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According to law, a detailed estimation is systematically provided prior to the surgery itself. Similarly, a document on mutual informed consent is explicited. A period of reflection is also recommended before undertaking any operative procedures in order to let one's decision mature and possibly let more questions be raised about the act and its fallout. We can answer any general question, although a medical consultation is required before considering a surgery. Thank you to fill out and send this form. Describe your situation as specifically as possible and we will reply to you as soon as possible.

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The contact database is filed with the C.N.I.L. (Commission Nationale de l'Informatique et des Libertés) under n°1284810. You have a right to access, modify, and delete your information (law «Informatique et Libertés» modified, january 6, 1978). For any request pertaining to your data, please inquire at contact@clinique-montaigne.fr

Dental implants to replace missing teeth

Tooth decay and periodontitis, a disease also known as “gum disease” that affects the support tissues of teeth, and causing teeth to loosen, are the two main pathologies that lead to tooth extraction.

 

Why & When have implants?
  • When what remains of the tooth root doesn't allow to place a ceramic crown, implant techniques take over.
  • Dental implants provide a technique of tooth replacement along with their roots without using dentures or bridges. They consist of titanium screws that are placed within the jaw bone. A post is then secured to the implant, and a ceramic crown or other dental device can be fixed to it.
  • In the case of multiple implants, computer-aided planning methods are used to simulate and prepare in advance the course of the protocol, depending on the specifics of each patient.
  • In some cases, lack of bone thickness makes the placing of the implant more complex. Surgical techniques such as bone grafting or sinus lift, can overcome these difficulties.
  • Implant placement results in restoring both a comfortable chewing function, and a natural looking aesthetic dentistry that looks and feels like real teeth.

The periodontal disease (periodontitis)

Periodontitis is an inflammatory bacterial disease that is considered to be one of the most common disease worldwide. The condition has degrees of severity depending on the bacterial virulence. It is a progressive disease that commonly starts with gingivitis (bleeding gums). Then, over a variable period of time, the emergence of periodontitis itself occurs, whose consequence is the destruction of supporting tissues of teeth: gums, ligaments, bones.
The gingival recession, bone resorption and tooth mobility lead to the inevitable loss of teeth. Periodontal treatments are many, medical or surgical, and must be implemented as soon as possible.

Results of periodontal therapy

  • Stopped gingival inflammation
  • Stopped bone resorption
  • Stopped tooth mobility
  • Restored chewing function
  • Restored aesthetics
Causes of edentulism

What causes early tooth loss?

  • The nature of dental problems evolves along the course of life.
  • During youth, tooth decay predominates. Then, in mid-life, around the forties, periodontal diseases appear. They involve the destruction not of the tooth itself, but of periodontium, that is to say the tissues that surround and support teeth: gums and jaw bone in which teeth are rooted.
    Commonly the tooth is said to loosen.
  • In some cases, tooth loosening occurs in younger patients under 40.
  • Different treatments are used against those diseases that can lead to total loss of teeth.
  • The ultimate treatments are surgical procedures that attempt to repair either gums, or the bone supporting the teeth.
    • They consist in some cases in the debridement of infected tissues - a professional cleaning to break apart the dental plaque below the edge of the gum (gumline), often followed by bone grafting using either the bone of the patient (autograft) or external filling materials according to each indication.
    • In other cases, simple gum grafts (gingival grafts) may suffice to prevent further root exposure, decrease susceptibility to root decay and improve appearance.
    These procedures, performed by a periodontist, can be undergone:
    • Under local anesthesia in multiple sessions,
    • Under neuroleptanalgesia, or local anesthesia with sedation, in 1 session.
The operating room

The Élysée Montaigne clinic operating room

Operating room - © Élysée Montaigne clinic The Élysée Montaigne clinic operating theatre provides for optimized operating conditions in terms of:

  • Asepsy,
  • Surgical instruments sterilization,
  • Full traceability protocols.

Performing dental procedures in the clinic's operating room ensures full control of pain and monitoring of vital functions, with the help of a team of anesthesiologists.
The surgical suite is particularly recommended in the following cases:

  • Placement of multiple implants.
  • Demanding, long lasting procedures.
  • Poor or pathological health status of the patient.
  • Anxious patient fearing the intervention.
Bone grafts & sinus lift

» Advanced surgery: bone grafting

  • The loss of a tooth creates a progressive resorption of bone in the jaw of about 9 mm in height over 10 years.
  • When bone loss is significant, conventional dental implants can not be placed in the overly narrowed site. This ruled out dental implants until yet a few years ago.
  • With bone grafting, it is now possible to reconstruct sufficiently broad and high bony sites. Long-established toothlessness, most reduced crests, bony tissue almost nonexistent, are no longer conditions that surgery can't overcome.

» Advanced surgery: “sinus lift” or sinus fill

  • Bone grafts in the sinus are indicated in some cases of edentulism to augment bone mass in the posterior top jaw.
  • Above the teeth of this area is the maxillary sinus (“maxillary antrum”) which is a air-filled space in the skull. After extraction of teeth, the problem is to know whether there is enough bone in the sinus floor to screw an implant in it (a bit like a wood plank that is too small or too thin to hold the whole of the screw shank).
  • Bone grafting surgery involves filling the lower part of the sinus with additional bone - for example harvested from the iliac crest, or a suitable material so as to increase the height of bone in which secure the screws that dental implants are.

“Sinus lift”

X-ray: implants in bone grafts

Partial edentulism - The roots of teeth lost in the upper right side are replaced by 4 implants.
A bone graft was performed into the sinus to increase bone volume necessary to screw the 4 implants in a secured position.

X-ray: sinus filling

Complete edentulism - The dental arch is completely rebuilt with a dozen implants. The bone of the upper jaw has been rebuilt with a double filling of right and left sinus and bone grafts on the front of the jaw to secure the volume of bone required to correctly position the implants.

© Dr J. Weinman - Bourbon Kosmeteeth

See also

Last editing on 13/01/2010
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Dr Martine ASSEMAT-TESSANDIER

Dr Siméon MOUYAL

Dental surgeon

Dr Siméon MOUYAL - © Élysée Montaigne clinic 2010

Dr Jean-pierre SALAMA

Dental surgeon

Dr Jean-pierre SALAMA - © Élysée Montaigne clinic 2010

Dr Jérôme WEINMAN

Dental surgeon

Dr Jérôme WEINMAN - © Élysée Montaigne clinic 2010
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