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Reconstructive Dentistry

     Dental Implants - Advanced treatment for missing and hopeless teeth

   If you have gaps in your smile from a missing tooth, or your dentist has informed you that you must have your tooth removed because it is no longer salvageable, dental implants may be for you. With the advances in dental implant technology over the last 4 decades, dental implants have become highly predictable and a dental treatment choice to restore function and beauty back in your smile.

All dental implant procedures from A-Z, under one roof only at MedAsia Healthcare Complex

   MedAsia Healthcare Complex and its affiliated cosmetic and reconstructive dentistry clinic, Smile Republic Dental Clinic is one of the trusted and most sought after dental facilities in Thailand for placement and restoration of dental implants. Our dental center offers the latest dental technology equipment for diagnosing and treatment of dental implants. Our dental implant department is equipped with 3-D cone beam CT scan so every dental implant case is diagnosed and designed properly from start to finish, increasing the predictability of each treatment.

What is Dental Implant and how does it benefit me?

   Dental Implants are an artificial root of a tooth that replaces a missing natural tooth’s root. It is made of titanium and more recently we have introduced an all zirconia dental implant to MedAsia Healthcare Complex. Dental Implants replace your missing teeth and can restore your teeth to normal esthetic and function. Also Dental Implants provide these additional benefits:

1. They become an anchor for artificial teeth such as dentures and bridges.
2. Improves speech and eating
3. Stops bone loss in the area where teeth are missing

Who is a good candidate for Dental Implant?

1. Patients that are cleared by physicians who can undergo surgical dental implant placement
2. Those patients who have healthy gum tissues
3. When a patient has solid bone present or has the potential to grow good bone through assisted bone grafting procedure.
4. Is committed to take care and maintain the dental implants as if it was a natural tooth.
5. Any young patient that has stopped growing at least for 6 months verified by a pediatrician.

What are the steps involved in Implant Surgery?

   There are various stages involved in a dental implant procedure. Patients must understand, as teeth did not grow in a day, dental implants cannot be placed and completed with a final restoration in a single day. There has been popularity in some of dental implant procedures that can be done in a selected group of patients where the surgical and restorative aspects can be done in a single visit. However, additional maintainace will always be required.

Dental Implant Consultation

All dental implant treatments must begin with a through consultation by one of our dental implant specialists. A through consultation will require

1) A review of patient’s medical and dental history including all of the prescribed or non prescribed medications
2) *Direct oral examination of the patient if the patient is already in Thailand
3) Review of Patient’s X-ray both Periapical as well as a panoramic unless a 3-D CT Scan is available
4) Intra-Oral photography

*International patients who are not present physically, only items #1,3 will be sufficient, but may require a Skype interview by one of our specialists.

Once we have received the above information, one of our representatives at MedAsia Healthcare Complex will be able to present you a written confirmation of your treatment including the associated fees as well any pre-operative instructions.

Dental Implant Surgical Appointment

   After you go through a screening procedure by one of our dental nurses to insure your vitals are within a normal range, You will meet one of our dental implant surgeons who administers a local anesthetic. An oral tablet crushed under your tongue or intravenous injection into your arm may precede those patients who want to be sedated at a deeper level with the local anesthetic.

   Once the surgeon determines that you are in a complete anesthetized state, the surgeon will make the first incision in your gum to expose the bone and prepares the bone to receive a dental implant. The surgeon will take an x-ray to make sure that the implant(s) are placed in in the proper position and place. The surgeon will then suture the gum closed over the implant. The time required for the surgical implant placement can range from one hour to several hours depending on the number of implants and the complexity of each case.

   When there is not enough bone to support an implant, your dental surgeon may recommend to building up the bone prior to placing of the dental implant. Bone grafting or bone-augmentation has become a common practice and is absolutely necessary for placement and also maintain dental implants for a long-term basis. There are times depending on the condition of your present bone that dental bone grafting can be placed at the time of dental implant procedure. But there are also times that your surgeon may recommend that the bone graft to be performed months ahead of time that you are scheduled for your dental implant surgery. If bone grafting is required, your dentist will be able to discuss with you the various options and the sources to be used for bone graft.

Bone grafts

Bone graft can be in a form of a powder or a solid block. The available sources of bone grafts are as follows:

1. Patient’s own bone
2. Bone from a cadaver of a human
3. Bone from an animal such as a Bovine, Horse or a Pig
4. Synthetic Bone manufactured in the laboratory
5. Bone From marine life

   If you have cultural and/or religious considerations regarding the source of the bone, please advise your dental surgeon know and they will be able to assist you with the best source of bone for your particular situation.

