Baltimore Subperiosteal Implant Solution
Dental Implants for Deficient JawbonePatients who have been denture wearers for an extended time can experience bone loss in the upper or lower jaws just from wear and tear issues.
Maxillary bone density (upper jaw) characteristics are significantly different from the lower jaw in most individuals. Upper jaw bone tends to be more porous.
With no teeth in the maxilla (upper jaw), the bone internal to the ridge tends to be lost over time. The porosity gets so great that implants have no internal bone in which to hold. Though the ridge may look sufficient from the outer surface, an x-ray may show total lack of bone density. Many times even repeated attempts at bone grafting prove unsuccessful.
Subperiosteal ImplantsDentists and oral surgeons who have access to and, perhaps more importantly, experience in subperiosteal surgeries, offer this implant device as a viable solution for patients who lack sufficient bone for traditional implants.
Because the need and popularity of subperiosteal implants is low (patient need) most implantologists (general dentists) and many oral surgery specialists and periodontists may not have accumulated enough opportunities to accumulate a good solid history of successful treatments.
Dr. Leventhal received training in subperiosteal implant placement from Dr. David Naisbit who successfully placed about 1000 subs during his career spanning 40 years. Patients unable to successfully wear a maxillary denture who lack bone density for root form implants find great comfort in maxillary subperiosteal implants.
Custom Formed FrameworkTitanium, the same metal used to make standard root form implants, is used to construct the implant framework. Molds of the upper jaw bone are created by exposing the bone and taking an impression. A second method using a Catscan 3 Dimensional xray has been determined by some doctors to produce an inferior fitting framework. The implant posts for the patient pictured here are a part of the framework.
The adjacent photo of a custom subperiosteal implant is used for illustration only.... demonstrating how the framework is molded over a stone model created from the impression molds taken of the maxillary ridge.
Notice the snug fit around the entire ridge. The implant posts sit on the very top of the bone.
Grafting products are added to the surgery site to completely fill any space between the framework and the patient's jawbone. The titanium framework will fully integrate into the maxillary bone
Technical data generated from his diagnostic studies and xrays indicated a 4 implant post device as being the ideal configuration for distributing the physical and biting forces across the entire jaw.
Implant Posts Centered on Boney RidgeAs can be seen from the two framework photos, our patient's upper arch is wider yet the framework is molded tightly around his existing bone to provide a stable, snug fit.
The next photo shows the gingiva pulled away from the actual boney ridge, with the implant framework in place. The implant posts are firmly centered on the bone.
Grafting material is packed around the entire framework and in locations where bone augmentation is needed the most.
Health Considerations for HealingMaintaining healthy blood supply in the surgery areas is an important key element for healing to take place normally. Cigarette smokers should or must cease smoking if healing and tissue regeneration is to be optimized.
Patients who are diabetic may have special medical considerations, depending upon their diabetes treatment histories.
Healthy Surgery ExampleOur last photo, was taken immediately post operatively.
Restorative Planning: Choices and OptionsThe process of deciding which teeth replacement options is usually underway at this point. Assessments for recreating a normalized bite height, or vertical dimension have been made.
Cosmetic options provide the patient the opportunity to select sizing, coloration, shading, choice of acrylic versus porcelain teeth and styling the smile line, the LVI Rule of Golden Proportions that uses a mathematical model for creating the perfect smile.
Questions about Subperiosteal Implants?Contact us at (410) 256-7300 to arrange an evaluation to learn more about the subperiosteal alternative to having no teeth due to bone loss or bone quality issues.
Persons with specific questions about the material on this page or other implant technologies and products can contact Dr. Leventhal directly with our on-line Ask The Dentist form. Dr. Leventhal will respond to your questions personally.