A to Z of same-day dental implants

17 Dec 2018

Smile in a Day is an advanced dental implant treatment that has transformed the lives of hundreds of TDC Implant Centres patients over the past decade.

As with any surgical procedure, there may be terminology used that you’re not familiar with.

In this A to Z, Drs Anthony and Michael Zybutz, brothers and co-founders of TDC Implant Centres, explain some of the most commonly used terms to help you understand and approach this life-changing dental implant procedure with complete confidence.

Abutment
When you have dental implants, a titanium screw (the implant) is placed into your jawbone to function as a substitute tooth root. This implant is then attached to the replacement tooth or teeth using a connector called an abutment.

Aesthetic dentist
This is a dentist who focuses on the appearance, feel and function of replacement teeth. TDC Lead Dentist Dr Anthony Zybutz is a qualified advanced aesthetic dentist with over 20 years’ experience in restorative and cosmetic dentistry.

‘We know how important it is for your new teeth to look and feel as natural as possible. I spend a lot of time with my patients, discussing exactly how they want them to look so that we can give them teeth that fit perfectly and a smile they’ll love,’ says Dr Anthony Zybutz.

‘We get the very best results by using only the highest quality materials, taking time to get things absolutely right and paying great attention to detail.’

After-care or post-procedure care

This refers to the care given after your procedure. On completion of your Smile in a Day procedure it is important that you have on-going care. Our after-care at TDC is caring, well-structured and individualised.

We pride ourselves on post-procedure care being absolutely first rate. On the day of your implant surgery you’ll be given dietary advice and detailed instructions as well as antibiotics and painkillers. You’ll also be provided with a team member’s personal mobile number so that you can call them at any time with queries or concerns.

And so that your new teeth last a lifetime, we’ll enrol you on our Maintenance Programme, which involves coming back to see our dentists and hygienists for check-ups and maintenance as appropriate (usually every three to six months). It’s important to remember that your implants still need to be cared for to keep the bone and gums that hold them firmly in place healthy.

Our programme ensures that your new teeth will be maintained in top-notch condition and that any issues will be addressed before they become problematic. ‘Cleaning your new teeth is as simple as brushing and flossing your teeth twice a day,’ says Lead Surgeon Dr Michael Zybutz.

All on 4
A technique utilising four implants in each jaw, onto which all the replacement teeth are attached. At TDC we are not limited to four implants, but use as many as are needed in each case.

Arch
A dental arch is the full crescent of teeth located in either the upper or lower jaw. Full arch restoration (also known as full jaw restoration) is when a whole upper or lower jaw of replacement teeth is placed on implants. The majority of our patients at TDC require at least one full jaw restoration.

Bone grafting
In patients with severe gum disease, bacterial infection causes bone to be eaten away. This means that in some cases, bone grafts are needed to replace the missing bone before implants can be placed, which increases the risk of complications and can take several months.

‘With TDC Smile in a Day, however, there is rarely any need for bone grafting as the implants are placed at a precise angle to take advantage of existing available bone,’ says Dr Michael Zybutz. ‘This eliminates the need for bone-graft surgery and the months of healing time that involves.’

Bone resorption
This is a process that takes place throughout life and involves cells called osteoclasts breaking down bone tissue. In the mouth this can lead to the loss of bone in your upper and/or lower jaw. If you’ve lost a tooth, bone resorption takes place at an accelerated pace.

Bridge
Bridges, as their name implies, quite literally bridge the gap left by one or more missing teeth. They can be supported on either side by natural teeth or implants.

Bruxism
This is the medical term for clenching or grinding your teeth, usually while you’re sleeping, and is a habit affecting up to 10% of us. Bruxism, which is often linked to anxiety or stress, can damage teeth and also cause jaw pain and headaches.

Calculus
When plaque (see below) calcifies around your teeth it forms calculus, which is also known as tartar.

Calculus is difficult to get rid of yourself and may need to be removed by a dental hygienist. It can be prevented by good oral hygiene such as brushing and flossing regularly.

