WILMINGTON - MDTVNews.com - Often times one may hear Delaware's only MDTV Select Periodontist for Dental Implants, Bradford Klassman, DMD say, "So you want me to place an implant?" His question is the response he typically gives while building rapport to both his new patients as well as referring dentists. Dr Klassman is often asked to do the surgical placement of the dental implant into the jaw bone. The MDTVNews.com Dental Implant Channel in Delaware asked their Expert, Leader and Educator the importance of a team  approach in placing dental implants and what actually happens behind the scenes.....

An MDTV Medical Moment on Dental Implants

 

QUESTION-MDTVNews.com- Dr Klassman, isn't it easy for any and all dentists to place the implant?

ANSWER-Dr. Klassman- I wish it were that easy. The amount of planning that goes into Implant Dentistry is often not understood or under appreciated by some doctors and patients alike. From a patient standpoint, most of the planning goes on behind the scene.

 

QUESTION-MDTVNews.com- Can you tell us what happens apart from the Patient... behind the curtain?

ANSWER-Dr. Klassman-  Sure, I can. Communication between the surgeon and restorative dentist as well as the laboratory technician often does not involve the patient. The surgeon and restorative dentist has to decide if the implant option is appropriate for the clinical situation. The surgeon then has to decide if there is enough bone height and bone width. The surgeon also has to decide whether or not there is sufficient gum for the esthetics of the restoration. The surgeon then has to correlate all of this to the laboratory technician so that the restoration can sculpt the soft tissue to ideal form. This then provides the stage and curtain for the restorative dentist to complete the restoration.

 

QUESTION-MDTVNews.com- What is the major function of the Surgeon in the Dental Implant Process?

ANSWER-Dr. Klassman- From a surgical standpoint, the primary factor that has to be assessed is bone volume. Having sufficient volume to place an implant is not enough. The bone volume has to be present where the future tooth needs to be. This is what has been called "Top-to Bottom Treatment planning".

 

QUESTION-MDTVNews.com- What role does laboratory technician have with the surgeon?

ANSWER-Dr. Klassman- In order to determine this, the laboratory technician first creates the restoration in wax and then provides the surgeon with an acrylic stent. The stent is then used to accurately place the implant in the proper position. This then allows the surgeon to see the future tooth position and thus determine if the bone is positioned where the tooth needs to be. Often radiographs or Cat scans are also used to see the bone in 3 dimensions to definitively determine the bone volume.

 

 QUESTION-MDTVNews.com- Why is it important to have a CAT Scan and to determine the bone volume?

ANSWER-Dr. Klassman- The actual bone volume tells the surgeon if a (bone) graft is needed or not. A Cat Scan makes it definitive.

 

QUESTION-MDTVNews.com- Where is Cat Scan taken?

ANSWER-Dr. Klassman- One could go to an Imaging Center or the surgical practice can have a unit specifically designed to take pictures of the oral cavity and jaw right at the practice. A surgical practice that is greatly dedicated to placing dental implants can make having the scan very convenient and typically less expensive for a patient. It actually pays for a patient to ask.

 

QUESTION-MDTVNews.com- What is the Surgeon's role in making the tooth look natural?

ANSWER-Dr. Klassman- Teeth are not round and a round restoration ultimately looks false. The goal of the restoration is to not to be able to tell it from a natural tooth. So the shape of the soft tissue has to be created by a tooth form. This crucial step relays on communication between the surgeon and laboratory technician. The final portion of the surgical phase of implants involves the surgeon sculpting the soft tissue to ideal form. To do this, the surgeon will use a tooth shape component connected to the implant that protrudes through the soft tissue. This can either be custom made by the surgeon or implant company, or custom made by the laboratory technician. Often this is done in conjunction with a temporary restoration. The shape of the soft tissue or emergence profile allows the final restoration to have a truly natural appearance.

 

QUESTION-MDTVNews.com- What is the general or restorative dentist's role in making the tooth look natural?

ANSWER-Dr. Klassman- The final portion of the restoration involves the communication between restorative dentist and laboratory technician. The dentist has to transfer the shape of the soft tissue and position of the implant to the technician as accurately as possible. This then allows the technician to create the final prosthesis out of the best materials for long-term success. The final restorations can be made out of gold, titanium, zirconium or porcelain. The esthetics of the final restoration requires an accurate shade assessment by the dentist, technician or both.

 

QUESTION-MDTVNews.com- What is the patient's role?

ANSWER-Dr. Klassman- Choosing and hiring the right team is of utmost importance for the patient. Without the team approach, the proper prosthetic replacement of a missing tooth is not possible. Although it seems easy enough to place a screw in bone to support a tooth, as you can see,  it really becomes a multifaceted restorative process that requires total team effort for an ideal prosthetic outcome.