Dental Implants – Proper Implant System & Precision Placement


Posted on Dec 13, 2022 by William J. Claiborne, DDS MS

A periodontist specializes in the diagnosis and placement of dental implants, in addition to the treatment of all stages of periodontal disease.

In our Asheville periodontal dental office, many general dentists refer patients to us for dental implants. With our specialized skills and advanced technology, we can diagnose and place the implanted portion for optimal comfort and success in treatment outcome.

We are also able to offer patients a wider variety of choices when it comes to implant systems.

There are many types of dental implants. Various systems are designed to support one replacement tooth (the “restoration”), a bridge of two or more teeth, or a full denture supported by several strategically-placed implants. Understanding the unique advantages of all systems enables us to choose the best type for the patient’s individual needs and goals.

For example, the All On 4 dental implant system is designed to support non-removable teeth on just 4 implants (per arch). With its specially-designed implanted portions, these longer implants can fully distribute biting and chewing forces.

The All-On-4 option is an ideal choice for people who have lost bone mass due to lengthy periods of tooth loss. Because All On Four can be placed in minimal bone, many patients are able to avoid the need for bone rebuilding procedures prior to traditional implant placement.

However, it is not just in selection of the implant that a periodontist offers, it is in the placement skills. For a dental implant to serve as a lasting tooth replacement system, it must be positioned in the jaw bone to specific depths and angles. An implant that is mis-positioned can function less efficiently and lead to the need for removal.

Patient comfort can also be enhanced through the specialized care of a periodontist.

Because a periodontal specialist is uniquely skilled in the care of gum tissues, he or she is able to provide a conservative approach to the placement process. Through respectful treatment of oral tissues (in both placement and exposure for restorations), less disruption to the gums allows for faster healing and higher comfort levels.

In our Western NC periodontal dental office, we also feature some of the most advanced technology in dentistry; many options which are not readily available in other dental offices in our region. These computerized images offer advantages to patients in helping to minimize treatment needs.

Some features include:

Computerized Dental Implant Placement – This advanced system for pre-surgical positioning of dental implants uses a 3D model of the patient’s jaw. Once the implant type is selected, a template is developed for optimal treatment success, even for complex cases.

3-D Cone Beam Imaging – Ideal for diagnoses and treatment planning, these images provide a clear view of the upper and lower jaw, used for: intricate review of tooth roots; periodontics; orthodontics; dental implants: TMJ; and prosthodontics, as well as dental and maxillofacial surgery. Because cone beam radiographs show sagittal, axial, and coronal planes, locating and tracking nerve canals optimizes implant placement. The process is quick, painless and at minimal levels of radiation.

CareStream Cone Beam Computer Tomography Imaging – This enhanced tomography works with 3D imaging for exceptional detail and range.

LANAP With PerioLase MVP 7 (Laser-Assisted New Attachment Procedure) – Is an advanced protocol that efficiently and effectively treats advanced gum disease with the added advantages of a dental laser. This offers a non-surgical alternative for patients with moderate to severe periodontal disease. LANAP treatment leaves very little discomfort and has a quick recovery time. It has also been found to stimulate bone regrowth in damaged areas.

CS 3600 Intraoral Scanner – Rather than make impressions with bulky, goopy trays, this scanner quickly and comfortably captures digital impressions accurately and easily for creating precision models or appliances (crowns, inlays, onlays, bridges, orthodontic appliances and aligners, custom abutments). The scanner can also reach difficult–to–access areas in the patient’s mouth for superior results with improved patient comfort.

When it comes to comfort, we are able to offer patients the highest level of relaxation through I.V. sedation (“twilight sleep”). Also available is oral sedation, which is in pill form for enhanced relaxation. While both options have an amnesiac effect, I.V. sedation places the patient in a deeper sedative state. It is administered by a doctor of anesthesiology for optimal comfort and safety. With both, patients are closely monitored with advanced safety equipment throughout treatment.

We know that dental fear is often the foundation of tooth loss, causing many adults to delay or avoid dental care for years. Here, our entire team are sincerely committed to patients in a compassionate and respectful manner.

After placement and restoration, it is important for dental implant patients to be highly committed to maintaining good oral hygiene. Although Dental Implants themselves do not experience decay, the gum tissues and bone supporting the implants are as susceptible to oral bacteria as before. When oral bacteria infection (gum disease) penetrates to the implant site positions, the only way to treat the infection may involve removal of the implant.

For a lifetime of confident smiles with your implants, we will work with your general dentist to help you maintain ideal oral health. This may involve instructions for thorough oral hygiene at home and dental check-ups scheduled for every four months rather than twice a year. During these visits, the condition of your gums will be assessed and a hygienist will remove accumulated oral bacteria to reduce risk to your implants.

