4 Major Reasons Why Dental Implants Fail

Southern Georgia Oral Surgery-Hinesville, GA.
Roger Myers DMD

The reasons why dental implants fail is a multi-factorial and very consistent.  The placement of a foreign body or material intended to be accepted by the human body has considerable unpredictability.  Provided the right conditions are met, the dental implant has a high degree of success and acceptance.  A plethora of considerations should be made prior to placement of an implant, which will be discussed later.  However, the following are some valid reasons for dental implants failing

1)  Suitable Host
     ASA classification is a very important factor, when considering the type of patient for implant  
      placement
     ASA Physical Status 1 - A normal healthy patient
     ASA Physical Status 2 - A patient with mild systemic disease
     ASA Physical Status 3 - A patient with severe systemic disease
     ASA Physical Status 4 - A patient with severe systemic disease that is a constant threat to life
     ASA Physical Status 5 - A moribund patient who is not expected to survive without the operation
     ASA Physical Status 6 - A declared brain-dead patient whose organs are being removed for   
     donor purposes
     The healthier the patient, the less risk of implant failure.  As a patients health status diminishes,
      the risk of of implant failure increases.

  2)  Quantity and Quality of Bone
       Height and width of  the bone is very important in order to assess when assessing or evaluating
       the patient.  Cancellous and cortical bone of sufficient amount is the real mitigating factor
       determining placement.   As the degree of cancellous bone diminishes, the patient is relegated to
        lesser quality of bone.  The cortical bone of lesser quality because of its decreased vascularity.
        A balance between the two is more optimal and usually correlates to better success.
   3)  Negligence by Dentist:
        One of the major causes of dental implant failure is the negligence of the dentist. A dentist is 
        supposed to follow the protocol of osseointegration appropriately(typically four month of  
        healing time for the implant). A dentist is should study the patients medical history very well
        and include it in their decision making process to advance with implant placement. 
        The following are requirements for a proper dental implant procedure.
        1)   Placement of implant at the site in jaw with the appropriate size
        2)   Proper preparation of the location
        3)   Suitable bone graft
        4)   Proper angulation of placement
        5)  Proper torque for placement @ 35-40 ncm-Excessive Torque
        6)  Do not use excessive drilling
        7) 
         It is also observed that many dentists take a shortcut for diagnosis. They follow the results of a 
         two dimensional panographic x-ray. The information shown by the two dimensional
         panographic x-ray is adequate for most of the dental surgery cases, however it is not sufficient 
         for all. This kind of x-ray cannot provide information about the amount and quality of bone 
         present to hold the implant and the accurate location of nerves and blood vessels running 
         through the bone.  This would require computerized tomography(CT) 3-Dimensional
    4)  Infection:

         Infection: Another common cause of dental implant failure is infection. It occurs mainly

         because of two reasons. The dentist does not follow proper techniques for implant integration or

         uses unsterilized instruments for fitting the dental fixtures. Secondly, you do not care much for

         dental health. Poor dental hygiene is sure to invite pathogens to infect your mouth and 

         eventually, leads to failure of dental implant

Southern Georgia Oral Surgery(Hinesville, Ga.)-Full Scope Oral Surgery

What is full scope oral surgery?
  Full scope oral surgery is the practice of implementing and incorporating all facets of the field of oral surgery in one's repetoire.  The field of oral surgery is a collage of dentistry, plastic surgery and ENT.  Oral surgery directly relates to reparing, altering and correcting problems of the craniofacial region.  The field provides care to the adult and pediatric patient with cosiderable emphasis on maintaining or re-establishing facial form/function.  In our office(Southern Georgia Oral Surgery), we provide a plethora of procedures and adjunct services, which enables our office to be considered a full scope oral surgery practice.
  1)  Dental Implants
  2)  Wisdom Tooth Removal
  3)  Botox and Facial Rejuvenation
  4)  Facial Trauma Repair
  5)  IV and Oral Sedation
  6)  TMJ Treatment (Surgical and Non-Surgical)
  7)  Routine and Surgical Removal of Teeth
  8)  Facial Trauma
  9)  Bone Grafting
10)  Oral Pathology and Recostruction
11)  Pre-Prosthetic Surgery
12)  Distraction Osteogenesis
13)  Sleep Apnea
14)  Cleft Lip Repair

We have oral surgery offices located in:
Hinesville, Ga. and Statesboro, Ga.
Roger Myers DMD

