Pi DENTAL CENTER BLOG

Dental Implants and Dental Mint Implants: The Common Denominator

Posted by Joanne Balshi, Director of Public Relations on Mar 27, 2017 5:09:39 PM

dentalmintplants2 copy.jpgThis year, in honor of National Prosthodontics Awareness Week, the Pi Dental Center took our healthy smile campaign on the road. On the sunniest, warmest day in our community this year, we participated in the Ambler Earth Fest, a first time venture to bring a community together in the spirit of making our little corner of it, refreshingly natural and healthy.

Many applauded the Pi Dental Center booth as the most “green” and energetic display. Our mission was to convey the importance of a healthy smile and the positive free energy it ignites within the person and within everyone around them. We tend to think of pollution as that which goes out into the atmosphere and compromises our fresh air, but in reality, dental decay, broken teeth and intraoral bacteria are a more lethal personal pollution, capable of causing serious damage to our vital organs if not kept in check.

The obvious question was often repeated. “What does a dentist have to do with Earth Day?” But the surprising answer is that we are very tightly interwoven. Unlike most other maladies, dental disease is highly visible. We have all experienced cringing when an otherwise pretty face reveals a very compromised, unhealthy smile.

At the Pi Dental Center, we strive to restore smiles to maximum good health and keep them as natural as possible. Our specialty is dental implant treatment, replacing all that is unhealthy and dysfunctional in the mouth with porcelain teeth that mimic nature; however, our wide scope of care embraces all restorative dentistry, still promoting the preservation of natural teeth when they can be kept esthetic and functional for a reasonable, cost-effective segment of time.

Our theme for National Prosthodontics Awareness Week was “Keep Your Teeth in Mint Condition,” so it was only natural that along with toothbrushes, tooth paste and floss, we gave away healthy, living, very green mint plants. Even without clinical intervention, our team made people smile all day long with the fragrance of the fresh herb and the play on words.

The common denominator is simple: we keep our Earth healthy and we keep our selves healthy. We seek what is natural and strong and bright in both arenas. It only takes awareness and the tools of knowledge. And every now and then, it also takes a mint!

By Joanne Balshi
Director of Public Relations and Marketing
At Pi Dental Center, Fort Washington, PA
piteam@pidentalcenter.com

 

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Tags: dental implants, prosthodontist and dental treatment, National Prosthodontics Awareness Week

Prosthodontists: A Pathway to Smile Longevity

Posted by Joanne Balshi, Director of Public Relations on Mar 27, 2017 4:16:29 PM

Prosthodontists provides a long lasting smile for beautiful patientBefore the Pi Dental Center became known as a mecca for superior dental implant care in suburban Philadelphia, it enjoyed a robust reputation for very esthetic, comfortable and long lasting restorative dentistry, accomplished with notable time efficiency.  Dr. Tom Balshi, the founder, always an architect and sculptor at heart, designed and built crowns and bridges that could never be recognized as anything but natural teeth.  More importantly, these restorations, whether a single tooth or the restoration of an entire arch, always went off the charts with longevity, often lasting the patients years beyond predictability while conserving both their funds and their time spent in a dental chair.

One of the pleasures of restoring smiles lies in the mail that the Pi Dental Center steadily receives from patients who are genuinely grateful for our care.  Last week we received a handwritten letter from a former patient, now eighty-seven years of age, and living across in the state in Western Pennsylvania.  Dr. Balshi restored her entire mouth with crowns exactly thirty years ago.  Visiting a new dentist for a teeth cleaning and check-up, she wrote to tell us of his amazement that her thirty year old dental work was still in pristine condition with perfect margins and no underlying decay.  She was writing to express the pride she felt in Pi’s behalf and the gratitude she felt for her comprehensive care that has richly endured.

The pathway to smile longevity is the mantra of the prosthodontist.  The additional training in “precision” that a prosthodontist receives translates directly into the quality of restorative dentistry.  When crowns and bridges fit like a glove and the “bite” that is established is as perfect as possible, the teeth stand up to the most rigorous attacks of bacteria and trauma.  A well designed and engineered smile tends to be a healthy smile, and a healthy smile impacts whole body wellness.  The prosthodontist is committed to that pathway and will try to steer all patients in the direction of long term function alongside natural esthetics, whether with crowns, bridges or today’s state of the art dental implants.

