A dental implant is an artificial substitute / replacement for the root portion of your natural tooth and is anchored into a pre-drilled socket in your jaw-bone to support a crown, bridge or secure a denture firmly in place. Implants are made from titanium, a material that is well tolerated by bone and integrates easily with bone tissue. During the placement of a dental implant the goal is to achieve a close contact between the outer surface of the implant and the surrounding bone tissue so they can “fuse” together (Osseo integration) creating a stable support for the new teeth.
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Before any implants are placed it is important for your dentist to assess the health of your teeth and gums, if there are any signs of gum disease or decay these must be treated first. Following this your treatment will be planned following several X-rays and a CT scan in some cases to assess that bone quality and check for nearby anatomical structures to avoid before any drilling. The procedure is usually carried out under local anaesthesia and sometimes IV sedation if it is a long procedure or the patient is very anxious.

The gum where the implant is to be placed is cut and lifted and a small hole is drilled in the jawbone at the precise location of the intended implant. The titanium implant is tightly fitted into this socket and the gum is stitched back over the implant. If there is insufficient bone material to accommodate the implant a bone graft may be required or alternatively the dentist may use smaller sized mini implants if suitable.

Once the implant has been placed it is left to heal and integrate with the jawbone for between 6 weeks to 6 months. The bone tissue will grow and anchor itself into the microscopic rough surface of the implant.

During this “healing period” patients are given temporary teeth (bridges) or continue to wear dentures. It is important that any temporary teeth do not exert any forces on the healing implant. After the healing period the gum is lifted again and a post is attached to the implant with a temporary crown. Four to six weeks later when the surrounding gum tissue has matured the final permanent restoration can be fitted to the implant.
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Having dental implants is quite a lengthy process. It is accomplished in two phases, which must be separated by a ‘healing period' of several months. During the first phase of treatment you will be thoroughly checked-over and a panoramic X- ray of your mouth will be taken. This will enable you and the dentist to plan your treatment in detail.

Next comes the actual implantation procedure. Depending on how many implants you are having you will be given either a local or general anaesthetic. If you have a local anaesthetic you will be given a sedative as well.

The implantation operation is carried out under strict hygienic conditions. The dentist will open the gum at the site of the implant and, using a low speed drill will make a hole in the jawbone. The implant is screwed into place. A temporary healing cap is placed in its centre. The site of the implant is closed and sutured.

The dentist will want to make post-operative checks over the next couple of days and after an initial healing period will remove the stitches. This completes the first phase of the procedure.

A healing period now follows. This is necessary so that the living bone can ‘ossify' around the implant. This will help the anchor really ‘set' in place so that it is better able to withstand the pressures exerted on it once the crown is attached.

After about six months the second phase of the procedure can begin. The first thing the dentist does is to make a small opening in the gum and uncover the implant. The healing cap is removed and an ‘abutment' or post is screwed into the implant.

After a day or two the next part of the process is undertaken. This involves taking castings and impressions of your teeth and gums. Your dentist will take a great deal of trouble to get a really accurate set of impressions. These are then sent to the dental lab that will use them to make the crowns or the bridge to your exact measurements.

When the dental lab has completed its work the dentist will fit the new crowns or bridge. Again, this is a quite painstaking process as your new teeth are adjusted to give the optimum bite. The dentist may well want to see you the next day, after you have had some time to get used to your new teeth so that final adjustments can be made.

IMPORTANT TO KNOW:

Absolute Contraindications:
• Not compensated, insulin-dependant diabetic patients
• Patients on radiation therapies
• Serious autoimmune diseases
• Patients with serious mental diseases
• Patients with serious clotting conditions

Relative Contraindications:

• Serious heart conditions
• Not compensated Hepatitis B or C
• Patients with kidney transplantations
• Serious breathing conditions

Pre - surgery indications

If it is necessary (for patients free from allergies to penicillin by - products) 2 grams of amoxicillin is supplied as bacterial prophylaxis, 4 hours before the operation, as well as one analgesic tablet, 1 hour prior to the intervention, depending on the patient. It is very important to interrupt the intake of aspirin by-products or the use of dipyrone or salicylic acid 48 hours after and before implant placement.

