Implant Procedure

The introduction of dental implants has transformed dentistry the most over the last quarter century. When we first began working after graduating from the University of Toronto Dental Faculty in 1980 the field of dental implantology was in its infancy and considered experimental. Dr Kirshen was definitely a visionary as he embraced the new technology early and has placed and restored thousands of implants. Today the field of implantology allows us to treat many conditions and improve the lives of our patients.
 Dr. Kirshen has used implants in fixed and removeable solutions used to replace the roots of missing teeth for over 30 years. After an implant is placed into the jaw bone, it may either be restored immediately or it is allowed to heal for several months to become integrated within the bone. Upon full healing, a coping is attached to the implant using a screw and an impression of the mouth is taken so the dental technician can fabricate a post that will screw into the implant with an ideal angulation. A new impression is taken with the post cemented in place so the dental technician can fabricate a crown to attach to the post. The crown will be made to closely replicate the shape, contour and colour of the natural tooth.


Crowns and Bridges

There are two types of implant crowns and bridges. Cementable or screwed in position. The crown screwed directly in place has an access hole that must be filled with a resin to match the colour of the porcelain restoration and screws directly into the implant. The cementable crown is cemented onto a post which is first screwed into the implant and this is the most aesthetic. The retreivability factor is easier for the screwed in crown when a situation presents itself that requires the crown removal but is not as cosmetic. I feel we live in very vain times and patients demand whiter teeth and no blemishes in their dental work so cementable crowns presently outnumber screwed in crowns.    



When it is not possible to restore a patients dentition in a fixed manner we turn to the use of overdentures or over partial dentures depending on the number of teeth missing for a very strong and satisfactory result. A minimum of 2 implants is required in the lower jaw and four implants in the upper jaw. Of course the more implants you are able to place the stronger the final result. Dentistry is an art and a science but Dr Kirshen has always expresssd the sentiment that a case must be engineered correctly to withstand the strong muscular forces of function especially in patients who clench or grind their teeth. This is certainly true in implant dentistry and overdentures. The quality of the patient's bone and the volume available to receive an implant determines the number. Dr Kirshen is always cognizant of a patients financial situation and will endeavour to design a treatment plan that will meet their expectations and achieve the desired result. Locator abutments are used to retain the dentures over the top of the implants. They are cost effective and very retentive to the point where if a patient has some arthritic conditions it can actually be hard to take the denture out of the mouth. We have various levels of retention to handle such situations. In our armementarium we also use bars and locks to help retain overdentures.