A Patient’s Guide to Dental Implants


Saving smiles,improving lives



Fourth Edition
ATHENS DENTAL IMPLANT CENTER
ATHENS ORAL & MAXILLO-FACIAL SURGERY, P.C.
STANLEY D. SATTERFIELD, DMD, FACOMS
Welcome to the Athens Dental Implant Center,
a Proven Leader in Implant Surgical Care
Thank you for choosing Athens Dental Implant Center for your dental implant needs. We are committed to providing you with the best information and care available. Our hope is that the enclosed material will answer most of your questions regarding implants and the services we provide. Thank you for this opportunity.
Dr. Stan Satterfield and Staff
NOTE: We know this booklet is lengthy. However, we know our patients are very intelligent and have many questions that should be answered about Dental Implants and Associated Bone Grafting. We would rather give you too much information than not enough.
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3
CALL
706-543-8377 or 1-800-277-5297
What are my options for replacing my teeth?
No replacement, a fixed partial denture (e.g. a bridge), a removable partial
denture, complete dentures (if you have no teeth) or dental implants.
Remember: healthy teeth and healthy dental implants help
preserve your jaw bones.
Bone loss secondary to
Healthy dental arch in elderly male.
tooth loss
Healthy teeth preserve the jaw bone.
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What are my options for replacing
my missing teeth?
No replacement
This is the poorest choice as teeth behind or opposing a missing tooth may eventually drift into the unfilled space and periodontal disease may develop. In the area where your tooth was extracted, you may lose 40% to 60% of your bone volume after 2-3 years.
A Fixed Partial Denture (e.g. a bridge)
Traditional/Resin-bonded Bridge
A fixed partial denture will require the cutting down of adjacent, healthy teeth that
may, or may not, need to be restored in the future. In addition, oral hygiene mea-
sures are more difficult with bridges. Teeth restored with crowns are more prone to
tooth decay and gum disease. Bone loss may occur under the fixed bridge since
there is no actual tooth in place to maintain stimulation of the bone. Further, there
may be future costs to replace the bridge once, twice or more often during the
patient’s lifetime. In general, a fixed bridge must be replaced every 7 to 15 years.
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CALL
706-543-8377 or 1-800-277-5297
A Removable Partial Denture
(All Acrylic/Metal base)
A removable partial denture, may contribute to the loss of
adjacent teeth and the loss of bone density. Studies show
that within five to seven years, there is a failure rate of about
30% in teeth located next to a removable partial denture. As
with fixed bridges, removable partial dentures need to be
replaced every 7 to 15 years.
Complete dentures (if you have no teeth)
If your teeth have been missing for some time, the adja-
cent support bone is likely to grow thinner and shrink. This
occurs because the root of the natural tooth has to be present
to stimulate the bone. As much as one third of your jaw’s
thickness can be lost in the year following tooth extraction.
Dental Implants
Of all the options open to the patient, dental implants are usually the best treat-
ment option and the solution of choice for replacing missing teeth. Implants do
not impact adjacent teeth or lead to bone loss. In general, dental implants seldom
need replacement once they have fused to the bone.
Remember: healthy teeth and healthy dental implants help preserve
your jaw bones.
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What is a Dental Implant?
Your natural teeth are made up of basically two functional parts: the root and the
crown. The dental implant replaces the root and will eventually (after fusing to the
bone) support the abutment (*) and new crown. The new tooth looks, feels, and performs like your natural teeth. In addition to replacing a single tooth, implants can also be used to anchor bridges or removable and fixed dentures, offering better fit and stability than dentures supported by natural tissue alone. The implant is fabricated from biocompatible titanium which may have a surface coating. Once healing is complete, the final crown, bridge or denture is fabricated and attached by your dentist for a separate fee.
(*) abutment (connects the crown to the implant)
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CALL
706-543-8377 or 1-800-277-5297
Chance for success (prognosis) ?
Since 1986, our success rate has been approximately 96%*. No dental treatment
available including root canal treatment, bridges or crowns has a better success rate
than dental implants. Poor oral hygiene, smoking, excessive use of alcohol, certain
serious illnesses (e.g. diabetes, cancer) and even uncontrolled bruxism (clenching of
teeth) will lower the chances for long term success.
* Includes Biohorizons, Calcitek, Centerpulse,Zimmer and Z-Max Implants
Can my Dental Implants be placed painlessly?
