Dr. Serge Lokot grew up here in the San Fernando Valley. He attended Notre Dame High School in Sherman Oaks, then went on to attended the University of Southern California where he earned his Bachelor’s degree in Pre-Dental. He continued his education at the USC School of Dentistry to earn his Doctorate of Dental Surgery. During dental school, Dr. Lokot was elected class president for two of the four years he attended. This was where he discovered his interest in Oral Surgery. He spent a significant amount of time in the oral surgery clinic, as well as completing multiple externships at some of the country’s top hospitals.

After dental school, Dr. Lokot accepted a residency position at the prestigious University of Miami/Jackson Memorial Hospital. During his 5 years of residency, Dr. Lokot had wide-ranging experience in dealing with the most medically and surgically complex patients. A hospital based residency provided him a complete surgical experience, ranging from complex dental implant procedures and extractions on medically compromised patients to facial trauma and repair of large maxillofacial defects. He also underwent extensive anesthesia training during this time. Dr Lokot was on the forefront of the latest advances in tissue engineering as well as the treatment of Medication Induced Osteonecrosis of the Jaws (MIONJ/BIONJ). Dr. Lokot served as Chief Resident and earned the Surgical Leadership Award that was presented by his faculty for his continued dedication to advancing the field or Oral and Maxillofacial Surgery.

Dental Implants

A natural tooth consists of a root and a crown. If you compare natural teeth to implant-supported replacement teeth, you’ll see they have the same basic parts. Both have a crown (the visible part used to chew food). Both have a root that holds the tooth securely under the gum and is anchored into the jaw. The difference is that the implant is made of titanium – the same time-tested material used by surgeons for artificial joints. When you lose a tooth, you lose both the root and the crown. To replace the tooth, the surgeon first replaces the root with a small dental implant.

Time is allowed for bone to heal and grow around the dental implant. The bone bonds with the titanium, creating a strong foundation for artificial teeth.  A support post (abutment) is then placed on the implant and a new replacement tooth (crown) is placed on top of the abutment. In many cases a temporary replacement tooth can be attached to the implant immediately after it is placed. If all of your teeth are missing, a variety of treatment options are available to support the replacement teeth.

Single Tooth Dental Implants

Your teeth affect your whole body. When they’re healthy, you’re healthier too. A missing tooth can affect your bite, speech and eating choices. As you rely more on your remaining teeth, you increase the chance they will wear out prematurely, or be damaged or lost. You may also experience headaches and/or jaw pain.

Who would want their appearance and health to deteriorate? That’s the natural consequence of missing teeth – the jaw literally melts away. Generally, people will lose 25% of their supporting jawbone structure within the first year after tooth loss. Dental implants are more easily placed when teeth are first extracted because bone replacement becomes more complex as time passes. The great news? Implants act just like your natural teeth. They safeguard and preserve your bone structure, oral health and appearance. Your dentist and the implant surgeon will provide you with options so that you can make the most informed decision concerning tooth replacement.

Overview of Implant Placement

The procedure to place a dental implant takes 30 to 60 minutes for one implant and only 2 to 3 hours for multiple implants. The number of appointments and time required, vary from patient to patient. The surgeon will bring great precision and attention to the details of your case.

Prior to surgery, you may receive antibiotics and for greater comfort, intravenous sedation or nitrous oxide (laughing gas). These options are discussed with you at your consultation appointment. A local anesthetic will be administered to numb the area where the dental implant will be placed.

When you are comfortable, the surgeon makes a small incision in the gum tissue to reveal the bone, creates space using special instruments, and gently inserts the titanium implant. The top of this implant is often visible through the gum. Sometimes it is better in the early stages of healing to have the implant covered by the gum tissue.

Full Mouth Dental Implants

Replacement Teeth for Those Missing All Upper & Lower Teeth

Although many patients have no problem wearing an upper denture, some people find it difficult to wear and eat with lower dentures. Several implant-supported replacement options are available if you are missing all of your lower teeth.