Post - surgery indications

• Apply ice or iced gel bags on the area for a 20 minute period, 5 times a day, for two days after the surgery.
• Avoid hot drinks or food.
• Do not smoke.
• Avoid activities.
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Reduced bone loss

Normally, the bone tissue surrounding the root of your tooth is maintained by your body's natural renewal process. However, if you loose a tooth, you will be left with a hole where your tooth root used to be and the bone around this area will slowly begin to disappear (atrophy) and may change the shape of your jaw. A dental implant placed in that area can actually stimulate bone growth and production, preventing loss of valuable bone structure. In some patients where bone loss is substantial a bone graft may be required before placing a dental implant. Bone loss is a problem for people who have dentures and as the shape of the jaw slowly changes the dentures need to be adjusted or re-made to fit the new shape of the jaw. Bone loss can also make a person look older since the area around the mouth can sag as bone is lost

Improved function

Once dental implants are fully integrated into you jaw they function just as well as your own natural teeth and you can eat the foods you want and speak with complete confidence. With dentures, eating hard foods such as an apple can be a problem, either the dentures come loose or patients cannot withstand the hard biting forces as they cause pain in the gums. Irritation and inflammation of the gums is a common problem amongst denture patients. Dentures can be supported by implants or mini-implants which will improve function greatly enabling patients to eat the foods they want with complete confidence and not having to worry about bone loss and loose dentures falling out.

Improved dental hygiene

Unlike bridges and dentures, which require special cleaning instructions and extra attention, dental implants just need regular brushing, flossing and hygiene appointments just like your natural teeth.

No need to drill or remove any healthy tooth structure

When replacing missing teeth with dental bridges, the teeth adjacent to the gap need to be prepared and healthy tooth structure is removed to accommodate a crown or bridge abutment to fit over the top of the tooth. In the future if one of the supporting teeth is damaged the entire bridge restoration will also be compromised whereas with an implant the restoration is independent of any of your other teeth. By replacing lost teeth with an implant, no support is required of the adjacent teeth, and hence your natural teeth do not need to be prepared or altered in any way

Better aesthetics

If done correctly a dental implant should be indistinguishable from your surrounding natural teeth. Dentures can come loose and look un-natural if they do not blend with your gums and some bridges and dentures have unsightly metal clasps to hold them in place. Dental implants provide a much better cosmetic and functional end result.
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Traditionally an implant placed into your bone supports a single crown and this is know as a “single tooth implant”. However if you have several missing teeth you do not necessarily need an implant for every missing tooth, one implant can support several teeth via a bridge or a denture. The number of implants required depends on the volume and density of bone tissue available at each implant site. Often smaller sized “mini implants” are used to secure dentures in place.

In the case of full mouth reconstructions where an arch of several teeth (10+) need to be supported in either the upper or lower jaw a minimum of 5-6 implants in each jaw would be required. The exact number of implants needed would depend on the individual case and your implant surgeon would be able to advise you on the best solution after a through examination and assessment.
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Dental Implants can be placed in patients of any age (with fully developed jawbones) provided that they have sufficient quality and quality of bone tissue available. Most healthy individuals that maintain a good oral hygiene program are suitable candidates for dental implants. Circumstances where implants may not be suitable or situations that have an increased risk of implant failure include:

• Heavy smoking – this slows down and hinders the healing process
• Excessive alcohol intake – disrupts healing of the gums
• Periodontal gum disease – all active gum disease must be treated prior to any implant procedure to ensure long term success of any treatment. Periodontal disease is a major cause of bone loss, which would hinder the success of any implant procedure.
• Immuno-compromised individuals (steroids, auto-immune disease, patients undergoing radiation treatment).
• Teeth grinders (bruxism) – a night time splint can be given to treat this.
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Using a combination of dental X-rays and a CT scan your bone density and volume can be assessed as well as information about nearby anatomical structures to avoid such as nerves.
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The alternative options for replacing missing teeth include dentures and bridges. However, there are various bone grafting and tissue regeneration procedures that can be carried out to enable treatment with dental implants:

Sinus Augmentation – if you need to replace missing teeth at the back of the upper jaw then a sinus augmentation, whereby new bone in the sinus is created can increase the height of the bone available for the placement of implants in this area

