MINI IMPLANTS FOR LOWER DENTURE STABLIZATION

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1 MINI IMPLANTS FOR LOWER DENTURE STABLIZATION From the Office of Dr. Michael J. Guy 511A Lakeshore Drive, North Bay ON, P1A 2E3 Mini dental implants (MDI) have become increasingly popular in the past decade and have been approved for many longterm uses in dentistry. Amongst the many uses, the stabilization of a loose lower dentures is probably the most utilized. DENTURES Dentures, especially lower dentures, in reality are a poor substitute for natural teeth. People do not have the tactile sense when chewing that is transmitted through the roots of teeth; dentures are often ill fitting and have but a fraction of the chewing and cutting efficiency of natural teeth. Most denture wearers struggle daily with their loose or ill fitting dentures and suffer a great deal of discomfort. Some will resort to denture creams, spending hundreds of dollars per year to secure their floppy denture, while others will just withdraw from any social engagement to avoid any risk of embarrassment that could occur. Despite how skilfully they can be made, ask any person who wears a lower denture and they will often tell you of the myriad of problems they experience. MINI-DENTAL IMPLANTS Fortunately with the advent of implants, there are many excellent options available now to denture wearers to address and solve many of these issues. There are many options when it comes to dental implants ranging from a mini-implant stabilized denture to a standard- size implant-supported removable denture to a fully fixed implant implant-supported denture (which results in a permanent bridge being placed). Treatment time, cost and commitment with each option varies (see Treatment Solutions For The Mandibular Edentlous Patient ). In addition, depending on your clinical and radiographic condition you may not even be a candidate for a certain option. If this is the case or you cannot afford to have your denture replaced by a full mouth dental implant reconstruction (finances and bone configuration are the two biggest obstacles to this treatment), an over denture mini-dental implant solution could be the answer. Mini dental implant treatment to stabilize your denture is the simplest and most economical of all the implant solutions, They are simply placed into the jawbone. and have several advantages over standard-size implants: Minimum trauma to the implant site, In some cases there is no need for surgical preparation, immediate stability upon completion of placement. Mini-dental implants are surprisingly affordable and are usually available at a fraction of the cost of traditional implants. Mini-implants can enhance your life, freeing you of a lot of the discomforts and heartaches of a loose or ill-fitting denture. Thousands of grateful patients all over the world have been blessed with this effective, simply dental system. HOW THEY WORK Typically four or more mini-implants are placed, depending upon the dentist s analysis of the case. The mini implant is basically a small one-piece titanium screw with the top consisting of a ball head that projects above the gum. Once placed, the denture, either the patient s old denture or a newly fabricated denture, is secured and stabilized to the ball with female retention caps inserted into the inside of the denture. The retention caps are positioned to snap over the ball head to enhance retention, reduce denture movement and facilitates eating and speaking. Mini implants differ from standard sized implants in how they gain their retention after they are place. The small, screw shaped miniature dental implant wedges into and expands the bone as it is inserted. After insertion, the elastic properties of bone create an intimate contact between bone and fixture, thus rendering it extremely solid and stable at placement. This allows it to be used to immediately to stabilize the loose dentures. The patient can walk out of the office comfortable and functional after just one visit. Standard-sized implant requires a 4 to 6 month period of integration before they can be placed into function. FAILURES It must be recognized that all implants systems as well as natural teeth are subject to potential failure due to natural causes, including osteoporosis, poor oral hygiene, wear and tear attrition, poor health, smoking, heavy, stressful biting habits, and lack of follow up dental maintenance care. Mini implants similarly do not carry any actual or implied

