Important Tips for Dental Implants Surgery

OsseoNews (ON): Could you present an overview of the immediate loading protocols that you and Dr. Wolfinger have developed and are utilizing at the Institute of Facial Esthetics.
Dr.: There are several basic concepts that distinguish our protocols from the traditional approach to implant placement and restoration. In the first place, we utilize an immediate loading approach where we place the implants and subject them to loading on the day of surgery. This is our standard operating procedure in contradiction to the traditional placement followed by a waiting period where the implant fixture is undisturbed and undergoes osseointegration. We have been collecting data over two decades and have firmly established that our protocol produces a very high rate of success over the long term.
ON: Could you explain how you have encorporated computer software into your protocols.
Dr.We make a CT scan of the patient to generate a three dimensional virtual replication of the bone, soft tissue and alignment of teeth. We feed this data into our software program to generate a surgical guide, which selects the most advantageous implant sites and angulations. The surgical guide will have three guide pins, which will securely stabilize the guide stent during the drilling and placement of the implants. The stent will first be used as a guide to drill a hole for each of the guide pins. The guide pins will then be inserted through the stent and into the bone. The advantage of this technique is that the drilling and placement of the implants is very precise and accurate. The implants end up exactly where you want them, at the desired angulation and the desired occlusogingival height.
ON: How do you generate the prosthesis?
Dr.:The prosthesis is generated by the software program based on the data from bone, soft tissue and alignment of teeth. We do a CT scan of the patient at the proper vertical dimension of occlusion in centric relation position.
ON: What if the patient is already wearing removable partial dentures or complete dentures?
Dr.: We scan the patient wearing the removable dentures. We do a second scan of the removable dentures alone. All of this information that we collect enables our software program to generate a fixed-detachable partial or complete denture that will fit the abutments torqued into the implant fixtures.
ON: The permanent abutments then are also torqued down at the time of implant placement?
Dr.: The permanent abutments are torqued down permanently at the time of implant placement. They are not removed after they have been torqued down. The final form and orientation of the abutments is established at the time of implant placement.
ON: The CT scan and software program provide accurate enough data to produce a prosthesis that precisely fits the abutments?

Best Tips to Prevent from Cavities

Like most drugs, fluoride causes what it purports to cure. And fluoride can't protect teeth from a bad diet.

Dentists tell us that drinking “optimal” levels of fluoridated water - 1 part per million or 1 milligram fluoride per liter (quart) - each day, reduces tooth decay without serious side effects. But this dental dogma has never been proven scientifically. However, research shows, above optimal fluoride levels causes tooth decay; and most Americans get more fluoride then they need.

The severe outward sign of fluoride overdose is dental fluorosis - yellow, brown or black stained teeth. Cavities increase in people with severe fluorosis according to a dentistry textbook entitled, “Dentistry, Dental Practice and the Community,” by Burt and Eklund.

This phenomenon has been demonstrated in the United States from National Institute of Dentistry and Craniofacial Research studies in seven communities in northern Illinois. The results of the dental decay examinations, related to fluoride concentrations in drinking water, form a J-shaped curve. With increasing fluoride levels, cavity experience diminishes to a certain point and then starts to rise again, the authors report.

These data suggest that the true relationship between water fluoride levels and dental decay is the J-shaped curve, with the turning point in the J being something between 3 and 4 times the optimal level, they write.

The problem is that children already receive above optimum doses of fluoride even without drinking fluoridated water, studies show. By 1974 samples of duplicate meals indicated more than ten times as much fluoride as had been found thirty years earlier – and this study didn't factor in fluoride content of snack foods.

Maybe excess fluoride is why tooth decay is still a major U.S. dilemma. Even though U.S. children are fluoride saturated from water, air, foods, beverages and dental products, the surgeon general reports that tooth decay is still a major problem and an epidemic in our poor and minority populations.

Yet, children from the African country of Uganda have less tooth decay than American children even though most Ugandan children don’t use fluoride toothpaste or even a toothbrush to clean their teeth. In fact, Ugandan children who drink high fluoride water have more tooth decay than their equals in low fluoride districts, according to “Clinical Oral Investigations."

“No teeth were lost due to caries (cavities) in the low fluoride district but 6 of 135 (4%) in the high-fluoride district,” report authors Rwenyonyi, et al. Ugandan children, aged 10 to 14, with similar socioeconomic backgrounds and diets, who lived their entire lives in either low fluoride (0.5 mg fluoride per liter) or high fluoride water districts (2.5 mg fluoride per liter), were examined for tooth decay by the same dentist, with results verified. “Surprisingly, there was a significantly higher caries prevalence and DMFT (decayed, missing, filled teeth) score in the high-fluoride district than in the low-fluoride district,” the authors write.

