Replacing Four Lower Back Teeth With Dental Implants and Bone Grafting – Start to Finish Detailed Video Review -Ramsey Amin DDS

This video has a lot of information on dental implants and bone grafting. There is also a lot of information on how the teeth and dental implant abutments are made in the rationale of why I did everything. You also see the sequence where three of the implants were placed in a delayed fashion and one was placed as an immediate dental implant.

***If you are considering having dental implants and perhaps socket bone grafting, this is a must-see video.**

X54316_1


IMG_1148
IMG_0823
IMG_0821

 

IMG_1165

Please be sure to watch the entire video as there is so much to learn about the entire process of having teeth replaced with dental implants. In this video I review the diagnosis, treatment planning, 3-D scan analysis, surgical placement of four implants and the restoration of the four implants with for non-connected monolithic zirconia crowns with prefabricated abutments.

This patient has several failing root canals and very heavily worked on teeth. The teeth have been crowned in re-crowned multiple times and now several molars need to be extracted. In fact a few of the crown/root canal teeth came apart during the healing!!! They were added to the list of teeth to extract and replace with dental implants.

I also show after photographs so that you can have a complete start to finish outlook on this procedure. I consider this patient a very basic case in my office. In the 3-D scan analysis, I discuss how the surgery and planning can prevent long-term complications such as peri-implantitis which is bone loss around implants.

I appreciate your comments and questions. I hope this video helps you.

Ramsey Amin DDS
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry

 

 


Share Your Comments or Questions About This Article

Your email address will not be published. Required fields are marked *

32 thoughts on “Replacing Four Lower Back Teeth With Dental Implants and Bone Grafting – Start to Finish Detailed Video Review -Ramsey Amin DDS

  1. Taehoon Kim

    I am impressed..

    Hi, I am a young dentist from S.Korea. I got here during googling about implant overdentures.
    I want to admire your great work for your patients and latent patients. Also, your clinical results are great!!
    I have a question. What kind of camera and flash do you use? The quality of photo is really amazing.

    Reply
    1. RamseyAminDDS Post author

      Thank you for your kind words. I have gone through several digital cameras over the last 17 years. You must use a macro lens with excellent light fusion. Currently I have a Canon G 10 that is set for aperture priority

      Reply
  2. Julie Becco

    The information was very helpful. I am considering having an implant done, as I have a fractured tooth and have had 3 crowns in the past 5 years. The very first crown lasted 17 years but since then nothing but issues. Different dentists have done the work with the same result, tooth sensitivity, ill fitting crown, and the inability to eat everyday normal food because of the discomfort either from the temperature or simple pressure of chewing this has now led me to the conclusion to have the fractured tooth removed and an implant put in. So my question next would be after the implant can I eat normally, is there any pressure or other discomfort due to the nature of the implant being embedded in the jaw bone? Any sensitivity to hot or cold? I only have sensitivity to cold so far. Can I have a tooth extracted and an implant put in on the same day and how soon after the procedure can a crown be placed? I just want the problem fixed, I understand that you would need X-rays and so on to make a definitive reply but my goal is to be able to eat/chew normally as I have not been able to do in years. Thank you for informative website it really is very helpful.

    Reply
    1. RamseyAminDDS Post author

      An implant that is done well should have zero symptoms whatsoever. It will not be sensitive to cold, pressure, biting or heat. Most implants should be placed in a staged technique rather than at the same time of extractions for best results. Front teeth and full mouth dental implants are often best done at the same time the teeth are extracted. Sorry for the delayed reply as your comment went to our spam filter.

      On another note, high-quality Dentistry should have no symptoms on natural teeth either.

      Reply
  3. Sonja Lewis

    Would it currently work as well, to use 2 of the titanium/zirconium posts in the LH mandible, instead of the 3, with a permanent interconnecting bridge? My daughter age 45 lost one molar 30 years ago with a bridge replacement, and is due for extractions of the 2 surrounding teeth. She is a non-smoker, and maintains good hygiene, including flossing. She is on Medicaid in Mendocino County, and although my finances are low, I am going to help financially with this.

