‘A Dream Come True’

Novel dental implant solves ‘complicated’ case, restores youthful smile.

By age 9, Cheryl Richards knew she wanted to work in health care. Her father was a physician, and by then she had already witnessed firsthand the difference a dedicated medical professional
can make in people’s lives.

Cheryl Richards

But it wasn’t until she lost her teeth in an auto accident at age 16 that her career path came into focus.

“We were on our way back from a winter school play, and it was snowing,” Cheryl, 75, recollects. “Our car skidded off the highway, rolled over several times and landed on its roof. I received considerable head and facial trauma, including fractured teeth.

The sound that followed the removal of every broken tooth the dentist had to pull still echoes in her head.

“He had a stainless steel metal plate, and every time he pulled a tooth, I could hear him drop the tooth onto that plate,” she recalls. “I lost all my upper teeth and my posterior bottom teeth as a result of that accident.”

To replace the lost teeth, the dentist fit Cheryl with a traditional, removable upper denture. It was uncomfortable and awkward, but in adjusting to it, Cheryl called to mind a phrase her mother often voiced: Remember to count your blessings.

With each passing day, she took that expression to heart as she learned to accept her fate. In time, though, acceptance morphed into inspiration as Cheryl pursued a career in dentistry.

She went on to work as a chairside dental assistant for 38 years and taught in the field for seven more. During those years, she learned about advances in denture technology, specifically the use of dental implants to stabilize dentures.

Confident in the technology, Cheryl was eventually fit with two dental implants in her lower arch. She also wanted to get an implant-supported denture for her upper arch, but five dentists told
her they couldn’t do it.

“My case was too complicated, they all said.”

The reason: After 59 years of wearing an upper denture, the bone between the roof of Cheryl’s mouth and sinuses had thinned due to the denture’s repeated hammering against her palate.

Cheryl was certain, though, that the right dentist could give her the implant-supported upper arch she wanted. When she began asking friends who they would recommend for such a job, one name came up repeatedly: Michael A. Pikos, DDS.

“I knew Dr. Pikos professionally,” Cheryl reveals. “I attended one of his classes on dental hygiene and advances in technology. The professionals I consulted with agreed that if anyone could get me out of a removable denture and into implants, it was him.”

Dr. Pikos is a board-certified oral and maxillofacial surgeon and the founder of Coastal Jaw Surgery. He is also a global leader in dental implants and surgical reconstruction known for developing the smile restoration process called Same Day Teeth®.

“Same Day Teeth is an innovative treatment that allows for the placement of dental implants and new teeth on the same day,” Dr. Pikos details. “It restores the aesthetic appearance of the smile and provides optimal functionality.”

Cheryl was first examined at Coastal Jaw Surgery in January 2020. Afterward, the news Dr. Pikos delivered was music to her ears. “He said, Yours is a complicated case, but I’m going to take it on,” Cheryl remembers.

Zygomatic Implants

“Like Cheryl, many patients in this situation are told by other dentists they don’t have enough bone for implants or bone grafting,” Dr. Pikos explains. “But at Coastal Jaw Surgery we have a solution for these patients, a novel type of dental implant called zygomatic implants.”

Zygomatic implants are longer than traditional implants. They can be as long as 2 inches because they are anchored in the patient’s cheekbone and come down into the mouth. The surgical team at Coastal Jaw Surgery is highly trained in the use of zygomatic implants.

Coastal Jaw Surgery is a certified ZAGA center, one of only two in Florida and the first in North America.

“Their work is amazing.” – Cheryl

ZAGA stands for Zygoma Anatomy-Guided Approach, which means that instead of basing treatment on an established technique, tools and processes are adapted to the patient’s anatomy.

“There are eight to 10 ZAGA centers in this country and 50 throughout the world,” Dr. Pikos discloses. “We are a focused group centered on helping patients who have otherwise been rejected for implants and feel utterly hopeless. Our methodology is grounded in science, and we are trained differently than other surgeons with regard to using these site-specific implants.”

Dr. Pikos used zygomatic implants for Cheryl’s Same Day Teeth process, which began with a cone beam CT scan of her head and neck. During the initial appointment, Coastal Jaw Surgery’s prosthodontist, Philip J. Hedger, DMD, MS, was brought in.

Dr. Hedger is the tooth-replacement specialist and “smile architect.” He designs the new teeth as part of the Same Day Teeth treatment.

“Our process is entirely digital,” Dr. Pikos asserts. “Once Dr. Hedger designs the patient’s smile using special computer software, all the records are sent electronically to a dental lab we work with in Los Angeles. Using the same software, the lab designs the final set of teeth based on our input and the patient’s age and desires.”

The lab also creates digital models for the implant surgery.

Cheryl is “thrilled” with her new smile.

Dr. Pikos uses the models to determine the precise location for the implants. Precision is required because there is minimal bone mass in the cheekbones.

In treating Cheryl, Dr. Pikos placed two zygomatic implants on each side of her upper jaw. Following surgery, Cheryl was left with small posts protruding from her gums and was sent home to recuperate. When she returned to Coastal Jaw Surgery two days later, Dr. Hedger fit her with a temporary prosthesis.

“Any small changes that need to be made to the smile are done when the temporary prosthesis is received,” Dr. Pikos informs. “Patients undergoing this procedure are then instructed to remain on a soft food diet for four months. This time allows the implants to integrate with the bone and tissue to heal. Then, after four months, the patient receives an even more beautiful, final permanent set of teeth.”

Cheryl is “thrilled” with her new smile and appearance.

“If you take a picture of my smile now and compare it to a picture of my smile at 16, this is the most natural I’ve looked in all those years,” she rejoices. “Dr. Hedger matched my teeth beautifully. They don’t look like anything other than my natural teeth. And they’re also functional. It’s a dream come true.”

One thing about Cheryl’s experience stands out to her: the coordination between Dr. Pikos and Dr. Hedger.

“I call Dr. Pikos my world-class architect and Dr. Hedger is the museum-quality artist,” she raves. “Dr. Hedger’s got the technology for the smile, and Dr. Pikos has everything it takes for the function. Their work is amazing.”

© FHCN article by Patti DiPanfilo. Photos by Jordan Pysz. mkb
Print This Article
    • Coastal Jaw Surgery

      With more than 30 years of extensive experience, their mission at Coastal Jaw Surgery is to provide excellent surgical care for their patients in a safe, efficient and compassionate manner. Their team of oral surgeons is unmatched in ex... Read More

    • Michael A. Pikos, DDS

      Michael A. Pikos, DDS, is a board-certified oral and maxillofacial surgeon and a diplomate of the American Board of Oral and Maxillofacial Surgery, the American Board of Oral Implantology/Implant Dentistry and the International Congress of Or... Read More

    • Philip J. Hedger, DMD, MS

      Philip J. Hedger, DMD, MS, earned his undergraduate degree in nutrition from the University of Florida. He received his dental doctorate from the University of Florida College of Dentistry. Dr. Hedger then completed an advanced pros... Read More