YES! The most predictable way to control pain and anxiety (nervousness) is through the use of intravenous (IV) sedation (twilight sleep) or general anesthesia (completely asleep). For less anxious patients, we offer local anesthesia (e.g. Lidocaine), orally administered sedatives (e.g. Xanax) and nitrous oxide (laughing gas). The best anesthetic technique for you will bediscussed at your consultation. Often the post-operative course is less painful than having a tooth removed.
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Surgical Timing
In most cases, placing dental implants is a one procedure process. Immediate
implant placement at the time of dental extraction (for a non-restorable tooth) can
be done if all conditions are ideal (i.e. extraction socket remains intact and stable).
If delayed placement is indicated, we usually wait 10 - 16 weeks after a dental
extraction before placing a dental implant. If significant grafting is not needed,
then a “single stage” (one step) procedure is performed in which the dental im-
plant is placed along with the temporary cover and the gum tissue is often sutured
around it. Usually, the process to restore the implant(s) can begin in about 10 - 12
weeks by your dentist. If your jaw (ridge) bone is deficient in thickness or height,
additional time (bone grafting procedures) may be necessary to complete the
process. Please note that it may take your dentist and lab technician about another
3-5 weeks to provide prosthetic reconstruction with an implant crown, an implant
supported bridge (fixed partial denture), or an implant supported removable or
fixed denture.
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CALL
706-543-8377 or 1-800-277-5297
Computer generated abutments (crown support posts) for
patients desiring faster replacement of missing front teeth
An impression is made during the surgery
Temporary Healing Abutment
(Space Maintainer)
to place the dental implant. This impres-
sion along with your dental models are sent
to the computer dental lab. In about 3-4
weeks a temporary crown, for appearance
only, will be placed on your custom implant
Implant with Custom Abutment
support post (implant abutment). This option
is offered at an additional cost. This system
uses the latest in CAD/CAM technology* to
give superior esthetic and functional results.
The decision to use this system is based on
your desires and the advise of your dentist.
Temporary Crown
* Means Computer-Aided Design/Computer-Aided Manufacturing
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CT (Cat Scan) Imaging
For our patients, the Galaxis 3D Cone Beam CT imaging provides the following
benefits for implant/bone graft patients:
  • Low dose radiation (the equivalent of 4 bitewings)
  • A quick, comprehensive scan of the complete oral/maxillofacial area (14 seconds).
  • Immediate virtual diagnosis and treatment planning in full view of the patient at the initial consult visit (eg. Implant placement).
  • More certainty during surgery (eg. Implants, bone grafting).
  • Easy sharing of images and diagnostic information with other professionals.
  • Affordable/less radiation - a hospital based maxillofacial CT will cost approximately 8 times more and deliver 64 times more radiation.
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CALL
706-543-8377 or 1-800-277-5297
Cat Scan/Computer Guided 3D Surgery
We want our patients to receive the best oral surgical care possible, which is why we have invested in the latest technology in oral and facial diagnostics.
Dr. Satterfield has been using the Swissmeda (developed in conjunction with the University of Zurich) CT guided implant surgical system since May 2013.
These guides know where the vital structures are (e.g. sinus cavities, nerves, roots, bone and soft tissue structures) and where the future implant crown will be. We can minimize complications by improving accuracy.
This system provides our patients with the best possible results while improving the surgical and prosthetic planning among dentists, dental lab technicians and the oral surgeons.
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Oral Hygiene
You care for your dental implant in the same way you care for your natural teeth.
It is critical to brush & floss twice a day. In addition, the use of proxy brushes and
* Periogard (Chlorohexidine) oral solutions maybe indicated in some cases. It is
extremely important to see your dentist for hygiene appointments 2-4 times per year
depending on your specific needs. You will be given more detailed information after
your implant placement.
* Use for the first 3-4 months following implant placement. You may need to use longer if you are having
problems with plaque control.
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Follow-up?
We will follow you for approximately one year (longer if needed).
Special Needs?
Some patients may need additional procedures for dental implant placement.
These may include:
Soft tissue grafting - if you have deficient keratinized gum tissue around
your implant.
Muscle repositioning - combined with soft tissue grafting is often needed
in the atrophic (severely resorped) edentulous (no teeth) lower jaw to recreate
the sulcus (vestibule) where the denture flange rests.
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CALL
706-543-8377 or 1-800-277-5297
What can Dental Implants do for me?