By Joanne Balshi
Director of Public Relations and Marketing
At Pi Dental Center, Fort Washington, PA
piteam@pidentalcenter.com

 

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Tags: dental implants, restorative dentistry, prosthodontists, smile longevity

Service with a smile

Posted by Chris Raines on Mar 14, 2017 2:01:48 PM

Did we serve you with a smile - sign at grocery storeThe sign at the grocery store said, "Did We Serve You With A Smile?" Service with a smile is a core policy of many companies in their goal to provide outstanding customer service.

A smile communicates a frame of mind and enhances an interaction. It validates statements made by the recipient of the smile. It conveys a caring attitude and improves communication.

Tricia, a center-city Philadelphia hairdresser, was asked if she often smiled while cutting customers' hair. She said, "Yes. My smile may be the only smile the clients see all day. They might not have spoken to anyone other than me. It can cheer a person up. A smile can make someone else's day!"

Some studies have shown that a smile must be genuine. Faking a smile can take an emotional and physical toll. Other studies suggest that the simple act of putting on a smile can be a mood booster, theorizing that smiling activates areas of the brain associated with reward and triggers the release of dopamine.

When asked about smiling while talking on the telephone, Maryellen at Pi Dental Center said yes, “They say people can ‘hear’ a smile.” Smiling while on the phone has been shown to be valuable. A University of Portsmouth, England study showed that people can hear a smile and some can even pick up on different kinds of smiles.

Reluctance to smile hinders communication. Some people who feel self-conscious because of their dental condition do not smile. Proven and predictable dental implant technology and digital dentures restore beautiful smiles and repair damaged teeth quickly and competently. Board certified prosthodontists at Pi Dental Center  have been successfully providing advanced dental care for over 30 years. Teeth In A Day and Computer Guided Dental Implant Treatment, and the No Bone Solution have helped patients with very little bone regain healthy mouths with permanent teeth supported by dental implants.

A smile establishes rapport and reflects the positive attitude that is so vital to productive relationships. A smile can do wonders! Call 215-646-6334 or contact us at the link below to learn more or schedule an appointment.

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Tags: dental implants, permanent teeth, healthy mouths, smile establishes rapport, smile improves relationships

The Opiate Crisis and How It Relates To Dentistry

Posted by Chris Raines on Feb 28, 2017 4:46:08 PM

Pennsylvania Guidelines for Dentists Regarding OpioidsDentists are among the leading prescribers of opioid prescriptions. The opiate crisis, which takes lives, destroys families and increases crime, has significantly increased in recent years. New regulations and programs address this issue.

A February 2017 panel discussion that included the Montgomery County Department of Drug and Alcohol, the Sheriff’s office, County Commissioner, Dr. Valerie Arkoosh, a Salvation Army representative, and survivors and advocates, was held to address the 138% increase in Montgomery County drug overdoses in 2016.

Research suggests that abuse of prescribed opioids can open the door to heroin use. Nearly half of young people who inject heroin surveyed in three recent studies reported abusing prescription opioids before they started heroin. Some individuals reported switching to heroin because it is less expensive and easier to obtain than prescription opioids. *

More people are dying from heroin overdose than in the past and authorities say that this is due to Fentanyl, which drug dealers often use to cut heroin. It is 80 to 100 times stronger than morphine.

Chief Deputy Michael Beaty, Montgomery County Sheriff’s Office, reported 237 drug related deaths in 2016 (213 were accidental and 98 involved Fentanyl). He asserted that drug use increases other crimes, such as theft.

Cocaine, methamphetamine, oxycodone and the prescription anti-anxiety medications alprazolam (Xanax) and clonazepam (Klonopin) contribute to overdose deaths.

Drug abuse is not only an urban problem. It occurs all locations, including suburban and, surprisingly, rural areas. A 2015 report from the Center for Rural Pennsylvania showed that overdose deaths from heroin, which sells for as little as $5 per bag on the streets, as well as prescription painkillers and other opioids have increased by 470% compared to the previous 20 years. More Pennsylvanians ages 20 to 44 are dying annually from overdoses than from motor vehicle accidents.

“Because of the uptick in cases, the treatment system is being severely taxed. Treatment centers, like Eagleville Hospital, need more beds.” said Kay McGowan, Montgomery County Deputy Administrator of Drug and Alcohol.

McGowan addressed the issue of relapse by recovering addicts. “So many people relapse when they are prescribed meds by a doctor.” Physicians and dentists must conduct careful screening  to determine if the patient is in recovery. Alternatives, such as Nsaids, should be prescribed.