   Bone grafting can be done at the same time of the dental implant placement or depending of the situation must precede the implant placement for several months. Having a solid bone in proper height and width is extremely crucial to a long lasting dental implant.

   Dental implants are typically placed in the jaw bone for a period of 3-6 months depending on the quality of the patient’s bone before the dental implant is ready to receive the final restorative option.

Dental Implant Recovery Phase

   After the implant has been placed in bone or a sufficient amount of time and your dental surgeon has determined that is your implant has osseo-integrated with the surrounding bone; it is time for your implant to be uncovered.

   If your dentist has stitched over the implant, then a second incision is necessary to uncover the implant. At this point your dentist will place a healing cap over each dental implant to prevent the tissue from covering up the implant again and also allowing the healing cap to create proper tissue cuff and collar for the future prosthesis that you will receive over your dental implant.

   Depending on each clinical case, your dentist may decide that you allow another 2-3 weeks of healing time. In some situations, your dentist may determine that additional healing time is not necessary and he/she may proceed in referring you to his/her prosthodontist or restorative dentist for the next phase of treatment.

Dental Implant Restorative Phase

   At this phase, a Prosthodontist or an Implant Restorative Dentist will be able to prepare the necessary step for the fabrication of the final prosthesis. This preparation will include:

• Taking an implant or abutment level impression
• Registering the correct dental bite
• Shade Selection and Color Mapping
• Fabricating Provisional or Temporary Prosthesis

Dental Implant Abutments

   A dental implant abutment is the prosthetic part that connects the dental implant to the restorative part. A dental abutment can be in a form of a tooth stump or in a form of a bar attached to several dental implants. These abutment are generally secured to the implant in following ways:

1) Cemented
2) Screwed
3) Friction Grip

The most popular form of an abutment being secured to a dental implant is a screw type.

Once your dentist has placed an abutment over your dental implant, they typically take an x-ray to verify the complete seating of the abutment. Once the complete seating of the abutment is identified then your dentist will tighten the screw using a specialized torque driver. The amount of torque is based on dental implant manufacturer’s recommendation.

Cement Retained vs. Screw Retained Prosthesis

   Generally the restoration that is placed over an abutment is either glued on with a dental cement, hence referred to as cement retained or they are made as a one piece restoration (abutment & crown) and is directly screwed inside of the dental implant well. When the restoration is screwed into a dental implant well, this is referred to as a screw retained restoration.

   A cemented restoration is a simplest form of restoration and may be cemented on a standard form of an abutment. This simplicity allows the patient the convenience of having the final restorative work completed at a very reasonable amount of time and cost. Sometimes, due to the position or angulation of a dental implant, a standard type of abutment cannot be used and your dentist must prescribe a custom abutment. A custom abutment can be milled in titanium or zirconia. In some cases the abutment is casted in gold, which is also known as a UCLA abutment. When a custom abutment is necessary, your dentist may decide on a screw retained restoration especially if there are multi units of dental implants involved in the same arch. Custom abutments require more detailed work both by the dentist as well as the dental technician, thus the fees will be higher than a standard type abutment.

   A screw-retained restoration allows your dentist to remove the entire restoration without ever having to cut or damage the final restoration. Thus it is a preferred option for long-term maintenance of dental implants. In cemented type restorations, should the underlying screw holding the abutment to the dental implant become loose, the final restoration must be cut and removed and new restoration needs to be made. This will add to the future cost of treatment even though the initial cost is less.

What are Dental Implant Access Holes?

   Screw Access Holes indicates the location of the screw from where the implant is secured. The holes are typically filled with a tooth colored dental filling materials and a barrier to prevent the filling material from getting inside covers the head of screws.

How long does it take to make the new teeth?

   Dental Implant surgery (placing of the titanium root) when acceptable levels of bone are available can be accomplished generally in one day. The restorative part in general can take up to 2-6 appointments. Simple single dental implants can be completed as soon as one week. However some of the more complex cases may take additional 3-6 appointments to complete. There are couples of dental options available to those who wish to have their teeth completed as soon as possible based on their treatment and qualification.

     All-On-Four Dental Implants - Immediate Loading single tooth with a temporary crown

How soon thereafter can a patient begin to eat and function?

   As soon as the final restoration has been placed, the patient can resume normal eating again. If the patient is going through an immediate loading dental implant or an All-On.Four then For the first two to three weeks after initial placement of the implant, a strict soft diet is necessary. As conditions vary per patient, different dietary instructions will be given in order to minimize stress on the implant until it has fully integrated into the bone.

