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E-Cigarettes as bad the Real Ones? – Newton, Wellesely, MA

Former and would-be smokers who opt for electronic cigarettes may not be doing their teeth a whole lot of good, according to a new study.  Dr. Ryne Johnson, ryneprosthodontist and managing partner of Newton Wellesley Dental Partners has been educating his patients on the harmful effects of smoking on dental tissues for 30 years.  "Many have shifted toward the e-cigarettes thinking that they are a ‘safe’ alternative but new evidence suggests that both may increase the likelihood of gum disease".

However, research published in the journal Oncotarget, which focuses on cancer-related issues, suggests that electronic cigarette smoke may wreak the same type of havoc on teeth and gums that conventional tobacco does. A team of scientists from the University of Rochester and Stony Brook University found that the vapors released in e-cigarettes can cause tissue inflammation and damage comparable to that produces by regular ones.

Furthermore, chemicals used to flavor some e-cigs may cause even more harm to mouth tissue, the researchers say.  project1

Some caveats: This particular experiment was conducted on gum tissue, not live human participants. It’s possible that there are other confounding factors that may contribute to gum disease and in e-cig and regular cigarette users alike.

But it’s the latest example of scientific skepticism surrounding the health benefits of e-cigarettes. Manufacturers claim that they are an obviously superior alternative to conventional products that contain known carcinogens; but the overall public health ramifications of the products remain unclear, including whether or not they may actually be encouraging more kids to smoke.

For additional blogs by Dr. Johnson, click here To contact the office or reach Dr. Johnson, click here

Original article:  http://fortune.com/2016/11/17/e-cigarettes-yellow-teeth-study/ Artwork: www.motherjones.com

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All-on-Four Dental Implants – Newton, Wellesley, MA

Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners rynerecently participated in the American College of Prosthodontics annual meeting in San Diego where he discussed the All-on-4® treatment concept. It provides edentulous and soon-to-be edentulous patients with an efficient and effective restoration using four dental implants to support an immediately-delivered full-arch prosthesis.  Dr. Johnson has been called a pioneer in the synergistic use of computers in implant dentistry. His first case, using a CT scan generated model was performed in 1988.

After the first dental implant patient was treated in the 1980s, a discussion began around the optimal number of implants needed to anchor a fixed dental prosthesis in edentulous patients. Some clinicians tended to install as many implants as possible, often one per tooth. Others argued that biomechanically, only four or even three were needed. Only long-term clinical data could provide answers.

At the forefront

The records of the early patients of P-I Brånemark allowed for an early retrospective study. After a 10-year observation period, the survival rates were demonstrated to be the same for restorations with four and six implants assuming that the bone levels and distribution of implants were ideal. The challenge of advanced resorption remained, however. Because it is not possible in many cases to insert distal implants without grafting and/or nerve lateralization, thproject1e concept of tilting the two distal implants was introduced.

Immediate results

In 2003, the concept of immediate loading (placing a dental prosthesis on implants the same day the implants are placed) of four implants in edentulous lower—and soon after also upper—jaws with two tilted distal implants. This one-stage procedure substantially reduced the costly and time-consuming bone grafting procedures, number of surgeries and healing time.

The success continues

In an early reported a cumulative survival rate of 96.7% for implants and 100% for prostheses at up to 3-year follow up.2 Since then, he and others have repeatedly reproduced high survival rates for both upper and lower jaws.  Today, the All-on-4® treatment concept is used around the world with similar high survival rates and patient satisfaction that is enhanced by limited costs.

Dr. Johnson, with his in-office periodontist, has done hundreds of implant cases with outstanding results.  To arrange a consultation with Dr. Johnson, contact Newton Wellesley Dental Partners.

For additional blogs related to dentistry, click here To contact Dr. Johnson or the office, click here Original article and artwork: www.nobelbiocare.com

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Dental Implants & Medications – Newton, Wellesley, MA

Each year, about 500,000 North Americans get dental implants. Dr. Ryne Johnson, ryneprosthodontist and managing partner of Newton Wellesley Dental Partners, considered by many as a pioneer in the synergistic use of computers in implant dentistry says, “If you are one of them, and are preparing to have a dental implant, it might be a good idea to start taking beta blockers, medication that controls high blood pressure, for a while. And to stop taking heartburn pills”.

A body of research indicates that in order to raise the odds that dental implants will attach properly, there are clear benefits to taking certain common medications and avoiding others.

Bone cell growth, healing and death

"The success of procedures like dental implants depends mainly on how the existing bone accepts the implants to create a connection between the living bone and the surface of the implant," says Dr. Johnson, who has been involved in implant dentistry since 1988. "Because some medications affect bone metabolism and the way that bone cells heal and multiply or die, they can have an important effect on the success of implants."project3

A McGill research team reviewed data about the integration of dental implants gathered from over 700 patients. They then confirmed the results they saw in human patients through studies in rats.

Implications for hip and knee replacements

"We believe that this research may have implications for orthopedic interventions such as hip and knee replacements, because the same mechanisms of bone cell growth break down, and healing take place in all the bones in the body," says one of the researchers. "Our work with implants in rats suggest that this is indeed the case, but further research will be needed to confirm it."