Onlay Grafting – this is where a piece of bone from somewhere else is taken and it is secured over an area that is deficient in bone, over time the newly placed bone will fuse with the underlying bone creating a better environment for an implant to be placed.
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The best source of bone for your graft is your own bone tissue from else where in your body and areas that can be used for bone grafts include the chin, back of the lower jaw, the hip and tibia. Bone taken from your own body offers the most viable and faster healing time when compared to alternatives. In many cases a combination of artificial bone substitutes and your natural bone is used. In any bone grafting procedure the grafted bone provides an anchor and stimulus for the existing bone to grow onto, eventually providing an environment suitable for the placement of implants.
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Dental implants have been used for over 30 years to replace missing teeth and they can last a lifetime depending upon how you look after them. Like any other restoration your implant-supported teeth can still be damaged by trauma and affected by gum disease and poor oral hygiene.
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The price of dental implants tends to vary considerably and depends on several factors including the level of skill of the surgeon, the type / quality / brand of implant used, the clinic where the treatment is carried out, the level of aftercare service provided and obviously the amount of work required (i.e. bone grafting) and number of implants required.

Important

Treatments will be performed with international - quality Straumann (I. T. I) implants, present all around the world.

It is very important to know that in case it is the patient's will, he/she can get the implants placed in Buenos Aires and get the rest of the work done in his/her home country.
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• High - tech Fedesa chair with Catanni aspiration.
• KAVO rotating instruments (Germany).
• Straumann Surgical Instruments (Switzerland).
• Hiu Freddy Surgical Instruments (USA).
• Bio - lock Fisiodispenser (USA).
• M.P.D. Radiovisiograph (USA) and Rx Satelec.

Other equipment & products used:

• Kavo
• Nobel Biocare
• 3i Biomet
• Gnatus
• Dentsplay
• Satellec
• Vita Porcelain

• IN OFFICE Porcelain laboratory with rapid turn-around time
• Personal and caring attention
• High standard of hygiene and sterilization
• Post operative care and instructions
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Veneers are wafer thin laminates or shells of tooth coloured material (which can be either porcelain, ceramic or composite bonding material) that are “cemented” to the front surface of teeth to improve their cosmetic appearance. Many dentists use the analogy that dental veneers are for your teeth what false finger nails are for your hands. In a similar manner to how false finger nails are placed or glued to your existing fingernails, veneers are bonded to the front of your existing teeth.
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There are a wide variety of reasons why patients opt for treatment with dental veneers.

Stained Teeth - badly stained teeth that cannot be improved by teeth whitening or prophyflex treatments can greatly be improved by dental veneers, which function to cover and "hide" any existing stains on your natural teeth.

Damaged Teeth - teeth that have either become badly worn with excessive grinding, by carbonated drinks, or have been chipped or broken in an accident can benefit from veneers. A small chip on a tooth can quickly be repaired with composite bonding or "composite veneers" which are one and the same thing. A single damaged tooth can easily be repaired with a single porcelain veneer that has the same characteristics and colour to match your surrounding teeth so that it looks natural.

Gaps - spaces or gaps (diastimas) between your teeth can be easily closed using dental veneers giving you a more uniform looking smile.

Crooked teeth - although veneers are not the ideal treatment choice for crooked teeth and from a point of view of preserving your natural teeth structure orthodontics or invisalign braces would probably a better solution. However, treatments can take up to a year or longer with braces. For teeth that are not severely crooked veneers placed over their front surface will give a straight and perfectly aligned looking smile. For this type of treatment many people refer to veneers as "instant orthodontics" since you get a similar end result in a fraction of the time.
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1. The first part of any dental procedure is the initial consultation and examination so that the dentist can get a feel for what you want and understand your needs and concerns. The dentist should explain the treatment procedure to you including an accurate guide to the likely costs of your treatment.

2. Before your veneers are designed your dentist will need to reshape and prepare the front surfaces of your teeth so that they can accommodate the veneers. The first stage is to numb the teeth and gums with a local anaesthesia so that you do not feel anything during the procedure.

3. Using a special tool called a burr (a dental drill or file) a tiny amount of the front surface of your teeth will be shaved off. The amount removed should be equivalent to the thickness of the veneer that will sit over the top of the tooth.

4. Next an impression or mould (copy) of your teeth is taken. Special dental "putty" is placed into your mouth on a tray and pushed into your teeth so that it takes an imprint of your teeth, similar to how you would leave a footprint in sand.

5. This "impression" or mould of your teeth is then sent to a dental laboratory. The laboratory use the impression to cast an accurate model of your teeth which is used as a guide to fabricate your new veneers, this process can tae between one to three weeks.

6. Whilst you are waiting for your veneers to be fabricated your dentist you may be fitted with some temporary veneers to protect your prepared teeth. Not all dentists will offer temporary veneers.