   Our dental specialists at MedAsia Healthcare Complex conduct dental implant surgery on a regular basis. Our Prosthodontists and Dental Implant Surgeons are licensed and trained according to the highest standards possible. You will receive the best pre- and post-operative care possible at our facility. We are a platinum provider for Zimmer, Astra, Straumman and Nobel-Biocare dental implants due to our high number of placement of those implant brands.

How safe is a dental implants surgery?

   Dental Implant surgery has the inherent risk like any other type of surgery. Having said that, dental implants have been
placed since 1960’s and within the last two decades, dental implants have become a routine dental procedure at most
dental practices. The safety of dental implant placement is dependent on the skills of the surgeon as well as proper diagnosis
and evaluation.

   At Smile Republic Dental Clinic, our dental specialists take the time to pre-plan each case thoroughly by use of 3D CT Scan.
The 3D CT Scan allows our professional team to identify all of the major vital structures ahead of time and virtually place
dental implants prior to the actual surgery. In addition, our dental implant specialists fabricate specialized surgical guides
to insure further safety for our patients.

     Dental Implants: Multiple Teeth Replacement in Thailand

   Whether you have lost one or more teeth due to periodontal bone loss, tooth decay or trauma and an injury; you cannot replace those teeth with dental implants. Dental implants provide the root replacement so crowns or bridges can be installed. Replacing your teeth will allow you to chew your food better and also provide the needed esthetic to let you smile confidently.

Advantages of Dental Implants to Replace Missing Teeth

• Provide a permanent replacement of the missing root structure
• Preserves the Jaw bone from Atrophy and bone loss
• Can be use to install a single tooth or a multiple teeth bridge
• Can be an alternative and a better treatment option than a fixed or a removable bridge or a removable denture

Why dental implants are superior to a bridge supported by natural teeth?

   Dental bridges have long been a choice for patients with missing teeth. However, overtime, it has been realized when bridges are anchored to natural teeth whether through a removable or a fixed design, the supporting teeth are damaged and decayed over time. This eventually leads to loss of those supporting teeth and it eventually leads to more complex problems. Dental implants provide a solution to this problem by being permanent and also being able to be restored independently from natural teeth. This alone provides a large advantage to the patient in terms of long-term dental prognosis.

     Zygoma Dental Implants - Advance Dental Implant Procedures In Thailand

   Zygoma Implants - The ideal treatment for patients who suffer from severe bone loss in the upper jaw.

   Many patients who have worn conventional upper dentures for years, they suffer from a large amount of bone loss due to long term pressure that was placed over the bone and the growth of maxillary sinus cavity. At MedAsia Healthcare Complex, our team of dental specialists, (Oral and Maxillofacial Surgeons and Prosthodontists) are able to provide Zygoma dental implants for these patients and in most instances the patients are able to leave the clinic, immediately after the surgery with a set of fixed dental bridge screwed on into these dental implants).

   The Zygoma dental implants allows the dentist to place very long dental Implants directly into the patient’s Zygoma (Cheek) bone to avoid bone grafting into the sinus cavity.

   Nobel Biocare a leading dental implant manufacturing company was the first to receive FDA clearance regarding the use of these dental implants and MedAsia Healthcare Complex has been at the forefront of providing Zygoma dental implants to hundreds of patients who travel to Thailand from Australia and also Middle East.

   There are a number of factors that must be considered by our dental surgeons before recommending Zygoma Dental Implants:

• Are the sinuses asymptomatic and clear from any disease or pathology?
• Are there enough bone width and height present in the frontal aspect of maxillary jaw bone to accommodate at least two regular dental implants?
• Can the dental lab design a prosthesis that has short Anterior-Posterior spread to avoid large span cantilevers while providing good cross-arch stabilization in the arch?

   All patients who need to be considered to undergo Zygomatic dental implants are required to have 3D Cone Beam CT X-ray so the surgeon can study the patient’s X-ray three dimensionally and also accurately preplan for the surgery. At Smile Republic Dental Clinic is equipped with the latest Digital 3D Cone Beam X-ray.

Steps involved in Zygoma Dental Implant Surgery

1. Consultation and Pre-Surgical Work Up
   Our Implant surgeon at MedAsia Healthcare Complex will examine your mouth thoroughly and order the appropriate X-rays such a 3D Cone Beam.
The X-ray will reveal the amount of the bone available in terms of height and width. It also will reveal any abnormities in the sinus walls and cavity. Our surgeons then may use special programs to place dental implants virtually to determine the width and the length of dental implant is best to be used.
At that appointment, you may also meet with our prosthodontist team as well as our dental laboratory technician whom will be responsible in designing and manufacturing the final prosthesis to be placed on the top of the dental implants. They will look at your overall bite and also discuss the type of smile and the color of the teeth you wish to have on your new set of teeth. At this appointment a series of dental impressions may be taken in order to prepare for your surgical appointment.