Dental implants are designed to last a lifetime and are the closest thing to the natural teeth you once had. Too, the restored ability to bite, chew, speak and laugh without worry can be a tremendous boost to one’s self-esteem and self-confidence.

If you are considering dental implants to replace missing teeth, we invite you to begin with a consultation appointment. This will take place in a private room where we can discuss your needs and concerns. From there, you can determine what pace is best for you.

Call 828-274-9440 to schedule, or tap here for more contact information.

The “Why” & “How” of Dental Implants


Posted on Nov 09, 2022 by William J. Claiborne, DDS MS

According to the Centers for Disease Control & Prevention (CDC), over one-fourth (26%) of American adults ages 65 and older have 8 or less natural teeth. The CDC equates this number (having 8 or fewer teeth) as “severe tooth loss” since it impacts an individual’s ability to thoroughly eat a healthy diet.

An even worse statistic shared by the CDC is 1 in 6 (17%) adults ages 65 and older have lost all of their teeth.

When it comes to losing natural teeth, they also share that the most vulnerable older adults are those who are poor, have less than a high school education, or are cigarette smokers.

Being totally edentulous (having lost all teeth) amongst the 65 or older age group has fortunately declined over the years. The CDC shared that the figure dropped by more than 30% from 1999–2004 (when it was 27%) to 17% in 2011–2016. At least American adults are moving in the right direction.

https://www.cdc.gov/oralhealth/fast-facts/tooth-loss/index.html

Tooth loss is a bigger deal than is assumed by a large segment of the population. When a natural tooth is removed, its absence causes a reaction that begins below the gum line. What occurs initially is typically not obvious. Yet, the repercussions of “resorption” can become quite the dilemma.

The absence of a tooth root in the upper or lower jaw bone is a loss of stimulation to the bone mass where it was once positioned. These roots provide both stimulation and nourishment that enables the bone to maintain a healthy mass. Without the presence of tooth roots, the bone begins to “melt away.” This process is known as resorption.

Think of the stimulation that tooth roots provide to how you might muscle atrophy. We all know that muscles, not used, will shrink in mass. When the jaw bones are lacking stimulation by the tooth roots they’re designed to hold, bone mass begins to shrink.

Resorption begins shortly after the tooth root is removed. Once it starts, it continues at an ever-increasing pace. For example, the first year after a tooth root is missing, the loss of bone may be minimal. With each passing year, the pace of loss accelerates.

As the bone shrinks in height, the natural tooth roots adjacent to the area of missing teeth are subject to movement and root damage. On average, the next teeth you’re most likely to lose are the ones bordering areas of missing teeth.

Obviously, it is important to replace lost teeth before bone loss begins. For the support of remaining natural teeth, it’s also important to replace missing teeth as soon as possible so adjacent teeth can retain their proper positions. And, it’s HOW you replace them that’s most important.

Because dental implants replace the tooth above the gum line AND the root portion below it, the bone is able to retain its mass. Through the sturdy foundation of the jaw bone, dental implants are able to restore the look, feel and chewing stability like that of natural teeth.

As a periodontist, I specialize in the prevention, diagnosis, and treatment of all stages of periodontal (gum) disease. I also have advanced training and skills in the selection and placement of dental implants. In addition, periodontists are particularly skilled in performing cosmetic periodontal procedures.

Our Western NC periodontal dental office features some of the most advanced technology available. This cutting edge technology is beneficial in a number of ways, with much specifically helpful in optimal dental implant diagnosis and planning. This includes:

LANAP With PerioLase MVP 7 – Laser-Assisted New Attachment Procedure is an advanced protocol that efficiently and effectively treats advanced gum disease with the added advantages of a dental laser. For patients who are preparing for dental implant placement, resolving gum disease prior to treatment is mandatory. LANAP offers a non-surgical alternative for patients with moderate to severe periodontal disease with very little discomfort and a quick recovery time.

Cone Beam Imaging – These amazing 3D “x-rays’ are ideal for diagnosing and treatment planning. The highly-detailed images provide a clear view of the upper and lower jaw. Because cone beam radiographs show sagittal, axial, and coronal planes, locating and tracking nerve canals optimizes implant placement. The images are captured in a quick, painless process and at minimal levels of radiation.

CareStream Cone Beam Computer Tomography Imaging – This enhanced tomography works with 3D imaging for exceptional detail and range.

Computerized Dental Implant Placement – This system provides the futuristic ability to position dental implants before the process actually begins. Through computerized technology, the implants are selected and “ideally positioned” on a 3D model of the patient’s jaw. From this, a template is developed for optimal treatment success, even for complex cases.

CS 3600 Intraoral Scanner – Rather than make impressions with bulky, goopy trays, this scanner quickly and comfortably captures digital impressions accurately and easily. These are used to create precision models or appliances (dental implant crowns, bridges, or full arches). The scanner can also reach hard–to–access areas in the patient’s mouth for superior results with improved patient comfort.