Drugs that aid integration of implants - Beta blockers

  • Conclusions are based on 1499 dental implants in 728 patients between Jan. 2007 -- Sept. 2013 at the East Coast Oral Surgery in Moncton, New Brunswick
  • 327 implants were in 142 people who took beta blockers for hypertension
  • 1172 implants were in 586 people who didn't take beta blockers
  • Failure rates of implants for people using beta blockers was 0.6%
  • Failure rates of implants in people who don't take beta blockers was 4.1%
  • More than 640 million patients around the world take beta blockers to control hypertension.

"We carried out this study because we knew that beta blockers have been reported to increase bone formation," says Prof. Tamimi from McGill's Faculty of Dentistry. "So we thought it was possible that they would also decrease the risk of failure of dental implants. However we didn't expect that there would be such a clear difference in the failure rates for implants between users and non-users of beta blockers. Randomized clinical trials will need to be carried out as well as other studies of large numbers of patients to investigate this phenomenon in more depth."

Drugs that impede integration of dental implants - Heartburn treatment

  • Conclusions are based on 1773 dental implants in 799 patients between Jan. 2007 -- Sept. 2015 at the East Coast Oral Surgery in Moncton, New Brunswick
  • 133 implants were in 58 people who took heartburn medication
  • 1640 implants were in 741 people who don't take heartburn medication
  • Failure rates of implants for people using heartburn medication were 6.8%
  • Failure rates of implants for people not taking heartburn medication were 3.2%
  • More than 20 million Americans, about one in 14 people, take heartburn medication.
  • Heartburn medication is rapidly becoming the third most prescribed pharmaceutical product worldwide, especially for elderly people, who take it either on an occasional or long-term basis.

"Scientists already knew that drugs for heartburn reduce calcium absorption in bones and generally increase the risk of bone fractures," says Dr. Tamimi, of McGill's Faculty of Dentistry. "That is why we wanted to look at how it affects the integration of implants and bone healing after this type of surgery. But we didn't expect to find that the negative effects of these type of drugs would be as great as they are. Further work will need to be done to find the appropriate dosages and time periods that people should take or avoid these medications."

For additional blogs by Dr. Johnson, click here

To learn more about Dental Implants, contact Newton Wellesley Dental Partners.

Original article:  www.eurekalert.org

Artwork: www.medicalxpress.com

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Dental Implants Failures – Newton, Wellesley, MA

Dental implants are now used widely around the globe.  However, questions about patient risk assessment prior to placing the implants still abound. Dr. Ryne Johnson, prosthodontist and managing partner at Newton Wellesley Dental Partners asks, “What causes implants to fail in some patients but not others?

There are several factors which negatively influence implant predictability:

1. Gum and Bone Disease:  The placement of implants in a patient with periodontal disease would be one relevant concern. Resproject1earchers from Sweden performed a systematic review to determine if persons with periodontitis are more susceptible to peri-implantitis. The conclusion was that an increased susceptibility for periodontitis may also confer an increased risk for implant loss, loss of supporting bone, and postoperative infection.

2. Smoking: A recently published study discussedproject2 the effectiveness of implant treatment in a large patient population nine years after treatment. They used a large and randomly selected patient sample, and concluded that patient characteristics and implant features affect results. They discovered that smokers and patients with an initial diagnosis of periodontitis were at higher risk of implant loss. A 2014 study confirmed that placement of implants in smokers pointedly affected implant failure rates, the risk of postoperative infections, and marginal bone loss.

3. Shoproject3rt Implants: Those with implants shorter than 6 mm and implants using particular brands of products also showed increased risk.

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4. Teeth Grinding:  Several studies have clearly demonstrated an increased failure rate on patient with nocturnal bruxism.  The off-axis forces delivered to implants in people who grind their teeth can be significant and will over-stress the bone.

Dr. Johnson is considered a pioneer in the synergistic use of computers in dental implant dentistry and performed his first implant reconstruction in 1988.

For additional blogs by Dr. Johnson, click here For more information on dental implants, Contact Newton Wellesley Dental Partners.

Original article in www.dentistryiq.com, Artwork: www.pintrest.com, www.implantninja.com, www.slideshare.com, www.ceraroot.com

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Dental Implants, A Patient’s Primer – Newton, Wellesley, MA

Dental implants have become ‘mainstream’ as a treatment option for many patients.  Dr. Ryne Johnson, prosthodontist rsj-10-10-16and managing partner of Newton Wellesley Dental Partners has been doing implant supported reconstructions since 1988 and has been regarded as a pioneer in the synergistic use of CT Scans, CAD/CAMs and state of the art dental material science to deliver outstanding results.  He wants people to have some perspective on the process:

Before the procedure

Dental implants require a strong jaw bone. Patients who have lost a lot of jawbone may need to have a bone graft procedure performed before this procedure. Dr. Johnson will identify the available bone…sometimes with a CT Scan if necessary.  In some instances, this can be done BEFORE any teeth are removed (implants may be placed the same day) or AFTER the area has healed from tooth removal (with adequate bone preservation techniques employed at the time of extraction).