Benny Mosakowski lived in a tranquil suburban community where he attended Plymouth Whitemarsh High School and played football in the 1980’s.  Prescription opioid medications had been prescribed for a football injury.  Benny states that he became instantly hooked on the prescribed pills. He found that the pills were readily available to him but eventually switched to heroin. Benny never thought that heroin addiction could happen but his life quickly spiraled out of control.  Mr. Mosakowski related, “I needed heroin as much as I needed air. I never learned to be an adult or developed coping skills. At 35, I’d had two marriages and 2 children and was sticking a needle in my arm every day.” It took Benny 10 years to stay clean. Thanks to Eagleville Hospital, as of 2012, he has not had another drug. “This is a disease and not a deficiency. I have seen more people die in the past 1 ½ years than in the previous 15. When you reach a state of willingness, if the help is there, you can quit. The problem starts in the medicine cabinet, but then heroin costs less than pills.” Today, Mr. Mosakowski is a survivor and advocate helping others.

The Journal of the American Medical Association reveals that dentists routinely prescribe opioid analgesics. The first sign of this unexpected source of opioid prescriptions was discovered in 2011. At that time a survey of members from the American Dental Association Survey Center was taken and the findings were surprising. The data shows the following:

  • 85% of dental surgeons said they almost always prescribed an opioid
  • 64% of surgeons said that their opioid prescription of choice was hydrocodone with acetaminophen
  • The average number of hydrocodone with acetaminophen was 20 tablets
  • In 96% of the cases, the only medical instructions provided for taking the pills was "as needed for pain”**

Gary Tuggle, who oversees the DEA’s Philadelphia Division, states, “It is imperative that law enforcement, healthcare and treatment professionals, elected officials, and community groups work together to address the factors impacting availability, use and abuse of these drugs.”

“There are many alternatives to opiates that are quite effective,” adds Valerie Arkoosh MD, Montgomery County Commissioner. “If a physician will not consider giving a non-narcotic medication, get a second opinion.” She emphasized, “Patients can just say no to opiates. Parents should always consider non-opiates.” Arkoosh also briefly discussed the new database that doctors and dentists must check before writing opioid prescriptions.

Many people believe that if pain relievers are prescribed by a doctor or dentist, then they are safe.  However, if these medications are taken in larger amounts, more often than prescribed, or for unintended reasons, they can cause severe adverse effects including addiction, overdose, and death. Prescribed medications should never be taken by someone other than the one for whom they were prescribed. Opioid medications should never be combined with alcohol or other drugs.

In light of the current opiate epidemic, dentists must ask themselves how they can effectively help to reduce the problem.  They must learn how to identify patients who have an addiction problem.

Pennsylvania Programs at PA.Gov

What should a dentist do if they suspect that one of their patients has an addiction problem?

New Pennsylvania Department of Health Prescription Drug Monitoring Program (PA PDMP) requirements took effect in January 2017.  Dentists must check the PA PDMP database each time they prescribe an opioid medication.

Governor Wolf said, “By reducing the pattern of over-prescribing painkillers that have such a high risk for abuse, we are fighting back against opioid abuse and heroin use before those habits even begin.”

Providers have a responsibility to diagnose and treat pain using informed clinical judgement that minimizes serious adverse effects. Consideration for the patient’s past and current history of opioid use and abuse must be included when determining which pain medications should be prescribed. The patient’s substance use history should be documented.

Ask open-ended questions to learn about the patient’s drug use. It is as difficult as it is essential. Broaching the subject feels awkward and intrusive.

Unless contraindicated, non-steroidal anti-inflammatory medications (NSAIDS) should be considered. In many cases, NSAIDs have proven to be more effective in treating dental pain than opioids. Pain therapy can be initiated immediately prior to the surgical procedure and continued on a scheduled basis following completion of the procedure.

Patients reporting unexpectedly prolonged pain, particularly those who do not show evidence of ongoing pathology, should not be prescribed opioids. They can instead be referred to a chronic pain specialist.

Relevant information should be provided so patients are well informed about the various options available for pain management. Good physician/patient communication is essential.***

Patients whose behavior indicates the presence of a substance use disorder, should be encouraged to seek evaluation for treatment through their primary medical care provider.

Pennsylvania Medication Take-Back Program ContainerPatients should be instructed in safe disposal of unused medications, to ensure that these meds will not be misused. Through the Pennsylvania Prescription Drug Take-Back Program, Med Return Collection Boxes are available for safe disposal of unused medications, including opioids. This program has placed 492 boxes across Pennsylvania. The total amount of drugs taken back and destroyed in 2015 was 56,252 pounds. https://apps.ddap.pa.gov/GetHelpNow/PillDrop.aspx

Prosthodontist, Dr. Glenn Wolfinger states, “The staff of Pi Dental Center and I have been very aware of the issues regarding opioid use and have been very careful throughout the years in how these medications were prescribed. Non-steroidal anti-inflammatory pain medications have worked well for Pi Dental Center patients.”

