Dental Implants

Dental Implant’s- A New Begining

~ Andrew Farr - Hereford Dentist

At the end of 2017 I had completed the FDI Certificate in Implant Dentistry and was looking forward to this new and exciting chapter of Dentistry. I just needed the right patient.

The key to starting anything new is to know your limits and when dealing with dental Implants you really need to start with a simple single tooth case, ideally in the upper premolar region. This reduces the aesthetic risk and there is little anatomy of concern (ideally no Maxillary antrum sneaking forward!)

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For you first Implant you need a good team  – At Broad Street Dental surgery we are very fortunate to have dental nurses with over 20 years of Dental Implant experience. A mentor is also key and is recommended by the GDC when starting out in dental implants. A good mentor will help guide you through the treatment planning phase, placement and restoration of cases.

In this case a single Straumann SLActive implant was placed in the upper right first pre-molar area. There was sufficient bone and no bone grafting was needed. The implant was restored with a Zirconia screw retained implant. The new implant has provided improved function and aesthetics for the patient who was very happy with the results.

Maintenance is now the key to long term success and the patient has regular hygiene appointments at least every 6months.

Final crown on working models
Final restoration in situ

Dental implants are now being provided regularly at the practice

If you are interested in dental implants or any other information please contact Broad Street Dental Surgery

or 01432 266899

Dentist Andrew Farr BDS(Hons)

 

 

 

 

Dental Implants

~ Andrew Farr - Hereford Dentist ~ Leave a comment

Why would you have a dental implant?

If you having missing teeth, Implants are a fantastic solution as you are not putting other teeth at risk to support the missing teeth. You can either have fixed restorations such as crowns and bridges that fix on top of the implants, or a removable denture that clicks into place over the implants. Having implants greatly improves the quality of your life if you are struggling with large spaces, or have a denture that is not retentive or stable. Implants can improve the look of your smile and regain confidence and function.

What is a dental Implant?

A dental implant very simply is a titanium screw that is placed in either the upper or lower jaw bone.

It serves as the tooth root where either fixed non removable replacement teeth or a removable appliance can be added on top.

There is no doubt that Implants are the best replacement option for missing teeth and they are the closest thing to getting back a natural tooth.

Although alternative treatment options to replace missing teeth such as bridges and dentures can be carried out, they are less stable and have higher maintenance costs. Therefore they will need to be replaced much sooner.

A major disadvantage of having bridge restorations is that teeth either side of the missing tooth have to be filed down, which could lead to problems with these teeth in the future.

Taking cost effectiveness into mind then, studies into Implants have shown having an implant is less expensive in the long term and that they do not involve restoration of any kind to adjacent teeth, which of course is a great benefit!

With the correct aftercare, an implant can last 20 years +, proving that implants are not only the more comfortable, reliable, functional and attractive option; they are indeed the best investment you will ever make in your quality of life.

Having an Implant with us at Broad Street Dental Surgery

We pride ourselves in careful and detailed planning, and we have the resources and equipment in practice to make sure you are being cared for to the highest possible standard.

You’re health and wellbeing is of upmost importance to us and our main goal is to give you exactly what you want, but in an ethical and non-detrimental way to your health.

Mr Farr has completed a Postgraduate certificate in Implantology with the Internation Team of Implantology and Straumann. Broad Street Dental Surgery have been placing and restoring dental implants for

We use the Straumann Implant system which is a leading implant company that provides technologically advanced, scientifically proven products that only ever get the best results.

Here are the reasons why we use Straumann to gain an exceptional results:

(From straumann.co.uk) –

  • More than 35 years of clinical evidence with over 700 scientific publications1
  • More than 14 million implants placed worldwide
  • Precision and quality “Made in Switzerland”
  • A trusted brand in over 70 countries
  • SLActive® – Our unique implant surface for better predictability and shorter healing times
  • Roxolid® – Our unique material for less invasive treatment options
  • Lifetime guarantee for your Straumann implants

The ITI Foundation in Implant Dentistry is the ideal way to get the best start in a career in implant dentistry

~ Andrew Farr - Hereford Dentist ~ Leave a comment
The Revu

Dr Andrew Farr talks to The Revu about his recent experience of undertaking the ITI Foundation in Implant Dentistry (FID) course and why, along with the guidance of his mentor, he is now more than ready to place his first implants.

