Fiorentini Family Dentistry is dedicated to helping every patient achieve the smile that they deserve. Our office will work with you from start to finish during the implant process. Dr. Fiorentini has extensive training in both surgical and restorative dentistry, allowing him to not only restore implants, but to also place them as well and any other regenerative treatment necessary. No longer do you need to go to multiple offices for each phase of treatment, everything is done in our office utilizing our state-of-the-art equipment to ensure unmatched predictability and precision with every case.
What are dental implants?
A dental implant is a biocompatible titanium screw that is placed in the bone for stabilization and acts as an artificial tooth root. Over the course of a few months, the bone surrounding the implant begins to attach to the implant itself integrating the implant into the bone. Dental implants can be used in a variety of ways to help stabilize your bone and also to restore your teeth.
Do I Need Dental Implants
Tooth loss can occur for many reasons: cavities, infection, gum disease, traumatic accident, or genetics. Missing teeth not only cause pain, but they can cause increased destructive forces on adjacent teeth as well as affect the aesthetics of the smile and lead to emotional distress. It is very important to replace these missing teeth to avoid these complications and create stabilized long term oral health.
What Can Dental Implants Do For Me?
- Permanent fixed replacement for missing teeth
- Prevent movement of adjacent teeth
- Preserve bone integrity
- Promote a full facial profile
Why Choose Dental Implants?
In some cases a dental bridge, or a partial or complete denture can be a viable solution for missing teeth. Each solution has its own risks and benefits and all will be discussed with Dr. Fiorentini during your treatment planning session. While these treatments are all effective, the most natural, long-lasting solution are dental implants.
Some of the biggest benefits of dental implants compared to other solutions are:
Dental implants more closely resemble your natural tooth compared to any other treatment. They maintain the contour of the tissue and bone over their lifetime. They look just like a natural tooth, no one will be able to tell that you have dental implants!
Dental implants integrate into the bone and closely mimic a natural tooth root. They provide a substantial improvement in chewing ability compared to any removable treatment.
Dental implants can be used to restore a single tooth, a quadrant, or to stabilize a complete arch! Ask Dr. Fiorentini about the different options for your individualized case.
A major concern with removable dentures is that they can come loose and cause irritation to the tissue and adjacent teeth. With implants, these dentures can be stabilized with attachments, or the implants can replace the removable dentures all together!
What is the process of getting an implant?
Before jumping to schedule surgery for an implant, a comprehensive evaluation must be performed to determine if you are a candidate for implant surgery and any risks that may be involved. There are a number of contraindications for implant placement and in these situations, alternative treatments must be seriously considered.
Dr. Fiorentini will review your medical history, perform an intraoral examination, take any necessary x-rays, and begin to plan your personalized implant surgery during the consult. We can digitally plan your surgery utilizing our 3D cone beam software. This includes finding the size and angulation of the implant for the optimum final aesthetic result and ensuring that we will not disrupt any major structures such as your sinus or nerves. Once the surgery is planned and treatment is agreed, you will speak with the front desk to discuss finances and to schedule the surgery.
What is implant surgery like?
In most cases, implant surgery is less invasive than an extraction. If you are nervous about the procedure you can be given an oral sedative or nitrous oxide if you wish to reduce anxiety. Dr. Fiorentini prefers not to have you under complete sedation so that you can provide feedback during the surgery. Please contact our office if you have any questions.
The area of the implant placement will be completely numbed with a local anesthetic. Dr. Fiorentini will begin surgery once the area is tested and complete anesthesia is confirmed. A pilot hole will be made in the bone and an x-ray will be taken to confirm proper depth and angulation. Additional drills will then be utilized in precise sequence to make the proper size osteotomy for your implant.
Your implant will then be placed and torqued to achieve primary stability. A final x-ray will be taken to confirm angulation of depth of the implant placement. If your implant is going to be immediately restored, a temporary abutment and temporary crown will be fabricated. If the implant is to be restored at a later time, a healing abutment will be placed to help guide your gums to properly heal and provide ideal tissue contours for the final abutment and crown. Comprehensive post-operative instructions will be given to help guide you as how to best take care of your implant as it heals and how to minimize post-operative discomfort. You can expect mild discomfort the following day after surgery that should get better with each day.
