Dental Implants – Periodontal and Peri-Implant Treatment with Expert Bhavin Pitamber
For Patients in Hindhead, Haslemere, Grayshott, Liphook and Surrounding Areas
Bhavin Pitamber’s unique approach to dental implants, Periodontal and Peri-Implant treatment, is unlike any other.
Bhavin’s treatment provides phenominal healing and minimises the potential for any post operative pain or discomfort. His cutting edge PRF technique really is “Science fiction becomes science fact.”
Bhavin Pitamber [GDC 78285], our resident expert, graduated in 2000 from the University of the Witwatersrand in Johannesburg, with awards in General Medicine, General Surgery and Operative Dentistry. He has a keen interest in surgical dentistry and periodontology, which is the cornerstone of implant dentistry. In 2007, he embarked on formal postgraduate studies, which culminated in the award, MSc in Clinical Periodontology.
Further training has been undertaken in the USA, Germany, Switzerland, Austria, France and Belgium. A significant proportion of his year is still allocated to education internationally.
His clinical expertise includes the diagnosis and treatment of periodontal and peri-implant diseases. His special interests lie in plastic periodontal and peri-implant surgery such as the treatment of gum recession, and in regenerative periodontal treatments. Growth factors and advanced biomaterials are routinely used to optimise the outcomes of such treatments. Implant dentistry including advanced bone and sinus augmentation procedures are a significant element of his daily practice. He is also actively involved in mentoring dentists regarding implant treatment and advanced grafting techniques.
Bhavin’s philosophy of care is to always have the patients’ best long-term interests at heart, to work closely with his colleagues and to never stop learning. His family and friends are his moral compass and inspires him to deliver care in a compassionate, dignified and ethical manner.
Bhavin is an active member of the American Academy of Periodontology, European Federation of Periodontology and the Association of Dental Implantology.
Teeth transmit chewing forces to the jaw. This maintains the health of the bone and keeps the jaw in shape. If one or more teeth are lost, these forces cease, and the bone may slowly recede. This will cause the shape of the face to change over time.
Dental implants can help prevent gradual bone deterioration as they mirror the action of the original root, transmitting chewing forces to the jaw bone in a natural way. This is not the case with conventional methods such as bridges or partial prosthesis.
Benefits of implants:
- Look natural
- Maintains the health and appearance of the jaw bone
- Comfortable and stable
- Tested and proven treatment over many years and millions of patients
- More cost-effective in the long term than conventional bridge
Why not have a bridge?
With conventional methods, the two healthy neighbouring teeth have to be ground down to fix a bridge in place. This results in a loss of natural tooth surface. Furthermore, the bridge does not transmit chewing forces to the jaw bone, so bone deterioration may also occur.
The dental implant replaces the root of the original tooth, while the healthy neighbouring teeth remain intact without having to be ground down.
Even the best prosthesis will always be a foreign body that requires extensive care. By contrast, a dental implant is simply an artificial root, which on healing, merges with the body and acts likes a natural one.
Functionality and visual appearance go together. An implant-borne restoration looks like a natural tooth – there is no visible difference, and no special care required.
- A 1 hour appointment with an expert who will go over your medical history, examine your mouth and assess the need for conventional X-rays or a further scan.
- Treatment options are then discussed, and a detailed explanation of the procedures involved and timelines is given using video imaging and tooth models.
After the X-ray/ scan reports are finalised, a detailed written treatment plan is provided outlining costs and appointment schedules. The cost of dental implant treatment varies and is related to the number of implants required, the need for bone grafting and whether gum tissue reconstruction is required. Other factors include the surgery itself, laboratory work, the prosthesis and the dentist’s and dental technician’s fees.
A cost plan will be developed only when all these aspects have been addressed, and in many cases, dental implants may be more economical in the long term.
Once you are happy with your chosen treatment option and signed all your consent forms – you will be provided with a surgery date.
Simple Implant Placement
A dental implant is a small but strong post made from titanium or ceramics. Under local anaesthetic, it is inserted into the jaw bone in place of the missing tooth root and acts as a support for the tooth.
The healing phase is between 6 and 12 weeks depending on the individual medical situation. During this period the implant becomes securely attached to the jaw bone. Once healed, this artificial root acts as a base for fixing individual crowns, multi-tooth bridges, or an entire dental prosthesis.
Titanium (commercially pure) is a biocompatible metal, non-toxic and well-tolerated by the body. Its many medical uses include surgical implements and implants, where high strength and low weight are preferred.
One of its most important medical applications is in implants. Those made from titanium have been shown to bond very well to living bone and can last for decades.
Sometimes when teeth are lost, the surrounding bone may also deteriorate. If this happens and implants are to be placed, then one solution is to build back the bone.
There are a variety of methods based on individual needs when it comes to bone augmentation, and your expert will explain in detail should this affect you. The standard procedure of simultaneous bone augmentation and implant placement is possible in most cases.
Occasionally augmentation needs to happen prior to the implant treatment, with a healing time of up to six months before implant placement.
The bone augmentation procedure allows bone to regrow where there is currently a lack of volume in the area around the implant. This enhances the appearance of the implant crown where it meets the gum line and helps provide the support needed for the implant.
Sinus Grafting and Sinus Lifts
The following problems can successfully be addressed by sinus grafting:
- Insufficient bone mass as a result of tooth extractions;
- Bone loss in the area due to periodontal or gum disease complications
- Complicated anatomy of a patient’s jaw area (difficulty in dental implants placement).
A sinus grafting procedure is necessary in cases when the patient has a very thin sinus wall, making it almost impossible to place dental implants in the area. Also called a sinus lift, sinus grafting involves the surgical addition (or augmentation) of bone into the upper jaw’s maxillary sinus, especially in the area where the molars and the premolars are located.