    Thank you for your all your ongoing information–especially your responses to questions! I live 1000 miles away, but I will recommend your services to family in your area. I do have a thorough dentist, who recommended bone implant after my single extraction a few years ago. What a difference the bone implant makes!

    Reply
    1. RamseyAminDDS Post author

      Thank you for your nice comments. In the lower jaw oftentimes 2 implants can work for her bridge rather than 3 individual implants. This will depend on bite force and bone density in the area and is dependent on many other factors also. If only short implants can be used than I would suggest using more of them.

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  4. AMBROSE OKORIE

    Great job educating people and prospective patients.

    Thanks for the good work you’re doing Dr. Amin.
    I’ve gotten about 3 implants now since 2007 and about to get my 4th one in a molar. Think I will do delayed implant after extraction since I’m traveling out of the country in about 10 days after the extraction and want to lower my risks. Hope my decision to wait about 3 months is sound vs. immediate implant and traveling to West Africa soon.
    Money is not a big issue because my medical insurance will cover my procedure and I know how to file such claims. My son and I have been doing medical billing for Oral surgeons.

    Reply
    1. Cay

      How do you Bill medical insurance for implants? That’d be a dream-come-true for me! Long story very shortened, I have tmj & had ground down my teeth. Went to LVI Dentist & eventually for 2nd opinion, to IU School of Dentistry for seven years. After being told I’d never need dentures since all teeth were repairable, being put in long term temps two years ago, I now have 6-8 “good teeth” left; teeth that are black & ready to fall out from decay (no decay when temps put on) & THEY wanted to put removable dentures in. Ugh, NO. Feeling depressed & sad at thought of losing all teeth & there’s no way I could deal w/dentures, especially removable! I’m 60 & we’ve had a few years of negative events after negative events but my hubby says get whatever done. After recently losing our home to vandals/burglars who flooded our home during our absence to point we lost EVERYTHING, even negatives kept in waterproof/fireproof safe (was ONLY submersible 4 hrs, apparently by water line on basement wall, much longer & higher then the 6′ high shelf safe was on) I’m tentative about spending a lot because we would eventually like to retire & don’t know how insurance will eventually work out. Plus, I broke femur 2 years ago & have a substantially shortened leg & all the pain associated w/walking unevenly. Ha. Sounds like a terrible story & that’s not close to ALL that’s gone on past two years. Just still thanking God no one walked in on thieves. They got all my mom’s & grandmother’s jewlery which I had saved for our “kids”. A lot of $ value but no insurance since I thought it was so safe. Well, I digress.

      How do you file medical insurance as we do have great med, lousy dental, thru large corp my hubby works for. That’d surely be a blessing!

      Also plan on asking Dr Amin to look over my records/xrays/molds & new ones if needed, to come up with a plan for immediate restoration as decaying teeth under unstable temps isn’t good for my health or confidence!

      Thanks so much!

      Reply
      1. RamseyAminDDS Post author

        Medical insurance pays for dental implants in less than 0.1% of cases. I am currently treating a 40 year old patient that was only born with only 3 adult teeth. Both of her kids are the same way.
        Sorry for the bad news.

        Reply
  5. asa olsen

    Just as orthopedic titanium pins etc used to reconstruct damaged & broken limbs can & often do cause cramping & pain many years after placement..(especially in cold weather) Is it common that dental implants cause these same problems of cramping & pain ongoing in the jaw &/or face in your experience please?

    Reply
    1. RamseyAminDDS Post author

      this is a great question! What happens in the long bones of the extremities does not occur in the mouth. Whether change will not affect your dental implants. As long as an implant is placed into a healthy amount of bone, they work out for quite a long time. Too often we see implants placed into bone that is too small and ends up shrinking or getting bone loss several years after placement. You can learn more about this on this post about peri-implantitis how to avoid it.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  6. Chris A kenworthy

    Once the abutments are placed do you mold that day for crowns and then how long do you wait to place the crowns?

    Reply
    1. RamseyAminDDS Post author

      This is really a great question!

      Dental implant abutments can be placed at different times during the process. They can either be placed at the time of surgery, later on to support a temporary, at the time of impressions, or at the time of delivery of the final crown, bridge or over denture.