Can the implant be placed on the same day?
There are certain instances where an implant can be placed on the same day. A comprehensive evaluation must be performed first to determine if you are a candidate for this type of procedure.
In order to be a good candidate, you must be in good health, have adequate bone, and the tooth that is going to be extracted needs to be free of infection. A large infection of the tooth at the time will prohibit immediate implant placement as there will not be adequate quality bone with which to stabilize the implant. Your tooth will be extracted and a bone graft and collagen membrane will be placed to stabilize the area and ensure optimum bone healing and growth if an infection is present. The implant will then be placed in a few months after complete healing of the bone has occurred.
If you are a candidate for immediate placement, Dr. Fiorentini will place the implant in the site of the extracted tooth. A temporary abutment and crown may be placed at the same time as well as long as optimum primary stability is achieved. Immediate provisionalization of the implant provides best possible aesthetic outcome, but you must be very careful not to chew on the area while the implant is healing or you will risk failure of complete implant-bone integration.
Immediate implant placement in the front of the mouth
Placing an immediate implant in the front of the mouth is the ideal way to replace a fractured anterior tooth. The tooth in question must be in stable bone and free from infection to ensure optimum primary stability can be achieved. Bone grafting and socket preservation will be required at the time of extraction if there is an infection. The implant placement will need to be delayed until after complete healing of the bone has occurred.
If you are a candidate for immediate placement and restoration of an implant, your tooth will be extracted and the implant will be placed in the site of the extraction. Dr. Fiorentini will ensure optimum placement of the implant by utilizing our 3D cone beam to achieve the best possible aesthetic outcome. A temporary abutment will be placed on the implant and a temporary crown will be fabricated to maintain the ideal contour of your gums and match the aesthetics of your adjacent teeth. Remember, you CANNOT chew on this tooth or you will risk failure of complete implant integration into the bone. After the implant has completely integrated, the temporary crown will be removed and an impression will be taken. Intraoral pictures will be taken so that our award winning laboratory can customize the aesthetics to perfectly match your adjacent teeth. On the day of final insertion, the crown will be placed, an x-ray taken to confirm proper seating, and care instructions will be given.
Immediate implant placement of molars
Placing an immediate implant in the posterior of the mouth is less common than immediate placement in the anterior. This is due to the anatomy of your molars with their multiple and wide roots that can prevent an implant from being placed in the optimum position for final restoration while also having optimum primary stability at the time of placement. While most offices may only preform delayed implant placement for molars, Dr. Fiorentini has been trained with specialized wide implants that have been proven to provide excellent long-term results. Just like with front teeth, the tooth in question must be in stable bone and free from infection to ensure optimum primary stability can be achieved. Bone grafting and socket preservation will be required at the time of extraction if there is an infection. Implant placement will need to be delayed until after complete healing of the bone has occurred.
It is not recommended that we immediately place a crown on a molar implant because of the risk of non-integration in the bone due to chewing forces and the limited aesthetic benefit. If a crown must immediately be placed at the time of implant placement, you must be very careful not to chew anything on that side of the mouth until complete integration of the implant has occurred otherwise the implant may not integrate.
Contraindications for Implant Placement
There are certain contraindications to implant placement, as complications that may arise can be serious or even fatal in certain situations. Contraindications can be classified into three categories:
Absolute contraindications: dental implants cannot be considered;
Partial contraindications: dental implants may be considered only after a specific problem has been solved;
Limited and Local contraindications: dental implants may be considered by taking extra precautions regarding problems involving the mouth or jaws.