2 guarantee of longevity. However, the loss of a mini implant is a far less critical event to the patient since it may be replaced at relatively minimal cost compared to the larger conventional implants, and with minimal associated bone or gum deterioration. Case failures involving mini implants are extremely rare. PROCEDURE Placement of the implants are done either non surgically or surgically depending on the shape and quality of the bone where the implants are to be placed. This will be determined at your examination Non-surgical Placement If the bone where the implants are to be placed is flat and adequately wide to accommodate the width of the implants than placement can be done nonsurgically. In this case treatment is as simple as anesthetising the patient and placing the 4 to 8 implants. During the procedure a few radiographs are taken to confirm implant orientation. Placement is completed in one to one and a half hours and this appointment is coordinated with the Denturist so your denture can be modified the same day. If you are going to get a new denture impression may also be taken at this time for the new denture. After the procedure there will probably be some minor discomfort and perhaps a little bleeding. We will prescribe pain medications to help control any pain. You will be instructed to leave your denture in for about 24 hours or until your follow-up visit. Once the anesthetic wears off you should be able to chew comfortable but it is recommended you eat softer foods at first until you are accustom to the new feel of your dentures. Surgical Placement If the bone where the implants are to be placed is not ideal or there is still teeth present surgery is needed to prepare the area to receive the implants. This may involve reshaping your narrow or knife edged so it can accommodate the width of the implants, removal of teeth or the placement artificial bone. If surgery is required the procedure will take longer- the new denture. about two to three hours. This appointment is also coordinated with the Denturist so your denture can be modified and placed into function the same day. If you are getting a new denture, ideally we will wait about 3 months for healing before impression are taken for After the procedure there will probably be some moderate discomfort and perhaps a little bleeding and swelling. We provide full instructions to help you through the healing period. You will also be instruction to take anti-inflammatories, antibiotics as well as pain medications they will help to control pain, swelling and infection. You will be instructed to leave your denture in for about 3 weeks and we will schedule follow-up visits weekly. You will have sutures and they will be removed after the three weeks. Once the anesthetic wears off you should be able to chew comfortable but it is recommended you eat softer foods at first until you are accustom to the new feel of your dentures There are numerous reports of people experiencing paralysis, developing numbness, tingling, loss of sensation or unexplained pain and muscle wealness in legs and arms, as well numerous other neurological problems as a possible result of zinc in super Poligrip, Fixodent and other Denture creams

3 ESTIMATE FOR MINI DENTAL- IMPLANTS DENTURE PLACEMENT AND REMOVAL As with all dental applications, there s a short adjustment period during which time you become comfortable placing and removing the denture. Placing and removing your denture is an easily learned skill. We will teach you in the office but you will have to practice at home until your hands get the feel of how and where to place the denture so they just snap into place. At first it is best done in front of a mirror. Care and Maintenance In the morning, brush your gums and implant area with a toothbrush and mouth rinse, rinsing the denture itself, then placing it in. Before placing them in the morning or at other times make sure each attachment receptacle is clean and free from debris. You must gently clean around each fixture with a soft toothbrush to keep debris and bacteria from accumulating on them just like real teeth In the evening, the denture is usually removed again and the mouth thoroughly rinsed. You should sleep without your denture. At night you should store the denture in a cleaning solution PROCEDURE FEE Placement of Implants (4 to 8) $ Use Existing Denture $ Make New Denture $ Make Temporary Use of Old Denture $ Make Stay plate $ Alveoplasty $ Extractions $ Bone Grafting $ Gingivectomy $ Tissue Conditioner $ Total Lower Cost: $ This Quote is good for four (4) months. A $1,000 deposit is required when making an appointment for the mini-implant procedure, due to the length of the appointment time. The deposit will be applied to the cost of your treatment. If the appointment is cancelled without forty-eight (48) hours notice, this deposit is NON-REFUNDABLE.

4 Treatment Solutions For The Mandibular Edentlous Patient Option 1 : Mini-Implants 4 to 6 mini-implants required Painless procedure Many cases can be done non-surgically Provides improved retention for the denture, but there still can be some movement of the denture Based on the mechanical lock of the implants to bone opposed to biological integration. No waiting period Easy to clean Easy to fix if you lose an implant O-rings are easy to change Smallest financial investment for patient With a new denture it is approximately $7000-$8000 per jaw. Option 2: Implant Over-denture 2 to 4 implants; can use locator abutment, ball abutments or a bar Surgical procedure always required Provides improved retention for the denture, but there still can be some movement of the denture Denture is removable Implants must osseo-integration before use, so takes 3 to 6 months before ready, Easy to clean O-rings are easy to change Hard to fix if you lose an implant. $9000 to $13,000 per jaw Option 3: Implant Over-denture with Hader Bar 4 to 6 implants Surgical Procedure Denture clips to a retention bar Denture is more supported and stabilized but there still can be some movement of the denture Denture is removable Implants must osseo-integration before use, so takes 3 to 6 months before ready, Easy to clean Hard to fix if you lose an implant $13,000 to $20,000 per jaw Option 4: Implant-Supported full fixed denture 6 to 10 implants Surgical Procedure Complete support, no denture movement. Closest thing to having your own teeth Denture is fixed and can only be removed by the dentist Implants must osseo-integration before use, so takes 3 to 6 months before ready, More difficult to clean Hard to fix if you lose an implant Largest financial investment $30,000 to $40,000 per jaw

