Our Services

Routine, advanced and complex treatments

We have considerable clinical and teaching experience, knowledge, and expertise in all aspects of implant dentistry. We accept referrals for treatment of advance and complex implant cases, and single, multiple and full arch reconstructions as well as diagnosis and management of failing and ailing implants and complications from other dentists and implant clinicians. 

Bone grafting

Bone volume is assessed in the implant planning stages using radiographs and, where appropriate, CT scanning. If there is insufficient bone for implant placement a bone graft may be used. This is a specialised procedure to re establish bone which has been lost through being edentulous for long periods, or as a result of periodontal disease, trauma or infection. The graft material will either be particulated (giving better adaptation to a defect) or en block (usually from the mandibular ascending ramus or the chin). Our principal particulate graft materials are produced by Geistlich(Bio-Oss, Bio-Guide).

Sinus grafting

If there is insufficient bone in the maxilla for placement of dental implants sinus grafting (sinus lift, sinus augmentation) may be appropriate.

Sinus grafting is an intra oral procedure. The incision is made into the gingiva and the soft tissue is reflected. A window is then cut into the sinus, followed by very careful reflection of the sinus membrane. The bone graft is placed onto the floor of the sinus and the surgical site closed.

A second technique for sinus grafting is performed using an osteotome to lift the sinus floor by a gentle tapping motion. This technique is used for simultaneous implant placement and sinus grafting to create more vertical height of bone.

The healing period following sinus grafting prior to implant placement is usually 3-6 months.

Guided bone and guided tissue regeneration

In these procedures barrier membranes and bone substitute materials are used to develop the hard tissues and the periodontal attachment when implants are to be placed at sites with insufficient volumes of bone or gingival tissue. It can be used to support new bony growth on the alveolar ridge, may be placed in tooth sockets after extraction to prepare for future implant and prosthetic placement, and filling of bony defects caused by cysts or impacted teeth.

Socket preservation

Socket preservation is a procedure in which graft material is placed in the socket of an extracted tooth at the time of extraction to preserve the alveolar ridge. After extraction, jaw bone has to be preserved to keep sockets in their original shape. Without socket preservation, the bone quickly resorbs.

The socket preservation procedure prevents immediate bone resorption after extraction thus keeping the contour and integrity of the socket with successful and natural looking appearance for tooth restorative procedures. All dental prostheses require good jaw bone support for them to be successful in the long run. Without socket preservation, residual bone could lose volume resulting in loss of facial vertical and horizontal dimension and changes in facial soft tissue aesthetics.

Failing implants and mediolegal cases

We accept referrals and give second opinions for failing and failed case treatment. We understand that this can be a most distressing time for the patient and clinician. We will endeavor to provide appropriate advice and recommendations and will be available to undertake the procedures necessary to resolve the situation in a holistic and cost effective manner.

Implants may fail due to:

   Failure to osseointegrate if planning and placement protocols are not followed

   Peri-implantitis

   Restorative failure

   Functional failure through occlusal factors

   Aesthetic failures

   Fractured implants/mechanical failures but these are rare in well planned cases

Peri-implantitis

Peri-implantitis is, in simple terms, when periodontal disease affects the tissues supporting an implant. The pathogens involved are also very similar to those involved in periodontal disease.

Prevention of peri-implantitis is critical by reducing various risk factors before proceeding with implant therapy and maintaining the implants long term. Risk factors include smoking, uncontrolled periodontal disease, unstable diabetes and other immunological disorders. If peri-implantitis is detected then various procedures can be used to stabilize the disease process and prevent its progress. This involves cleansing the implant surface with or without flap reflection, the use of various medications, guided tissue regeneration techniques or, in advanced cases, explantation. ICE runs the Centre for Treatment of Peri-Implant Diseases where patients are referred by their dentists and implant surgeons for the diagnosis and management of peri implant diseases.

Explantation

Implant removal may be necessary due to a variety of reasons. This can usually be performed in a controlled and atraumatic procedure. An additional implant can often be planned subsequently.

Restorative failure

Crowns, bridges and implant-retained overdentures can fail and fracture with time. This may be due to de-cementation, or screw loosening or due to fracture to the porcelain or substructure. The underlying cause needs to identified and corrected prior to proceeding with repairing or replacing the prosthesis.

Aesthetic failures

Dental implants are a functional replacement for missing teeth which can blend harmoniously with the adjacent teeth. However dental implants are prostheses which are used to replace missing teeth often in difficult and challenging situations. The effects of gum recessions, bone resorption and tooth movement need to be properly assessed and considered before a realistic aesthetic outcome can be realized. Our experience in this area allows us to take on these cases, remedy difficult circumstances and deliver predictable and stable results. This may mean additional surgical correction, orthodontics or the clever use of gum coloured porcelains and composite to disguise the effects of tissue loss.

 

Call us on 0161 413 8330
Prof C Ucer 01612371842
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