In light of the severity of the opioid crisis, it is obligatory that dentists and physicians follow the new Pennsylvania guidelines to identify at-risk patients and to ensure patients are prescribed safe medications.

Contact Pi Dental Center for information about dental treatment and surgical procedures and pain medications.

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Learn More about the opiate crisis and how it relates to dentistry:

Pennsylvania Department Of Health Prescription Drug Monitoring Program
http://www.health.pa.gov/Your-Department-of-Health/Offices%20and%20Bureaus/PaPrescriptionDrugMonitoringProgram/Pages/PDMP-Portal.aspx#.WLCb-m8rKM8

Link to Portal
https://pennsylvania.pmpaware.net/login

Mapping Pennsylvania’s Worsening Heroin Crisis
http://www.pennlive.com/news/2016/03/pennsylvanias_heroin_crisis_is.html

DEA: Drug overdose deaths up sharply in Pennsylvania By Michael Goldberg
http://www.thereporteronline.com/article/RO/20160715/NEWS/160719879

* National Institute on Drug Abuse
https://www.drugabuse.gov/publications/research-reports/heroin/how-heroin-linked-to-prescription-drug-abuse

** http://www.soberrecovery.com/recovery/how-dentists-are-contributing-to-the-opioid-epidemic/

Info about Gary Tuggle
https://www.dea.gov/divisions/phi/phi_sac.shtml

*** Improving the management of post-operative acute pain Meissner et al.
http://www.efic.org/moxiemanager/data/files/Improving%20the%20management%20of%20post-operative%20acute%20pain.pdf

http://sanctuary.net/prescription-drugs-lead-to-illegal-drug-use/

http://www.health.pa.gov/Your-Department-of-Health/Offices%20and%20Bureaus/PaPrescriptionDrugMonitoringProgram/Pages/PDMP-Portal.aspx#.WLCb-m8rKM8

http://www.newbeginningsdrugrehab.org/guide-to-addiction-prevention-for-seniors/

https://addictionresource.com/addiction/substance-abuse-among-seniors/

http://www.health.pa.gov/Your-Department-of-Health/Offices%20and%20Bureaus/PaPrescriptionDrugMonitoringProgram/Pages/GeneralInfo.aspx#.WK84UW8rKM8

http://www.health.pa.gov/My%20Health/Diseases%20and%20Conditions/M-P/opioids/Documents/opioid_dental_prescribing_guidelines3_13_15.pdf

http://www.health.pa.gov/My%20Health/Diseases%20and%20Conditions/M-P/opioids/Pages/Prescribing-Guidelines.aspx#.WK85N28rKM8

https://www.drugabuse.gov/nidamed-medical-health-professionals/about-addiction-performance-project/addiction-performance-project/talking-to-patients-about-their-drug-use

http://ocw.tufts.edu/Content/70/lecturenotes/1260782

http://us14.campaign-archive1.com/?u=daa8d6d8dddc3e7cf2f933b1c&id=f538cf95e1&e=be06d005f4

http://www.medscape.com/viewarticle/867751

http://www.npr.org/sections/health-shots/2017/02/26/513865623/dentists-work-to-ease-patients-pain-with-fewer-opioids?sc=17&f=1001

Tags: dentist, dentistry, opiate crisis and how it relates to dentistry

What Does the Dental Term, “Oral Cripple” Mean?

Posted by Pi Dental Center on Feb 17, 2017 4:12:44 PM

knowing-is-not-enough-do.jpgHave you heard of the term, “oral cripple”? Dentists use the term to describe a person who has such significant dental problems that they substantially and negatively impact the quality of life.

Do you know someone who:

  • Hides their mouth when they smile or laugh?
  • Complains about jaw pain?
  • Has broken teeth?
  • Have loose or clicking dentures?
  • Cannot pronounce certain words?
  • Refuses to eat in public or struggles when chewing certain foods?
  • Declines social invitations because of their teeth?
  • Cannot find a job because of the state of their teeth?

As a person’s dental condition deteriorates, their oral and medical dilemmas mount. If left untreated, a person can experience numerous complications that affect every aspect of life. Tooth loss, poor quality dentures, shifting teeth, periodontal disease, and broken teeth can be devastating.

