile Questionnaire
1. Are you unhappy with the color of your teeth?
2. Are your teeth worn, chipped or cracked?
3. Do you have missing teeth?
Do you have old dental work that you don’t like?
4. Do you tend to smile with your lips closed in photographs?
5. Do you cover your mouth with your hand out of habit?
6. Do you look and feel older than you want to?

If you answered YES, call us
617-471-8882

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