Dental Double Play

Specialized grafting procedures critical to challenging restoration.

Doris gives the staff at DeLand Implant Dentistry a “topnotch” rating.

Tired of being left alone at home for three or four days a week, Doris Ford took up golf some 15 years ago mostly in an effort to spend more time with her husband and the many friends who would steal him away for a relaxing day on the links.

“It seemed like everybody who came to visit us played golf, and I used to just meet them all for lunch,” Doris remembers. “Then one day, I finally said, Enough. I’m going to learn to play golf, too. It was a struggle at first, but I learned, and I couldn’t be happier.

“The thing I love the most about golf is the people you meet and play with. I’m lucky that I play two or three times a week with some of the most fabulous gals. They’re all so wonderful and nice. I’m very grateful for that.”

A former medical technologist, Doris, 70, is also grateful that she and her husband moved to Florida some 20 years ago. It was here in Florida, after all, that she was able to resolve her concerns about a longstanding dental issue.

“My teeth were always very soft, and they’d crumble, so I had no choice but to get false teeth much earlier than most people do,” she says. “And don’t get me wrong – my dentures looked great. But they weren’t my own teeth, and that always bothered me.

“Another thing that bothered me about them was that I was afraid that if I ever wound up in a nursing home or something like that, someone might lose them. I guess I’m too vain, but I would be mortified if something like that ever happened.”

Doris’ fears prompted an investigation into possible alternatives. The one that intrigued her the most was a fixed denture supported by dental implants, which are screw-like posts that are surgically placed into the jawbone.

After an implant is seated in the jaw, bone naturally grows around it to create a solid foundation for replacement teeth. A single implant supports an abutment and crown for a single tooth, while two or more implants can support a fixed bridge or a full denture.

Once she decided that implant-supported dentures would best replace her traditional dentures, Doris visited several dentists before choosing her husband’s dentist, Rajiv Patel, BDS, MDS, of DeLand Implant Dentistry, to perform the restoration.

Spectacular Solutions

During her initial consultation with Dr. Patel, Doris learned from a CT scan that she lacked the amount of bone necessary to support implants, particularly in her upper arch. She was pleased to learn, though, that Dr. Patel has a solution for that problem.

“When a person has been without teeth for a long period of time, as Doris was, the bone in the jaw deteriorates from lack of function,” Dr. Patel educates. “The good news is, we can correct those deficiencies by doing a bone graft.

“With Doris, though, a simple bone graft would not do. Because her teeth had been missing for so long, she had suffered a pneumatization of the sinuses, where a hollow area develops in the sinus floor.

“To correct that problem, we had to perform a special procedure that we call a bilateral sinus graft to reclaim the sinus floor before fitting any implants.”

The procedure for reclaiming the sinus floor is an intricate one that starts with the creation of a small window in the upper arch. During that process, the residual bone from the upper arch is collected and briefly stored.

“I could not be happier with the results. It’s like I have real teeth again, and that is wonderful, absolutely wonderful.” – Doris

The residual bone is then mixed with a bone substitute material that is placed into the sinus through the window created in the upper arch. The mixture of residual bone and bone substitute material sparks the growth of new bone in the sinus.

“It is a very delicate surgery,” Dr. Patel informs, “but when performed by an experienced hand, it is a very successful surgery. We have a one hundred percent success rate with that surgery in terms of creating the bone necessary to place implants.”

Dr. Patel maintained that high success rate with Doris, who agreed to the surgery and had the bilateral sinus graft done in January 2018. Meanwhile, fitting Doris with implants for her lower arch presented a completely different challenge for Dr. Patel.

When Doris came to me, she was wearing lower partial dentures on both sides, but there was some bone deficiency there as well,” he says. “To correct that, we did what we call a vascularized ridge-split procedure to widen the bone so we could seat the implants.”

Doris was missing the molars and bicuspids on each side of her lower arch, so Dr. Patel had to perform the three-stage vascularized ridge-split procedure twice to create the environment where she had the bone necessary to secure implants.

During the first step in that process, the soft tissue is enhanced through a grafting procedure. Then, the area where the split will eventually be made is designated. Finally, the split itself is made where the bone will be widened to allow for placement of the implants.

The healing period for this remarkably pain-free procedure is about six weeks, according to Dr. Patel. During those six weeks, the vascularity of the bone is reestablished, which allows for greater security of the implant and the crown, bridge or denture it supports.

The final stage of the implant process is the placement of the abutment and crown. Some dentists require patients to visit specialists for all or parts of the implant process, but Dr. Patel performs all phases of that process in one office.

“A Cut Above the Rest”

“He does it all and has all of this state-of-the-art equipment to do it, which is one of the reasons why I chose him,” Doris says of Dr. Patel. “When I looked at all the dentists, he just seemed a cut above the rest because he was so explicit in his explanation of everything.

“During our consultation, he told me everything he was going to need to do in great detail. He even wrote it all out for me and told me where the cadaver bone was coming from for the bone grafts. I was really impressed with his attention to detail.

“I could not be happier with the results. It’s like I have real teeth again, and that is wonderful, absolutely wonderful. Dr. Patel even bleached the eight healthy teeth I still have on the bottom so that they match the teeth in the dentures.

“I was a bit concerned about that, but he took care of that, and he did an excellent job. I really can’t say enough about him or the staff. Everybody there is so professional and nice. I recommend them to anybody. They’re topnotch.”

Print This Article
    • Deland Implant Dentistry

      Rajiv Patel BDS, MDS, has practiced general dentistry in Deland, Florida for more than 26 years. He strives to deliver the most advanced, personalized, comprehensive and professional dental care to his patients while building relationships b... Read More

    • Rajiv Patel, BDS, MDS

      Rajiv Patel, BDS, MDS, has practiced general dentistry in DeLand for more than 25 years. He is a Diplomate of the American Board of Oral Implantology/Implant Dentistry, and Fellow of the American Academy of Implant Dentistry. With hundreds of h... Read More