Doctor Antolak here from thegentledentist.com in Shelby Township, Michigan. Our phone number is 586-247-3500 and today we have our patient Maria and she’s agreed and allowed us to video tape this and put it on YouTube. And what we’re going to do is we’re going to be actually placing a couple of implants in today. She’s got something in her mouth right now; basically we’ve had issues before. We had to take a tooth out before and we had a fixed bridge that was done and you just felt like you had a sucky motion. You just couldn’t get used to having a bridge. Come on over here, I’m just going to point out a couple of things.

First of all, this is a molar tooth that we had to remove previously. We did a bridge. There was a tooth here. But we did a bridge on this before, and she just couldn’t tolerate it, so now there’s no tooth here, so we’re going to put an implant here. And also on her left hand side of her mouth we’re going to put it in place an implant here. So, this is the right in the lower jaw, this is the nerve right here that transverses come down into here and into where the nerve that gives sensation to the teeth and to the lip.  But we’re going to have adequate space here to place an implant in both areas. So we’re going to be showing that today. Dental implants are one of two of the most requested ways of replacing missing teeth in Dentistry. And so we’re going to do that today. I know you’re excited right?

Dental Patient: Oh yeah.  It’s a first bridge that I could use, right.

Doctor Antolak:  Yeah well, sometimes it is, sometimes it isn’t. For you, that was what we tried to do first. And then obviously that didn’t work for you, so we’re going to do the next procedure.

Dental Patient: Now you know the top one work great.

Doctor Antolak: Yeah. So sometimes people have different noise and the lower, you have the tongue that’s there. And your tongue sometimes creates that vacuum. And then that’s where you get that feeling. So you get this in there.  So we’re going to go ahead and do is we’re going to create a little incision here. And she’s numb. She says she can’t tell if she has a chin or a tongue. That’s a good sign. And so we just create a bit of an incision here and come down, then we are going to expose this area just like we would, I like to use the analogy of a banana, it’s like doing a banana peel.

So what we do is we just take this tissue back, and she’s numb so she just feels pressure. And she’s breathing in her gas, she’s a happy camper.  So we’re going to go ahead and I cleaned everything out there so now we’re ready to just start putting little holes in there for the implant. And so you can see right here is the bone, you can see right here.  And then this is the implant we’re going to place in there. I actually placed some holes, called osteotomies in there, and the implant’s going to be about this long, right here, okay? We did remove, in the past we removed a tooth there, so we have kind of a large space that’s there. The larger diameter of an implant we can place, the better we are. The larger it is, like I say, the more that it emulates the natural tooth when we place it in, so we’re just going to put that in, and we’re going to actually torque it in place with pressure.

So we went ahead and made what’s called the osteotomies in her mouth, and now we’re going to place an implant in. This one we’re doing on her left-hand side, and I wanted just to record this portion to see as we concluded. So, now we got basically a hole in there and within in that context of where that’s going to go. Actually this is a little different style.

It’s called a Bicon and it’s actually press fit and we actually will tap it into place. And if you can see right there see over it is going to fit right inside that little hole there and then bone is going to end up growing inside of those little fins that are there, okay. So we’re just going to place it in here a little bit and then, put on pressure, good. Now I’m just going to go ahead and remove this little black element.  And then, we’re going to seat that in a little bit better. Can you go ahead and suction again please?

So I’m just going to remove this right now. Okay, so the implant is in there and we’re just going to seep that down a little bit and actually with a little mount that we use. And as Maria’s biting down, use this. So what we’re going to do is we’re just press that in and then over time those fins that are on there, if these represent the fins, the bone is going to grow over each one of these fins and it’s going to create a nice stable foundation for her. This is going to fit like that. You’re going to feel a little tapping sensation and takes just about three months or so for this to heal.

It kind of gives you an idea, to show you what we’re talking about here.  So, there you go now we got the implant in place. You can see that. See it right there. And then inside that little well there we’re going to create the crown. And so we’re going to fix it up and we’ll see how it goes. There’s actually some bone that we got when we created the little hole, or osteotomy as we call it. And I’m going to place a little bone around the opening of this. As we allow this to heal, that will create a much better healing environment for the other situation. And actually I am going to use part of this bone for the other implant site that we had done. So we just spread it over the top, and so we are just going to just pack this bone into where the hole was. Now the dental implant is sitting in there, now we are just going to stitch this up.

Doctor Antolak:  You sweet thing. Okay. You okay?

Dental Patient: Mm-hm.

Doctor Antolak: Okay, so we’re going to go ahead and we’re just putting a stitch in here. We’re going to close this up, so it’s going to have a good seal. Sometimes we will try to create a tooth in function at the time that we do the surgery, the time that we place the implant. The fact that this is a molar tooth back here, we need to get a lot of strength for that. If this was a front tooth and molar teeth actually take a lot more stress than a front tooth would.