 What first motivated you to attend the FID course?

We were already offering implant treatment at our practice, but I was keen to learn for myself how to place and restore implants. I qualified over 10 years ago and received no implant training at all at undergraduate level, so it was a question of looking at the introductory courses out there that could get me confidently started in implant dentistry and the FID course was definitely the one that suited me best.

How did you find the course content?

Because it’s a Foundation course it’s designed to give you a solid theoretical understanding of how and when to use implants and to guide you in implant selection. I believe that the theory is very important when you are starting out in implant dentistry and the FID course definitely gets you off on the right foot.

I was very impressed at the quality of the teaching from some of the most experienced implant dentists in the UK, including Dr Shakeel Shahdad, Prof Nikos Donos and Dr Nikos Mardas. Between them they have a vast amount of experience, and I found them to be very open and honest about real life situations in practice, both good, and occasionally not so good. It would be easy for the experts to just say how good they are at placing implants, but that’s not what the delegates need, nor what they did. It’s just as important to learn about the things that can go wrong as well as the vast majority of cases with highly successful outcomes.

The FID modular course is spread over six months and you successfully completed the course in September. What has been happening in that time?

The most significant thing I’ve done is to partner with my mentor, Michael Betteridge. Michael is a specialist oral surgeon who is very experienced in providing not just oral surgery care in the primary care environment, but also a highly-regarded dental implant service, and is therefore ideally suited to being a mentor.

Are you looking to now move on to an MSc course or similar in implant dentistry or is mentoring giving you everything you currently need?

For the time being, with the help of Michael, my plan is to first get the basics right in practice before considering moving onto further education and I’m already in the process of planning my first implant cases. It can be a bit daunting when you first start out, but it’s probably more a fear of the unknown and that’s why a mentor is such a good idea to guide you over those first hurdles until you find your feet.

How have you found the support from Straumann – do you plan to place Straumann implants?

Yes, that’s my plan. Straumann are market leaders and when you are starting out you want to place the implant that offers the best chance of long-term success and is backed by a huge amount of research.

The support they offer is terrific and our local Straumann representative Hayley has been a great help in terms of my surgery set-up and making sure I have everything I need to get me started. Everyone at Straumann really knows what they are doing and if I have any problems I know they are there to help. It’s about the whole support package – not just the implant.

What are your plans now going forward?

I want to be doing a lot more than just placing the occasional implant. My aim is to eventually place something in the region of 100 implants a year and be in a position to accept referrals from local colleagues.

Finally, would you recommend the FID course to other GDPs?

Yes, I would definitely recommend this course – it’s ideal for any clinician looking to get the best start in a career in implant dentistry.

surgical guide

In association with Straumann, the next ITI Foundation in Implant Dentistry course begins in February 2018. For further information or to reserve your place, please call the Straumann Education Department on +44 (0) 1293 651270 or visit iti.org/uk

Facebook: Straumann UK

Twitter: @StraumannUK

broadstreetdentalsurgery.com

Broad Street Dental Surgery, Broadway House, 32-35 Broad Street, Hereford HR4 9AR

Andrew Farr BDS(Hons), MJDF RCS Eng 

Andrew joined Broad Street Dental Surgery, Hereford in October 2014. Born and raised in Caerphilly, South Wales he studied dentistry at the University of Cardiff, graduating with honours. He completed his vocational training in Plymouth, then spent a year as a Maxillofacial Senior House Officer at Derriford Hospital where his duties included emergencies in A&E, head and neck surgery and wisdom tooth removal. He has developed an interest in orthodontics and is qualified to offer Quick Straight Teeth short-term orthodontics.

@DentistHereford

 

Implant Surgical Guide

~ Andrew Farr - Hereford Dentist ~ Leave a comment

A surgical guide as the name suggests serves as a guide to place implants accurately in 3 dimensions i.e. bucco-lingual, messiah-distal and apiece-coronal.

