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!)
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.
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)
Whether you have been a regular dental attendee all your life or have avoided the dentist like the plague due to anxiety or other factors, all patients are welcome at Broad Street Dental practice.
We are a family run practice in the heart of Hereford, where you will always find a welcoming smile at every visit to our clinic. We are able to provide a wide range of dental treatment ranging from general examinations, maintenance to complex full mouth rehabilitation.
At every stage of your journey with us we will keep you informed of the treatment options and likely outcome of each option available to you, giving you an open and honest opinion of which treatment will best suit your individual needs.
November is Oral cancer awareness month.
Every patient at Broad Street Dental receives a complete examination of the hard and soft tissues i.e. we don’t just check for holes in your teeth but examine the health of your mouth, lips and neck for any signs of abnormalities and can make an appropriate referral if needed.
So if you haven’t seen a dentist for many years or are a regular attendee – if in doubt get checked out!
To book an appointment please call 01432 266899
Assoc. Dentist Andrew Farr
By Andrew Farr Associate Dentist
Broad Street Dental Surgery. Hereford
This young lady presented to Broad Street Dental Surgery complaining of a buccally placed mandibular left lateral incisor. She had undergone orthodontic treatment in her teens but due to a lack of retention her labial segment has changed as shown below.
Treatment options for this case included fixed orthodontics, removable orthodontics or accepting the current situation. With removable orthodontics using clear aligners Inter proximal reduction (IPR) would be needed to create space to allow the mandibular incisor to move lingual. It was decided therefore that a fixed solution would provide a more predictable outcome and would need very little if any IPR.
We use only clear/tooth coloured brackets from QST (Quick Straight Teeth) which are straightforward to use and provide excellent aesthetics. The treatment was estimated to take around 4-6 months and the patient would be provided with adequate retention following treatment to reduce the risk of relapse.
Post operative photos shows a nicely aligned lower arch. The patient was very happy with the final results.
If you or a friend are interested in having straighter teeth please visit Broad Street Dental Surgery
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
At Broad Street Dental Surgery we ONLY use 3M brackets. These have a proven track-record worldwide for their performance, beautiful aesthetics, and are nearly invisible in the mouth. We also use tooth-coloured wires making our braces the most aesthetic when compared to similar systems.
QST is used to correct mild misalignment of the front 6 to 8 teeth, to give you a beautiful smile. Because we only move the front teeth, the force required is minimal. The wires exert mild pressure to move the teeth, without the need for severe tightening which can cause the discomfort noted in conventional orthodontic treatment.
Have you ever wondered how to straighten teeth without using any fixed braces?
At Broad Street Dental Surgery we use the QuickStraightTeeth™ which has a clear “teeth straightening” system that has been developed to be a quick, discreet and very cost effective alternative for patients not wanting traditional braces.
For more information please contact Dr. Andrew Farr
Dentist Andrew Farr BDS(Hons) MJDF
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.
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.
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.
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.
This is a nice little case that I wanted to share. It shows that sometimes the simple treatment plans and simple minimally invasive techniques can have a profound effect on a patient.
Mrs A. a 68 year old grandmother was concerned regarding the appearance of her central incisor, which her granddaughter had said looked “dirty.”
The UL1 (12) composite had leaking margins and a stained buccal enamel crack. The composite was removed and the enamel crack was cleaned with air abrasion. The UL1 (12) was then restored with A2 and enamel shade Synergy composite. The patient was very happy and so was her granddaughter!
Dentist Andrew Farr