Conscious sedation
Conscious sedation is a very safe way of keeping patients relaxed and pain-free during implant surgery,’ says Dr Anthony Zybutz. ‘It doesn’t have the risks and side effects associated with having a general anaesthetic and keeps patients in a comfortable, responsive but dream-like state where they can’t remember very much about the procedure afterwards. Another advantage is that patients lose track of time so the procedure seems to be completed very quickly. This can be especially helpful for nervous patients.’

Consent form
It is a legal requirement that patients are provided with a consent form.

At TDC Implant Centres we provide our patients with a full description of the treatment envisaged, with the risks and benefits clearly explained. We also spend time going through treatment options with patients so that they are comfortable with their treatment decisions. During these discussions patients usually take the opportunity to ask questions.

Consultation

TDC Implant Centres offer free initial consultations so that you can discuss possible treatment options with one of our qualified dentists.  This includes assessing whether you’re likely to be suitable for Smile in a Day, and sedation options. ‘At this meeting we also do a full examination of your mouth and gums and take photographs,’ says Dr Anthony Zybutz.

CT scan
CT stands for ‘computerised tomography.’ It involves using a computerised scanner to take detailed X-ray images of your jaw from different angles to ascertain the quality of the bone in your jaw and confirm whether Smile in a Day is a suitable treatment for you.

‘We use these images, along with all the clinical data from your first consultation, to plan where we’re going to place your implants during surgery,’ says Dr Michael Zybutz.

Dental implant
These are little posts resembling screws that can be placed into your jawbone to provide a stable base onto which artificial teeth can be attached to replace teeth that are missing, loose or decayed.

‘At TDC Implant Centres we use the highest-quality implants made from titanium, a metal that is very strong and highly resistant to corrosion. The bone surrounding the implant fuses with it in a process called osseointegration [see below],’ says Dr Michael Zybutz.

Dentures
Dentures, or false teeth, are removable artificial teeth and can be made of plastic (acrylic), metal or nylon.

Complete dentures replace all your upper or lower teeth, while partial dentures replace individual teeth.

Dentures should be brushed and soaked in a denture-cleaning solution daily to help remove more stubborn stains and plaque. They are normally removed at night. Unlike dental implants, they do not remain fixed in your mouth.

Extraction
The removal of teeth.

‘If you have to have teeth removed (extracted) before having Smile in a Day, we’ll do that on the day of surgery to save you having an extra surgical appointment,’ says Dr Michael Zybutz. ‘This is not only less stressful, but also saves weeks of healing time and minimises gum and bone shrinkage, thereby providing more bone for the implants.’

Fixed teeth
Fixed teeth are replacement teeth that, unlike dentures, can only be removed by your dentist. Smile in a Day patients have fixed teeth fitted on the day of surgery and wear them throughout the healing period – usually about three months. The final fixed teeth are placed at a non-surgical appointment (see ‘Smile in a Day,’ below).

‘Fixed teeth look and feel like natural teeth and are much more comfortable than the removable dentures or plates that patients having traditional implants are given,’ says Dr Anthony. ‘This means that soon after surgery you can eat whatever foods you like without worry, even crunchy ones.’

Gingivitis
This is the mildest form of gum disease (see below) and is caused by plaque.

Gum disease
Bleeding, sore, infected or swollen gums and bad breath are a sign you may have gum disease, which is when the soft tissues along the gumline become inflamed due to a build-up of plaque (see below), a sticky substance containing harmful bacteria.

There are three stages of gum disease: gingivitis, periodontitis and advanced periodontitis, the most severe type, which affects the bone and tissues holding your teeth in place resulting in loose teeth that may eventually fall out or have to be removed. People usually don’t show signs of gum disease until they are in their 30s or 40s.

Integrate/integration
Also known as osseointegration (see below), this is the natural process whereby your jawbone and the titanium implants placed into it, fuse together. This takes place during the two to three months after the implant is placed.

It was first observed by Per-Ingvar Brånemark, Professor of Anatomy at the University of Gothenburg in Sweden, who’s since become known as the ‘father of modern dental implantology’. The dental implant he placed in his first human patient in 1965 was still in place 40 years later.

Immediate occlusal loading (IOL) procedure
This involves inserting titanium implants into a patient’s jaw and then attaching fixed temporary teeth to them on the same day, unlike with traditional implants where there is a wait of several months between the implants being placed and the fixed teeth being attached.