You will receive instructions about how to prepare for the day of the procedure. It is highly recommended you quit smoking several months before the procedure as smoking can cause poor osseointegration (poor bone and implant integration), which is the leading cause of implant failure.

Anesthetic

The procedure starts with a local anesthetic. This will make the implant site and the area around it completely numb. project1You will be awake, but you won't be able to feel any pain in that area. You might still feel pressure, vibrations, or some other sensations that might be uncomfortable, but no pain. Some offices offer conscious sedation or partial sedation where you are awake and numb, but "out of it" and mostly unaware of what is going on. Some people describe the feeling as similar to being drunk. Partial sedation is usually more expensive than local anesthetic and is not available at every office.

A dentist applies local anesthetic to a patient's lower jaw. A numbing gel is usually applied so that the patient will not feel the injection.

Preparing the implant site

After the anesthetic has taken effect, the implant site will be prepared and the gums will be retracted so the dentist can access the jawbone and evaluate the implant site. The bone needs to be relatively flat and smooth, and the dentist might use a drill to reshape it.

Drilling the pilot hole

The dentist will then use a series of drills to make a hole in the jawbone for the implant (s)…sometimes a “placement jig” will be fabricated from the CT Scan work up. They will first create a divot using a small round bur, and then a pilot drill to create a pilot hole. They may use a plastic jig prepared from plaster casts to help guide the pilot drill, but this is mostly up to the dentist if they need one. They may also use an alignment pin to make sure the pilot hole is on target. project4If no adjustments are needed, the pilot hole will be drilled deeper. As the hole is being created, the dentist may flush the area with water or saline to keep the bone cool and prevent overheating caused by drilling. Once the pilot hole is finished they will check its alignment again using the alignment pin. If the positioning of the implant is close to other anatomical structures, such as nerves or blood vessels, they may take an x-ray with the alignment pin in place to check its position.

Finishing the hole

When the pilot hole is finished, the dentist will use a series of increasingly larger drill bits until it's the correct diameter for the implant. The size of the implant will have been chosen ahead of time based on the condition of the bone.Usually, your dentist will want to select the largest implant that your bone can sustain because larger implants distribute their load to the bone better than smaller implants do. Most are about 4 mm in diameter.

After the hole for the implant is finished, the alignment will be checked again using the pin. Then the whole will be threaded using a screw tap to match the threads on the implant. Some implants are self-tapping and don't require this step. Dental implants are roughly the size of the root of a normal tooth.

Placing the implant

Finally, the implant will be placed. This can be done using a special head for the dental drill or using a small hand wrench. Sometimes it is actually done using a small torque wrench. This can cause some unpleasant sensations but skilled surgeons are able to minimize the discomfort. The surgical site will be closed using an implant cap and stitches.

Healing and osseointegration

The stitches will be left in place for 7 to 10 days, after which they will be removed. In some cases, the gum flaps may be stitched so that they cover the implant cap as the site heals and the gum tissue will later be trimmed back when the abutment is placed. The implant will be given 3 to 6 months to osseointegrate (fuse with the bone) before the restoration (consisting of the abutment and crown) is placed.

Note: It is extremely important that you keep the implant area and surrounding teeth clean. Peri-implantitis isproject3 a condition that is caused by bacteria infecting the area surrounding an implant and can cause bone loss and implant failure due to poor osseointegration. Some clinics offer "immediate load" implants where a temporary restoration is placed the same day as the implant. This restoration will be removed in the future and a permanent one placed. Not every patient is a candidate for immediate load implants; this is an option you should discuss with your dentist. The treatment will be completed on a second trip, after osseointegration is complete and the abutment and prosthesis is custom-made. Dental implants are made up of three parts; the implant (screw), the abutment (stump), and the crown (tooth).

Final/Definitive restoration

After the implant has healed and is stable, the definitive restoration can be placed. This can consist of a crown, bridge, or denture. The implant cap (think ‘manhoproject2le cover’) is removed and replaced with an abutment and the dental prosthesis is placed on top of it. For most conventional implants, this is a crown that either screws on to the abutment or is cemented in place. Removable restorations like dentures may have clips or snaps of some kind.

After the procedure

Most patients are extremely satisfied after dental implants. After the implant is placed, your dentist will advise you to stick to chewing soft foods while the implant osseointegrates. Immediate load implants will also need time to osseointegrate, and your dentist will tell you when the temporary parts of the implant need to be replaced with a permanent restoration. Patients who have had dental implant surgery say that the pain is mostly a dull ache in their jaw after the anesthetic wears off and it is gone completely within a week. After the final restoration is complete, though, patients are able to treat the prosthetic like a normal tooth and can hardly tell the difference. They look, feel, and can be used just like normal teeth.

For more blogs by Dr. Johnson, click here For more information on dental implants or to arrange a consultation, contact Newton Wellesely Dental Partners.

Original article:  www.medigo.com

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