Most Common Causes of TMJ Pain

Southern Georgia Oral Surgery Roger Myers DMD Statistics indicate that the vast majority of TMJ problems are caused by traumatic occureneces. By trauma, we mean an injury as obvious as a blow to the jaw with a fist or something as subtle as a whiplash injury from a car accident that causes direct trauma to the head or jaw.  Violent insults to the head and neck region can result in longterm injury and in some cases the injuries can be irreparable.  The jaw joint specifically is an area that articulates the lower jaw bone to the base of the skull.  It is a hinge joint and functions similarly to the the knee joint and is very sensitive to any abnormal stimuli causes change to the joint space.                    The most common forms of trauma that cause TMD are: Whiplash (cervical acceleration/deceleration) Air bag deployment Opening the jaw too wide Bruxism Bad bite (malocclusion) Orthodontics Ligament laxity Stress Systemic diseases Whiplash (Cervical Acceleration/Deceleration) Whiplash injuries often damage the soft tissue in the neck, back and TMJs. Usually these injuries happen when a car is hit in the rear. The violent motion of the head being thrown from a still state backwards and then forwards again often causes the mouth to be forced open. This produces stretching and/or tearing of the ligaments and connective tissues in one or both TMJs, and possibly bleeding and displacement of the disc in the TMJ. Common complaints after a whiplash injury include neck pain, neck stiffness or difficulty in turning the head, headaches (especially where the neck attaches to the head), TMJ pain, limited ability to open the mouth, TMJ noises, face and/or ear pain, change in bite, dizziness, visual changes (such as light sensitivity or blurry vision) and swallowing difficulties or hoarseness. Air Bag Deployment While air bags have undoubtedly saved lives, they have also been implicated in causing TMJ problems. Patients who have been injured with air bags often experience one or more of the following symptoms: burned or abraded skin on the chin, face or nose; almost immediate TMJ pain; swelling of the TMJs; limited mouth opening; neck pain; and change in the dental occlusion (bite). Opening the Jaw Too Wide All joints have limitations to movement, and the TMJ is no exception. If you open wide for a long time or if your mouth is forced wide open, ligaments may be torn, swelling and bruising develop and disc dislocation may occur. Bruxism Bruxism is the abnormal grinding of the teeth. Bruxism usually occurs during sleep, which is why many people don’t realize they are doing it. But when grinding continues, TMJ problems may develop. An indication that a person is grinding their teeth in their sleep is sore jaw muscles when waking. Minimally, bruxism may produce muscle pain, tooth sensitivity or worn teeth. In some cases, the pressure to the TMJ from constant grinding of teeth leads to ligament injuries, which might cause the disc to dislocate. Bad Bite (Malocclusion) A bad bite, or malocclusion, may be produced by poor development of the jaws, removal of teeth without replacement, a high dental restoration, a poor fitting denture or partial denture, or a displaced TMJ disc. Orthodontics Some dentists feel that orthodontic treatment, or braces, might be a cause of TMJ. By moving teeth with orthodontic appliances, malocclusion is produced during treatment. That’s probably why many people undergoing orthodontics report sensitive teeth, pain in the jaw muscles or even bruxism. However, there is no scientific proof that orthodontic treatment produces TMJ problems, particularly once the treatment has been completed. Ligament Laxity People who appear to be double-jointed suffer from a problem termed aligament laxity. When this occurs, a joint appears to be double – or loose. This does happen to the TMJ. Ligament laxity is a fairly common problem in active young women who suffer with TMJ problems and, often, injuries to other joints. Stress Stress has many effects on our bodies: some good and some bad. Physiological changes can produce muscle tightness and pain. When a person is subjected to chronic stress, these physical changes may produce harmful effects. When it comes to TMJ problems, stress is like throwing gasoline on a fire. The gasoline doesn’t produce the fire, but it does make it worse. Similarly stress intensifies TMJ problems. Muscles tighten, teeth clench, abnormal pressure is forced against the TMJ disc, and if the ligaments are weak or if the patient is one that has ligament laxity, the disc may dislocate. There are a number of other pain disorders that are often confused with TMJ because they involve pain in the jaw. Most common among these are: Temporal Tendinitis Ernest Syndrome Occipital Neuralgia Trigeminal Neuralgia Atypical Trigeminal Neuralgia Atypical Face Pain Neuralgia Inducing Cavitational Osteonecrosis (NICO) Temporal Tendinitis – The “Migraine Mimic” Temporal tendinitis has been called “the migraine mimic” because so many of its symptoms are similar to migraine headache pain. It is characterized by TMJ pain, ear pain and pressure, temporal headaches, cheek pain, tooth sensitivity and neck and shoulder pain. Treatment consists of injecting local anesthetics and other medications, a soft diet, applying moist heat, using muscle relaxants and anti-inflammatory medications, and physiotherapy. In very rare cases (less than 4%), surgery may be needed. Ernest Syndrome This TMJ-like problem involves a tiny ligament structure that connects the base of the skull with the mandibular or lower jaw. If injured, the structure can produce pain in the face, head, neck, temple, ear, cheek eye, throat and/or TMJ. Treatment of Ernest Syndrome, which is successful about 80% of the time, consists of injections of local anesthetic and medication (like cortisone or Sarapin), physiotherapy and, at times, the use of an intraoral splint. Occipital Neuralgia This disorder is characterized by pain radiating to one or both sides of the head, temples, cheek and forehead and particularly pain above and behind the eye.  This is attributed to the sensory nerve supply to the globe of the eye socket. Trigeminal Neuralgia Also known as tic douloureux, this is a disorder of the trigeminal, or fifth cranial nerve. It is characterized by sharp electrical pain, which lasts for seconds. The pain is triggered by touching a specific area of the skin, as when washing, shaving, applying makeup, brushing the teeth, kissing or even from exposure to cold air. The pain is often very severe. Atypical Trigeminal Neuralgia In contrast to the typical type, atypical trigeminal neuralgia produces constant pain that increases or decreases in intensity. There are trigger zones, but there is also an area of dull aching. A common cause of this disorder is trauma, especially after a surgical incision or blow to the face. (June: how is it treated? does it go away or is it chronic? what do you do for it?) Atypical Face Pain While the same trigeminal nerve is involved in atypical face pain, in this case the facial pain seems to affect people who are under a tremendous amount of stress or have a history of psychiatric problems. Neuralgia Inducing Cavitational Osteonecrosis (NICO) Also known as osteocavitational lesions or Ratner’s bone cavities, this disorder produces pain similar to that of typical and atypical trigeminal neuralgia as well as referred pain patterns. There are trigger areas for the pain, which, in this case, develop directly over areas of dead bone. Generally, the lower jaw is affected more often than the upper jaw

