Braces, Implants And A Soaring Smile

JORDAN PYSZ / iFoundMyDoctor.com
Myles was born with hypodontia, a congenital absense of teeth. In his case, he lacked lateral incisors, but the condition was corrected by Dr. Leong through bone grafts and the placement of dental implants.

A lot of young pilots dream of flying fighter jets, engaging in simulated dogfights and performing the maneuvers depicted in the immensely popular Top Gun movies.

Not Myles Jenkins.

Though the glory of the skies often goes to the “Maverick,” “Goose” and “Iceman” of the flying fraternity, there’s a lot of grunt work to do, and Myles says he will be more than happy to do it.

“I want to fly the big cargo planes, the C-17s,” says Myles, 21. “My father was a load master on one of those big planes, which means he was responsible for loading the fuselage with things like tanks and helicopters. He’s my inspiration.”

Currently a student at Eastern Florida State College, Myles says he will soon transfer to the University of Central Florida, where he intends to study aerospace engineering. Following graduation, he plans to commission to the Air Force.

“I’m hoping that somewhere in the next four years I’ll be flying,” Myles says. “In the meantime, I’m working my way through school by working part time at the Kennedy Space Center, where I’m considered a support specialist.

“I help with all the processes of getting people and tools in and out of certain locations where the rockets are put together. I also help with the movement of the rockets and do a bunch of other stuff.”

Myles is doing all of that with a smile wider than he’s ever shown before thanks to a procedure he had to correct hypodontia, a congenital absense of teeth that do not develop naturally. In Myles case, he lacked lateral incisors, the teeth on either side of the two front teeth, or central incisors.

“My dad and my grandfather dealt with the same issue,” Myles explains. “And other than occasionally having something like a potato chip jab you in the gums where I didn’t have those two teeth, it didn’t really cause me any problems.

“As a kid, though, I got teased a lot. For the most part, I just laughed that off, but as you get older you start to realize that in a professional setting you’re not presenting your best self if you’re missing teeth, so I decided to do something about it.”

Long Way Home

The path to correcting hypodontia can be short if the patient opts for a bridge that fills the empty spaces with false teeth or veneers that simply hide the spaces. But Myles wanted a permanent solution, and that takes time because it starts with the patient being fit with braces.

The objective of the braces is to create enough space for new teeth to be placed in the gaps where the lateral incisors never came in. Myles was fit with braces four years ago, and last spring he began a two-month search for a dentist to provide the replacement teeth.

Myles met with several dentists to discuss their approach to providing two new lateral incisors. In the end, he entrusted that task to Richard Leong Jr., DDS, PA.

Dr. Leong met Myles last June. By then, the braces were just about ready to come off because they had created the spaces necessary for Myles to be fit with replacement teeth. All that remained was for Myles to decide how he wanted that done. Dr. Leong presented three options during his initial consultation.

The first would have resulted in Myles receiving a flipper, a partial denture that consists of a pink plastic base and two false teeth. The second involved a bridge with two false teeth. The third, which Myles chose, called for dental implants, which are screw-like bodies that serve as the foundation for replacement teeth.

This was also the option that Dr. Leong recommended because the flipper does not allow the false teeth to function like real teeth and the bridge required a procedure that would have ruined what Dr. Leong referred to as “two perfectly good teeth.”

“Myles has perfect teeth, and to do the bridge, we would have had to grind down the two teeth that bridge would attach to and place crowns on them,” the doctor explains. “I didn’t want to do that, so I strongly recommended the option calling for dental implants, and Myles agreed.”

Dr. Leong explained to Myles’ that the process for his dental implants would take several months because a bone graft would be required.

A bone graft is designed to enhance the volume of the jawbone so that it can properly support an implant, and it is often necessary for patients who have been missing teeth for an extended period.

“When someone has been missing teeth, there is no pressure from chewing to stimulate bone growth in the jawbone,” Dr. Leong explains. “That’s why the bone deteriorates and why bone grafting is sometimes necessary.

“In Myles case, he never had any teeth at all in the spaces where we were going to place the implants, and I could see just by looking at him that he did not have enough bone to support the implants. But, just to be sure, I did a CT scan to confirm that.”

The CT scan revealed that Myles had what Dr. Leong referred to as a “very thin shelf of bone.” To prepare for the implant, the doctor would have to create a small opening or “window” in the jawbone through which grafting material could later be placed.

In November, Dr. Leong performed the first procedure, where he prepared the bone for the graft.

“I manipulated the bone to get it ready for the second procedure, in which I would actually split the bone and perform the bone graft,” the doctor details.

The gum tissue was kept intact to ensure that blood flow to the bone was maintained from all directions.

Saving Time

To further enhance the creation of a solid foundation for the implants, Dr. Leong mixed the graft material, which can be real or synthetic bone, with platelet rich fibrin (PRF), a blood product high in growth factors.

The blood is obtained through a typical draw from the patient’s arm. In an office procedure, the blood is then spun in a centrifuge to separate the PRF.

When mixed with graft material, PRF helps bone grow faster and stronger, and in Myles case, that critical step allowed him to shave three months off the wait for the implants to heal.

“During the same visit in which I placed the bone graft material and PRF, I also placed the implants, which are specialized implants,” Dr. Leong reports. “They’re smaller and thinner than what we normally use because we had less bone than normal to work with.”

Once they’re secure in the bone, dental implants are then fit with an abutment. The replacement teeth – in Myles case, a single crown – are then cemented or screwed onto the abutment.

That final phase of Myles’ implant process was completed in mid-March, when he was fit with the permanent crowns that were affixed to the abutments.

Myles and Dr. Leong are both pleased with the outcome.

“My teeth look and feel great,” Myles enthuses. “It’s nice to not have to hesitate whenever I want to smile, and even though it took a while to get here, it was worth it. And the implant process was probably the easiest part of it all.

“Dr. Leong did a great job, and he’s a great man. He’s really on top of everything and very organized. He’s straight to the point, and I really enjoyed the time I spent with him during this process. I’d absolutely recommend him to anyone.”