Ball Attachment Denture

One option is to have two implants placed in your lower jaw and a denture made that snaps onto these implants. This option allows your lower denture to be more stable while chewing than without implants. However, there will still be movement of your lower denture, and sore spots will occur if any food particles, especially seeds, are caught under it. As with all removable replacement teeth, you still will need periodic appointments for denture adjustment.

Screw Retained Denture

A third option involves placing five or more implants in your jaw and attaching a permanent denture. Your denture is held in place by screws or clasps that secure it to the support posts or bar. It doesn’t touch the gum tissue, which allows you to clean under the denture without removing it. This denture will replace all your missing lower teeth and will not be removed except at maintenance visits. Although cleaning under your denture without removing it is more time consuming and requires more dexterity, many patients who want a permanent denture prefer this option.

Individual Implants

The final option is to have all your teeth individually replaced so that they will appear to be growing out of your gum tissue and will most closely resemble the appearance of your natural teeth. This option usually requires eight or more implants. Separate abutments or support posts for each one of these implants will be made and crowns for each missing tooth will be placed. The teeth are often joined together for sinus grafting to replace bone height strength and support. Overall, this is the most costly option, because it requires the most implants and individual replacement tooth fabrication. Your replacement options may also be limited by the current size and shape of your jawbone.

Bone Grafting for Implants

After tooth extraction, if the walls of the socket are very thick, they will usually fill naturally with bone in two to three months. However, when the walls of your socket are very thin (such as in your upper and lower front teeth), this type of healing will not be as predictable. In these situations, a bone graft is often placed at the time of tooth extraction to help your body fill in the empty socket with bone. This step will maintain the width and volume of bone you will need for implant placement several months later.

There may be inadequate bone for implant placement if your tooth was removed many years ago and your bony ridge is extremely thin. In this case, a bone graft can be placed next to the thin bone and allowed to heal for up to six months. After the graft has fused to your pre-existing bone, the ridge will be re-entered and the implant placed. Bone grafting is usually a relatively comfortable office procedure. Many different bone-grafting materials are available, including your own bone.

Implant Supported Overdenture

An Implant Supported Overdenture is a contemporary restoration that has revolutionized the way surgeons and dentists think of replacing a full set of teeth. Standard dentures are unsecured prostheses with inherent limitations. Most often, dentures are painful, inconvenient and unstable. Such dentures can make chewing foods difficult, limiting the foods that you once enjoyed. Modern dentistry can help with implant supported dentures.

The Implant Supported Overdenture treatment concept replaces your missing teeth with a full dental bridge supported by dental implants.Fewer implants are needed and overall treatment time and cost is reduced. An Implant Supported Overdenture solution also ensures greater stability in the bone, reducing the need for bone graft surgery to increase bone volume. Implant-supported overdentures stay connected with bar and clip attachment methods or use a variety of abutment-based attachments (ball, magnets, and resilient stud attachments such as Locators). The most appropriate attachment system for your individual needs relates to a variety of factors that are determined early in the treatment.

Implant Supported Overdentures offer you many advantages:

  • A cost effective solution. When compared to some other implant supported restoration methods, your new replacement teeth require fewer implants for each jaw. With fewer implants required, the cost is lowered.
  • Reduced need for bone grafting. The special angled placement of two of the implants ensures a secure and stable anchorage for the replaced arch, often making bone grafting unnecessary.
  • Faster treatment and healing time. Your replacement arch can be attached to your implants immediately after insertion.

 

 

 

 

Q What can I use for teeth while the implants heal?

Many options are available, and they are tailored to your specific requirements. If you need a replacement tooth while the implants are healing, temporary removable teeth or a temporary bridge can be made. If all of your teeth are missing, we can usually modify your present complete denture or make you a new temporary denture. If you would prefer non-removable teeth during the healing phase, temporary transitional implants usually can be placed along with the permanent implants, and temporary teeth may be made and inserted the same day. Depending on your particular situation, some implants can be placed and “loaded” immediately. This means a temporary or permanent replacement tooth can be placed on, or shortly after, the day the implant is placed.

