Replacement Plan

Techniques restore proper chewing function.

Harold Manney, 44, was born and raised in a tiny town in upstate New York. He says it was a great place to grow up, but he didn’t want to stay there his entire life. He yearned to see different places and live someplace warm, so 26 years ago, he packed up and moved to Florida.

Photo by Nerissa Johnson.

Harold Manney

For 21 years, Harold plied his trade as a plumber. But the job took a toll on his back, knees, elbows and fingers, so two and a half years ago, he switched careers and became a truck driver. Driving a rig across the country gave Harold the opportunity to visit many diverse locales.

“I’ve been to every state in the country except Alaska and Hawaii,” Harold relates. “I don’t really have a favorite place to drive through, but I like the Pacific Northwest. It’s especially nice in the summertime. It’s not quite as nice in the wintertime, but it’s still pretty. I just like it out there. Oregon, Idaho, the entire area is nice.”

Back home in Florida, Harold and his wife eventually settled in DeBary, where they recently needed to find a local dentist. Harold heard that Parvez Baig, DMD, and Richard C. Montz, DDS, of River City Dentistry, had excellent reputations in the community. He chose River City Dentistry to manage his dental health needs. The dentists discovered a serious problem on Harold’s first visit.

“I went in for a cleaning, and I had a couple of teeth that had root canals many years ago that were failing,” Harold describes. “They were my last two molars. Dr. Montz also found a cyst growing in my lower jaw on the right side.

“I was actually experiencing physical symptoms. I was feeling tired and sick. Dr. Montz said nothing about an infection. He was surprised that I was having symptoms with a cyst. But the day he removed it, I felt amazing. It completely changed everything.”

The molar affected by the cyst also had to be removed, as did a failing molar on the left side of Harold’s mouth.

Dr. Montz recommended dental implants to replace both of the missing teeth, but for the molar undermined by the cyst, that was not possible.

“Dr. Montz told me it was a very large cyst, and it ate away sixty to seventy percent of the bone in the right side of my jaw, so there wasn’t enough bone to hold a dental implant,” Harold recalls. “They tried to do a bone graft, but the bone never came back enough to support an implant.

“We decided it was fine not to have an implant on the right side as long as I had the left side to chew on. The tooth on the left side had been crowned for twelve or thirteen years, so when it finally failed, we were still able to put an implant there, which is what we did.”

Chewing in Mind

After Harold received the dental implant on the left side of his mouth, Dr. Baig and Dr. Montz placed the permanent crown restoration over the top as a replacement tooth. They also created an occlusal guard, or mouth guard, to protect Harold’s teeth and bite.

Dr. Baig explains that it’s important to protect Harold’s implant tooth, as well his other posterior teeth, because they handle the bulk of the chewing. The dentist reveals that Harold’s entire treatment plan was designed with chewing in mind.

“It is always my goal to restore patients to their normal chewing function, so the plan was to restore Harold’s occlusion, which is the relationship between his teeth, to a point where he has a complete biting and chewing surface in the back of his mouth,” Dr. Baig informs. “That way, he can use that biting surface in the back and not damage his front teeth by using them to chew.”

Dr. Baig was able to restore chewing function on Harold’s left side using a dental implant, but the inability to develop enough bone through a grafting procedure to use an implant on the failed right molar forced Dr. Baig to find another option for the restoration of that tooth.

“Although dental implants are the ideal way to restore missing teeth and chewing function, there are instances when implants are not the treatment of choice,” Dr. Baig discloses. “One of those instances is when there is not enough bone structure to support an implant, which is true in Harold’s case.

“An alternative in those instances is a fixed bridge. Once the right side of Harold’s mouth heals from the cyst, we will determine whether a fixed bridge is the best option for restoring chewing function on that side of his mouth.”

Long-Term Success

In the past, Dr. Baig performed only restorative work on dental implants. But in June, he completed a unique course on implant placement at Augusta University in Georgia. It was a maxi-course designed to help dentists become more proficient at implant placement surgery.

“The maxi-course was an opportunity for me to spend time with the medical school’s residents successfully placing implants,” Dr. Baig describes. “So, I recently started offering dental implant placement at River City Dentistry.”

When Dr. Baig is surgically placing dental implants, his focus is on the restorative properties of the implants. He plans ahead for what comes next, notably the crowns over the implants and their role in chewing.

“My dental implant is absolutely perfect. I’ve had no issues with it at all. And the crown hasn’t fallen off or cracked or been a problem. It’s really been good as well.” – Harold

“The goal of placing implants is to replace missing teeth and restore the patient’s biting surface,” Dr. Baig asserts. “Focusing on the restorative aspects of an implant procedure leads to long-term success of the implant.”

Crowns are another restorative service offered by River City Dentistry. In addition to serving as replacement teeth over implants, crowns are often used over teeth that have been treated with root canals. They may also be used for teeth that have cracks that have not progressed beyond the gumline.

Another service offered at River City Dentistry is Invisalign® invisible aligners for straightening teeth and restoring smiles. While in private practice, Dr. Baig was a preferred provider for Invisalign, so he has expertise in the modality.

“Tooth alignment is essential for good periodontal health, not just for the aesthetics of a good smile,” Dr. Baig observes. “When the teeth are straight and located where they should be, they are easier to clean. In addition, any restorations put on the teeth yield better results when the teeth are aligned.”

Photo by Nerissa Johnson.

“Everybody at River City Dentistry is absolutely awesome.
They always take care of me.” – Harold

Perfectly Awesome

The dental implant placed in the left side of Harold’s mouth restored full chewing function on that side. He is very happy with the outcome of the restoration process.

“My dental implant is absolutely perfect,” Harold raves. “I’ve had no issues with it at all. And the crown hasn’t fallen off or cracked or been a problem. It’s really been good as well.

“Nothing has been done on the side where they removed my cyst, but they check it every six months when I have my cleanings to make sure it isn’t growing back.

“So far, everything has been fine. The bone in my right side isn’t as solid as it used to be, but it’s fine as well.”

What Harold finds consistently solid is the positive attitude that underlies his visits to River City Dentistry. He is extremely pleased with the caring treatment he receives from Dr. Baig, Dr. Montz and their staff.

“Everybody at River City Dentistry is absolutely awesome,” Harold enthuses. “They always take care of me. As a truck driver, my schedule is crazy, and sometimes, I can only give them a day’s notice, but they fit me in. They always work with me and are nice to me.

“I came from a town where the doctor knew everybody and took care of my siblings and parents. When I came to Florida, I basically became a number. But I’m happy with the way I’m treated at River City Dentistry. They’ve got that small-town feel. They’re really good at what they do, and they treat me like family.”

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    • River City Dentistry

      River City Dentistry focuses on their patients' overall experience. They strive for excellence in every aspect of patient care. They do this by maintaining the latest technologies, working convenient hours, and by implementing a comfo... Read More

    • Parvez Baig, DMD, MPH

      Parvez Baig, DMD, MPH, completed his undergraduate studies at an undergraduate dental school in his native India, where he also completed a year of residency. He then earned a Master’s degree in Public Health at Wichita State University in Kans... Read More

    • Richard C. Montz, DDS

      Richard C. Montz, DDS, completed his undergraduate studies at Bowling Green State University, OH, and earned his degree in dental surgery from Ohio State University. Dr. Montz served as a dental officer in the US NAVY DENTAL CORPS from 1985 u... Read More