And also this system where we do the pressed fit system like he just showed you. It actually creates a very, very nice result. We don’t actually do it right away. And the benefit also is that these implants can be very short. That is the reason why I used those in this scenario for Maria.  Like I showed you at the beginning of this video, we always contend with the fact that the nerve is there. And when we do the top teeth, there’s always the sinus membrane that’s right there too. So we have to be very, very cognizant and aware of all of our anatomy that’s obviously there. So sometimes you use short implants like that, like this Bicon implant that were using, the short ones. Also another issue that we have with the lower jaw is near the tongue, there’s like a concavity there. And whenever we place an implant in there, we have to make sure that that implant is completely surrounded and encased by bone. Sometimes, like in this situation we are currently doing is this one in the area that didn’t have any teeth there at all. So bone filled in here very nicely since her right side, which is the first implant we started. What that one was when that implant was placed, because the bridge, she just had a hard time talking.

There were still some areas where the bone hadn’t completely healed in there, so we had a little different scenario. The nice part is where all the bone was in this case, on her left side we had a lot of good healthy bone that we could actually save. And we’re going to actually, when I get done putting these stitches in on the other side, I’m going to go ahead and just crack that bone all around where that dental implant was placed to create a good environment for bone to heal well in there.  So, that’s over here on this side here. I’ll stitch it up a little bit more on that side, but I want to get to this other side first.

It’s going great Maria. Okay? I’m sure you still feel like you don’t even have a lip anymore, right? Okay, I’m going to go ahead and put this bite block in your mouth. Okay, bite down. That will help stabilize your jaw. And so if we come over on this side here, we’re going to have a little bit of a space. So let’s see that foam again. And I’m just going to pack that bone that we got from her other side. And I’m just going to pack it right over the threads of, or over the top of that one implant there. So just go ahead and suction that there for me, please?

Okay so, we’re going to just place this in here, right over the top.  I’m just going to pack it right in there and then, it’s going to help that to heal up. And then we’re going to stitch that one up the same way that we did.  And we create this little stitch over here, what is nice about that is, sometimes you can get discomfort from the way that the soft tissue is handled. This is actually a gentle way of handling the gum tissue because we’re not getting in there and pushing our instruments all under the flap. But just, actually, if I pull her cheek, it comes back naturally for her.  Alright, so we’ll do that and we have a little bit more left here.  Were just going to put that in there and stitch you up. There you go. See now as we take this stitch out of here which we started on. This whole thing is going to come right out and literally will heal within week or so and it will all heal. So it’s all going to grow back nicely right over the top, just like that. We’re just going to shut it together. Okay.

We went ahead and finished up. We finished stitching up both left and right sides. We’re going to end up on that right side when she had a fixed bridge. In the fore, we will go ahead and cement that in for her. So then get that. We’ll show what that is. Its right here and this part right here is a place where the tooth was replaced where the implant was placed. If we come up here to the x-ray this is the x-ray of where she is now. This is the implant that has been placed. This is the tooth that has the two. So normally, this bridge is going to fit over the top of it like that. She couldn’t tolerate getting stuff through here, so we’re going to end up taking this eventually and cutting it off here, and cutting it off there, using these two crowns over this and then placing a new dental crown on the implant. And so that’s what we’re going to end up doing. But this is the implant here and that’s going to heal. That’s the one that you saw, the last one we did.

It’s going to take around four months or so for that bone to really heal in there well. Until then, we’ll cement this bridge back on for your right side and that way you can use that. Your left side, it’s the same way it’s been for a number of years, you’re just not going to have anything there for a little while, okay?

What we’ll do, in about that period of time, is we’ll uncover everything and we’ll place what’s called the button on top of that which will simulate, like a tooth that’s been prepared for a crown and we put a cap on the top of that and do both sides for you, okay?  It went really well for you. The reason why we had to switch, you asked about that right side when we first did it and she had a pretty bad infection on that tooth when we first did it. Because it was such a large hole we had to kind of switch gears in the middle of using a different implant system. That’s one thing that’s beneficial I think because we use a number of different systems.  If there’s a situation that arises we can switch what we do and yet get a favorable result and not have to stop what we’re doing and continue solving it.

No chin. She feels no chin and no tongue. If you have one, in just about one hour or so from now you’ll know if you got one.

Dental Patient: I’ll know if I have anything.

Doctor Antolak: What you’re going to end up doing, you’re going to ice on one side for about half an hour, and then switch it over to the other side for about half an hour, and keep switching back and forth today. Okay? I’ll give you some pain medications and then you should be fine with that. Then we’ll see how you do. How was the experience for you?

Dental Patient: Different, you know?   I’ve never had something done like that before, so I think overall, it was all right, and it was not terrible.

Doctor Antolak: Not terrible.

Dental Patient: Not terrible. It was not something I would pick to go through, but it was okay.

Doctor Antolak: Okay. Well, the truth is, is that you’re going to have to go through that one time and then you’ll be done with it. And then you’ll be able to function better, and to chew on both sides, equally. And not have that issue with that sucking thing.  Okay. So anyway, if there are any questions our phone number is 586-247-3500. If this is some type of information you are interested, then you can either go under our website thegentledentist.com or call us. Thank you. Have a blessed day.

Dental Implant Placement in Shelby Township, Michigan

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