Dental implants will improve your ability to properly chew your food and even help you gain confidence in your appearance. Dental Implants can improve the quality of life for almost everyone who is missing one or more teeth. People of all ages can benefit from dental  implants.   If you are  unfamiliar  with dental implants  or maybe
thought they were similar to traditional fixed bridges and removable dentures, you may be surprised by their unique quality of life benefits. Not only do dental implants look, feel, and perform like your healthy, natural teeth, they help protect your oral health by reducing the bone loss that often accompanies the use of conventional dentures that rest on the gum line. Dental implants enable you to eat and enjoy the foods you crave without restriction and allow you to speak clearly and confidently without embarrassing clicking noises or slipping dentures.
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Lifestyle benefits
Not many years ago, when you lost permanent teeth you had two replacement choices: bridges or dentures. While bridges reside in your mouth 24/7, they can create other problems. Installing bridges usually requires grinding down and capping adjacent teeth, that exposes otherwise healthy teeth to decay and gum disease - not to mention the extra stress of supporting the replacement tooth. Bridges usually last no more than 7 to 15 years. Overall, dentures fit poorly causing pain and difficulty chewing and speaking. What is more embarrassing than going out to eat with loose dentures that will not stay in place? In addition, there is nothing like waking up to your teeth in a glass of water to make you feel old. Implants have been successfully placed in people from ages 16 to over 100. Overall, they have a spectacular success rate. More than 95% of implants placed 20 years ago are still in place. If the surrounding tissues remain healthy, implants may have a potentially unlimited life span. Implants can improve your appearance, confidence and freedom. Since dental implants look and feel like real teeth, they naturally enhance your appearance. More importantly, the securely attached dental implant(s) gives you the confidence of eating what you like, speaking easily and clearly (freedom from embarrassment). By following a regular routine of careful oral hygiene and regular check-ups, you can ensure the success of your implants for many years to come.
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CALL
706-543-8377 or 1-800-277-5297
Who qualifies for the placement of Dental Implants?
There are few medical reasons why a patient may not be a candidate for the
placement of dental implants. In general, if you are healthy enough to have a tooth
removed, then you should be healthy enough to have an implant placed. If you
are medically compromised, then our staff will communicate with your physician to
ensure that you can tolerate the procedure and have the potential for a successful
outcome. The major limiting factor in determining whether some patients can have
a dental implant is whether there is sufficient bone remaining to accept the dental
implant. An estimate of the bone quantity and quality can be in part determined
by the radiographic and clinical examination.
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What is the treatment process?
Prior to your operation, you will receive IV antibiotics (and oral antibiotics for 5-7 days afterwards). You will also be given local anesthesia so that the involved area will be numb for up to 8-12 hours and beyond. This is part of our pain control system. In addition, you will be given one of the anesthesia techniques previously discussed (local, nitrous, IV sedation or general).
Step One: An implant can be placed wherever adequate bone structure
is present. (If necessary, a bone graft will be performed first or simultaneously). An
incision is made in the gum tissue and a small hole is drilled into the bone. The
proper-sized and shaped implant will be placed in the bone, a small metal healing
cap will be attached to the top of the implant which protrudes slightly above the gum
line. This may or may not require small
dissolvable stitches.
Note: If you have a tooth that requires removal (not possible to restore), then immediate implant placement at the time of dental extraction can be done if all conditions are ideal. If the extraction socket is not ideal, then a particulate bone graft may be placed in the socket to prepare for the future implant. The procedure to place an implant may take approximately 30-60 minutes. Multiple implants in both jaws may take up to 2 hours or longer. The number of appointments and time required will vary for each patient.
Placing the Healing Cap
In many cases, a healing cap (also
called a healing abutment) is temporarily secured to the implant.
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Step Two: After an adequate healing period of 10-12 weeks, you are ready for placement of the prosthetic (replacement) tooth. Its shape, size and shade will be determined by your individual dental structure. Your dentist will take an impression to create a model of your teeth so that the proper prosthetic tooth (crown) can be made. The healing cap that we placed will be removed and replaced with a prosthetic abutment. This abutment will become the support post for the replacement prosthetic tooth. At this time you may have a temporary prosthetic tooth (crown) placed. The temporary crown will be removed and replaced with your permanent implant crown.
Placing Final Abutment
The Prosthesis in Place
When the gums have healed, the final
The crown may be screwed or cemented
abutment is placed.
to the abutment. In some cases, the crown
and abutment are a single unit.