Sedation – Our Asheville periodontal practice is known for its environment of comfort and respectful care. We understand that over 70 percent of the adult population have some level of dental fear or anxiety. For optimal comfort and relaxation, we offer several sedation options, including oral and IV sedation. With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.
• Oral sedation is a pill that helps patients relax. It also has an amnesiac effect, leaving most with little or no memory of treatment afterward.
• I.V. sedation (also known as ‘twilight sleep‘) places the patient in a deeper sleep state and erases memory of the procedure. It is administered by a Medical Doctor (MD) who is a board certified Anesthesiologist.

Ideal diagnosis is important, and can save the patient much in overall treatment costs. For example, when missing more than one tooth in one area, one implant can often hold two or a bridge of teeth. Several strategically-placed implants may also be used support a full arch of teeth.

Dental implants restore the ability to eat with stability, chew comfortably, laugh and speak with confidence. Dental implants do not decay and will never need root canals. They have an extremely high success rate, higher than any implant-in-bone option. And, Dental Implants are designed to last a lifetime. With proper selection and maintenance, they will never need replacing or repair.

Dental implants come in many sizes and shapes, each system designed to accommodate various needs and preferences. This means your implant can be chosen to suit your long-term goals.

Proper placement and support in caring for implants is an important part of a successful outcome. However, dental implants can fail. This is why a periodontal specialist can be an asset to your investment. When dental implants are chosen and placed by a Periodontist, he or she can select the one that will work best for you now and throughout your lifetime.

In our Asheville periodontal dental office, we combine technology with our advanced skills and compassionate approach to care so you can enjoy a comfortable, efficient experience that allows you to have optimal success.

Call 828-274-9440 to arrange a consultation. During this time, we can discuss treatment that can achieve your needs and goals as well as the process and anticipated costs.

Why Missing Teeth Cause Changes To Facial Appearance


Posted on Sep 30, 2022 by William J. Claiborne, DDS MS

The shape of our face is made by the bone structures beneath the skin. Essentially, we inherit our facial appearance from our ancestors. You may have your mom’s nose or your dad’s chin, but how you look is thanks to your genes.

However, facial appearance can also change due to a decline of bone mass. In dentistry, this is typically based on the presence, or absence, of natural teeth. Losing teeth – even when replaced by a denture, partial, or crown & bridge – leaves the upper and/or lower jaw bone susceptible to bone shrinkage. This is known as resorption.

The presence of natural teeth is vital to the health of upper and lower jaw bones. Tooth roots provide stimulation to the bone, stimulating blood flow that helps the jaws to maintain a healthy mass. Without tooth roots, the lack of stimulation causes the bone(s) to slowly decline.

Resorption causes the gum ridge to flatten out over time, giving your denture a continually-declining foundation. Application of denture adhesive becomes more frequent to prevent the denture from moving while eating, which causes uncomfortable rubbing. Laughing and speaking becomes overshadowed by the fear of embarrassing slips.

When dentures are first made, they may feel secure for the first five or so years. However, as resorption continues, relines help only on a temporary basis. As bone loss progresses, relines will last at less frequent intervals each time.

On average, denture wearers experience a 25% bone loss one year after natural teeth have been extracted. Three years later, 60% of the bone is gone. While natural teeth provide a biting force of 250 pounds, the average denture wearer bites with about 5 pounds of force.

Denture wearers are often surprised to learn that the pressure of wearing them actually accelerates resorption. For people who sleep in their dentures, the 24/7 pressure speeds the process of resorption even more.

To see the extent of bone loss you’ve experienced, remove your denture and look in the mirror. You may see deep wrinkles around the mouth and notice the corners of your mouth turn downward. If bone loss is severe, our mouth may appear to be collapsed inward with a pointed chin. Jowls may have formed on the sides of your face as facial muscles detect from the shrinking bone.

As a periodontist, I specialize in the treatment of all stages of periodontal (gum) disease as well as in the diagnosis and placement of dental implants. And, we are adept at placement of all types of dental implants. With over 40 different implant types, each designed to accommodate various needs, understanding the best type – and correct placement of it – can have a significant impact on your overall success rate.

For example, new designs in dental implant systems can overcome even severe bone loss. The All-On-4 dental implant can be placed in minimal bone using just four implants. Using specific angles, All-On-4 can support a full denture that is non-removable. And, because it is supported by implants placed in bone (just as natural tooth roots), biting and chewing stability is restored.

A periodontist can also assist patients prior to implant placement when severe bone loss has occurred. To ensure a sufficient level of bone mass to support the implanted portions, procedures such as bone generating materials or a “sinus lift” may be advised (to increase bone mass between the upper jaw and sinus cavity).

