Bridge Over Troubled Water

Retiree’s smile reconstructed using implant-secured fixed bridges.

Riccardo Billi, 55, left his native New Jersey to pursue business opportunities in Florida. He followed his relatives’ example and purchased a mobile home community, which he sold last year when he retired. He didn’t give up property ownership entirely. He simply scaled down his involvement to suit his retirement lifestyle.

Photo by Nerissa Johnson.

Retiree’s smile reconstructed using implant-secured fixed bridges.

“Two of my uncles moved from New Jersey to Florida about ten years before I did,” Riccardo states. “They started buying properties and did very well. They owned one mobile home community together, sold it and doubled their money. Then they each bought their own community.

“When I sold my mobile home community, I had to reinvest the money, so I bought five homes all within a mile of my house to rent out. I started a corporation, and all five homes are under that corporation. I use a management company to manage the homes, but overseeing the corporation is essentially what I do now.”

As a property owner, Riccardo knows the importance of maintaining his properties and keeping them up to municipal codes. He wasn’t as vigilant about maintaining his teeth and recently faced the prospect of needing to reconstruct his smile. He points to a period in his early childhood as the commencement of his poor dental health.

“When I was four years old, I contracted whooping cough,” he explains. “I was very sick and almost died. Apparently, I was overmedicated with antibiotics, and my dentist said that ruined the enamel on my teeth.

“I got my first root canal at age twelve, and it was a horrible experience. For years after that, you couldn’t get me near a dentist. I had problems with my teeth almost all my life.”

Over time, the condition of Riccardo’s teeth deteriorated further, compounded by his distaste for dentists. But in 1996, while living in New Jersey, it became necessary for him to face his fear, and he underwent a significant amount of dental work.

“I had some teeth extracted and seven root canals,” Riccardo remembers. “My dentist also made four bridges for the top of my mouth and two for the bottom. The dental work was very expensive, thousands of dollars. I was working for the New York City Transit Authority at the time, and that was a lot of money for us.”

Unfortunately, Riccardo’s investment depreciated over the years. Because he smoked cigarettes for a long time, a habit he’s now quit, and drank coffee, his dental work became stained and unattractive. But those aesthetic issues were the least of Riccardo’s problems.

“After I moved to Florida, a couple of my bridges fell out,” he reports. “But I didn’t replace them right away. I decided to have my teeth redone when I sold the mobile home community. My uncle went to Dr. Brown, and he did an excellent job on my uncle’s teeth, so I decided to go to Dr. Brown as well.”

Amazing Process

Like his uncle, Riccardo chose Clark F. Brown, Jr., DDS, of Implant Dentistry of Florida in Melbourne. At Implant Dentistry of Florida, Dr. Brown works alongside William S. Vaughn, DMD, and Kim N. Doan, DMD, to provide a full range of dental services. They perform cosmetic and general dentistry, as well as all phases of dental implant surgery and smile restoration.

Dr. Brown performed a thorough evaluation of Riccardo’s dental health and determined his remaining teeth were unsalvageable. The dentist recommended removing the remaining bridges, extracting the teeth and replacing them with implant-secured fixed bridges. It would be the complete smile reconstruction that Riccardo needed.

“Riccardo came to us with natural teeth that were failing and existing bridges that were faltering, but we were able to extract his teeth, place the implants and secure his temporary bridges during one sedation visit,” Dr. Brown observes.

Implants are screw-like posts made of a titanium alloy that are placed in the jaw, where they fuse with the jaw bone. Once the fusion process is complete, the implant can function as a solid foundation for the restorations that will replace the missing teeth. Restorations can be anything from a crown for a single missing tooth, a bridge to replace multiple teeth or dentures to replace all the teeth.

“My overall experience at Implant Dentistry of Florida was great. With Dr. Brown, I had no fear at all.”  – Riccardo

“The dental implants must integrate with the bone,” Dr. Brown confirms. “It is a process called osseointegration, and that is when the bone actually grows and fuses to the implant. We can often secure temporary fixed bridges on the day of implant surgery when the entire arch of teeth is being replaced since they will all be attached to the same bridge that helps the implants support each other.

