Kisella Surgery

Learning the Lingo – Dental Implants

Dental implants are a safe and effective replacement for a missing tooth or teeth. The implant is placed in your jawbone and integrates with your natural bone. This implant then forms a stable, sturdy base for your new teeth.

What They Are
Implant: The implant itself is a rod that is screwed into the jawbone.

dental implantAbutment: This is the connection between the implant and the crown.

Crown: A tooth shaped cap that is attached to the abutment. It is the part of the tooth that is visible above the gum line.

What They’re Made Of

Titanium: Most implants are typically made of titanium, a biocompatible metal.

Zirconia: Often used for crowns and bridges and can be used as a metal-free option. Zirconia is biocompatible just like titanium.

Where They Go

Endosteal Implants: Placed in the jawbone. These implants are typically shaped like small screws, cylinders or plates, and they are the most commonly used.

Subperiosteal Implants: Placed under the gum, but on or above the jawbone. These implants are mostly for people with smaller jaws or shallow jawbones.

What Happens To Them
Osseointegration: Creates strength and durability by fusing directly to the bone and is bio-compatible. Bone cells attach themselves directly to the titanium/zirconium surface, essentially locking the implant into the jaw bone. Osseointegrated implants can then be used to support prosthetic tooth replacements of various designs and functionality. Anything from a single tooth, to all teeth in the upper and lower jaws. The teeth/crowns are usually made to match the enamel color of the existing teeth to create a natural appearance.

Bone augmentation: Some people do not have enough healthy bone to support dental implants, so bone must be built. Procedures can include bone-grafting which means adding bone to the jaw.

Talk to us today at Kisella Surgery Center to discuss your options with an implant specialist!

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Pre-Implant Bone Augmentation

We are all unique, and so is your mouth! Sometimes, your jaw needs to be beefed up a little, and we’re not talking a hefty workout at the gym.
You may have lost teeth due to gum disease which has resulted in bone loss, or you could just have been “born that way” and need a little help expanding!

Don’t let life get you down! We’ve got these options for you;

Sinus Lift or Sinus augmentation:
man lifting weightsA sinus lift is often performed on people who have lost teeth in their upper jaw or are lacking adequate bone density. This procedure adds bone between your jaw and the maxillary sinuses (which are on either side of your nose), the area of your molars and premolars. To make room for the bone, the sinus membrane has to be moved upward, or “lifted.”
The new bone means implants can be placed. This procedure does not affect speech, intonation or cause sinus problems.
Sometimes this procedure is required in the alveolar ridge. The alveolar ridge is the part of the gums immediately behind the upper front teeth. Alveolar ridges contain the sockets, or alveoli, of the teeth. You can feel it on the upper palate if you say words like “tight”, “dawn” because the consonants are made with the tongue tip or blade reaching for this alveolar ridge.

Ridge Expansion or modification: If your jaw isn’t wide enough to support dental implants, bone graft material can be added to a small ridge, or space that is created along the the jaw. Malformation in the lower jaw can result in not enough bone to place dental implants and it can also cause an unattractive indentation in the jaw line near the missing teeth that may be difficult to clean and maintain.

During ridge expansion, the bony ridge of the jaw is increased and bone graft material is inserted and allowed to heal before placing the implant.
Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come. It can enhance your restorative success both aesthetically and functionally.

Whether you require a lift or expansion, the bone usually will be allowed to develop for about four to 12 months before implants can be placed. However, in some cases, the implant can be placed at the same time the ridge is modified.

What are you waiting for? Ask us today what your implant options can be!

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Oral Cancer and Hepatitis C

Oral Cancer and Hepatitis CThe Journal of the National Cancer Institute (JNCI) recently found that individuals infected with the hepatitis C virus are two to five times more likely to develop head and neck cancers. The JNCI study found that the risk for hepatitis C patients of developing head and neck cancers more than doubled for oral cavity and oropharynx cancers, and increased nearly five times for larynx cancers. As well, patients that are hepatitis C virus-positive were also more likely to test positive for human papillomavirus (HPV).