Our Asheville periodontal dental office is also known for our advanced technology and features (including our on-site 3D Cone Beam and laser). Additionally, our patients enjoy a high level of patient comfort through the administration of IV sedation (twilight sleep). This is administered by a Board Certified Anesthesiologist for optimal safety and comfort.

As dental implants have become a more practical and popular option, adults are turning away from dentures, partials, or bridges. In addition to restoring biting and chewing comfort and stability, implants offer a lifetime replacement option that actually enhances the well-being and lifespan of surrounding teeth.

Because of their ability to restore the presence of natural teeth to such a great extent, the dental profession now sees dental implants as the preferred choice for replacement for most patients. Although the overall treatment costs may seem greater initially, over time, it becomes obvious that the benefits far outweigh the expense.

When you consider that dental implants are designed to last a lifetime, the investment is a wise one. There are very little things in this day and age that will last as long as we do!

If you are considering dental implants, increase your potential for a successful outcome by asking a Periodontist to join your dentist in team treatment. Most general dentists have close relationships with periodontal specialists for implant placement and in treating gum disease.

Before you make your decision, you may wish to schedule a consultation to discuss your specific needs and desires. We are always happy to welcome new patients and being referred is not required. Call 828-274-9440.

Overcome Obstacles To Achieve A Confident Smile


Posted on Sep 12, 2022 by William J. Claiborne, DDS MS

It’s not unusual to see a new patient who has delayed seeking advanced dental care for many years because of perceived obstacles. I say “perceived” because many of these obstacles are not nearly so daunting once people actually learn more there are solutions for about any dilemma.

For example, a bride-to-be with a “gummy smile” realizes, after years of postponement, that she can have her gum line corrected through laser treatment that provides quick recovery with an easy payment plan.

Or, an individual who has worn a self-described “wobbly” denture for many years and overcame misperceptions about the need for pre-placement bone rebuilding. Through specially-designed and uniquely placed dental implants (“All-On-4”), patients may be able to bypass the extended treatment time and added expense to restore bone mass.

In a conversation once, a friend reminded me “we don’t know what we don’t know.” How true. Often, once we learn the details surrounding a big decision in our lives, moving forward becomes an easier process. Achieving goals gets closer and closer.

Below are a few of the common barriers that patients can often overcome when it comes to periodontal treatment or dental implants…


COST: There are few things in life that last a lifetime. When it comes to cosmetic gum enhancement and dental implants, the lasting benefits make these procedures an excellent investment. However, treatment cost can seem challenging to some budgets. For people who wish to enjoy the benefits of their results without straining their budget, payment plans can be the solution.

There are a number of these financial options, most requiring no down payment, are interest-free, and have no prepayment penalty. For some people who see the total treatment fee at first, vocalizing their concerns regarding payment is an uneasy thing to do. Yet, once we are made aware of the need for budget-friendly options, we are able to help many people move forward with treatment that can enhance physical appearance, self-confidence and emotional security. Those are pretty priceless benefits!


DENTAL FEAR: Dental fear and high anxiety associated with dental visits is not rare. As a matter of fact, some estimates rank this as affecting up to 60% of U.S. adults. There are a number of reasons that lead to these fears. For some people, they are able to overcome these fears once in the hands of a gentle, caring dentist. For those whose fears are so deeply embedded they cannot, we offer a special team who administer and oversee the safety of oral and IV sedation (twilight sleep).

In our office, we employe the skills of a a medical doctor to provide sedation and anesthesia for our patients. Dr. Stone has published several articles on techniques and safety in anesthesia as well as a book contribution on intravenous access.


TIME IN TREATMENT: We all live lives that are busy. Schedules seem to be overloaded so much of the time. This is why time in treatment can seem “too much” to add to one’s schedule. However, the advanced skills of a periodontal specialist, coupled with our immense array of advanced technology means we are able to alleviate many of these worries for our patients.

Once the patient’s imaging and treatment plan is in hand, we are often able to schedule patients soon thereafter. With the relaxation provided by our sedation options, we can perform long procedures in a single appointment rather than have the patient return for several appointments to complete treatment. Too, using our advanced imaging and computerized technology, treatment is more precise, often more conservative, and healing time improved.


TREATMENT SATISFACTION: The best way to make a decision that works to achieve your meeds and goals is through a consultation appointment. During this time, we can discuss what options are best for your individual needs, estimated treatment time, costs, and comfort options. This is a time when you can get to know us and we can give you the information that is factual and applicable to you. And, this is where trust is formed. I have a long-standing reputation for my commitment to patient excellence.

Begin by calling our Asheville periodontal dental office and speaking to our friendly staff at: 828-274-9440. Or, tap here to see our beautiful Western NC location.

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