The expert will need to move or lift the sinus membrane upwards, so that a space can be created; this space is where the additional bone will surgically be placed. The goal of sinus grafting is to add bone mass to the sinus area, so this particular area can then provide firm support to the dental implants that the patient needs.
To regenerate enough bone for successful implant placement, Guided Bone Regeneration is often required. There are two approaches in implant therapy;
- At implant placement (simultaneous approach)
- Before implant placement to improve the bone (staged approach).
When carrying out this surgical procedure Bhavin uses PRF with or without particulate bone grafts or/and bone substitutes. Platelet-rich fibrin (PRF) is a concentrate of platelet rich plasma protein derived from the patients blood and then centrifuged to remove red blood cells. PRF is a powerful healing biomaterial with inherent regenerative capacity and can be used in various procedures such as for the treatment of periodontal disease and implant surgery.
Bhavin uses the PRF process in all implant and sinus grafting cases to significantly improve healing.
Periodontal disease is defined as a complex, multifactorial disease characterized by the loss of connective tissue attachment with destruction of periodontal tissues. The aim of periodontal therapy is to eliminate inflammatory process, prevent the progression of periodontal disease and also to regenerate the lost periodontal tissues.
Platelet-rich fibrin is used as a therapeutic tool to improve tissue repair particularly in periodontal wound healing.
Another recent development in periodontal treatment is the use of lasers to regenerate soft and hard tissue in a minimally invasive manner with minimal discomfort. The therapy does not involve scalpels or sutures. This technology is available on both teeth and dental implants.
A frenum is a naturally occurring muscle attachment, normally seen between the upper and lower front teeth and connecting with the inner aspect of the lip.
An excessively large frenum can prevent the teeth from coming together resulting in a gap between the front teeth.
If the gingiva is thin the frenum could exaggerate the pull on the gum margin resulting in recession.
A frenectomy is simply the surgical removal of a frenum, usually carried out using lasers.
When Orthodontic treatment is planned or initiated, a frenectomy with or without a gingival graft, can increase stability and improve success of the final orthodontic result.
Treatments for recession
A “long-in-the-tooth” appearance, results from the recession of the gum margin away from the ‘crown’ of the tooth, which exposes the root surface.
We have effective treatments for receding gums with minimally invasive corrective gum repositioning.
Over or incorrect brushing is one cause of recession, but this can also occur because of an unfavourable position of the tooth root within the jawbone. Recession may also be a result of active gum disease.
Correcting the recession by repositioning or grafting gum over the exposed root surface will reduce sensitivity and protect the root surface, and also improve the appearance if the tooth and exposed root is visible. There are a number of techniques to correct recession; treatment is very much dependant on the severity of the problem and the thickness of the nearby gum tissues – thick gums are less prone to recession.
During the dental crown lengthening procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile.
Your dentist or periodontal expert may also recommend dental crown lengthening to make a restorative or cosmetic dental procedure possible. Perhaps your tooth is decayed, broken below the gum line, or has insufficient tooth structure for a restoration, such as a crown or bridge. Crown lengthening adjusts the gum and bone level to expose more of the tooth so it can be restored.
Other special services
Pigmented gingivae treatments and Mucocele removal
What are the risks?
Implant therapy is not an experimental approach; rather it is a well-proven, state-of-the-art medical dental technique that has been scientifically tested and used for decades by dentists and surgeons worldwide.
Depending on the condition of each patient, potential risk factors may vary. Bad oral hygiene or limited healing of the wound due to pre-existing medical conditions may reduce the odds of the implant remaining in place.
Since every surgical procedure carries potential risks, your dentist will evaluate whether dental implants are the option for you.
Is the surgery painful?
Dental implants are generally inserted under local anaesthetic to help minimize discomfort. If you experience any doubts about the condition of the implant site after the procedure, please make sure to consult with your dentist. In some cases, IV sedation may be advised.
Is there any age limit for implant therapy?
It is possible to insert implants as soon as the jaw has stopped growing. Therefore, in young patients, dental implants can only be placed after their jaw bones are fully developed. At the other end of the spectrum, there is no upper age limit, given of course that the patient does not display any significant medical risk factors. This will be evaluated by the dentist.
How do I know I won’t be allergic to titanium?
Titanium is a biocompatible metal. This means it is non-toxic and well-tolerated by the body. Implants made from titanium bond very well to living bone and have been used for decades in the medical device industry. To this day, there has been no documented case of any allergic reaction to titanium. Because of these attributes, titanium dental implants can last for decades.
Is there an alternative to titanium?
If you are looking for a metal-free alternative, there is an option with the Straumann® PURE Ceramic Implant. This is made from high-strength ceramic and designed to achieve maximum functional and aesthetic demands. In cases of thin or recessed gums, the implant will not shimmer through as it has the colour of a natural tooth.
Why choose 5 Dental?
Implantology is a special field that requires expertise in both hard and soft tissue – bone and gums. The UK is unusual in using periodontal experts who combine this expertise. In most other countries, oral surgeons are usually used who may have excellent knowledge of the bone but are not specialised in gum manipulation.
Our consultant, Bhavin, is a periodontal expert. He can manipulate the bone to ensure that the implant is in the correct position for new crown but that the gum around it can be shaped to give the most natural and aesthetic appearance as well as making the implant easy to clean ensuring long term success.
At 5 Dental, we pride ourselves on ensuring that the team work together to ensure the most seamless and comfortable patient journey possible. We understand that dental treatment can be stressful to many and do everything we can to minimise that stress – from initial consultation to patient aftercare and involving everyone from receptionist to consultant. It is why we were voted Best Team in the 2017 Private Dentistry Awards.
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