“In one low fluoride area..., all children were caries-free compared to 75% to 86% in the other areas,” they report.

A different paper, presented at a June 2001 meeting of the International Association of Dental Research by Louw, et al, shows the same unexpected results with a different African population. Children drinking 3.0 mg/L water fluoride have more cavities than children drinking .19 and .48 mg/L fluoride. In contrast, only 65% of fluoride-saturated American 10-year-olds are cavity-free and a, mere, 35% of 14-year-olds are cavity-free.

Americans drink fluoridated water, use fluoridated toothpaste, eat foods and beverages made with fluoridated water, along with fluoride pesticide residues. Fluoride supplements, mouthrinses, treatments, varnishes, and other fluoridated dental products are used profusely in the U.S. And fluoride is a major industrial air pollutant.

The big difference between American and Ugandan children is diet. The basic Ugandan diet is composed of complex carbohydrates, e.g., cooking banana, cassava, potatoes, maize and sorghum eaten at regular meals. About 80% of the children reported no between-meal intake of sugar containing items.

According to “Fast Food Nation,” by Eric Schlosser, Americans drink soda at an annual rate of about fifty-six gallons per person - that’s nearly six hundred twelve-ounce cans of soda per person. And, since sales of soda is subsidizing education in many U.S. school districts, children are encouraged to drink more, rather than less, soda while in school. This leaves less room and desire for milk in schoolchildren's diets.

Schlosser reports that twenty years ago, American teenage boys drank twice as much milk as soda, now they drink twice as much soda as milk. And soft drink consumption is common among American toddlers.

Milk contains calcium and magnesium, essential nutrients required to form healthy teeth. Soda depletes the body’s calcium stores. Fluoride is neither a nutrient nor essential. Fluorosed teeth contain more fluoride and less calcium than normal teeth, according to A. K. Susheela, Ph.D., Director, Fluorosis Research and Rural Development Foundation, in “A Treatise on Fluorosis.”
One would think dentists would be campaigning to have calcium placed in the drinking water but then they might lose the financial support they enjoy from fluoride manufacturers of toothpastes and other dental materials. When dentists endorse fluoride, people buy it.

Dentists report they are seeing more tooth decay among their soda drinking patients despite full fluoride “protection.” Ironically, many soft drinks and juices contain “optimal” fluoride levels because fluoridated tap water is used to make them.

And a study in the Journal of “Contemporary Dental Practice” shows that, among people who drink fluoridated water and use fluoride toothpaste, tooth decay still progresses after snacking on cola, apple juice or sweetened yogurt between meals. However, cavities remineralized (partially reversed) when snacks were whole milk, skim milk, 2% milk, cheddar cheese, plain yogurt and chocolate milk or no snacks at all.

An article in “RDH” (Registered Dental Hygienist) reports, “Dr. Carole Palmer, professor of nutrition and preventive dentistry at Tufts University, says, ‘We’re looking at why these things (nutrition in dentistry) have fallen by the wayside. There was a perception, perhaps, that fluoride had resolved the problem (of caries), but that’s far from the truth. A lack of research and funding in nutrition and oral connections has made it difficult to move forward. But nutritional counseling and diet counseling need to be important components of preventive dental care.’”

One such study presented at the International Association for Dental Research meeting this year shows, to no one's astonishment, that obesity and tooth decay are linked. There is also an epidemic of obesity in the U.S. according to the Centers for Disease Control.

Tooth decay is a disease of poor nutrition and high fluoride. Based on thirty years of study on .4 million children, Teotia and Teotia report "Our findings indicate that dental caries was caused by high fluoride and low dietary calcium intakes, separately and through their interactions."

Further substantiating the hypothesis that nutrition and not fluoride is the answer to less cavities: Ireland, 73% fluoridated since the 1960’s, has a higher tooth decay rate than five other European countries that don’t fluoridate the water, according to the June 30, 2001, Irish Independent. The Irish are also fluoride saturated; but tooth decay is still rampant in under-privileged areas of Ireland, they report.

In fact, an Irish legislator is calling for a ban on fluoridation in Ireland immediately.
Like most things American, fluoride is overblown, over-prescribed, and over-used. Along with the expansion of fast food restaurants and American waistlines, fluoride's expansion into the food supply via the water supply is out of control and may be creating instead of curing tooth decay. It's time to stop water fluoridation. Fluoride can't fix a poor diet.