The question remains, how does hepatitis C virus increase oral cancer risk?

The JNCI research found that patients infected with the hepatitis C virus had a higher odd ratio of having cancer of the oral cavity, oropharynx, or larynx than those without hepatitis C virus infection. Enhanced replication of hepatitis C virus in oropharyngeal tissues may in fact contribute to chronic inflammation, ultimately prompting cancer development. Human papillomavirus is known to suppress local immune response, which may accelerate the production of hepatitis C virus in oropharyngeal cells. The JNCI notes that human papillomavirus and hepatitis C virus may play a “synergistic role” in the development of oropharyngeal cancers by stimulating loss or destruction of tumor suppressor proteins p53 and retinoblastoma protein.

The JNCI notes that one of the study’s limitations is that it didn’t include individuals with hepatitis C virus who didn’t have oral cancer. All and all, it is important to take away from The Journal of the National Cancer Institute’s study that it is important to educate Hepatology (study of liver, gallbladder and pancreas health) and infectious disease specialists. These doctors who treat patients with hepatitis C virus need to understand that the hepatitis C virus not only drastically affect liver health, but it’s also a systemic infection that can drastically affect oral health.

Your oral health is important to us. If you suspect that your oral health is at risk, give Kisella Surgery Center a call today and schedule an oral cancer screening!

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Wisdom Tooth Removal – Aftercare

 

Immediately Following Surgery

Keep a firm, yet gentle, bite on the gauze packs that have been placed in your mouth to keep them in place. You can remove them after an hour if the bleeding is controlled. If the surgical area continues to bleed, place new gauze for another 30 to 45 minutes.

Be careful!

Do not:
woman smiling after Wisdom Tooth Removal Rinse vigorously
• Probe the area
• Smoke (hopefully you don’t!!)
• Participate in strenuous activities
You can:
• Brush gently (but not the area)
• Begin saltwater rinses 24 hours after surgery (mix 1 tbs of salt with 1 cup of water). Make sure to swish gently. These rinses should be done 2-3 times a day, especially after eating.

Enjoy some down-time!

Keep activity level to a minimum! Enjoy a day of couch or bed-rest, as being active could result in increased bleeding. Avoid exercise for 3-4 days, and when you do begin exercising again, keep in mind your caloric intake has been reduced so you may feel weaker.

Bleeding

As you’ve just had surgery, some bleeding will occur and it’s not uncommon to ooze blood for 24-48 hours after your procedure. REMEMBER-the blood you see is actually a little blood mixed with saliva, so don’t panic!
If excessive bleeding persists:
1. Try repositioning the packs. They may not be putting enough pressure on the site.
2. Sit upright and avoid physical activity.
3. Use an ice pack and bite on gauze for one hour.
4. You can also try biting on a moistened tea bag for 30 minutes (the tannic acid in tea promotes blood clotting).
5. If bleeding persists, please call our office at 704.846.1166.

Pain

Unfortunately, some pain is to be expected after surgery. Try not to let the anesthetic wear off before taking your prescribed pain medication. Dr. Kisella will have discussed a plan to manage your pain, make sure you follow these instructions.

Diet

Eat nourishing food that takes little effort.
Avoid:
• Extremely hot foods
• Straws (for the first few days)
• Chewing (until tongue sensation has returned)
• Smaller foods that can become stuck in the socket area
• Skipping meals—while eating may seem like a lot of work, you need your nourishment to be able to heal and feel better!

Day 2 and 3 Following Surgery

Swelling

Swelling is a completely normal occurrence. Keep in mind, swelling will usually be at it’s worst in the 2-3 days after surgery. You can minimize swelling by applying a cold compress (covered with a towel) firmly to the cheek next to the surgical area. Apply the pack with 20 minutes on, and 20 minutes off for the first 24-48 hours. Also make sure to take the medication prescribed by Dr. Kisella. This helps with pain and swelling.

