Mike Wiegenstein: Graduated from school.
Joseph D’Angelo: Well, its just like anything else Mike. If you want something to be done that’s as technically and artistically demanding is veneers I would want to have somebody has done lot of them because overtime they are going to get -- is going to work.
Mike Wiegenstein: We have to take another quick break. When we come back I want to talk about implants, single tooth implant you talked to me before about when it’s the time to put an implant and right when you take your tooth out and also about securing dentures with implants. You are watching Medical News Network, we will be right back.
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Mike Wiegenstein: Welcome back, in studio we have Dr. Joe D’Angelo and we are discussing easy and convenient ways of obtaining a more confident smile. We were talking about veneers and what is the most challenging part of cosmetic dentistry for you?
Joseph D’Angelo: Some of the most challenging cases of those we have to fix a single front tooth and try to get --
Mike Wiegenstein: So, you don’t do anything with other teeth, you have one tooth missing, you are going to change that one.
Joseph D’Angelo: Sometimes everything looks fine except for one tooth got a problem, you don’t really want to touch the other ones, you just got to make that one match, alright, single front tooth has its mirror image right now.
Mike Wiegenstein: I know you brought along pictures, so lets take a look at the image. I see this gentleman, I see the great line around his tooth, is that the tooth that we are having problem.
Joseph D’Angelo: This gentleman came in knowing he had a problem with the tooth and the obvious problem is the great line at the top and the crown doesn’t really mess the one next to it.
Mike Wiegenstein: So, you have got to take the tooth out.
Joseph D’Angelo: In this case actually, the tooth had come out. We needed to fraction and it was fraction in such a way that made it not as terrible.
Mike Wiegenstein: Okay, so you taken out and that you placed an implant right, what is an implant?
Joseph D’Angelo: Well, implant is a titanium root replacement.
Mike Wiegenstein: Okay.
Joseph D’Angelo: This is very large.
Mike Wiegenstein: So what happens with that?
Joseph D’Angelo: So, this goes inside where the root used to be.
Mike Wiegenstein: Alright.
Joseph D’Angelo: Okay, on top of the implant we may attachment some abutment, which gets screwed down into the implant and some say hard.
Mike Wiegenstein: So, if we look at the next picture this gentleman, a part of it is screwed in and the abutment is that we see sticking out there.
Joseph D’Angelo: That right there is actually a temporary abutment, not the permanent abutment. It’s a temporary abutment. This implant just went a moment ago before this picture is taken.
Mike Wiegenstein: Okay, and now when he leaves what we have it will there be a temporary tooth in there, just out of curiosity.
Joseph D’Angelo: When he leaves he will walk right with temporary tooth and everyone smile. So, then in this picture the tissue is verily even red and this is extremely important aspect of trying to use single immediate front tooth replacement. We will get the tooth out without creating any trauma to anything around it. I will be able to put the implant.
Mike Wiegenstein: Because that help to heal faster.
Joseph D’Angelo: Normally, they help at heal faster but it helps maintain the tissue profile in our front tooth in somebody this has showed so much gum line. We have to make sure that the tissue profile looks natural like it did before.
Mike Wiegenstein: How long before you put the permanent abutment in?
Joseph D’Angelo: It could be anywhere from three to six months.
Mike Wiegenstein: Okay, so you put it in and then you are going to put in one tooth and try to match all the rest of them.
Joseph D’Angelo: Where now it’s the added challenge of trying to get force that match the rest of the teeth especially the one right next to it in a front tooth situation and have it on a piece of titanium not coming out of the tooth and not coming off the tooth.
Mike Wiegenstein: Right, lets take a look at what you did and lets see how I did. That’s incredible. Now that is not his natural tooth.
Joseph D’Angelo: That is a crown that’s built to match the addition to it, it would not restore any of the other tooth just that one tooth.
Mike Wiegenstein: The next gentleman, you made a comment to me about how this gentleman’s got missing most of his teeth in the upper. He has got three standard theory, standard practice and standard protocol for most times to pull those three teeth and replace it with a complete denture. You made a comment to me about why that’s not a good idea. What did you say?
Joseph D’Angelo: Well, in this gentleman’s he actually came to my office saying I was at another dentist office, they wanted to take all my teeth out, or the rest of my teeth and put a denture and he just wasn’t ready to loose that last couple of teeth and get a denture and I was in full agreement with him, it’s a matter of fact when considering implant it might have some natural teeth somewhere in the arch for awareness of where the bite is.