“There are several reasons why we might not install the final bridges on the same day. The main reason is that the bone and gums remodel during the healing process. It becomes more difficult to get the final bridges to look and fit perfectly if we do not wait for this remodeling to occur.”

During the implant surgery, Dr. Brown placed six implants in Riccardo’s upper arch and four on the bottom arch. Two of the implants placed in the upper arch were implanted at an angle, not straight up and down. Dr. Brown says this isn’t unusual when creating a full-arch bridge.

“Typically, posterior implants are put in at an angle when they will be securing a restoration that is fixed in place, meaning it is not removable except by a dentist,” Dr. Brown explains. “Angled implants give fixed bridges the most support with the fewest number of implants and support the bridges evenly from front to back.”

In opting to have multiple teeth extracted and multiple dental implants placed on the same day, Riccardo also elected to use intravenous conscious sedation to make the process easier and more comfortable. The IV conscious sedation allowed Dr. Brown to work without interruption because Riccardo was not anxious or agitated and experienced no discomfort.

“IV conscious sedation puts patients in a very relaxed state,” Dr. Brown describes. “While in that state, patients do not mind what is going on with treatment. They also have little memory of what occurred during the procedure after it is completed.

“With IV conscious sedation, patients are still breathing on their own. All their protective reflexes remain intact, and they are able to move and respond if we ask them to, so it is a very safe level of
sedation. We also use local anesthetic to numb the surgical areas after the sedation is in place, so they do not feel any discomfort.”

Enthusiastic Endorsement

Photo by Nerissa Johnson.

Riccardo Billi

Once implants are placed, they typically need between three and six months to heal and fuse with the bone before the abutments and final restorations can be placed on top of them. In Riccardo’s case, only three months were needed before Dr. Brown could create and insert his final bridges.

“Now, I have my permanent bridges, and I love them,” Riccardo raves. “They look great. They look very natural, and I have no problems chewing with them.”

Riccardo can eat most anything he wants because his bridges are fixed in place. Secured by dental implants, fixed bridges offer strong chewing power, and they don’t slip or move when people eat, like a denture would. They stay in place.

“My bridges are screwed in tight,” Riccardo says. “I can’t remove them. Dr. Brown has to do that. Once a year, I go to Dr. Brown’s office and have them removed so his staff can clean them. They clean everything underneath as well.”

In addition to reconstructing Riccardo’s smile, Dr. Brown also alleviated Riccardo’s misgivings about dentists. The retired property owner is now a regular patient at Implant Dentistry of Florida. Riccardo fervently endorses Dr. Brown and his practice.

“My overall experience at Implant Dentistry of Florida was great,” he enthuses. “With Dr. Brown, I had no fear at all. I was a little anxious before the implant surgery, but he told me what to expect, so it wasn’t that bad.

“I have no complaints at all about Dr. Brown and his staff at Implant Dentistry of Florida. Dr. Brown is genuinely a nice guy. He’s a gentleman and very pleasant to be around. He was very gentle and made me feel comfortable. I definitely recommend him.”

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    • Implant Dentistry of Florida

      Dr. Clark Brown and his team at Implant Dentistry of Florida are committed to providing you with excellent dental care in a warm, comfortable setting. They provide the latest techniques in implant dentistry, cosmetic dentistry and general ... Read More

    • Clark F. Brown, Jr., DDS

      Clark F. Brown, Jr., DDS, is board certified by the American Board of Oral Implantology/Implant Dentistry. He earned his undergraduate degree from the University of California, San Diego, and his Doctor of Dental Surgery degree from Geo... Read More

    • William S. Vaughn, DMD

      William S. Vaughn, DMD, earned his undergraduate degree from Kentucky Wesleyan College and his Master of Science degree in Oral Biology and Doctor of Oral Medicine degree from the University of Louisville. Dr. Vaughn has participated in c... Read More

    • Kim N. Doan, DMD

      Kim N. Doan, DMD, graduated summa cum laude with a degree in Biology from the University of North Florida and completed her Doctor of Dental Medicine degree at Nova Southeastern University in 2015. A former resident of Brevard County, Dr. Doa... Read More