Keeping your mouth clean

Keeping your mouth clean is very important! Continue saltwater rinses as often as you’d like, but at least 2-3 times a day. Begin your normal oral hygiene (remember to brush softly and don’t do anything that hurts)!

Healing

Everyone heals differently, but your timeline should look similar to this:
1. Day 1-2 will be the most uncomfortable and you will experience some swelling.
2. Day 3 you should be more comfortable and while still swollen, you should be able to begin a more substantial diet.
3. Day 4 and on you should see a gradual and steady improvement.

Other Normal Things

• Discoloration. Bruising is a normal post-operative occurrence you may notice 2-3 days after surgery.
• Stiff jaw muscles. You may find it difficult to open your mouth wide in the days following your surgery. This is normal and usually resolves itself within a week after surgery. Stretching these muscles may help to speed up recovery.
Since no two mouths are alike, do not take advice from friends (even well-intended advice could cause a healing set-back). The advice given to you from Dr. Kisella and the Kisella Surgery Center team are tailored to fit your needs. Please call us at 704.846.1166 if you have any questions or concerns about your recovery. Happy healing!

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Dental Implants 101

Whether you are missing a tooth, or at risk of losing many, dental implants may be a great solution for you. Dental implants are an increasingly popular fix for missing or dying teeth, and have many benefits.

What is a Dental Implant?

Dental Implants 101Dental implants are high tech teeth. The root of your current tooth is removed, and replaced with a screw attached to a ‘cap’ that looks identical to a natural tooth. Many people report higher confidence and comfort after receiving their new tooth.

What’s so Great About Them?

The cool thing about implants is that if taken care of, they can last for life. Usually all that needs to be replaced, if anything, is the cap. The other great thing about implants is that they can’t die like natural teeth. You still have to clean and maintain them like your other teeth, but no roots are any longer at risk of causing that tooth to fail. In addition to that, many implants can last a lifetime!

What is the Surgical Process Like?

The process is done either all at once, or in steps. This depends on the recommendations for your particular case. The first step is to remove the root of your natural tooth, and place the implant in its place. If there is not enough bone to place the implant, we may encourage you to have bone grafting first. The gum is then stitched closed and allowed to heal. This can take five to six months. The next step is to reopen the gum and place an abutment on the implant, along with a temporary crown so you can heal while the permanent crown is made for you. You then return to get your permanent crown attached in a few weeks. In other cases, all of these steps can be done in a single visit, but it depends on your specific case.

If you have any questions, please call our office for more information, we would be glad to help!

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Weighing the Costs of Dental Implants

When compared to the costs of other tooth replacement options, boy do dental implants seem expensive! Yet you may be surprised to learn that, in the long run, dental implants can be more affordable than their traditional counterparts. Understanding this procedure and the factors that determine the costs can help you decide if dental implants are a good investment for you!

What is a Dental Implant?

two older people smilingA dental implant is a permanent replacement for lost teeth. It is made of an artificial tooth firmly held in place by a tooth root made of titanium (which is biocompatible) that is surgically placed into your jaw. Dental implants help stabilize the jaw and the bone around it to avoid future bone loss and maintain the shape of your jaw. They never have to be removed and feel more natural and comfortable than dentures. And unlike bridges or crowns, which are cemented in, the chances of slippage or shifting are eliminated. With implants, talking and eating become worry free.

Steps In a Dental Implant Procedure.

We will first use extensive imaging to determine bone health, height, and thickness to assess your bone and teeth structure carefully. The surgery itself is done in our office in separate stages. First, the implant is surgically placed into your jawbone, completely hidden within your gum tissue. Once the implant has integrated into your bone, a healing process of about 4 to 6 months, the next stage is the placement of the abutment, or the post that penetrates the gum and will connect the replacement tooth to the implant. The final stage involves attaching your artificial tooth (made from impressions of your natural tooth) to the abutment. If more than one tooth is being replaced, a removable bridge is used, as it is more affordable than implanting each tooth separately. For a bridge, it takes only one implant on either side to span an area holding several teeth. The bridge snaps into place for a more permanent and natural fit than dentures.