Our Smile in a Day treatment is an example of an IOL procedure.

At TDC we routinely attach fixed, functioning teeth on the same day as the implants are placed, so patients leave with secure teeth and a new smile.

These fixed teeth remain securely in place until they are exchanged for the final, permanent set about three months later.

Implant stability
This is an assessment of how well the implant has fused with the bone, something that’s key to implants being successful.

At TDC we guarantee your bone will integrate with your dental implant. This means that if it hasn’t done so by the time we need to replace your temporary fixed teeth with the permanent set (usually two to three months after surgery), we will either replace the implant or give you an additional implant to support your teeth at no additional cost.

The long-term success of dental implants is the responsibility of the patient as success depends heavily on home care, hygienist visits, continuing not to smoke and regular dental check-ups. Both sets of fixed teeth are subject to wear and tear ‒ just like natural teeth ‒ but TDC will repair any chips or breakages quickly and easily, free of charge, for one year after they’ve been placed.

Impressions
These are the moulds that are used to create perfectly fitting teeth: they’re vital to the success of the implant procedure. To ensure a perfect fit for your new teeth, we take impressions of your existing teeth, along with very precise measurements.

‘The look and feel of both your temporary fixed teeth and your final, permanent teeth are very important as they can affect your smile and ability to eat,’ says Dr Anthony.

Osseointegration
This process (see ‘Integrate/integration’, above), where the bone and implant fuse together, typically takes two to three months with Smile in a Day and results in implant stability (see above).

Periodontist
According to the American Academy of Periodontology, “A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants. Periodontists are also experts in the treatment of oral inflammation.”

Periodontitis
A more severe form of gum disease than gingivitis (see above) caused by the harmful bacteria in dental plaque. It can lead to tooth loss because the gums pull away from your teeth and form spaces that can become infected. Your immune system fights these bacteria and the resulting toxins begin to destroy the connective tissue and bone that hold your teeth in place, eventually resulting in loose teeth that fall out or have to be removed.

Permanent teeth

With TDC Smile in a Day, the temporary teeth remain securely fixed in your mouth until they are exchanged for the final, non-removable set of permanent teeth about three months after surgery.  This ensures that your new teeth fit perfectly with your healed gums.

‘The permanent teeth are custom-made for a perfect fit, and are formed from hard-wearing advanced composite materials fused to a robot-milled titanium base.’

‘We have found that this provides the ideal combination of strength and resilience together with “shock absorber” properties by mimicking natural tooth wearability and providing long-term strength’ says Dr Anthony Zybutz.

Plaque
Plaque is a film of sticky, colourless bacteria that builds up on teeth if it’s not removed by twice-daily brushing and flossing. Plaque contains both harmless and harmful bacteria, and it’s the latter that cause tooth decay because they feed on the sugars in our food and release acids that attack tooth enamel. If it’s not removed within 48 hours, plaque hardens to form something called tartar (see below) or calculus (see above) which needs to be removed by a dental professional. Plaque is the primary cause of gum disease (see above).

Post-operative discomfort
Some discomfort and bruising is to be expected after any surgery or dental procedure, including Smile in a Day. An experienced surgical team can help ensure that this is kept to a minimum so that it can be controlled with simple over-the-counter medication such as paracetamol or ibuprofen.

‘None of our patients at TDC Implant Centres has ever found it necessary to use prescription-only painkillers,’ says Dr Michael Zybutz. ‘In fact, most of them remark on how surprisingly pain-free the procedure is – much less than expected.’

TDC reviews on independent review sites Feefo and Trustpilot confirm this:

‘I was very pleased with the procedure and surprised how painless it was.’ (Feefo, June 2017)

‘Michael was very re-assuring that I wouldn’t feel any pain and he was quite right, although after the anaesthetic wore off there was minor discomfort. I had some bruising to my face and some swelling but followed the post-op care I’d been provided with and was soon feeling fine.’ (Feefo, June 2017)

‘I can strongly recommend TDC to anyone thinking of implant surgery. Most remarkably I had no pain at all during and after the surgery.’ (Trustpilot, May 2017)

Prosthesis
This is another name for the temporary fixed teeth that are attached to your dental implants on the day of surgery.

