Vasyl Leskiv, DDS, an important member of our professional team, is always eager to learn about the latest techniques in modern dentistry and to refine his outstanding skills. In this interview, he discusses his upcoming training in dental implants, as well as some of the impressive implant options that our practice offers.
Dr. Leskiv, what is the next training course you will attend, and why are you going?
The course that I’m going to is an advanced course in implantology. It’s for soft tissue grafting. It will help me provide new procedures for our patients. In our office, we’ll be able to perform soft tissue grafting, which helps with root coverage. For patients with gum recession, soft tissue grafting is helpful.
This course will also help me learn more about soft tissue management. The placement of the implants also involves management of soft tissue—gums. Learning about this helps us make our implant work and results more predictable, which leads to more aesthetic results. Many dentists can place implants, but being confident about predictable results is also important.
Winchester Dental also offers immediate implant placement. How does that benefit patients?
Let’s say a patient comes in with a tooth that cannot be restored and must be extracted. Before we began offering immediate implant placement, we would frequently extract the tooth and prepare the extraction site, then let the gums heal for 2-3 months, and then the patient would come back to have the implant placed. Now, if a tooth cannot be restored, in most cases we suggest removing it and placing an implant right away. Immediate implant placement saves patients time in office visits and healing, as well as the discomfort of a second surgery. Placing an implant on the same day the tooth is extracted is really a nice option for our patients.
Have you always done immediate implants?
Before I came here, I did implants, but I didn’t do immediate placement. I’m still following the same basic implant placement system I always have, but nowadays the technology is much better than it was before. Over the years I’ve gone through several different courses, and have built my confidence in placing implants right away.
What else helps you to be confident in placing implants?
The 3D scanning technology we have in the office is tremendously useful in implantology. With the CBCT scan, which scans in three dimensions, we can check patients’ bone levels on the day we place their implants. We can determine the bone height, the bone width, the quality of the bone, the distance to the nerve, and the distance to the sinuses, and determine how predictable the surgery will be. Then we can place the implants safely, based on real-time information.
So it’s non-experimental, and it’s not like sending patients for x-rays first.
Right, we’re not guessing. We have everything right here, and the scan is painless and only takes a couple of minutes. We can measure the bone, and within about five minutes, I can determine the size of the implant that I will place.
Does all this help patients to more easily accept the idea of implants?
I think that nowadays, implants are so successful and so much more comfortable than before, with more predictable results, that it is quite a nice option. More and more people come in and ask, “Well, I have a missing tooth, could you place an implant there?” because they are aware of this treatment option.
There are also options that involve removable appliances, like dentures, or partials, but I think implants are one of the best options nowadays, maybe the best option, because patients don’t have to worry about removing and then replacing dentures or partials. Implants are more like having your own tooth or teeth.
Will dentures eventually go away?
Well, I wouldn’t say that dentures will go away, but I do a lot of maintenance work of dentures. Some patients have problems retaining dentures properly in their mouths. Dentures rely on retention (suction) to the gums. By adding implants, we can add stability to dentures, which is a good option for some patients. They’re happy with their dentures, and the dentures are stable. If they go out somewhere, they don’t have to worry about their dentures coming out or getting loose, because they are fixed with the implants.
How does the combination of dentures and implants work?
It depends on what the patients expect. If they need only a bit of support, we place just two implants. If they would like to have a little bit more support, we place four implants. Or we offer a different option. For example, a patient might need a full-mouth extraction due to areas of decay or periodontal disease. We can fit them with a non-removable appliance, which is not the same as dentures, but it’s fixed over four, five, or six implants. We place the implants and they support the appliance, which is much smaller than dentures. This is easier and more pleasant for patients, and the appliance is fixed so they don’t have to remove it or move it. Once a year they come in and have a cleaning done, and it’s easy for them.
So it’s a low-maintenance option?
Yes, and it allows us to create a kind of celebrity smile. Patients really like it!