Ramsey Amin DDS

Alternatives To Bone Grafting For Dental Implant Teeth: A Unique Approach by L.A Dentist Ramsey Amin, DDS

Ramsey Amin DDS — Mon, 06 Feb 2012 17:19:31 +0000

First off I want to be clear that you cannot have dental implants without having enough bone to support dental implants. BUT…sometimes you don’t need to rebuild ALL the bone to have the same result. Sometimes rebuilding ALL the bone does not yield as nice of a result than if you bone grafted back just SOME of the bone and used smaller, shorter dental implants.

This is most critical in the front of the mouth where the smile and how the dental implant or bridge looks. The look of the gumline is just as important as the look of the teeth!

Please read this article for the necessary background information.

Many times the result is far better building missing gum tissue with porcelain than it is by gum grafting or adding bone through surgery! Even with the best implant dentist in Los Angeles, rebuilding the “details” of your gums back is the at best unpredictable if you are missing bone in a vertical direction. I perform about twenty different types of bone grafts and am very successful at it.

Even if you build back 90% of the bone defect, that last 10% is what makes a smile perfect, or what makes it look fake! This is a good example:

The patient below came to me with dental implants already placed and wanted a fixed, cemented dental implant bridge. She did not want to have to click in and out her teeth daily and have an overdenture.

As you can see there is no bone there! She is missing most of the bone to the base of the nose and ten teeth are missing. Many dentists would say “you can’t do implant or a fixed bridge here.”

In her case, I rebuilt her smile of 11 teeth using five dental implants, a porcelain bridge and very detailed “pink porcelain.” Pink porcelain is really not pink, it is many shades and has a certain texture. By building this bridge using pink gum colored porcelain I avoided her having to rebuild massive amounts of bone in the front of her mouth, that would take about 2 years and many surgeries.

Of course, there are downsides to this approach as there are to any approach, but in the front of the mouth, the results are great. This is a technique that I have used for the last 11 years. Very few lab technicians in the world are talented enough to do this type of work.

If you have neglected your smile or dental health for years, and now wish to fix your smile with dental implants, please come see Los Angeles implant dentist Dr. Ramsey Amin today!
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow of the American Academy of Implant Dentistry

How to Fix a Broken Dental Implant Screw – A Case Report-Burbank Dentist Ramsey Amin, DDS Explains

Ramsey Amin DDS — Thu, 12 Jan 2012 16:14:22 +0000

In the last 11 years of placing dental implants in Los Angeles I have only ever had to remove a broken screw on old implants placed 25-30 years ago. Dental implant abutment screws really don’t break anymore!

They used to break when cheap dental implants were used that had an “external hex” as opposed to an “internal connection.” A dental implant is a screw within a screw. The implant itself looks like a screw and then the implant abutment usually connects to the implant by a screw. These screws are about 1.25mm with an allen hex on the end, and they are made of medical-grade titanium. It is the silver one in the picture. The green piece is not relevant.

Internal connection implants like I use take the force off the screw and place it on the connection or deeper in the implant. The main reason for a screw to loosen or break on a well- placed implant is excessive bite force on the implant. Keep in mind that your bite changes over time on your implant and that it can become excessive over time.

Other reasons a screw can loosen or break are: poor quality implant, rounding out the connection by excessive force of placement, poorly casted screw seat in a screw-retained crown, or an abutment that didn’t get torqued properly.

The x-ray shows the broken screw still inside this implant. That tiny piece is not easy to get out as it needs to be backed out about seven revolutions. It is like trying to take out an eyeglass screw and the Phillips head is broken off.

Careful technique, patience, and a slow drill in reverse can grab the screw out. Most dentists that are involved in implants have never done this.

This case happens to be an implant held in by a screw with a metal biting surface rather than a traditional white cemented crown. Many dentists often resort to extracting the entire implant over a broken screw…yikes!
Ramsey A. Amin, D.D.S.

Diplomate of the American Board of Oral

Implantology /Implant Dentistry

Fellow of the American Academy of Implant Dentistry
Burbank, California
Voted Best Dentist in Burbank -2006, 2008, 2010, 2011 www.burbankdentalimplants.com

Learn more about dental implants!

RamseyAminDDS — Fri, 06 Jan 2012 02:32:07 +0000

Have you heard about dental implants, and you are excited to learn more about them? Well, you will be happy that, in this video, Dr. Amin will explain important details about the abutments used in dental implants cases.

In the video, you will learn about two major classifications of abutments: pre-fabricated and custom abutments. Dr. Amin, our Los Angeles implant dentist will inform you about specific benefits and drawbacks of each type, as well as explaining the different uses that pre-fabricated and custom abutments have in dental implants cases.