As teeth are lost, the surrounding teeth begin to shift in the mouth.  Missing teeth cause the bite to collapse, which in turn damages the jaw joint. This is because the stress of clenching the teeth intensifies pressure on the joint. Over time, the damage to the jaw joint and muscles that control jaw movement increase. Temporomandibular joint disorder causes pain in the area of the joint, neck, shoulder, back, head, and trouble chewing.

Well-fitting removable dentures can be an adequate temporary solution.  But dentures must be regularly maintained by a dentist. Ill-fitting loose unsightly dentures cause clicking, pain, sores on gum, and limit one’s ability to speak, and eat.

The feeling of self-consciousness because of dental appearance permeates many aspects of life. People often feel too embarrassed to smile. Making friends, building relationships and finding a job can become more difficult.

Tooth loss shortens a person’s life span. An October 2016 article in Periodontology 2000 concluded that the number of teeth in aging humans affects longevity and life expectancy. An inability to eat nutritional foods that require the ability to properly masticate is one factor is reducing life span.

One patient mentioned, “Life with removable dentures really makes you appreciate the teeth you lost.” Healthy functional teeth really contribute to the quality of life.

Replacing lost, damaged and diseased teeth with complete non-removable restorations allows patients to return to a state of anatomic, functional, psychological, and social good health. It allows them to again enjoy the simplest of pleasures, like ordering a dinner in a restaurant.

Dr. Balshi said, “Advances in prosthodontics have made remarkable alternatives available for replacement of missing teeth. The osseointegrated dental implant system permits the placement of a fixed bridge in patients who would otherwise require removable dentures. This technique involves placement of implants within the jaws, which are physiologically attached to bone and to which the teeth are attached.”

Johan Wolfgang von Goethe and later Bruce Lee stated, "Knowing is not enough; we must apply. Willing is not enough; we must do," It’s important to diagnose dental problems, meticulously research all solutions, choose the best option, then begin treatment.

When people decide to move forward and actively pursue dental treatment, they often do not have a regular dentist and wonder who to place their trust in.  The board certified dentists at Pi Dental Center created the trademarked Teeth In A Day® procedure that enables patients to enjoy the benefits of fixed replacement teeth on the same day implants are placed, rather than following a three to six month process. At 467 Pennsylvania Avenue, Fort Washington, we have everything under one roof. Advanced evaluation is possible in-house with CT-scanning and digital intraoral scanning technology. From prosthodontics and oral surgery to endodontics and orthodontics, patients can have most treatment in our center.  Three on-site laboratories provide a wide variety of prostheses.

High quality dentistry is a combination of advanced technology, visual artistry and manual skill. As board certified prosthodontists with over 30 years of experience, Dr. Thomas Balshi and Dr. Glenn Wolfinger provide patients with teeth that are attractive, functional and customized for the individual patient.

Quality of life is enhanced by comprehensive dental restoration.  Call Pi Dental Center and schedule a complete diagnostic evaluation so that you can smile again!

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Tags: removable dentures, dental problems, dental condition, tooth loss, temporomandibular joint disorder, dental appearance, healthy functional teeth

Healthy teeth like diamonds

Posted by Chris Raines on Feb 3, 2017 6:12:58 PM

Strong healthy teeth are like diamonds“A tooth is much more to be prized than a diamond.” States Miguel de Cervantes Saavedra in Don Quixote

Diamonds are greatly valued and the most cherished of all gemstones. Strong healthy teeth have often been compared to diamonds. The word, diamond, is derived from the ancient Greek term adámas meaning indestructible and unbreakable. Both diamonds and teeth are described as sparkling, shiny, bright and gleaming.

Strong healthy teeth help to ensure good overall health. Problems in the mouth can affect the rest of the body. Studies suggest that oral bacteria and inflammation associated with gum disease play a role in certain diseases. Diseases like diabetes and HIV/AIDS can lower the body's resistance to infection, making oral health problems more severe. Read Mayo Clinic Oral Health Page.

An attractive smile is both socially and professionally significant. Your smile is the first thing people see when they meet you. A sparkling smile can improve self-confidence and help you to radiate charm and assurance.


In her book, Smile Your Heart Out, Joanne Balshi says, “We all tend to live up, or down, to the vision we see in the mirror.” Dental restoration often leads to widespread improvements in life. Many of our patients who’ve had complete dental makeover’s find that they look years younger with their gorgeous new smiles. And, in some cases, this dental rejuvenation has prompted them to make needed life changes or take on challenges that had previously seemed impossible. Some have improved their overall health regimens; others have completed higher level education. Some have simply begun to smile widely when photographed.