2. Surgical Appointment

   At this appointment, your surgeon will install your dental implants based on pre defined locations from your consultation appointment. He / She will make sure that the implants are inserted correctly through the sinus cavity to support path of insertion of the final prosthesis

3. Prosthetic Attachment
   In most cases where possible, your dental bridge will be installed on the day of your surgery. In some cases, it is an up to a week’s wait time before the final dental bridge is inserted onto the dental implant. At all times, you will be able to wear something temporarily so you never go without a dental bridge.

4. The results are magnificent
   Your Zygoma implants will sure make a huge difference in the way you use your teeth to eat, smile, speak and interact socially. The Zygoma implants not only will provide you with a fixed set of dental teeth but it also will stop your bone from further loss

     Full Jaw Fixed Bridge on Implants in Thailand.

   If you have missing teeth or your teeth are in a hopeless situation, you may consider replacing them with a full set of teeth
supported on several dental implants and choose a Fixed option where your teeth can only be removed by a dentist and not by you.

   Prior to the introduction of dental implants in 1960’s no particular solutions really existed for individuals who had permanently
lost their whole dental formula. Patients had no choice but to wear conventional dentures. With development of dental implants,
patients are now able to say goodbye to loose dentures and all of the adhesive glues that are typically used to keep them in place.

Treatment with Dental Implants

   There are many options available to patients who seek dental implants to replace their missing teeth. Each option has advantages
and disadvantages that patients need to discuss with our dental specialist team at Smile Republic Dental Clinic. Regardless of the
final prosthetic option, dental implants require multiple dental visits with most options as there will need to be enough time for
the dental implants to heal and fuse to the bone.

   If you are already wearing a conventional denture, then your dentist may decide to place your dental implants and let you continue
wearing your dentures while the dental implants are becoming strong by fusing to the bone. This process is referred to as
“Osseo-Integration”. Typically the average time need for a dental implant to fuse to the bone properly is about 3-6 months
depending on the condition of your bone.

   In the upper jaw, the bone is very spongy in nature, also referred to as a cancellous bone. Because of the lack of density that is
present, dental implants in the upper jaw need to stay an average of 5-6 months for the bone to grow properly around the dental

   In the lower jaw due to the presence of cortical layers which makes the bone more solid, the amount of time is less than of
the upper jaw. It can average about 3 months for the bone to heal properly around the dental implant.

   There have been a number of dental implants that have been introduced to the market that the makers of these implants claim
that they can Osseo-integrate as fast as six weeks. One of these implant companies is Straumann, a Swiss Made dental implant
Roxolid- SLA Active. Our dental specialists at MedAsia have placed a large number of these types of dental implants but are very
cautious until they are able to review these cases for at least five years before promoting as a routine dental implant to our patients.
So far we have had a 98% success rates with all of our dental implant systems regardless of the brand used.

   Once your dental implants have fused completely to the bone, your dentist will prepare special attachments so he can capture
an impression of your implants and also be able to try and insert the final prosthesis over your dental implants.

   At Smile Republic Dental Clinic, most patients are able to recover from their dental implants surgery within a very short time and
resume their daily normal activities.

Treatment course for a fixed screwed in type of a dental bridge

   This is only one of the options to have a dental bridge over dental implants for an edentulous jaw. Please consult one of our
dentists for all options available to you.

Before the beginning of the procedure

Edentulous jaw

   At this phase, you dentist will have a discussion with you regarding your prosthesis and also the steps required to have this work
completed. There may be a need for some dental impression of your jaw so further studies can be conducted as well as temporary
types of dentures are fabricated just in case one is not available.

Placing the dental implants in the jawbone

   The dental implants are placed in the jawbone and the time is waited for healing. Once the dental implants are solid, your dentist
will uncover those dental implants and will use proper matching attachments to capture and impression or install new temporary
teeth as indicated on the picture below.

Attaching the bridge

   The temporary teeth will act as the prototype of your final bridge while aiding you with chewing, function and esthetics. This will
allow you to see and feel them and be able to communicate with your dentist any medications that you like to see made on the final

Final Restorative Bridge

   The new teeth will look and feel like natural teeth. Traditional denture wearers become super excited as the ability to have teeth
that feels and looks like natural teeth. They no longer have to worry about denture sore spots or loose dentures falling out of their
mouths. They can chew their food properly which improves their digestion.

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