Restoring your dental implants is critical to your long-term dental health, which includes minimizing your risk for bone loss in the future. Rest assured, Dr. Amin is well-experienced and skilled to create your dental implants for a breathtaking, healthy smile.

When you choose Dr. Amin, you will receive top-notch, award-winning dentistry. When you come in for your consultation, Dr. Ramsey Amin will patiently listen to your concerns, and help you decide if dental implants are right for you.

Below is the photo series of the dental implant restoration using my patient’s existing custom abutment.

(from L to R: This is how the patient came to me with her existing temp in place, a picture of the abutment after I reshaped it, and the final porcelain crown and corrected gum line appearance).

Dental Implants to Replace Baby Teeth

Ramsey Amin DDS — Fri, 16 Dec 2011 15:58:53 +0000

If you are reading this post you are probably one of a small percentage of adults that has a baby tooth without a permanent tooth below. As an adult with a baby tooth, often the tooth is lost between the ages of 20 and 45 and must be replaced with a dental implant.

A baby tooth may become fused to the jaw bone and look submerged compared to the other teeth. Those baby teeth may be difficult to extract if they are fused (ankylosis).

The most common tooth to be missing is the upper front tooth called the lateral incisor. Those teeth are just next to the two big upper front teeth. Dental implants are used very commonly to replace those teeth. Many times, I replace these front baby teeth before the age of 18 because of cosmetic concerns of not having one or both front teeth.

The other common tooth is the lower second bicuspid or “premolar.” This very common missing tooth replaced with dental implants is located in the middle of your bottom teeth. The bicuspid tooth is usually sitting atop of a nerve in your jaw. Extreme care must be used to avoid this nerve during placement of a lower second bicuspid implant. A shorter implant is usually used in this area. A special curve of the nerve referred to as the “mental loop” should also be assessed.

Also, the size of the implant and the size of baby teeth are different. The real bicuspid tooth that should have been there, is smaller than the baby tooth. This makes the dental implant look more like a molar. In the front of the mouth, it is the opposite, so more space is needed to prevent the tooth from looking too small.

Often times, I will extract a baby tooth and replace it with a dental implant, abutment and crown on the same day. Bone grafting may be needed to fill the voids between the two.

If you are missing just one permanent tooth, often times your smile midline will shift to one side or the other making your smile appear crooked. I have my orthodontist work closely with me so that we can get the spacing just right so that the dental implant looks great. Planning is the most important when it comes to replacing baby teeth with dental implants.

In summary, your baby tooth or teeth can be replaced with dental implants. Just make sure that all the details about the treatment plan and diagnosis are made well in advance of starting treatment. This will make for a very smooth process for you.

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow of the American Academy of Implant Dentistry
Burbank, California
Voted Best Dentist in Burbank -2006, 2008, 2010, 2011
www.burbankdentalimplants.com

Disadvantages of Dental Implants: The Cons

Ramsey Amin DDS — Thu, 17 Nov 2011 19:15:03 +0000

As an authority in the field of dental implant dentistry I can tell you there ARE disadvantages to dental implants. Like anything else, there are pros and cons. Many dentists and patients speak about the pros of implants and bone grafting but there is not a lot of good information on the cons.

The Cost of Dental Implants

The cost of the procedure(s) is probably the most common disadvantage cited by patients. How much do dental implants cost? How much is a sinus lift bone graft? How much is an implant crown? These are questions I hear all the time. Dental implants and grafting in my office are reasonable and affordable.

Keep in mind that implants are body parts that you really want to make sure you have a very experienced surgeon as opposed to a novice that may do few implants per year. The cost varies depending on the difficulty or ease of your unique mouth.

Dental Implants Normally Will Not Cover the Implants Procedure

Dental Insurance is another disadvantage. Most dental insurance plans don’t cover dental implants, bone grafts, sinus lifts, etc. Sometimes they will cover part of your procedure. They may only cover the crown, abutment OR the implant itself.

Keep in mind that dental insurance does not go very far at all. Unlike medical insurance, it has a very low yearly limit that has not changed in 30 years! So what ends up happening is the whole implant process costs more than the average $1000 or $1500 yearly limit set 30 years ago!

Don’t get me wrong, dental insurance helps, but it only helps with part of ONE implant if they even cover any of it. Many plans just exclude them altogether.

Dental Implants Require Surgery

Another disadvantage of dental implants is that it requires a surgery. The implant has to be placed into your bone. Surgery is not without risks. In my own hands, the dental implant complication rate is about 1%, but the average is somewhere between 5-10%.

