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Tischler Dental 
         Woodstock, NY  679­3706 
         Michael Tischler DDS


Dental Implants: 
    Ideal Tooth 
    Replacement 
Michael Tischler, DDS 
Board Certified American Board Of Oral Implantology 
Diplomate International Congress Of Oral Implantologists 
Fellow Misch International Implant Institute 
Fellow Academy Of General Dentistry 
Associate Fellow American Academy Of Implant Dentistry 
Certified /NYS Conscious Sedation
Patient Education At The 
Tischler Dental
Conscious Sedation 
                   Relaxation and cooperation 
                   while maintaining 
                   responsiveness. 




Medical history 
is important
Reasons for tooth loss 

1.  Trauma­ Injury 
2.  Gum Disease­Loss of supporting structures of 
    bone 
3.  Genetic Causes­Missing teeth, history of gum 
    disease 
4.  Severe Decay­ Allowing decay to progress 
5.  Failed Root Canal 
6.  Cracked tooth from biting stress
Statistics of Tooth Loss
                Age is directly related to indicators of 
                tooth loss. (Marcus  et al) 
                1965 average life span 65 years old 
                1990 average life span 78 years old 
                Population above 50 in 1995 68 million 
                Population above 50 in 2020 115 million 
                Average 65 year old in 1995 will live to 
                81 years old, and this is increasing! 
                                                 nd 
Misch C.E Contemporary Implant Dentistry  Mosby 2  Edition 
Statistics of Tooth Loss Cont’d 
 NIH/NIDR Study ( 1988­1991) 
 10.5%  of US adult population totally 
 edentulous (18 Million People) 
 17% of US adult population edentulous in 
 one or both arches (30 Million People) Not 
 found to be gender specific. 
 45 million US adults are missing posterior 
 teeth in one or more quadrants 
                                                 nd 
Misch C.E Contemporary Implant Dentistry  Mosby 2  Edition
Consequences of tooth loss 
1. Loss of width and height of bone 
2. Decrease in facial height, loss of muscles of 
facial expression and negative facial esthetic skin 
changes, increased length of upper lip. 
3. Lessened chewing ability leading to decreased 
nutritional uptake 
4. Shifting of remaining teeth, negative esthetics 
and change in bite 
5. Higher susceptibility to decay and gum problems 
in remaining teeth
                                 Tischler Family Dental Center 
                                 Woodstock, NY 679­3706 
Consequences of tooth loss




                Tischler Family Dental Center 
                Woodstock, NY 679­3706 
Psychological Consequences Of Tooth Loss 

 20% of edentulous patients don’t wear both 
removable prosthesis all the time. (NIH Oral 
health of US adults national findings Publ No 
87 1987) 
7% of edentulous patients are not able to wear 
their dentures at all (NIH) 
  88% of denture wearers have difficulty with 
speech (Misch LS Misch CE Denture 
Satisfaction: a patients perspective, Int J Oral 
Implant 1991)
               Source Misch C.E Contemporary Implant Dentistry 
                       nd 
               Mosby 2  Edition 
Psychological Consequences Of Tooth Loss Cont’d 



   62.5% of mandibular denture wearers had 
   awareness of movement (Misch) 
   50% of denture wearers avoided certain food 
   (Misch) 
   17% of denture wearers masticated better 
   without prosthesis (Misch) 
   16.5% of mandibular denture wearers never 
   wear denture (Misch)

     Source Misch C.E Contemporary Implant 
                       nd 
     Dentistry  Mosby 2  Edition 
Disadvantages Of  Removable Dentures

       1.Average bite force in first molar 
       area 150­250 PSI with electronic 
       strain gauge studies and edentulous 
       person with dentures 50PSI 
       ( Howell, 1948) 
       2.  32% less masticatory efficiency 
       with natural teeth compared to 
       complete dentures(Rissen et al J 
       Prosth Dent 1978) 

                                                   nd 
  Misch C.E Contemporary Implant Dentistry  Mosby 2  Edition 
Disadvantages Of  Removable Dentures Cont’d




“Compromised dental function may 
favor systemic changes creating 
illness and lower life expectancy” 
(Chen and Lowenstien JADA 1984) 



                                                 nd 
Misch C.E Contemporary Implant Dentistry  Mosby 2  Edition 
Disadvantages Of  Removable Dentures Cont’d