5 Best Ways To Stop Wisdom Tooth Pain

Ways To Stop Wisdom Tooth Pain

1.  Partial bony impacted wisdom teeth typically are associated with inflammed tissue on the back portion of the tooth(distal portion).  This tissue gets intermittently edematous and is an area of a focal infection.  It acts as a food trap and hard to reach area, which can cause an infection(pericornitis).  This focal infection can be sporadic and unpredictable, which in extreme cases can require antibiotics.  A severely decayed tooth can also cause an infection in the form of an abcess.  An abcess usually forms at the base of a tooth root and purulence(pus) develops in a focal region.  The pus is encapsulated in a wall of epithelium and penetrate bone/sot tissue, which results in soft tissue swelling.  Antibiotics is the therapeutic choice to resolve an infection.

2.  Tooth pain can be very excruciating and could require potent pain meds.  Analgesics(Narcotics) are stronger meds that can alleviate painful toothaches.  These meds are required to be prescibed by a licensed dentist or physician.

3.  NSAIDS are non-steroidal anti-inflammatory drugs.  Motin and alleve are two excellent examples, which can reduce the inflammatory process associated with a painful tooth.

4.  Warm salt water rinses is a method of washing debris in the area of an infected tooth.  For example, removing debris form under the tissue of a partially impacted wisdom tooth can reduce the probability of pain and infection.

5.  Warm heat is a great adjunct to assist in reducing swelling and drawing the abcess to a halt.  Heat assists in localizationof the abcess to help identification and drainage.

www.southerngeorgiaoms.com
Roger Myers DMD

Southern Georgia Oral surgeon Hinesville Ga. and Oral Surgeon Statesboro Ga.: Top 10 Reasons to have wisdom teeth removed

Southern Georgia Oral surgeon Hinesville Ga. and Oral Surgeon Statesboro Ga.: Top 10 Reasons to have wisdom teeth removed

Top 10 Reasons to have wisdom teeth removed

Wisdom Teeth- Southern Georgia Oral Surgery
Why We Should Remove Wisdom Teeth
Roger Myers DMD

Why do they cause so many issues for us?
The more patient evaluations for wisdom teeth that I perform, the more I ponder on their lack of necessity.  When a wisdom tooth is erupting, I call it the adult teething stage and the symptoms for a tooth erupting for a child appear to the same.  The infection, erythemas, swelling and pain appear and removal of the tooth is warranted.  Called "wisdom teeth" because they emerge later in life, the upper and lower third molars generally cause problems because there is not enough room in the mouth for them to erupt, or break through the gum, into a normal position. As a result, these molars are often left impacted in the gum or jawbone. Impacted teeth can lead to a variety of problems including pain, infection, crowding, or damage to adjacent teeth, and can contribute to more significant inflammation that can spread to other teeth, which can compromise the integrity of adjacent teeth.
2. Oral inflammation associated with wisdom teeth may contribute to preterm or low birth weight infants.  Extremely important to pregnant patients.
3. Fully erupted wisdom teeth rarely provide meaningful use and are difficult to keep clean.  Their incidence of developing caries is very high.
1. Limited space for wisdom teeth to erupt can lead to infection and by, the risk of caries is always present.
4. Impacted wisdom teeth may develop associated cysts and/or tumors that could require extensive procedures to remove & repair jaw function and appearance.
5. Chance of complications related to the removal of wisdom teeth increases with age.  The tooth position and roots may compromise the nerves and blood vessels.
6. Gum disease and inflammation associated with wisdom teeth may lead to receding gum tissues, deterioration of the jawbone and tooth loss.
7. Full eruption of wisdom teeth may lead to crowding of nearby teeth.  Normally the lower anterior mandible is affected with the canine to canine area being most compromised.
8. Even wisdom teeth that seem to be problem-free remain a breeding ground for oral infection & inflammation. This inflammation can enter the bloodstream and contribute to the development or progression of diabetes, heart disease, and stroke.
9. Wisdom teeth removed at an early age allows for easier and faster recovery. TRUE
10.  They serve absolutely no function at all.

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