Risks include, infection, prolonged bleeding, damage to other teeth, nerve damage, delayed bone healing, jaw fracture and many others. Knowing how to recognize and quickly treat complications is the key

Restoration replacement

Another con of dental implants are that the teeth or tooth will probably have to be replaced some day.

If you have an overdenture or a full arch fixed implant bridge with plastic teeth, those teeth WILL wear out and need to be replaced. A porcelain crown or bridge on an implant can chip or break, too. The teeth that go on top of implants are no different than the teeth without implants. It is normal to replace crowns, fillings, bridges and dentures…they don’t last forever. Good design, a great lab and the diagnosis is the key to minimizing having to replace your dental work. Making implant teeth is often more complex and costly than the surgery and bone grafting…experience counts.

Over time you can lose bone around your dental implants

Some slight bone loss over many years is normal. If you lose too much bone, you may have to replace the whole implant. The original surgery and original fabrication design of the teeth are a huge factor in the long-term health of your dental implants. Choose a very skilled implant dentist.

Implants Take Time

A common disadvantage for dental implants is that they take time. Although I replace many teeth, with same day implants and bone grafting, the majority take three to four months to complete. This is because bone just heals slowly. If you need bone grafting, treatment time can extend from 3 months to 18 months or more depending on your unique situation. A regular bridge can be made in days or weeks.

The bottom line is that there are disadvantages to the dental implant process. The reality is the pros outweigh the cons. Overall, the process is a long-term benefit for a short term sacrifice. Dental implants are by far the best option in the majority of situations when teeth are lost.

Do you take Fosamax, Actonel or Boniva? What You Need To Know Before Having Dental Implants

Ramsey Amin DDS — Wed, 09 Nov 2011 20:39:51 +0000

Dental implants can be problematic if you take Fosamax, Actonel or Boniva. Contrary to popular opinion, This does not mean you cannot have dental implants, sinus lifts or bone grafts just because you take or have ever taken these medications called “bisphosphonates.”

Need Dental Implants, but Also Take Bisphosphontates?

For more than a decade, I have safely placed dental implants on patients who take or have taken these medications.

Oral bisphosphonates like Fosamax , Actonel and Boniva are commonly used for the prevention and treatment of osteoporosis. They work by preventing bone breakdown and increasing bone density (thickness).

This sounds great, but when having a dental implant, bone graft or extraction, you need to have both types of cells that make bone and remove bone to heal normally.

Your risk involving dental implants

Having been treated previously or currently using bisphosphonate drugs you should know that there is a risk of future complications associated with dental implants, bone grafting or oral surgery treatment. Fosamax type drugs appear to adversely affect the ability of the jawbone to break down or remodel itself thereby reducing or eliminating its ordinary excellent healing capacity.

This risk is increased after surgery, especially from tooth extraction; implant placement or other “invasive ” procedures that might cause even mild trauma to bone.

The risk is significantly higher in patients who have received the injectable (IV) forms of these drugs.

Osteonecrosis may result. This is a smoldering, long-term, destructive process in the jawbone that is often very difficult or impossible to eliminate. The bone becomes exposed in the mouth and the gum doesn’t heal over it.

Fortunately this complication is fairly uncommon and happens in only about 1% of cases. I have personally seen it. It is most common in the lower jaw as opposed to the upper jaw. The risk of osteonecrosis after having an implant is increased if you have been taking it longer than 3-4 years.

Fosamax , Actonel and Boniva last in your bone long after you stopped taking it. It may last in your bone for 10-50 years!

Make Sure Your Implant Dentist Knows Your Medical History

Your medical/dental history is very important to me. Let me know if you take or have taken Fosamax , Actonel and Boniva before a sinus lift, bone graft or dental implant. I may write you a prescription to have a special blood test to check your risk before we start. I may consult with your medical doctor to modify your regimen. It is critical to use a very knowledgeable implant dentist when you have taken these types of medications because there are many other factors that can cause problems not listed above.

Full Mouth Dental Implant Reconstruction -Audio Explanation With Burbank’s Ramsey Amin, DDS

RamseyAminDDS — Sun, 25 Sep 2011 21:13:14 +0000

Full mouth dentistry with dental implants and crowns can get very complex. I treated this patient in my Burbank office with nine dental implants and a total of more than 20 crowns. The full mouth reconstruction involved the upper and lower teeth and opening the bite to be taller.

The three minute audio recording will guide you through the patient’s case from start to finish.

(click link to listen) Download Ramsey Amin Blog Audio

Besides nine dental implants, sinus lift bone graft and bone widening was done. All work was done while he slept under IV sedation in my office.

