Dental implants are a marvel! They look just like your natural teeth, and, even better, they function just like your natural teeth. So, when you’re planning on a dental implant after an extraction, you want to make sure that your implant has the best chance of success—and we do, too. That’s why we might recommend a socket preservation procedure, where socket grafting takes place immediately after your extraction.

What is a socket graft, and what does it “preserve”? Let’s take a closer look.

Socket Preservation—A Logical Choice After Extraction

You’ve decided on a dental implant for some excellent reasons.

• A missing tooth can change the appearance of your smile.
• Your remaining teeth might shift to fill the empty space, causing alignment and bite problems.
• A lost tooth affects the amount, shape, and health of the bone surrounding your teeth.

No one wants to lose a tooth, but sometimes, due to injury or decay, an extraction is the only choice for your oral health. Seeing an oral and maxillofacial surgeon is especially important for complex extractions, when you have impacted or fractured teeth, roots close to nerves, or other complications which require surgical treatment.

After your tooth is extracted, if the socket bone holding the tooth is perfectly healthy, we might be able to place an implant post in the socket right away.

But often, even with a simple extraction, bone needs time to heal before placing an implant post, and you risk losing the bone size and density you need to make a future implant possible. How can you lose bone? That’s an unfortunate consequence of losing teeth. Teeth are important not just because they let us eat comfortably—they also help maintain bone health.

Without the stimulation of biting and chewing, the bone beneath the teeth begins a process called resorption. As older cells are absorbed back into the body, new bone cells aren’t produced as quickly to replace them. The alveolar bone, the thick ridge of the jaw which holds our sockets, shrinks in size. As the bone gets smaller, gum tissue shrinks around it, causing a sunken spot where your tooth used to be.

For a dental implant to anchor successfully in the jawbone, you need healthy bone that is high enough, wide enough, and dense enough to hold the implant post securely as it fuses with the bone.

A socket graft at the time of extraction provides two important benefits: grafting material fills the empty socket immediately, preserving the bone and gum area around it, and the graft material acts as scaffolding for new bone growth, creating a firm, dense foundation for your implant.

Grafting materials are gradually and safely absorbed as your new, healthy bone tissue replaces them. The result, after several months of healing, is an alveolar ridge with normal height and width and with the density needed to anchor an implant successfully.

The Grafting Procedure

Grafting material comes in different forms, including allografts (made from donor bone), synthetic grafts (made from synthetic materials which function like bone tissue), and autografts (bone taken from your own body). Growth factors may also be included in the grafting material to encourage new cell growth. Dr. Jenny A. Kanganis will recommend the type of graft which will work best for you.

A socket preservation procedure will frequently involve the following steps:

• Local anesthesia to numb the area before your extraction. You might choose sedation options as well, which we’re happy to discuss with you in advance.
• Careful cleaning of the site after the tooth is extracted.
• Filling the empty socket with bone grafting material.
• Placing a barrier or membrane over the graft to protect it as it heals.
• Suturing the surrounding gum tissue.

Aftercare Treatment

Aftercare treatment for a socket graft is a lot like the treatment for a tooth extraction. You’ll need to be careful around the graft area for several days as it heals, and we’ll give you specific instructions for your recovery. Normally, these may include:

• Don’t disturb or touch the area. Even pulling on lips or mouth to look at the site can put stress on your sutures.
• Immediately after the procedure, we can give you suggestions for reducing swelling and managing any pain you might be feeling.
• We’ll let you know when and how to rinse your mouth clean and when you can return to brushing. And no spitting!
• Eat carefully. We might recommend a liquid diet for a few days before transitioning to bland and cool soft foods. We’ll let you know the best diet for the period after your surgery. Don’t use a straw for your liquid diet, because suction can interfere with the wound.
• Treat yourself carefully for a few days by avoiding strenuous activities, including workouts.
• Don’t smoke. Smoking interferes with the healing process, and the suction involved does your graft no favors either.
• Visit our Bronxville office for follow up appointments as recommended. We’ll monitor your healing, and give you a timeline for your future implant.

Preserving your socket now instead of repairing it later has many advantages. Immediate placement of a graft protects bone size and density, eliminates the need for a potential bone grafting procedure in the future, and makes it possible for you to enjoy the natural look and feel of a dental implant as soon as possible. If you’ve scheduled an extraction with us, let’s discuss why socket preservation might be your best path to an efficient, timely, and successful dental implant.