4.Tissue borne dentures yield: Increased 
bone loss, increased caries on rest teeth, 
increased mobility of rest teeth, increased 
bleeding upon probing, greater plaque 
retention, non compliance of use, speech 
inhibition, taste inhibition.(Vermeulen A 
et al:Ten year evaluation of removable 
partial dentures:survival rates based on 
re­treatment, not wearing and 
replacement, J Prosthet Dent 1996) 
                                                 nd 
Misch C.E Contemporary Implant Dentistry  Mosby 2  Edition 
PROSTHETIC  REPLACEMNT ANALOGIES 



          Hip replacement­ 80% 10 year 
          survival 
          Knee­ 50% need to be replaced 
          in 10 years 
          Dental Implants­ 90% success 
          rate over 10 years
What is a dental implant? 
“ Titanium structure surgically inserted into the 
remaining bone to support teeth for function and 
esthetics” 
Dates back thousands of years­ Chinese, Egyptians, 
Incas 
Titanium­ Biologically compatible, integrates with bone 
Can support a single tooth, multiple teeth, or dentures 
Different designs are available through various 
companies 
Surgically placed in bone and bone grows around it
Options with Dental 
Implants:Single tooth 
replacement (continued)
What is a dental implant? 




Mandible found in Honduras from A.D 600 
Pieces of shell.                           Modern Dental 
Peabody Museam, Harvard                    Implant
Ring M Abrams 
Advantages Of Implant Prosthesis 

Bone maintenance of height and width 
Bite height dimension maintenance 
Ideally esthetic tooth positioning 
Improved psychological health 
Regained biting awareness 
Increased stability in chewing



                                                  nd 
 Misch C.E Contemporary Implant Dentistry  Mosby 2  Edition 
Advantages Of Implant Prosthesis Cont’d


Increased retention 
Increased phonetics 
Increased Biting force 
Increased success rate of prosthesis 
Eliminates need to involve adjacent teeth 



                                                 nd 
Misch C.E Contemporary Implant Dentistry  Mosby 2  Edition 
Options with Dental Implants: 
Single tooth replacement
Options with Dental Implants: 
Implant Supported Bridge
Options with Dental Implants: 
Implant Supported Dentures
Comparison of Tooth Replacement 
Options:Dentures 
Full dentures­ 
Creates further bone loss and will need to be relined 
Inhibits speech, and taste ability 

Partial dentures­ 
Loosen teeth they are attached to as bone is lost 
Inhibits speech and taste ability
Comparison of Tooth Replacement 
 Options :Crowns and Bridges 

1.Necessitates removal of healthy 
tooth structure 
2.Can create need for root canal 
3.Can have decay on supporting teeth
Rational For Single Tooth Implants 




       Misch C.E, J. Implantology, Vol 2 1999
Rational For Single Tooth Implants 
Cont’d 
Summary: 
 Prosthesis       Success rate 5 yr 
 Removable Denture 83% 
 Removable Denture 
 Resin Bonded     64% 
 Bridge 
 Conventional     79.3% 
 Bridge 
 Implant          97.2% 

                      Misch C.E, J. Implantology, Vol 2 1999 
Benefits Of Dental Implants 
1.Prevents further bone loss through stimulation of 
bone 
2. Increases retention and stability of dentures 
3. Reduces denture size­ less palate on full denture 
4. Does not compromise adjacent teeth 
5.Offers biting awareness 
6. Offers improved psychological health 
7. Improved esthetics­ ideal tooth placement
Benefits Of Dental Implants
Benefits Of Dental Implants
Benefits Of Dental Implants 
              Before 




                        After
Benefits Of Dental Implants 
              Before 




                        After
Benefits Of Dental Implants 




             Before 




             After
Bone levels for implants 
There must be sufficient bone to place a dental 
implant or else bone must be added 
Determined by X­Rays and or CAT Scans 
Bone grafts 
Sinus augmentation
Bone levels for implants
Implant Treatment at 
The Tischler Family 
Dental Center
Platelet Rich Plasma
Bone levels for implants 




Bone can be added through a variety of bone grafting 
procedures.
Bone levels for implants 
Sinus Grafting
Sequence of treatment 
1.  Initial Exam­ X­Rays, Study Models, Health 
    History, CAT Scans 
2. Treatment Planning/Forms 
3. Surgical Appointments 
4. Restorative Appointments
Questions? 

FAQ's 
How long will implants last? 
Does it hurt? 
How much will it cost? 
Does insurance cover implants? 
Now your questions:

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