The results are dramatic. Please listen to the audio and look at the pictures, CT scan and x-rays.

slight blood from cleaning

What a difference! My patient is learning how to smile again!

Lifting, Moving Over-Denture…Leading Burbank Dental Implant Dentist Reviews Reasons Why. (3 min Video)

RamseyAminDDS — Thu, 15 Sep 2011 10:00:00 +0000

Dentures lift and move and dental implant overdentures can too! In this video shot in my Burbank office, I review some of the common problems that can lead to a denture supported with dental implants to lift up when you chew. Your anatomy can also contribute to a denture that moves.

Careful planning and an understanding of your unique situation can help reduce or eliminate your denture or overdenture from lifting.

Dental implants are the best denture adhesive!

What is Sinus Expansion? Do I Need a Sinus Lift? Sinus is Big and Close…Burbank Dental Implant Expert Reviews

RamseyAminDDS — Mon, 12 Sep 2011 09:03:00 +0000

Your sinuses are big hollow holes above your upper teeth. The roots of your upper back teeth are really close to your sinus. In order to have dental implants in that area, sometimes a sinus lift bone graft is necessary to treat the expanded sinus. Whether you live in Burbank ,Glendale or Los Angeles, all of our sinuses pretty much expand when teeth are lost.

When you lose your teeth, your sinus expands. This destroys the bone needed to have dental implants. When these upper teeth are removed, there is often just a paper thin wall of bone separating the maxillary sinus and the mouth.

Normal Moderate expansion Severe Expansion

When all teeth are present, the sinus is protected from expansion which is really bone loss. The presence of teeth keeps the maxillary sinus in place. The expanding sinus destroys surrounding bone.

Most of the sinus lift bone grafts I do in my Burbank, California office are to add back the lost bone height from the expansion of the sinus. If you are missing teeth on both sides, then usually the bone loss happens on both sides too. Dental implants prevent bone loss.

You can prevent the need for a sinus lift bone graft by either placing your implant on the same day the tooth is extracted (immediate implant) or by placing the dental implants within a few months of losing the tooth or teeth.

There are two main ways you can add bone to an expanded sinus: (follow links for details)

Internal Sinus Lift

Lateral Window Sinus Graft

In cases where the sinus has greatly expanded, your body may form or accentuate “septae” in your sinuses. Septae are like “cross bar stabilizers in the sinus when the sinus is big and expanded. Sinuses with septae should be grafted by a very experienced implant surgeon to reduce the chance of the sinus membrane ripping (perforation.)

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow of the American Academy of Implant Dentistry
Burbank, California
http://www.burbankdentalimplants.com

Burbank Dental Implant Specialist: Review of Immediate Dental Implant Considerations

RamseyAminDDS — Mon, 29 Aug 2011 08:44:35 +0000

Immediate dental implants are those that are placed at the same time the tooth is extracted. In my Burbank dental office, I have been placing immediate implants for the last eleven years.

Typically immediate implants can be done for almost any tooth from the middle bicuspid area forward. I also place immediate implants into the molar areas when the situation is just right. This can save you money and time if the dental implants can be placed at the same time the teeth are extracted.

The bone of the extraction socket needs to be mostly intact with bone around. Often times the thin outer wall of bone is lost due to infection or inflammation. If the bone is missing, or the implant diameter is smaller than your extracted tooth socket, a bone graft may be needed to fill the void.

The images below are from an immediate implant I did last week on a patient from Burbank. The crown broke off her tooth with a root canal so she had a big gap in her smile from the side.

Last month, a referring dentist also from Burbank sent his patient to see me for potential of a same day immediate extraction dental implant. He told me that the tooth had been broken for a few months and was now hurting. After examining him, the delay caused the entire outer wall of bone to be missing on his front and center tooth. In his particular case, I recommended that he not do the extraction and implant on the same day.

Every situation is extremely unique so a careful examination, diagnosis and treatment plan is crucial.

Another excellent situation for immediate dental implants are when all of your teeth need to be extracted on the upper or the lower. Most often, if all of your teeth need to be extracted, the immediate dental implants can be placed AND temporary teeth placed on the same day! Even when I have a patient that travels from out of state to Burbank, I try to give them their new teeth or temporaries on the same day of the surgery.

Immediate dental implants do not always get immediate same day temporaries. This depends on many factors such as the location of your implant, whether a bone graft was done, and the initial stability of the implant. Immediate dental implants are not for the novice dental implant dentist, but rather by someone who is highly experienced in implant dentistry.

A discussion about “plan B” should always be discussed if the dental implant can’t be placed even though it was planned to. In my Burbank office, going home without a front tooth is not an option!