Factors That Affect the Cost.

While dental implant surgery is a safe and routine option, it is a complex procedure that takes time and expertise to be done effectively. There are many factors that will influence the final costs including what X-ray and CT scans are necessary to evaluate and assess the implant area and the brand and material of the post, abutment and artificial teeth. However, the biggest cost factor is the complexity of the surgery itself. For example, how many teeth are we replacing and what is the location? Will additional procedures, such as bone grafting or sinus elevation be required? We do our best to make sure that your estimate includes all of the possible costs of each of the steps of your procedure.

While dental implants may seem expensive, they are often more affordable in the long run than traditional restoration methods such as crowns and bridges, which are more vulnerable to damage and usually require repairs or replacement every few years.

Dental implants are known to have a 95% success rate when completed by professionals with the right experience and training, such as us! Because dental implants offer a permanent solution, are natural and comfortable, and require little maintenance, they are a cost effective choice for most of our patients.

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Dental Implants: High Tech Teeth

What are dental implants? Dental implants are replacement tooth roots that provide a foundation for both fixed and removable replacement teeth. Like roots, dental implants are secured within the jawbone and not visible once surgically placed.

Dental Implants High Tech TeethTeeth replacement is not new to dental technology. Early civilizations practiced teeth replacements; archaeologists have discovered skulls where teeth have been replaced by cast iron and sea shells. Despite their primitive methods, some of these implants were fused with bone like modern dental implants! However, unlike the ancient cast iron or sea shell implants, modern implants are composed of titanium. Titanium is lightweight, strong, and biocompatible.

According to the American Academy of Implant Dentistry (AAID), dental implants have the highest success rate of any implanted surgical device — 98%. Dental implants are available in several designs that meet individual needs: single tooth replacement, multiple tooth replacement, implant supported prosthesis (removable), and an implant stabilized denture. Aside from meeting individual needs, there are a few other advantages to having dental implants:

  • Improved appearance. Dental implants are designed to fuse with bone, and look and feel like your natural teeth.
  • Improved comfort. Because dental implants become an extension of your natural mouth, implants remove the discomfort associated with removable dentures.
  • Easier eating. Dental implants act as your natural teeth, allowing you to eat without the pain and discomfort that often accompany slipping of dentures.
  • Improved self-esteem. Dental implants give your best natural smiling, helping build self-confidence!
  • Improved oral health. Dental implants are the only proven way to prevent bone loss after the loss of natural teeth. The jawbone needs consistent chewing action to stimulate continual bone growth. Tooth/teeth replacement with dental implants offers a solution to prevent bone loss.
  • With proper care, consistent brushing, flossing and routine dental visits, dental implants can last 40-years to life.

If you are interested in dental implants, or have any questions regarding the procedure, call Kisella Surgery Center today at 704.846.1166!

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Modern Options for Bone Grafting Technology

Bones, grafting, or any combination of the two are rarely the subject of casual conversation. Most of us, regardless of our profession, are happier discussing recent football scores, the price of gasoline, or the abnormally high number of Dunkin Donut franchise locations. Perhaps for it is for this very reason, however, that we should bring up this important topic–to raise awareness, maximize modern technology, and inform the public about the options offered in terms of dental implant surgery.

modern staircaseBone grafting for dental implants is the process by which bone tissue is placed (grafted) into the mouth to act as a placeholder for tissue that has been lost. In the modern medical landscape this is a safe, painless, and routine process: indeed, more than two million bone-grafting operations occur worldwide each year, making bone the second most transplanted organ (after blood!).