7. On your second appointment your dentist will fit your new veneers to your teeth. First the dentist may just sit the teeth over your teeth to see how they look with your smile and he or she may need to trim or adjust the veneer.

8. Next your teeth will be thoroughly cleaned and the front surfaces etched (roughened) with a special acid gel so that they provide a good surface for the dental cement to stick to.

9. The veneers are then cemented into place and a special curing light is used to activate the dental cement so that it permanently bonds the veneer to the front surface of your prepared tooth. If there is any excess cement it is usually trimmed away and polished to leave a beautiful and natural looking restoration.
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Porcelain veneers will typically last between 5-10 years and composite veneers maybe a year or two at the most. The bottom line is that eventually your veneers will need to be replaced. Although veneers are strongly cemented into place they have been cases where they come loose and fall off, in such situations it is important that you keep hold of your veneer and contact your dentist immediately. To make your veneers last longer it is important to follow a good oral hygiene program and also visit your dentist for check ups on a regular basis.
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Usually porcelain veneers are placed over a minimum of two visits as described above. A few cosmetic dentists have invested in CAM/CAD in-house ceramic studios (CEREC) which can custom produce high quality ceramic veneers on site in as little as six minutes. This CEREC technology enables the dental practice to offer single visit, same day ceramic veneers which are fitted within an hour.
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• If your tooth has undergone significant decay and there is not enough tooth structure remaining to support a filling or an inlay and maintain functionality.
• If a large portion of your tooth has fractured and it cannot be built up using traditional composite bonding techniques.
• If you have a large cavity and opt for the additional protection a crown offers to your tooth over a large composite filling or an inlay.
• If you have had a dental implant to replace a missing tooth, a crown will be fitted to the abutment of the titanium implant.
• Following root canal treatment a crown is often needed to strengthen the tooth.
• If you grind your teeth and have a poor diet, acid erosion may reduce your teeth to a point where the only option available is to crown them.
• For cosmetic reasons to improve the aesthetics of your smile, you may opt for all porcelain cosmetic crowns.
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Crowns should not be the first treatment of choice just to improve the aesthetics of your teeth, because a dentist needs to grind a significant portion of the original tooth away. Less invasive alternatives include veneers or dental bonding. Crowns are required when the strength of the tooth supporting the restoration is compromised since veneers and dental bonding restorations are only as hard as the supporting tooth.
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In modern day dentistry there is a wide variety of dental materials to choose from. Some crowns are made from full gold, where as others are made from an alloy of metals fused to a porcelain outer shell. After time, crowns that are made from a combination of metal fused to porcelain can begin to show dark gum lines that are not aesthetically attractive. All porcelain or ceramic crowns are the best choice for a natural cosmetic look. There are many different brands and types of porcelain crowns and the variation between the costs of dental crowns at different dental practices may well reflect the quality of the materials used.
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Once you have had a consultation with your dentists and discussed all the treatment options, your dentist will prepare the tooth ready to be crowned. The first stage is to clean the tooth, remove any decay and reshape it using a burr (a special dental drill for shaping teeth) under local anaesthesia. The shape of the prepared tooth is usually tapered to allow the crown sit comfortably over the top of it. Once the tooth is prepared an impression (mould) of your teeth will be taken using special “dental putty”. This impression is sent to a dental laboratory that will use the impression of the prepared tooth as a guide to fabricate the new crown to the exact specification of the dentist and to fit perfectly. It usually takes between two to three weeks for laboratory technicians to custom fabricate your new crown. During this time your dentist will fit you with a temporary crown to cover and protect your prepared tooth.

On your second visit your dentist will remove the temporary crown, and roughen the outer surface of your prepared tooth with a special etching acid to give the dental cement a good surface to bond to. Your dentist will sit the crown over your tooth to see if it fits with your smile correctly and is the right colour match and shape. Once you are both happy with the restoration and how it looks, your dentist will cement the crown firmly into place.
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This will depend largely on how well you look after your teeth. Dental crowns require the same level of care and attention as your natural teeth. Provided you have a good oral hygiene program and attend regular check ups at your dentist and do not suffer from teeth grinding, maintain a tooth kind diet and do not do things like open beer bottles with your teeth then a high quality dental crown can last 10-15 years.
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The price varies between dental practices and depending on where you go for your treatment. The price will depend on the skill of the dentist, the quality of the crown and the materials used and also number of teeth that you are having crowned.
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