      This timeline is hopefully chosen by what will yield the best results, keep cost down and minimize your number of visits. In general having a dental implant from start to finish with a traditional method takes about 3 to 6 months.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  7. Minei Kiefer

    Aloha Dr. Ramsey
    I did submit a thing I will soon be going through. I do not know how many patients you have treated that like me have BRONJ. Osteonecrosis of the jaw. It is rare and not much info til around 2003. Rare but I got it due to the cancer I have, Muliple Myeloma and was given Zometa I.V. for 5 yrs. I have lost all my teethe in 14 months. I have bone exsposer and a extractions site yet to heal that has cause a hole up into my sinus. I actually have 3 unhealed sites and pieces of bone working there way out that opens another hole for 8-10 months. I stopped the Zometa and am on Peridex, Augmentinad 2 oral surgeon and an Infectios Desease doctoron board. My main question is after all is grafted and healed, will I ever be a candidate for implants of some sort? Please I need answers. You seem ti be the best. What would or could you do for me? I live in Hawaii but will go anywhere I need to go to vet some normalacy back to my life. I wrote you
    before on this but not have heard back.

    Reply
    1. RamseyAminDDS Post author

      Thank you for your very kind words. Sounds like you have been through so much. Hang in there. Multiple myeloma is one of the very few conditions that contraindicates having dental implants. If you are not healing from extractions, you are extremely unlikely to heal after having dental implants. I’m sorry to tell you all of this.

      I have treated many patients who take medications that can cause osteonecrosis of the jaw. Everything has to be very carefully planned and tested to lower the chance of having this complication. Most often this occurs with the medication you discussed which is intravenous Zometa and other oral bisphosphonates such as Fosamax, Actonel and other ones that act like bisphosphonates such as Prolia.

      Occasionally someone that has osteonecrosis may have successful treatment by doing hyperbaric oxygen treatment but this is not available in all locations and definitely carries risks.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  8. Jennifer Ha

    Hi Dr. Ramsey,
    Thank you for your wonderful website! I am currently a pre-dental student from New Orleans. I am looking for some interesting news/articles about modern dental technologies. Your blog amaze me. I read two articles so far. Words are very easy to understand. Even though I have no idea what Dental Implants are about but I sure got some ideas now.

    Reply
  9. Minei Kiefer

    Aloha Dr. Ramsey,
    I really liked your video. I hope one day I will be able to have some sort of implant procedure done to restore some normalacy to my life. I do not have much hope due to the fact I have BRONJ. I am a cancer patient. Multiple Myeloma and was given Zometa i.v. for 5 yrs. I lost ALL of my teeth and am going on month 15 of antibiotics, Peridex rinse and still have 2 open sites that are slowly but surely healing and exsposed bone at one extraction site. I did send a comment/story of my plight. Still hoping one day in the far future to at least be able to have snap on dentures. Implant teeth I am not shooting for. Dentures that don’t come out with a flick of my tongue is all I can at this time wish for. Hope for.

    Reply
    1. RamseyAminDDS Post author

      Thank you for your very kind words. Sounds like you have been through so much. Hang in there. Multiple myeloma is one of the very few conditions that contraindicates having dental implants. If you are not healing from extractions, you are extremely unlikely to heal after having dental implants. I’m sorry to tell you all of this.

      I have treated many patients who take medications that can cause osteonecrosis of the jaw. Everything has to be very carefully planned and tested to lower the chance of having this complication. Most often this occurs with the medication you discussed which is intravenous Zometa and other oral bisphosphonates such as Fosamax, Actonel and other ones that act like bisphosphonates such as Prolia.

      Occasionally someone that has osteonecrosis may have successful treatment by doing hyperbaric oxygen treatment but this is not available in all locations and definitely carries risks.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  10. Jeani Barrett

    In my case you proposed to extract my two upper rear molars, do a sinus augmentation, then implants. You said the molars had descended. It is possible to keep the two molars, maybe by putting crowns on them? Just wondering. Jeani Barrett.