As well as natural bone tissue, synthetic tissue is an alternative for patients seeking the best results. Structured as a ‘biodegradable scaffold’ that can be implanted within the body and trigger bone regeneration, this strong, flexible material has been compared to tire rubber! Dr. Karin Hing, author of the study and reader in Biomedical Materials at Queen Mary’s University of London Institute of Bioengineering stated that the challenge being tackled currently is the development of a graft that is as clever as bone. By mechanically evaluating the way bone adapts to its environment and reacts to chemical and physical components, progress is taking place in leaps and bounds.

What does this mean for the average person who just wants to be happy with their mouth? Comfortable outpatient procedures complete with local anesthesia or intravenous sedation make bone grafting a sensible and worry-free choice. Browse our procedures page for more information on maximizing your resources!

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On the Lookout for Oral Cancer

Oral cancer screenings are performed regularly at dental exams, but that doesn’t mean you shouldn’t be paying attention to your dental hygiene between appointments. Taking matters into your own hands is the best way to maintain your oral health. Not sure how to screen for oral cancer? We’ll show you!

woman getting checked for Oral CancerWhat is oral pathology?
This branch of dentistry involves the evaluation and treatment of diseases of the mouth. The most dangerous, but not always the most obvious, of these diseases is oral cancer.
What should I look for?
Keep an eye out for these oral cancer symptoms during your self-screenings:

  • Red or white patches in the mouth
  • Lumps on the tongue or lining of the mouth
  • Mouth sores that won’t heal
  • Unexplained bleeding
  • Chronic throat soreness
  • Difficulty chewing or swallowing
  • Mouth numbness

How do I perform an oral cancer self-exam?

  1. When performing your oral cancer self-screening, be sure to check all areas of the mouth, including the roof, floor, tongue, lips, cheeks and the back of your throat.
  2. Examine your face in the mirror for abnormal asymmetry and irregularities.
  3. Feel your neck and the back of your head with your fingers to look for any bumps or changes in texture.
  4. Examine your throat by placing your fingers around your thyroid cartilage (Adam’s apple) and swallowing.

How often should I perform a self-exam?
Self-exams should be performed at least once a month. Changes to your oral health can occur rapidly, so it’s important to stay on top of things. Treatment is most effective if we detect symptoms early.

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Are You a Good Candidate for Dental Implants?

woman in dental chairIt’s estimated that 125 million Americans are missing at least one tooth. If you are one of them, you may be considering dental implants for tooth replacement. We think it’s important for you to know what factors make a person a good candidate for such a procedure. Here are a few things to consider.

Most People Are Good Candidates. Dental implants can replace one, several, or all of your teeth. They can be used in place of bridges or dentures. Good candidates have healthy gums and are old enough so that their jawbone has stopped growing. You should also have enough bone to support and anchor the implants. Even if you have lost bone in your jaw, however, you may still be a good candidate for implants. In fact, dental implants may be recommended to prevent further bone loss. In these situations, bone can actually be rebuilt with grafting procedures as part of the implant process.

Evaluation. Successful implantation starts with a thorough evaluation of your jaw, teeth, mouth and overall health. You will receive a mouth X-ray and possibly a Computed Tomography (CT) scan. This will help us identify areas of bone loss and carefully see the shape of your sinuses and nerve location to make accurate assessments for your treatment. We will also do a thorough medical evaluation, as your overall health and history plays a big role in how well your implant will heal and fuse to the bone.

People At Risk of Poor Outcomes. Uncontrolled diabetes, cancer, radiation to the jaws, smoking, alcoholism, or uncontrolled gum disease are all risk factors that can adversely affect your outcome. You may still be a good candidate with one of these diseases, but we’ll want to thoroughly assess your situation and work with you and your doctor to increase your overall health and functioning. People who take certain medications, such as steroids or drugs that suppress the immune system may not be suitable candidates, either. And people with certain habits, such as people who severely grind or clench their teeth may put too much pressure on the implants, causing long term damage.

Overall, dental implants have a very high rate of success and patients tell us how happy they are with the outcome. If you are considering implants, we can complete a careful examination to determine what options are best suited for you. Call us today to make that appointment!

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