New method offers tooth implants in one hour

By Colleen Newvine
News Service

Ann Arbor retiree Bill Madalin needed to replace his teeth but hated the idea of traditional dentures.

"I didn't want to put my teeth in a glass every night, Madalin says.

Instead, he was one of the first patients at the School of Dentistry to undergo a new procedure that implants permanent replacement teeth in about an hour.

Dr. Michael Razzoog, professor of prosthodontics, says this new approach to replacing teeth saves time and causes less stress for mouths. Before this, patients typically had surgery to install anchors in their gums and waited months for their mouths to heal before getting new teeth attached to the anchors.

By comparison, third-year prosthodontics student Dr. Bill Abbo installed Madalin's implants in one visit, and that night Madalin ate steak for dinner. Razzoog says U-M was the first dental school in the country to use the technique. Razzoog and Dr. Richard Scott, a dentistry alumnus, performed the first such operation in North America in 2003.

While other U.S. sites now offer the treatment, the University has the only known American dental school in which students are learning the procedure, and it is teaching the technique to practicing dentists from across the country.

Patients meet with a dentist for a preoperative consultation in which the patient gets a three-dimensional CT scan. Using the scan and computer software developed by Nobel Biocare, a model of the patient's oral structure is made. Both the 3-D image and model help the team determine where to place the implants and make the new teeth.

A surgical template, designed to fit the patient's mouth, guides the dentist in drilling four to eight holes through the gums and into the jaw bone, allowing implants to be held in place with titanium screws.

Youngjoo Lee, a dentist who returned to U-M for a specialist degree, installed lower teeth for Dale Carlsen of South Lyon. It was the first time she'd done the surgery herself, and she says the method made it easy. Carlsen, who lost his teeth to diabetes, also was pleased.

"I can eat with confidence; I'm not self-conscious," he says.

Fewer than 1,000 people worldwide have had the new procedure, which was released for use in the general public this past summer.

Razzoog and Marianella Sierraalta, clinical associate professor of prosthodontics, have been training about 40 dentists a month to install the implants, and they say it can reduce complications because it involves smaller incisions than the old method, giving less chance of infection and swelling.

Compared to removable dentures, the contrast is even greater, giving patients the ability to eat what they want, have more confidence in speaking, and not have to cover the roof of the mouth, like upper dentures typically do.

Razzoog says insurance does not cover the procedure, which costs about $12,000 for a full mouth of teeth at U-M and is more expensive for patients treated by a private practice dentist.

The primary audience for this technique is people who already have had problematic teeth extracted, perhaps those currently wearing dentures, Razzoog says. If patients need to have teeth pulled, they must wait for gums to heal after the extractions before placement of the implants.

Sierraalta hopes to see modifications to the procedure to allow tooth extraction and implants in the same day.