    Reply
    1. RamseyAminDDS Post author

      If the molars have been descended too badly, then yes placing crowns on them is an option. In many cases, the molars have descended so badly that in order to drill them to the new level, intentional root canals have to be done because we have to drill them beyond the nerve chambers. In addition to the intentional root canals, another additional procedure called a crown lengthening has to be done to move the gum and bone up higher also. After the root canal and crown lengthening, then and only then, can crowns be made which are placed deeply on the roots.

      Oftentimes it does not make sense to go through all of this process end up with teeth that are so heavily drilled that you end up losing them just a few years. Every case is unique and different.

      Please call me today if you want to discuss the upper teeth options.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  11. allison

    Thanks for your wonderful site.

    1. I am getting molar 14 extracted. Are the odds high that I would need a sinus lift? What is the criteria?
    2. How long can one wait before getting a extraction/bone graft and then doing the implant? Cost might be an issue
    3. Also, my general dentist said she can do the extraction and bone graft. Would that be recommended? She would refer out for the implants.

    Thanks so much!

    Reply
    1. RamseyAminDDS Post author

      Hello Allison

      As for your first question this video blog post on internal sinus lifting will be extremely helpful to you as I am replacing that exact tooth as the example in the video.

      2. I would not wait longer than six months at the most. Your other teeth will begin moving in the bone is already shrinking. The sooner you are evaluated, the better.

      3. I don’t think I would go this route. The person placing the implants should be the one doing the bone graft. There are many different techniques, materials and most importantly, experience level.

      respectfully,

      Ramsey Amin DDS

      Reply
      1. allison

        thanks so much for the video! Your sight is amazing.
        1. So the odds are high that molar 14 generally needs sinus lifts because of the way it is positioned?
        2. I would be very nervous about getting sinus lifts because of complications and it seems so involved.

        Reply
        1. RamseyAminDDS Post author

          Yes the position lends itself to that because of anatomy.

          Just make sure you see somebody who has a lot of experience in the sinus lift procedure. Most of my patients will take Tylenol or Advil afterwards.

          It is a procedure that requires a lot of skill but it works extremely well and has been done since the mid-1970s!

          Reply
      2. allison

        Dr. Amin,

        I had a tooth extraction and bone graft, but I still have Facial swelling, close to three weeks after bone graft. Is that normal? I had a one-week follow up appt with the OS and said the area looks good and non-infected. But my face cheeks is still swollen three weeks after. No pain but just puffy cheeks/face on that side. I can open my jaw no problem. Any advice would be helpful. Thanks!

        Reply
        1. RamseyAminDDS Post author

          It would not be completely unusual if it was a massive bone graft and/or you have a very thin build.

          Reply
  12. Lars B

    Dr. Ramsey 🙂 Not sure how to start, I live a 1hr20m south of your office and I am a boat captain by trade who deals with the public. My smile is deteriorating fast and have had 4 teeth pulled with bone graft material put in and was to finish by having implants done. My dentist who sold his practice to another dentist went under and I am feeling quite lost. I have some probably true horror stories about some past dental work but I hesitate to bad mouth the old dentists, I know they meant well. I am in need of some serious work and after watching a whole lot of your videos I’m pretty darn sure I found the right guy. Your straight forward approach is amazingly calming to me and hope to become your patient. I know your office is closed for the holiday. I am in pain due to some serious tooth decay but I more than happy to wait until the 4th to try and become a patient. Your level of expertise shows to even a layman like myself. Thank you for these videos and please know I will be calling.

    Reply
    1. RamseyAminDDS Post author

      Hi Lars,
      Thank you for your very kind words. I am extremely flattered.

      My team and I are out of the office until January 4. I would be happy to help you. It seems strange to be dealing with a dental office that has gone out of business. I know it happens, but it is probably a good thing that you did not continue having such major work done there.

      I will alert my staff by forwarding your email to them to expect your call. Sounds like you need a very comprehensive approach to your entire dental reconstruction. If it ends up that we don’t good to meet you soon as you/I would like, we may have to help you manage pain. Take care of yourself

      Very respectfully,

      Ramsey Amin DDS

      Reply