- Active cancer therapy
- Radiotherapy of head/neck
- Recent heart attack/heart failure
- Use of IV Bisphosphonates (bone density medication)
- Drug abuse
- Oral Bisphosphonates
- Uncontrolled diabetes
- Uncontrolled hypertension (high blood pressure)
Limited and Local Contraindications
- Controlled hypertension
- Controlled diabetes
- Anatomical barriers (sinus, inferior alveolar canal)
- Insufficient alveolar bone
Types of Restorations
Whether you are missing one tooth, a few in a row, or all of your teeth, dental implants can help provide a stable, aesthetic solution. A comprehensive consult with Dr. Fiorentini will help you to determine the best personalized solution for you.
Replacing a single tooth
Compared to alternative solutions, an implant to replace a single tooth will provide you with the most natural tooth-like solution that has the greatest chewing ability, optimum aesthetics, and best long-term prognosis. If you fractured a tooth, an implant can be placed in the same spot and in some instances can even be restored with a crown on the same day! In the posterior region, an implant will provide greater chewing power than any other solution. If you are missing the most posterior teeth, an implant is the only option as a bridge needs a tooth in front of and behind the missing space.
Replacing a few teeth in a row
If you are missing multiple teeth next to each other, you have the option of placing multiple single implants or you can also consider an implant supported bridge. Multiple single implants are as described above and provide the best chewing power and optimum aesthetics.
With an implant supported bridge, two implants are placed a certain distance apart and are connected by multiple crowns to replace a larger section of missing teeth. Compared to multiple single implants, less overall implants are placed and the final crowns are connected to each other. This type of restoration is ideal when we are limited by anatomy such as lack of bone or a low sinus.
Replacing an entire arch
Having a complete denture, especially one on the lower jaw, can be uncomfortable when retention is not adequate and the denture is not stable. There are multiple different possibilities to restore a complete arch using dental implants. Dr. Fiorentini will discuss with you the benefits of each and provide you with the information to choose the best solution for your particular situation.
An overdenture is a removable denture that has attachments embedded in its structure that snap into the implants and help provide increased stability. When the denture is in place on the implants, you will notice reduced rocking of the denture and increased chewing power. This type of restoration requires a minimum number of implants in each arch and is ideal in situations with limited bone quality. The overdenture still requires a partial flange for stability of the denture, and thus will cover a portion of the palate on your upper arch. The overdenture must be taken out at night and care must be taken to wash the denture and also the attachments of the implants. Inadequate hygiene can lead to instability if the overdenture does not seat completely on the implants.
Implant Supported Hybrid Denture
A hybrid denture requires more implants to be placed per arch than an overdenture, but it has the advantage of having no extended flange and is locked into place and thus is not removed by you every night. The only time this type of prosthesis is removed is by Dr. Fiorentini at your yearly check-ups during which he will clean the hybrid denture and make sure everything is stable with the implants and their attachments. A hybrid denture is even more stable and provides even greater chewing power than an overdenture. Aesthetics are also improved as the hybrid can be fabricated with a wider range of materials.
Full Arch Implant Supported Crown and Bridge
The final way to restore a full arch is with full mouth crown and bridge. This type of prosthesis requires the most number of implants to be placed in each arch, but also provides the best stability, chewing power, and aesthetics. Every part is permanently placed in your mouth and is never removed. Proper hygiene are care are key for longevity of this type of restoration.
The three parts that make up a dental implant crown
There are three parts that together make up a restored implant. The first part is the implant itself. The implant is the part that is placed in the bone, becomes integrated, and mimics the root of one of your natural teeth. There is then the abutment. The abutment attaches to the implant and then widens to provide a platform for the crown to be seated on. Dr. Fiorentini prefers to use custom abutments instead of stock parts so that he can control the contour of the abutment which will provide better gum tissue control, ensure proper shape of the crown, and provide better stability for the crown. The third and final part is the crown.
What You Can Expect After Treatment
Just because you now have a dental implant does not mean that you can become careless with your home care. Dental implants are like your own teeth, they can attract plaque and bone loss and gum recession can occur. Dr. Fiorentini will review proper brushing and flossing techniques for your implant to ensure longevity and health of the implant and surrounding tissue. Periodic follow-ups with our hygienists are required to monitor the implant.
What is the cost of dental implants?