Many people wonder if they are candidates for dental implants. Today, anyone who is missing one or more of their teeth due to injury, disease, or decay may be a candidate for dental implants. Drs. Thomas Balshi and Glenn Wolfinger are board certified prosthodontists, experts in the restoration of teeth. They have successfully treated patients for over 30 years at Pi Dental Center in Fort Washington with everything from crowns, fillings, dental extractions, removable dentures, to digital dentistry, advanced dental implant treatment with bone grafting and computer guided surgery.

Like a diamond, a beautiful smile lights up a whole room. Call to learn how to have strong healthy teeth like diamonds!

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Tags: dental makeover, dental health, dental health and quality of life, healthy teeth

Blending digital dentistry and implant prosthodontics

Posted by Dr. Thomas Balshi and Joanne Balshi on Jan 30, 2017 4:41:16 PM

ACP Messenger (Winter 2017)

 

3-soccer.jpgBlending digital dentistry and implant prosthodontics

Thomas J. Balshi, DDS, PhD, FACP
Joanne Balshi

Blending digital dentistry and implant prosthodontics

I first met Michael Frank on a job site where he was artistically and meticulously setting tile for a designer kitchen. Mike exuded energy and had an admirable work ethic. He had a good technician’s eye and measurable pride in accomplishment, but the first time I saw him smile, I knew I could contribute something very valuable to the rest of his life. 

At the age of thirty-three, Mike had a lot going for him. Besides his talent; he was a vivacious athlete with a great sense of humor and an uncommon warmth. Married with two young daughters, he worked a sixty-hour week and played soccer in his spare time. A smile was the only part of his signature that simply did not fit. 

It was not difficult to convince Mike to allow me to evaluate him clinically and present him with a treatment plan. His evaluation revealed advanced periodontitis with extensive bone loss around his remaining teeth in the maxilla and mandible, most likely the result of his heavy smoking and excessive consumption of soda for quite a few years.

Mike's clinical presentation demonstrated extensive flaring of the mobile anterior teeth. Diagnostic casts were made and articulated at the appropriate vertical dimension. These models were scanned digitally and the data files transmitted to a milling center for the construction of the fully milled monolithic PMMA resin provisional dentures. The anterior teeth were repositioned vertically in the 3-D planning software prior to production.

Fig 1: Before -- Fig 7: AfterOn the day of surgery twenty cc's of blood were drawn and Platelet Rich Plasma (PRP) was produced for use during surgery. Local anesthesia was administered to both maxilla (upper jaw) and mandible (lower jaw), and all remaining teeth were extracted. Alveoloplasty was performed in preparation for future implant placement.

In the mandibular arch, full tissue flaps were reflected to identify the mental foramina. The anterior loop of the mental nerve was measured and noted. Beginning with the posterior implant placements in the mandibular right and left sides, a precision drill introduced the initiation of osteotomies (bone drilling). These were placed at a forty-five degree angle posterior tilt.

 Four implants were coated with PRP and installed according to the All-On-4®treatrnent concept protocol. Autogenous (host) bone was gathered during all of the osteotomy preparation procedures and reintroduced into the extraction sites. Angulated multi-unit abutments were installed on the posterior tilted implants and 1mm straight abutments were placed on the anterior axially placed implants.

Following the Teeth in a Day® procedure, special multifunctional copings were installed with guide pins on all four abutments. The rubber dam was then installed to the base of the copings. Using autopolymerizing acrylic resin, the monolithic conversion prosthesis was connected to the multifunctional copings. It was then removed and refined chairside.

2xrays.jpg

 

 

 

Figures 4, 5, and 6

Fig 4: All-On-4® implants to support non-removable teeth in the lower jaw.

Fig 5: Three months after implant surgery, the final digital upper denture and the All-On-4® monolithic fixed (non-removable) prosthesis for the lower jaw ready for delivery to the patient.

Fig 6: Completion of treatment changes Mike's life.


Flap closure took place with multiple interrupted sutures. The Teeth in a Day conversion prosthesis was then installed using prosthetic screws. The upper monolithic fully milled removable denture was relined, adjusted, and delivered at the same time.

Mike was given post-operative instructions and medications. One week following surgery, he returned for suture removal and minor adjustments to the maxillary immediate complete denture. At ten weeks post-surgery the patient presented for final impressions, initiating the construction of his mandibular fully milled implant-supported prosthesis reinforced with a milled titanium frame. New occlusal records were made and a reline impression made in the maxillary removable immediate digital complete denture.

