Dr Shumantov comes from a family of dentists and was exposed early to the professional dental field. His father was the Dental Clinic Director of the hospital at the Ministry of Internal Affairs, and his mother is still actively practicing dentistry in Sofia. From his parents Veselin learned not to judge other dentist’s work because one cannot know the circumstances under which the dentist had performed it. Dr Shumantov has been active in communicating, learning and collaborating with the most prominent dentists in New York City, Europe and Asia. He has a large network of dental specialists that he has learned from and consults with regularly. He often refers to his mentors and is grateful for their inspiration and guidance.
Metal-Free Dental Implants
Metal-free implants (often known as zirconium or all-ceramic) are made of zirconium oxide, a naturally occurring, extremely hard ceramic substance. This material is resistant against acids and corrosion, and is biocompatible, which means no allergic reactions should be expected. Until recently, all dental implants was made of titanium, but today’s state-of-the-art dental care includes this advanced nonmetal alternative.
Advantages of Metal-Free Implants
The advantages of zirconia implants are:
– NATURAL: Now it is unnecessary to implant titanium or any other metal into the jawbone in order to create fixed teeth replacements. No artificial material can be identical to the biological root structure, but from the materials approved for implantation, the ceramic is more natural choice than the metal.
– HYGIENIC: It is shown to retain less plaque than their titanium counterparts, which will promote healthier gums around the implant. The implants is most often used in a single-piece design, which eliminates a common problem with two-piece titanium implants – the so called “microgap”. The microgap is space between the two pieces of a metal implant that may become a trap for bacteria. The single-piece design avoids that problem and therefore is more hygienic, in addition to the hygiene benefits of the zirconia itself.
– COSMETICALLY APPEALING: The material has the advantage of its tooth-like color which, as a base for a tooth replacement, appears more natural than crowns with metal substructure underneath. The white color also eliminates the possibility of a darkened gum line that sometimes occurs in patients with thin, more transparent gum tissue (gingiva).
– STRONG: Zirconium is the second hardest material found in nature, next to the diamond. Again, the sigle piece design allows for even greater strength
– OSSEOINTEGRATIVE: This orthodontic option has a high rate of osseointegration, confirmed by numerous studies in Germany and the United States.
Titanium Implant Removal
Titanium implant removal service is offered in those unfortunate situations that no longer justify saving a dental implant. Usually the patient complains either of aesthetic issue, of a health issue that overrides the benefits of having an implant, or a combination of both.
Dentistry was revolutionized by the application of implanted fixtures as a root replacement anchorage for stable dental prostheses. However, the implant may require removal if one of the following presents:
1) Advanced periimplantitis with poor prognosis. When the soft tissue is severely inflamed or the bone loss around the implant is significant, it is better to take it out rather than trying to save it. The reason to do that is the poor risks vs benefits ratio. Complete decontamination of the implant surface is not possible, even with chemicals, ozone and laser. Therefore, bone regeneration using graft will be hard to achieve and it will be partial regeneration at the most. Sometimes, the graft looks good on xray but it is not actually attached to the bone. Soft tissue (gum) graft works better, especially after removing the titanium implant threads in the exposed area and polishing the surface, because new soft tissue attachment to the implant surface is easier to form than new bone attachment. However, knowing that we offer superior products, such as zirconia implants, the patients often choose to replace the implant rather than trying to save it.
2) Adverse reaction, including allergy, to impurities in the titanium alloy. Reaction to the titanium itself is possible, although more rare. A simple test that we use is to ask the patient if he or she reacts to metal jewelry. If the patient has skin reaction to metal necklaces, earrings and rings, then we can expect a reaction to grade 5 titanium implants. The most common reactions are of neurological character (chronic fatigue syndrome, fuzzy brain) or skin allergy. When required or requested, we would refer the patient for specific skin test and/or immunology test from a blood sample.
3) implant fracture – it occurs due to one or a combination of the following:
– material fatigue
– pure titanium implants which are more fragile than alloys
– single tooth mini implants (too narrow to carry full load individually, with some exceptions)
– poor implant design with walls at the implant-abutment interface that are too narrow
– zirconium implants placed under unfavorable angulation, over-drilled or too narrow to use in the specific tooth location
4) abutment fracture or abutment screw damage – when removal of the abutment or the abutment screw is impossible, removal and replacement of the whole implant is indicated
5) otherwise healthy implant, placed in less than optimal position AND creating an aesthetic or functional issue. Not every implant placed in a wrong position, requires removal.
Cosmetic Dentistry
METAL-FREE ZIRCONIUM IMPLANTS –Nonmetal solution for superior aesthetics
FULL MOUTH RECONSTRUCTION – PORCELAIN VENEERS
Complete lower arch dental reconstruction with porcelain veneers and crowns. This patient from Canada was phobic and the thought of a dentist was horrifying him. His phobia is gone now and he enjoys the new smile and actually looks forward to a recall visit to spend some time in New York.
FULL MOUTH RECONSTRUCTION – Pictured result treatment time: ONE VISIT (temporary tee
FULL MOUTH RECONSTRUCTION – PORCELAIN CROWNS, ZIRCONIA CROWNS
A lady from Ireland came with main concern of having old, short crowns with inferior aesthetics. She was also showing too much gum tissue when smiling, a.k.a. gummy smile. Mild soft tissue re-contouring was done on all upper teeth, and zirconia crowns were placed to accomplish the new uniform smile.
INLAYS AND ONLAYS – Provide natural life-like appearance in two visits. Preserve healthy tooth structure. Made of porcelain or composite
INVISALIGN – Provides dramatic results for specific orthodontic problems. Can be combined with veneers for ultimate aesthetics (if desired). The pictured result is patient’s own teeth. Co-effect: increased self-confidence. More valuable.