5 Mini-dental Implants Informed Consent I,, hereby consent to the insertion or placement of mini dental implants in my jaw for the purpose of providing the immediate and ongoing stabilization for my dental prosthesis to enhance function. The placement of anywhere from 4 to 8 implants is necessary to accomplish denture stabilization. I understand mini implants are a small diameter (2.1to 3.0) implant, made of a titanium alloy which is a biocompatible material that allows for integration to the bone. SUCCESS AND POSSIBLE FAILURE I also understand that function and comfort will be the primary goals of this dental procedure but that success rates of each patient vary so their long-term function cannot be predicted 100%. With that in mind, no guarantee of success has been given to me by Dr. Guy, or any member of his staff. I understand that like any other titanium implants, the factors that determine the long-term success of my mini implants are the density of my bone, the quantity or height of my bone, the quantity of implants used and mainly the care I am going to provide to keep them clean and free of periodontal disease. Also my general health and use of tobacco or excessive alcohol consumption may be important factors. I understand that in the event the mini-dental implants may fail, they can be removed through a subsequent non-surgical procedure. I also understand after a period of healing another implant could place into the area if needed. This would be at an additional cost. CARE AND FOLLOW-UP Dr. Guy has explained to me that once mini-implants are inserted, a recommended dental treatment plan including a program of personal oral hygiene must be strictly followed by me and completed on a schedule of every 3 to 4 months minimum for dental cleaning. I understand that if I do not follow this schedule and plan, the implants may fail because of periodontal disease. OPTIONS I have been informed of the different types and uses of dental implants and the other option available to me to stabilize and/or support my denture. I understand that mini-dental implants are available as one of several options for the stabilization of my dental prosthesis. Dr. Guy discussed the option of standard implants and also the use of dental adhesive alone. Alternate treatments are: No treatment Fabrication of a new denture or reline of my existing denture in an attempt improve comfort and function Placement of two or more standard-size implants with locator attachments to secure my denture Placement of three or more standard-size implants with a bar and clips to secure denture Placement of four to eight standard-size implants and fabrication of a fully fixed denture Other PROCEDURE AND COMPLICATIONS I have also been fully informed by Dr. Guy that the placement of implants may or may not require surgery and this is dependent on the shape and quality of my bone. If I require surgery for bone reshaping, I have further been informed of the procedure and that it is more involved than the non-surgical procedure. Dr. Guy has also discussed the possibility of alternative procedures that may be require for the proper placement of implants. These procedures may include but are not limited to bone reduction, bone grafting, extractions, and/or gum reduction. I have also been advised that swelling, infection, bleeding and/or pain may be associated with any procedure., though it is unlikely to happen if the implants are placed in the non-surgical procedure. In addition, antibiotics are prescribed to prevent or minimize any infection from occurring. I have also been advised that temporary or permanent numbness may occur in my tongue, lip(s), chin, as a result of this procedure if they are placed in my lower jaw, as well as the possibility of sinus involvement if implants are placed in the upper jaw. I further understand though improbable an implant can fracture during insertion depending of the density of my bone, or during the implant s life cycle. In the event that a fracture were to occur, I give Dr. Guy permission and consent to leave the fractured implant in my jaw or remove it under professional conditions and using professional judgment. Titanium

6 implants can usually be left in place with no problems and keep the height of the bone creating no problems. I have carefully read this the contents of consent form, they have been verbally explained to me and any questions I had have been answered. I understand and have been fully informed of all the above, I hereby knowingly consent to the recommended procedures outlined to me by Dr. Guy, and request him/her to place one or more mini dental implants in my jaw for the purpose of dental reconstruction and function enhancement. The specific reason for the treatment is: My diagnosis is: My possible result if treatment is not done: My prognosis is: Patient Printed Name Patient Signature Date CERTIFICATION BY CLINICIAN I, Dr. Guy, certify that I have explained to the above patient the ramifications of the use of mini dental implants to the best of my professional ability. I further certify that in my opinion, the above patient is fully informed of the risks and benefits of the particular procedure agreed to. Dr s signature