Q What are the potential problems after dental implant surgery?

Although it is natural to be concerned about the pain that may be caused by these procedures, most patients do not experience severe or significant post-operative pain. Pain medication and antibiotics will be prescribed for you to make your recovery as easy as possible. Occasionally, some people develop post-operative infections that require additional antibiotic treatment. Even though great care is taken to place the implant precisely, occasionally adjacent teeth are injured in the placement process. In addition, there is a chance that the nerve in the lower jaw, which provides sensation to your lower lip and chin, may be affected. If you are missing quite a lot of bone, it might be difficult to place an implant without infringing on the nerve space. Although we take great care to avoid this nerve, occasionally it is irritated during the procedure, resulting in tingling, numbness or a complete lack of sensation in your lip, chin or tongue. Usually these altered sensations will resolve within time, but they can be permanent and/or painful. If you notify us of post-operative numbness as soon as possible, it will allow us to manage your care in the most appropriate way.

Q How long will the implants last?

Implants usually last a long time. When patients are missing all of their teeth, long-term studies (more than 30 years) show an 80 to 90 percent success rate. For patients missing one or several teeth, recent studies show a success rate of greater than 95 percent, which compares favorably with other areas in the body that receive implant replacement (such as hips or knees). However, if one of your dental implants either doesn’t heal properly or loosens after a period of time, you may need to have it removed. After the site heals (or on occasion at the time of removal), another implant usually can be placed.

Q When are the replacement teeth attached to the implant?

The replacement teeth are usually attached to the implant when adequate healing has occurred and your jaw bone is firmly fused to the implant. Depending on a variety of factors, it may be possible to begin this phase of your treatment immediately or shortly after implant placement. We will review the most appropriate treatment sequence and timing for your particular situation.

The dental work required to complete your treatment is complex. Most of the work involves actually making the new teeth before they are placed. Your appointments are considered more comfortable and more pleasant than previous methods of tooth replacement. Frequently, this process can be performed without local anesthesia.

Your restorative treatment begins with specialized impressions that allow us to produce a replica of your mouth and implants. We will also make “bite” records so that we see the relationship of your upper and lower jaws. With this information, we will make the abutments (support posts) that attach your replacement teeth to your implants. Various types of abutments exist. Frequently, we can use “off the shelf” abutments. Other times, custom abutments must be made of gold or a tooth-colored ceramic material. As you can imagine, these custom made abutments add to the cost and treatment time involved. Which abutment to use is a decision that often cannot be made until after healing is complete and impressions have been made.

Q How do I clean my new teeth?

As with natural teeth, it is important that you clean implant-supported restorations regularly with toothbrushes, floss and any other recommended aids. You should also visit your dentist several times each year for hygiene and maintenance. As with regular dentures and other tooth replacements, your implants and their associated components are subject to wear and tear and eventually will need repair, including clip replacement, relines, screw tightening, and other adjustments.

Q Will one doctor do everything?

Usually, a dental surgeon places the implant(s) and performs other necessary surgical procedures – your general dentist provides the temporary and permanent replacement teeth. Both doctors are involved in planning your dental treatment. Also, depending upon a variety of factors, different dental specialists may help with your dental care.

Q How much does dental implant treatment cost?

Before treatment begins, every effort will be made to give you an accurate estimate of all the expenses involved in placing the implants and making your replacement teeth. In many cases, there is an initial charge for the diagnostic work-up, including study models, x-rays, and the fabrication of a surgical template to ensure the best possible result. In addition you will be charged for the abutment or support post(s), plus the crown, dentures, or anything else that will be placed over the implants, including temporary restorations. Periodic maintenance such as hygiene visits, tissue conditioners, denture relines and other repairs will also incur additional charges.

When different doctors are involved in your treatment, you will be charged separately for their services. We will try to assist you in estimating what your actual payments will be after we evaluate your insurance coverage or other third party payments. Also, you should consider your personal financial investment in each treatment option as some insurance companies provide limited or no coverage.

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