Here I am showing a simple surgical guide that has been produced from an initial wax up (there are more accurate guides available). It is constructed of hard acrylic and can also has barium sulphate incorporated into it so it can double as a radiographic stent.

With the guide in place, the long axis of the teeth are marked a small pilot hole is made in the centre of the tooth and old implant drills can then be used to enlarge the guide window. A window can also be made in the buccal aspect of the guide to aid vision and insertion of the drills in the mouth.

This can be worn by a pt during a CBCT to confirm the correct angulation and position of the final restoration.

surgical guide

http://www.broadstreetdentalsurgery.com

Andrew Farr

FDI – Implant Retained Dentures

~ Andrew Farr - Hereford Dentist ~ Leave a comment

Managing the edentulous patient can be at times, very difficult. Following extraction of the dentition bone is remodelled and resorbed, muscles and ligament insertions become closer to residual ridges. This can in turn lead to an unstable and unretentive denture due to a lack of bony support.

When treatment planning for the edentulous patient, it is useful to classify the edentulous ridge. Ridge classification can aid both the dentist and patient in communicating any difficulties and the likelihood of a successful outcome.

3b. Adaption of Cawood & Howell classification with explanation (1).compressed

The optimum conventional dentures should be both aesthetic and functional with good fit and stability. The McGill consensus statement 2002 and York Consensus statement 2009 say that the “Minimum standard of care” in the edentulous mandible is two implant retained dentures. Working in both the private sector and primary care/community sector I find the both statement of little use. From my experience the patients who can afford two implants tend to be well educated and well informed regarding diet, oral hygiene and are regular dental attendees – they are less likely to be edentulous. Those in need are less likely to be able to afford two implants and the prosthesis.

For a mandibular implant retained denture – a minimum of two implants should be placed and four in the maxilla. The ideal position in the mandible would be the canine region and in the maxilla it would be the canine and second premolar region allowing for adequate bone and other anatomical features.

Locators, bars and milled bars can be used to improve retention, stability and support. These are a good option if an optimally made denture is still unretentive or is lacking support.

At Broad Street Dental Surgery we can provide dental implants to aid and improve the support of dentures as well as replacing single and multiple spaces.

implants1
Tissue level implants with locator attachments in situ

Dentist Andrew Farr 

Broad Street Dental Surgery

 

Foundation in Implant Dentistry Part-1

~ Andrew Farr - Hereford Dentist ~ Leave a comment

February 2017.

This was the first part of the FID course held annual by the ITI (International Team for Implantology) and Straumann. The course is being held at Crawley (quite a journey from Hereford) and was easily accessible.

The first module focused on Assessment and Treatment planning in Implant Dentistry. By comparing implants to other restorative techniques, survival rates, cost and biological implications and mechanical factors. It was clear from the outset that although this is a course aimed at implant dentistry that it would be foolhardy to be solely focused on placing implants as many of our patients would not be prime candidates for the provision of implants. Indeed we spent a few hours looking at cases that were not suitable for implants due to medical history, age, current periodontal status, bone support available and more! As someone once said – “Fail to prepare, prepare to fail.”

The course looks at using ITI’s SAC classification, which is an assessment tool of the potential difficulty and risk of a case. It uses a traffic light system and serves as a guide in both case selection and treatment planning.

S – Straight forward – low difficulty and low risk

A – Advanced – moderate difficulty and moderate risk

C -Complex – high difficulty and high risk

As this is the beginning of the “Implant Journey” for myself I will be looking at placing implants in the “straight forward” patient. These cases are generally in the premolar/molar region where aesthetics are less of an issue and ideally situated in a bounded saddle so that stresses on the abutment are less. It is recommended that we use the tissue level implants as our starting point.

The big advantage of the ITI/Straumann FID course is the mentorship scheme. Each student is provided with a mentor who has a vast amount of experience and will guide me through the treatment planning phases, consent through to placing implants and maintenance. This will also allow me to develop at my own speed and gives time to select appropriate patients to continue my training.

The next part of the course focuses on single tooth implant placement.

Andrew Farr

http://www.broadstreetdentalsurgery.com

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