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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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Biting force extends one’s life – Newton, Wellesley, MA

According to Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners, “ One’s ability to chew has a direct correlation with longevity.  Many studies show that one loses 75% chewing strength wearing a denture”.  The force of a man’s bite at age 70 may be a marker of his longevity, says a study in the Journal of Oral Rehabilitation.Project1

The risk of dying before reaching their mid-80s was 84% higher in men with a weaker bite than those with a stronger bite, the study found. The association was significant even when such factors as tooth loss and severe gum disease were included in the analysis.

No connection was found between jaw strength and long-term survival in women of the same age group.

Low bite force may be a sign of poor dental work, loss of teeth and this musculoskeletal decline that can ultimately lead to disability and death, the study suggests. Low intake of vitamins, minerals and other nutrients can also affect oral health and increase people’s vulnerability to chronic disease, the researchers said.

The study, conducted in Japan, involved 559 people born in 1927, who were enrolled in a larger study in 1998. At the start of that study, the subjects underwent dental and medical examinations and reported personal information, such as diet, chewing ability and smoking habits, on surveys.

Dr. Johnson suggests that you see your dentist routinely and address factors that will influence your bite force.  If you are wearing a removable prosthesis, consider implants as an adjunctive approach to improve your chewing ability…and this is likely to increase your life expectancy.

For additional Blog Topics by Dr. Johnson, Click Here

To Contact the office, Click Here

Original article:  www.wsj.com Artwork:  www.webmd.com

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Gum Disease and Pancreatic Cancer – Newton, Wellesley, MA

Gum disease may cause more than just bad breath, according to a new study presented at the 2016 American Association for Cancer Research meeting, which points to a connection between periodontal disease as a potential early marker for pancreatic cancer. According to Dr. Ryne Johnson, prosthodontist and managing partner at Newton Wellesley Dental Partners, “This could pave the way for early detection of pancreatic cancer – one of the most deadly forms of the disease –because of the advanced stage at which it is often diagnosed”. Project1

It is estimated that in 2016, 53,070 new cases of pancreatic cancer will be diagnosed with only 7.7 percent of victims surviving 5 years.  Initial findings support a hypothesis and previous research showing that people who have developed pancreatic cancer tended to have poor oral health. The researchers reasoned that periodontitis, which is inflammation of the tissue around the teeth often causing shrinkage of the gums and loosening of the teeth, is due to oral bacteria dysbiosis.  Dysbiosis is a term for an unhealthy change in the normal bacterial ecology of a part of the body, such as the mouth.

Many previous studies have shown a strong relationship between associated periodontal disease with pancreatic cancer. Findings from a 2013 European prospective cohort study showed having high levels of P gingivalis antibodies in blood caused a 2-fold increase of developing pancreatic cancer. Another 2007 prospective cohort study looked at over 50,000 male health professionals with a history of periodontitis and found a 64 percent increased risk of pancreatic cancer. Both of these previous studies however, were unable to determine which came first, poor oral health or pancreatic cancer.

A new study from NYU is the first study to determine that periodontal dysbiosis does in fact precede the development of pancreatic cancer and does not develop after the diagnosis. This was determined by looking at the oral samples of saliva collected prior to the onset of pancreatic cancer confirming the positive association with P gingivalis.

Researchers pointed out that this finding does not confirm that the two periodontal disease-causing bacteria cause pancreatic cancer. Rather, they most likely correlate it with systemic inflammation occurring within the body, known to be a precursor for developing cancer. Having periodontal disease-causing bacteria in the mouth may increase the likelihood of inflammation.

Symptoms of pancreatic cancer

The pancreas is located deep within the abdomen sandwiched between the stomach and the spine, with a small portion of it nestled in the curve of the upper portion of the small intestine. It functions as a glandular organ having an essential role in converting the food we eat into fuel for the body’s cells. It has an exocrine function of secreting digestive enzymes into the small intestine helping with digestion, and an endocrine function of releasing the hormone insulin into the bloodstream, a critical controller of blood sugar levels.

Tumors of the pancreas are rarely palpable, which is why most symptoms of pancreatic cancer do not appear until the tumor has grown large enough to interfere with the functioning of the pancreas, or has spread to other nearby organs such as the stomach, liver, or gallbladder. Symptoms of pancreatic cancer may include:

•    Upper abdominal pain spreading to the back

•    Jaundice or yellowing of the skin and whites of the eyes

•    Diminished appetite and unexplained weight loss

•    Fatigue

•    Digestive difficulties

•    Nausea

•    New onset of Type 2 diabetes in people over 50

Risk factors which may increase the risk of pancreatic cancer include:

•    Cigarette smoking

•    Age – over 80 percent of pancreatic cancers develop between the ages of 60 and 80

•    Race – more common in African Americans

•    Gender – more common in men

•    Religious background – more common in Ashkenazi Jews

•    Chronic pancreatitis

•    Diabetes

•    Obesity

•    Diet – diets high in meats, cholesterol, fried foods and nitrosamines

•    Family history

Future additional studies are planned to determine if periodontal disease is a cause of pancreatic cancer. Until then, good oral hygiene including regular brushing and flossing of the teeth and visits to a dentist are recommended. If a person does have periodontal disease, they should be seen regularly by a periodontist for regular cleanings and checkups to get the condition under control.

Anyone who has any of the potential symptoms of pancreatic cancer should make an appointment with their physician for an evaluation and testing as soon as possible.

For additional dentally related blogs, click here. To contact Dr. Johnson, click here. To get more information on Newton Wellesley Dental Partners, click here.

Original article:  http://www.foxnews.com/health Artwork: www.medicineworld.org

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