Dental implants are an increasingly popular choice when we need to replace a lost tooth or teeth. The reasons for choosing an implant are clear: implants look just like our natural teeth, are firmly anchored in the jaw just like our natural teeth, and are easy to clean and care for just like our natural teeth.

Not as clear? Whether your insurance will cover your implant procedure. Because implants are often more expensive than other replacement options, it’s important to learn just what your insurance plan provides, and what your out-of-pocket expenses will be. What do you need to know?

Know your policy

Dental and medical plans vary widely, from individual to individual, company to company, and state to state. Depending on your specific policy, you might be covered for part or most of the cost of a procedure, or your plan may provide no coverage at all. It pays to find out ahead of time!

Know the reason for your procedure

Your coverage may be affected by the reason for your procedure and whether it’s seen as medical or dental.

• If your dental insurance policy considers an implant to be a cosmetic or an elective treatment, implant surgery may not be covered. However, the cost of the crown restoration could be, at least in part.
• If implants are used to anchor a bridge or a denture, your dental policy might provide partial coverage, at least to the monetary extent that the insurance company would cover standard bridges or dentures.
• If you are suffering medical complications because of tooth loss due to illness, accident, or injury, your medical health insurance could cover some of your expenses.

 Know your plan’s annual and lifetime limits

If you do have dental coverage, there might be limits imposed on the kind and number of procedures allowed during a calendar year. You could also have yearly maximum benefits or lifetime maximum benefits, after which your expenses will be out-of-pocket.

Find out which steps of the implant procedure are covered

The implant process can require different steps, some of which may be covered by insurance while others are not. Depending on your needs, these steps can include:

• Extraction
• Bone grafting
• Implant surgery
• Crown restoration
• Anesthesia

Your policy may or may not cover any of these individual procedures, so it’s always best to discover exactly what’s involved in your implant treatment before you begin.

Know how to find out what you need to know!

• Talk to our Bronxville office before you schedule surgery. Oral and maxillofacial surgeons are experts in implant procedures, and can provide you with an explanation of just what services will be involved at every stage of your implant treatment, as well as a pre-treatment estimate.
• Talk to your dental insurer to see exactly what coverage they provide for the procedure or procedures you might need.
• And don’t forget to touch base with your medical insurer if you need implants as the result of a medical condition, accident, or injury.

Finally, talk to Dr. Jenny A. Kanganis again! We want to make sure that you receive all of the coverage that you are entitled to, and that your implant procedure is as affordable as it can be for this lifetime investment in your oral health. Whether it’s working with you to make the most of your insurance coverage, or working with you to discuss a financing plan that fits your budget, we will do their best to provide the clear answers you need.

Since dental implants first started being implemented in the 1980s, they have been primarily made of titanium. Recent advances in implant technology have allowed dental implant manufacturers to shift from all-metal implants, to part-metal and part-ceramic implants, to the newer all-ceramic or zirconia implants.

Zirconia implants are made of high-impact resistant ceramic called tetragonal zirconia polycrystal (ZrO2+Y2O3). They remedy many of the issues and complaints doctors and patients have with traditional metal implants and have several advantages—let’s take a look at some of them.

Advantages of Zirconia Implants

• Do not cause allergic reactions – Although titanium is considered non-toxic, some people still have allergic reactions to titanium. Zirconia implants are inert, non-corrosive, and hypoallergenic.
• Have been used for decades in medical applications – Millions of patients have had zirconia used safely and effectively as the base material for their hip replacements. The zirconia used for medical applications also undergoes strict radiation monitoring to ensure its safety for use within the body.
• They are incredibly strong – Unlike titanium implants, zirconia offers a much higher degree of resistance to scratching, corrosion, and fracture. The aerospace industry even uses zirconia (ZrO2) due to its high resistance to heat and fracture. This all means a safer and more aesthetically pleasing result for the patient.
• One-piece design is more hygienic – Zirconia implants are a one-piece design, meaning there is nowhere for bacteria to build up or liquids to penetrate like with titanium implants. They are highly biocompatible (how a material reacts with the human body) which leads to healthier gums and no risk of corrosion.
• Implant margin is at gum not bone level – With titanium implants the margin (or gap between the implant and the tooth) is at bone level, which can lead to bacterial buildup since you can’t brush there. The zirconia implant margin, which is at gum level, allows you to brush and clean your implant and restoration regularly.