The cost of an implant might surprise you. Because of its high predictability, long term success, and low maintenance costs, a dental implant may actually cost less than other tooth replacement options. One example would be a single dental implant vs. a three unit bridge. The three unit bridge requires preparing the two teeth adjacent to the empty space for crowns, sometimes working on a perfectly good tooth, just to fill in the missing space. If there becomes a problem with one of these teeth, the entire three unit bridge must be replaced. In contrast, a single implant crown does not require touching any other tooth.
If a dentist gives you an overall cost for dental implants before a comprehensive consultation, be wary. Your restorative treatment plan is customized for your mouth. The number of implants, precise positioning of placement, and adjunctive treatment such as bone grafting to build up a site with insufficient bone can all alter the overall treatment plan. Also not all dental implants are created equally. Lower cost implants are manufactured without a lot of the specifications improve integration into bone and they come with less long term studies of proven success. There are also mini implants which are very small in diameter and should only be used as a last resort if a standard size implant cannot be placed. The larger the implant, the greater the surface area of integration between bone and implant meaning greater stability and long term success. You may be getting an implant for less up front, but you may be paying much more in the long term if the implant is placed in less than ideal conditions or if there is a failure.
Dr. Fiorentini is an experienced implant surgeon and restorative dentist. Only after a comprehensive consultation including review of medical history, intraoral exam, and 3D cone beam, will he be able to provide a custom treatment plan for you. Utilizing the data from the 3D cone beam, he will be able to digitally plan your surgery while you watch and explain to you all the specifics of the surgery. This eliminates any surprises on the day of surgery and helps to prevent complications. There is no reason to pay “list price” for a worst-case implant and restorative scenario when you can get a custom treatment plan for your specific situation.
Alternative treatments for implants
Although implants are the most natural tooth-like replacement for missing teeth, they are not always the best course of treatment. Major medical concerns, history of IV bisphosphonate use, and lack of bone are just a few reasons why an implant may not be the best option. During your comprehensive consultation with Dr. Fiorentini, he will review any concerns with you and discuss all possible treatment possibilities. Our goal is for long term success and will never suggest any treatment that has a questionable prognosis.
Choose the right dental home for you!
Fiorentini Family Dentistry provides comprehensive dental care in both of our locations in Highland Park and Monroe Twp. NJ. Because we treat all aspect of dentistry, we can provide unparalleled expertise to not only in placing a successful implant, but also in ensuring the proper position and overall treatment to achieve optimum aesthetic results. All implants and implant surgeons are not the same. The implant systems that we utilize in our office have decades of research validating their success while some other companies offer a lower cost option because they have untested and often unreliable results. For overall long term success, the implant must not only integrate into your bone, but also be angled and placed in the ideal position. If the implant is not placed ideally, the resulting crown will need to compromise which can lead to decreased aesthetics and an increased chance of catching food between your teeth and long term periodontal issues. Dr. Fiorentini not only places the implants, but also restores them and will ensure that the implants are placed with the final result in mind.
Meet Our Doctors
Fiorentini Family Dentistry, is an award winning father and son dental team that consists of two dental practices with convenient locations in Central New Jersey. Dr. Mario S. Fiorentini, D.M.D. has been practicing dentistry since 1982 and passed his love of dentistry on to his son Dr. Mario C. Fiorentini, D.M.D. Together they run the Fiorentini Family Dentistry practices.
What We Offer
Fiorentini Family Dentistry is a family practice located in Highland Park and Monroe Twp., NJ with two generations of dentists and the experience to handle your every dental need. Our team of skilled professionals is dedicated to providing each of our patients with the compassionate and individualized care they deserve. We recognize that every patient has different needs, and we pride ourselves in the courteous service we deliver to each person who walks through our doors. Fiorentini Family Dentistry serves the surrounding towns of Edison, New Brunswick, North Brunswick, South Brunswick, Jamesburg, Cranbury and many others in Middlesex County. Whatever treatment you may need, we are here to ensure that with our precise mix of cutting-edge technology and time-proven methods, we will work to give you a smile you can be proud of!
Call us today to schedule a consult with Dr. Fiorentini about dental implants