Mike Wiegenstein: So, that means you can feel where your teeth are?
Joseph D’Angelo: You get that feel of what it a piece of take feels like.
Mike Wiegenstein: Okay, how many implants did you do for this gentleman.
Joseph D’Angelo: This gentleman has six implants, three on each side.
Mike Wiegenstein: Alright, lets a look it as after, well its incredible. Now you are telling me that the whole right side of his mouth is all implants.
Joseph D’Angelo: Right, everything you see is implants. We only restored as far back as you could see he is wanting to restore at some point in the future as soon as he feels comfortable with it that more area but with three implants together on each side aesthetically we solved the problem. He loves to smile, he feels the teeth are incredibly strong, he feels he can eat that he never has before and.
Mike Wiegenstein: And he doesn’t have to worry about replacement. It is not like a bridge, they are not going to break, they are not going to crack, he is not going to they are in there they have done their.
Joseph D’Angelo: Implants are strong and stable.
Mike Wiegenstein: Any special stuff I mean in brushing and flossing that you really has to do to take care of them?
Joseph D’Angelo: Brushing and flossing is when coming in for regular checkups is just like regular tooth. So, he needs to do.
Mike Wiegenstein: Let’s talk about dentures real quick. I wear dentures, somebody wears dentures they have got. How many implants do you have to do put in to stabilize and I am not saying but to stabilize the dentures so they don’t have to worry about I am flying out when they speak.
Joseph D’Angelo: Well, Mike, a lot of times on what the arch form looks like. If somebody has got a good arch and all they want to do is keep the denture from floating up in embarrassing situation. Then we can get away with two implants on the bottom, front of the mouth. Dentures cannot.
Mike Wiegenstein: Putting implants in early if you have dentures, if you have -- putting implants in early help keep that arch support up, it will help keep the bridge there for you.
Joseph D’Angelo: The less movement you have in the denture, the more likely is for the bone cannot if the bone not to reserve.
Mike Wiegenstein: Okay, so.
Joseph D’Angelo: As soon as the teeth are removed anywhere now the bone starts to reserving right away.
Mike Wiegenstein: You brought me a model, show me what you are talking about with two implants.
Joseph D’Angelo: Okay, this is a example of lower denture an unlowered denture. Two implants kind of attachments will place the implants in the bone, the attachments on the denture itself and the patient could snap the denture until.
Mike Wiegenstein: I mean its locked in.
Joseph D’Angelo: And that’s locked in.
Mike Wiegenstein: A little bit on the back bone when they chew.
Joseph D’Angelo: They would have a awareness in the back bone and yes as they chew put a little pressure on the back. So, implants or dentures supported this way are going to be very stable.
Mike Wiegenstein: What if I don’t want to feel that. What do you do to support if I may be don’t have a good enough jaw bone, the bone resolve can you do anything with implants to support my denture then.
Joseph D’Angelo: Right, if there is not enough form in the back of the mouth to stabilize the denture and I am not just talking about keeping it from floating up, I mean stabilize I mean there is not enough bone to keep it stable or somebody is worry about loosing more bone overtime, the trick is to build put extra implants in.
Mike Wiegenstein: Like a regular denture would be if they have this end, okay.
Joseph D’Angelo: In some cases the denture could be entirely far supportive, so it doesn’t touch it at all.
Mike Wiegenstein: No pain on their gums no, what are people trying to because it will change their life.
Joseph D’Angelo: Well, its so secure that they feel, take it as efficiently as when they had that naturally healthy teeth.
Mike Wiegenstein: On your website, I know you have complete information on implants, complete information on veneers, at either joethedentist.com or josehangelodds but for people that are not computer savvy don’t have that time. Can I put you on the spot if they have a question they don’t know where to turn to, can I call you.
Joseph D’Angelo: Absolutely Mike. I more than happy to help out anywhere I can I do this because I love doing it in the fact to help out anyway I will.
Mike Wiegenstein: Dr. D’Angelo I want to thank you for coming on the show today. You have been incredibly informative.
Joseph D’Angelo: Thank you Mike.
Mike Wiegenstein: You have been watching Medical News Network. For more information on this subject or any other please visit our website at medicalnewsnetwork.info. For now, I wish you good health.
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