If you are in need of a restorative dental implant, it would be wise to consider zirconia due to its many advantages. It might not work in every situation, but feel free to discuss your options with Dr. Jenny A. Kanganis or one of our Bronxville staff members.

It’s human nature to delay tackling problems. We even have the clichés to prove it:  “Leave well enough alone.” “Out of sight, out of mind.” “If it’s not broken, don’t fix it!” But when it comes to your health, proactive care is always best. And when it comes to dental health, your wisdom teeth are certainly something to be proactive about!

Children have 20 baby teeth that are replaced over time with 32 adult teeth. The last to arrive, in our late teens and early twenties, are the four third molars, or wisdom teeth. But that “32” total is a little flexible. Some people never develop wisdom teeth at all. You can stop reading here if you are one of this carefree group. The rest of us have from one to four wisdom teeth, and it’s a smart idea to ask our dental professionals just what we have going on below the gumline.

Your dentist might be the first to mention your wisdom teeth at your regular checkup, or you might be surprised to see a new tooth emerging while you are doing your nightly brushing and flossing. Wisdom teeth can remain trapped under gums and bone, a condition called “impaction,” they can erupt partially, or sometimes even erupt completely. They can be symptom-free, or may present with pain, redness, swelling, or bad breath. But whenever the first signs of wisdom teeth appear, in an X-ray or in your mirror, it’s time to discuss your options.

Completely Impacted Tooth

A wisdom tooth may never erupt, remaining trapped below your gums because it has no room to emerge. Even though it isn’t visible, an impacted wisdom tooth can pose serious risks requiring its extraction:

• Other teeth might be pushed out of alignment as the tooth tries to emerge
• The roots of neighboring teeth can be damaged by pressure from the trapped tooth
• A cyst can develop around the impacted tooth which can damage neighboring teeth, nerves, and bone
• Rarely, a tumor can develop. While these are usually benign, they can require the removal of bone and tissue.

Even if you are symptom-free, regular exams and X-rays are important for monitoring the condition of impacted wisdom teeth to make sure that they remain problem-free.

Partially Impacted Tooth

A wisdom tooth can also begin to erupt, but never break completely through the gums. The partially exposed tooth and the gum tissue are very difficult to clean effectively, trapping food particles and bacteria. Partially erupted teeth:

• Have a greater chance of serious decay
• Increase the risk of gum disease
• Can also cause problems as they emerge when they are angled toward neighboring teeth.

When infection and rapid decay are present, or the tooth is emerging at an angle which can damage nearby teeth or bone, extraction is often considered the best treatment option.

Preventive Extraction

Some people have enough room in their mouths to accommodate wisdom teeth without affecting the alignment of their other teeth or their bite. Some wisdom teeth never erupt at all, staying within the jawbone without affecting other teeth. If there are no problems with these teeth, your dentist and oral surgeon might recommend leaving them in place and monitoring them carefully.

If there is the potential for crowding, damage to nearby teeth, or any other future problems, extraction could be recommended as a preventative measure. Age can be an important factor in recommending extraction as well. Patients in their late teens and early twenties often have an easier time with wisdom tooth surgery because:

• The roots of the wisdom tooth aren’t as developed
• Jawbone structure is not as dense
• Shorter roots aren’t as likely to impact sinuses in the upper jaw
• Shorter roots are less likely to cause interference with nerves in the lower jaw
• Bone healing and regeneration is more efficient at this age.

If you are considering the best plan of action for your wisdom teeth, an appointment with Dr. Jenny A. Kanganis at our Bronxville office is a very good idea. Oral and maxillofacial surgeons have a minimum of four years of advanced studies in a hospital-based residency program, where they train with medical residents in the fields of general surgery, anesthesiology, internal medicine, and other specialties with a specific focus on the bones, muscles, and nerves of the face, mouth, and jaw.

Oral surgeons like Dr. Jenny A. Kanganis are experts in dealing with wisdom teeth and surgical extractions. And while most extractions are fairly straightforward, their surgical training and experience is invaluable where extractions are more complicated due to the position of the tooth in the jaw, the degree of impaction, and the length and development of the roots. They are trained in all forms of anesthesia, and can provide whichever method you choose for your most comfortable experience, whether it be local anesthesia, sedation, or general anesthesia.

When you’re dealing with your health, the only cliché that really applies is “An ounce of prevention is worth a pound of cure”! Whether your wisdom teeth are best treated with extraction or regular monitoring, Dr. Jenny A. Kanganis can help you decide on the best plan for your dental health both today and for your future.