Septicaemia

Also known as sepsis or blood poisoning, this is a potentially fatal condition in which harmful bacteria invade the bloodstream. Septicaemia is now on the rise, especially in hospitals, because of the increase in antibiotic-resistant bacteria.

‘In over 20 years, we’ve never had a single case of septicaemia at TDC Implant Centres,’ says Dr Michael Zybutz. ‘We’ve achieved this through implementing strict infection-control protocols and rigorous medical screening of our patients to minimize risk factors.’

Sinus augmentation
This surgical procedure, also known as sinus lifts, involves using synthetic bone or bone taken from elsewhere in the body, and inserting it into the sinus to encourage new bone to grow in order to ensure that there is enough bone available in the upper jawbone to insert the implants.

‘It’s rare for Smile in a Day patients to need augmentation as our implants are accurately placed specifically to utilise the maximum amount of remaining bone, something that takes a high degree of skill and experience. In situations where there is simply insufficient bone we also have the option of zygomatic implants [see below],’ says Dr Michael Zybutz.

Smile in a Day
This is a life-changing procedure used to give people with severe dental problems a full set of new teeth in a single day. To achieve the best and most successful results this advanced technique requires a skilled and experienced team.

‘On the day of surgery we remove any remaining teeth in the jaw, place the implants at a very precise angle to maximise the use of available bone, and then attach a set of fixed teeth onto the implants,’ says Dr Anthony. ‘These temporary teeth are then replaced with a final, permanent set about three months later when the gums have settled. This exchange is done at a non-surgical appointment.’

At TDC Implant Centres we routinely perform this procedure, restoring bite function and a natural-looking smile.

Specialist surgeon (dental)
Specialist surgeons must be registered with the General Dental Council (GDC) and have completed a specialist training programme approved by the GDC.

In the UK, only dentists who have completed these years of extra training can call themselves a specialist.

Dr Michael Zybutz, Specialist Periodontist and Lead Surgeon at TDC Implant Centres, is the only specialist surgeon in the UK accredited by the American Academy of Cosmetic Dentistry.

Tartar
This is another name for calculus (see above).

Teeth in a Day / Same Day Teeth

Same-day implant treatments can be referred to in different ways including Teeth in a Day, Smile in a Day (see above), Same-Day Teeth and All on 4 (see above). The procedure can be performed on single or multiple teeth, or on full sets of teeth.

At TDC the majority of our patients require at least one full jaw restoration. We routinely, and successfully, treat the most complex case of extreme bone loss, including cases where people have been told they are not suitable for implants.

Titanium
Titanium is a metal widely used in the medical profession for prosthetics and plates due to its non-corrosive properties and the fact that it integrates with the jawbone more reliably than alloys, which are cheaper. At TDC we use implants made of pure titanium because we’ve found this gives the best, long-lasting results and is one of the reasons we have such a high success rate with placing implants.

Treatment plan
This is a written plan detailing what treatment a patient will be receiving. Ideally it should be easy to understand, should describe the dental issues and the treatment envisaged, and clearly outline the cost of the treatment. It should not simply be a list of billable items or codes.

At TDC, once your surgeon has confirmed that you’re suitable for Smile in a Day, you’ll be sent your personalised treatment plan summarising your specific dental issues and your treatment options. Included will be a consent form (see above) for you to sign. Once you are satisfied with the proposed treatment and we have received your signed consent form, we will book in your treatment dates.

Zygomatic implants
Whereas most implants are placed into your jawbone, these are special implants that are inserted into the inside of your zygomatic bone, also known as your cheekbone. There is an additional cost if you’re having zygomatic implants.

‘Zygomatic implants are used for patients with extreme bone loss who don’t have enough bone in their upper jaw to support conventional implants and keep them stable,’ says Dr Michael Zybutz.

‘These implants utilise the inside of the cheekbones. TDC Implant Centres is one of a very small number of dental practices that can offer this service as the procedure is more complex than standard implants and therefore requires an experienced surgeon. Success rates with zygomatic implants are excellent.’

For more information about TDC Smile in a Day, or to book a free consultation, call one of our friendly Patient Advisors on 02035536415 or visit www.smileinaday.co.uk.