Both arches were scanned and the data transmitted for the construction of a new fully milled monolithic maxillary removable digital denture and an All-On-4® final prosthesis with milled titanium framework for the mandibular arch. 

Three weeks following the impressions, the final prostheses were delivered to an ecstatic patient whose sparkling personality and boundless energy went up still another notch, proof that at any age, a healthy, esthetic smile is a priceless asset.


Thomas J. Balshi, DDS, FACP / Joanne BalshiThis article was published in the ACP (American College of Prosthodontists) Messenger (Winter 2017) and written by Dr. Thomas and Mrs. Joanne Balshi.

Dr. Thomas J, Balshi maintains a private practice in Fort Washington, Pennsylvania, where he blends clinical care with scientific research, education, and philanthropy. 

Joanne Balshi has served as Director of Marketing and Public Relations for the Pi Dental Center over the last thirty years. She is a freelance writer and authored Smile Your Heart Out, a coffee table book about the value of a healthy smile and dental makeover.

 

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Terminology: 1acpmessenger.jpg

  • All-On-4 Dental Implant Treatment - uses a prosthesis strategically supported by four dental implants that are biomechanically positioned for maximum stability. 
  • Anterior teeth - front teeth
  • Conversion prosthesis - An interim fixed-prosthesis that the patient wears from the time of uncovering of implants until the final prosthesis is completed. This prosthesis is made from the removable denture or temporary prosthesis that the patient has been wearing since first stage surgery. This removable prosthesis is modified into a fixed prosthesis. It allows the patient to experience the benefits of dental implants immediately after the implants are uncovered.
  • Digital dentistry - dental treatment that includes utilization of CAD/CAM software enabling the dental specialist to visualize the patient's dental structures in 3D format
  • Mandibular - referring to the lower jaw
  • Maxillary - referring to the upper jaw
  • Monolithic - formed of a single large block of material.
  • Occlusal record - a record of the way teeth come together - a registration of the opposing occluding surfaces of the teeth
  • PMMA - Poly(methyl methacrylate) - a clear plastic
  • Provisional denture - a temporary removable denture
  • Posterior Teeth - back teeth
  • Teeth In A Day® - Click here

 

Tags: bone loss, Teeth In A Day, All-On-4 dental implant treatment, digital dentistry

3D Scanning for Superior Crowns at Pi Dental Center

Posted by Pi Dental Center on Dec 29, 2016 6:50:00 AM

graphic for trio blog.jpg Pi Dental Center strives to offer patients the best dental care using 3D technology.  Drs. Thomas Balshi and Glenn Wolfinger continuously evaluate new dental equipment and technology to provide patients the highest quality, most attractive, best-fitting dental prostheses in the shortest time possible. 

Pi Dental Center’s crowns have just gotten better through digital dentistry! TRIOS is an intraoral scanner that enables us to make the highest quality crowns with better patient comfort.

A good crown begins with a good impression. The TRIOS digital scanner is:

  • Accurate
  • Ensures correct occlusion
  • Totally safe

Patient satisfaction and ease is a key advantage of TRIOS.  Patients find intraoral scanning is a more comfortable procedure than traditional methods that use trays and impression materials.  It is a great option for patients with strong gag reflexes.

TRIOS scanner takes thousands of pictures per second providing a 3D high resolution image that can be viewed from all angles.

Tooth shade is no longer subjective. Manual shade measurement can be inaccurate. The TRIOS scanner automatically records a shade measurement that is more precise and consistent. TRIOS shade detection tool eliminates shade errors caused by eye fatigue, color of clothing, makeup and levels of daylight.

Pi Dental Center’s scanning technology can be used to create:

  • Dental Crowns
  • Bridges
  • Veneers, inlays and onlays
  • Abutments, implant bridges and bars
  • Temporary crowns and virtual diagnostic wax-ups
  • Post and core
  • Removable partial dentures

Learn more about Pi Dental Center's superior crowns. Call Pi Dental Center to schedule dental crown treatment using our 3D scanning technology.

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Tags: digital dentistry, dental crowns, 3D Scanning Technology, superior crowns

Can’t Fool Santa or the Dentist

Posted by Chris Raines on Dec 20, 2016 4:18:41 PM

naughty-nice.jpgHe's making a list,
He's checking it twice,
He's gonna find out who's naughty or nice
Santa Claus is coming to town

He sees you when you're sleeping
And he knows when you're awake
He knows if you've been bad or good
So be good for goodness sake


We’ve all heard the Christmas song, “Santa Claus Is Coming to Town,” written by John Frederick Coots and Haven Gillespi.  This Christmas classic, first sung on Eddie Cantor's radio show in November 1934, cautions children to behave because Santa can magically perceive whether they are naughty or nice.

20161220_100703 copy.jpgSome people try to hide their dental habits from the dentist.  They try to hide their irregular and haphazard oral hygiene by brushing their teeth vigorously right before their dental appointment.  Oral hygiene habits cannot be concealed. Built up stain and food impaction are visible tell-tale signs of poor dental hygiene.  Poor dental hygiene will eventually result in tooth decay, cavities, gum disease tooth loss and can even affect overall physical health.

The dentists at Pi Dental Center recommend brushing after every meal, cleaning between the teeth with dental floss, water flosser or Proxabrush and scheduling oral hygiene cleanings and examination at least twice a year.  Oral hygiene instruction can help patients improve their oral hygiene techniques.

Pi Dental Center’s dentists and hygienists are your partners in dental health, helping you to make sure that your teeth are as healthy and attractive as they can be. Call to schedule your dental hygiene visit.

Ask A Dental Question Or Schedule An Appointment

Related Subjects:
Tooth Extraction
Bone Remodeling
Maintaining Dental Investment

Tags: dentist, oral hygiene, dental health, dental hygiene

Dental Implant Treatment with Accelerset Prosthesis by AvaDent: Part 2

Posted by Stephen Balshi MBE on Nov 18, 2016 2:45:17 PM

Ken smiles following completion of dental implant treatment with an AvaDent prosthesis.During the last blog post, we discussed Ken who was diagnosed with rare disorders called Osteogenesis Imperfecta and Odontogenesis Imperfecta. These disorders caused extensive dental problems. Ken was treated by Dr. Balshi and the team at Pi Dental Center with implant supported AvaDent Accelerset prostheses. This technology is discussed below.

Ken's is the first Accelerset Prosthesis engineered by AvaDent (Global Dental Science). It's fully automated and consists of 3 main parts:

1) a milled titanium framework that is designed with individual keys to support,

2) fully milled keyway teeth and is veneered with

3) a fully milled PMMA gingiva.  

The teeth can be made of several different materials.  In Ken's case, the front teeth are lithium disilicate (e.max) and the back teeth are multi-layer zirconia.  


Photos detailing progression from computer model to final:
AvaDent prosthesis design in AvaDent Viewer

AvaDent prosthesis design in Viewer Software

From the design the framework is built and individual crowns are placed.

From the design the framework is built and individual crowns are placed.

The completed prosthesis which has been designed according to the digital design that was created in the AvaDent Viewer.

The completed restoration, which has been designed
according to the digital design that was created in the Viewer.

The completed prosthesis which has been designed according to the digital design that was created in the AvaDent Viewer.

The completed prosthesis which has been designed
according to the digital design that was created in the Viewer.

ken-final-prosthesis-closeup.jpg

Ken's final restoration


Ken is also part of a research project to study the retention of the crowns to the milled titanium framework.  Half of the crowns are cemented to the titanium framework with resin cement and the other half are press-fit to the framework using an intermediary sleeve made from polyether ether ketone (PEEK).  

The technique of cementing the crowns in place is the industry standard.  

The press-fit technique with the PEEK sleeve is the subject of our clinical research.  All of the milled components are made separately in three different types of milling machines simultaneously.  They are then assembled and made ready for delivery to the patient.  

Ken's Accelerset prosthesis is the first of its kind.  It is supported by 6 dental implants.  Accelerset prostheses can be be made on any number of implants and most types of dental implants.

Ken before and after dental implant treatment with delivery of the Accelerset AvaDent Prosthesis

Board certifed prosthodontists, Dr. Thomas Balshi and Dr. Glenn Wolfinger, are skilled at providing advanced dental implant care and delivering superior prosthetic solutions.  To learn more about dental implant treatment using the Accelerset call 215-646-6334 or contact us using the link below.

Ask A Dental Question Or Schedule An Appointment

Terminology:

Osteogenesis Imperfecta (OI) is a rare disorder affecting the connective tissue and characterized by extremely fragile brittle bones that break or fracture easily, often without apparent cause. The specific symptoms and physical findings associated with OI vary greatly from case to case. The severity of OI also varies greatly, even among individuals in the same family.

Odontogenesis Imperfecta is a developmental disturbance of one or of several adjacent teeth, characterized by deficient formation of enamel and dentin. Such teeth exhibit delayed eruption into the oral cavity.

Tags: dental implants, dental prostheses, prosthetic teeth, prosthodontic dental restoration