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CALL
706-543-8377 or 1-800-277-5297
Please Note:
In some cases, the implant must be covered with the gum tissue and allowed
to heal for 12-16 weeks (when the bone is soft or simultaneous grafting was
necessary). You will return to our office for removal of a small amount of gum
tissue over the implant. A small metal healing cap will then be attached to the
implant as mentioned before. In approximately 2 weeks you will be seen by your
dentist for impressions to allow fabrication of your prosthetic tooth replacement
(implant crown) that inserts into the implant.
Risks of Dental Implant Surgery?
Essentially the same as removing teeth and may include sinus and/or nerve injuruies, infection, poor healing, and failure of the bone to fuse to the dental implant. Anesthesia risks may include nausea, inflammation of the veins, and allergic reactions (a rash, swelling, or even a medical emergency may occur, but is extremely rare.)
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What are my implant (tooth replacement) choices?
Single Implant - For a single missing tooth, only one implant is needed. The
previously described process would be performed at the site of the missing tooth,
and in approximately 12-16 weeks, you will have an artificial, replacement
tooth. For patients desiring faster replacement of missing front teeth the Computer
Generated Abutment System (described earlier) allows placement of a temporary
crown in about 3-4 weeks.
NOTE: There is also the option of placement of an immediate temporary crown
using a modified stock abutment if all conditions are ideal and your dentist agrees
to this technique.
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CALL
706-543-8377 or 1-800-277-5297
Multiple Implants - In the case of several missing teeth, multiple implants
can be used, one implant for each missing tooth. Placement of all implants can
usually be accomplished at the same time, following the same procedure for a
single implant.
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Fixed Partial Prosthesis (Implant Supported Bridge) - An implant
supported bridge is similar to a traditional bridge, but crowns are attached to
implants adjacent to areas of missing teeth where implants will not be placed.
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CALL
706-543-8377 or 1-800-277-5297
Removable Prosthesis (Implant Supported Denture) -
Two to four implants
are placed in the upper or lower jaw and are stand alone (Locator or O-ring
attachments) or connected by a bar. A removable denture locks into the
specialized attachments or the bar appliance. This implant supported prosthesis is
both stable and comfortable but can be easily removed for cleaning.
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Fixed Removable Prosthesis (Fixed Implant Supported Denture) - This
hybrid appliance requires four to eight implants and is secured in place with
screws. It can be removed only by your dentist for periodic examination and
cleaning.
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CALL
706-543-8377 or 1-800-277-5297
The MAX Implant
The MAX dental implant fits the multi-rooted molar extraction socket and allows for immediate placement following extraction. This alternative treatment modality maximizes bone preservation, minimizes the need for bone grafting and reduces the number of procedures and treatment time by three to four months.
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Do I have enough bone?
If you are lacking sufficient bone (height or thickness) for placement of a dental implant then bone grafting may be indicated. This may include a particulate bone graft (human, cow or plant source) with or without an artificial covering (collagen membrane) to hold the graft in place. In most cases, the dental implant can be placed at the same time. If a porous polyethylene mesh (tent pole) graft or a block graft (a small piece of your own lower jaw bone or donated cadaver bone) is needed, then the placement of the dental implant may be delayed by approximately 20 weeks while the graft heals. Sinus grafting may be needed when the amount of available bone in the back of the upper jaw is limited due to very large or low lying sinuses. Another bone grafting option is the Infuse bone graft. This is recombinant (engineered) human bone morphogenetic protein, a synthetic version of a protein everyone’s body produces naturally to regulate bone growth and healing. It attracts your body’s own bone building cells to the site where it is needed and over time (4-6 months), new bone is formed. Bone grafting is usually an office procedure.
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CALL
706-543-8377 or 1-800-277-5297
Bone Grafting Materials
Bone from the patient - Autograft - Surgically harvested from another site
in the patient’s own body, transplanted into site of the defect. These sites include:
inside the mouth (chin/ramus), the iliac (hip) crest and the tibia (just below the
knee). This may require outpatient hospitalization. These techniques will add sur-
gical (anesthesia) and recovery time if they are necessary or preferred.
Recombinant (Engineered, man-made) human bone morphogenetic
protein-2 - A synthetic version of a protein found in your body that promotes
bone growth and healing. It releases the protein over time where it is placed,
provides a scaffold (framework) for new bone to grow into, and is absorbed and
replaced by bone. It may be used for sinus grafting or alveolar (jaw) ridge aug-
mentation following tooth extraction. This eliminates the need for a second surgery
to remove bone from your body.
Human (Cadiver) Donor -Allograft - An allograft consists of tissue intended
for transplantation into another individual of the same species. An allograft is used
to fill in bony defects, provide structural support and build up deficient areas of the
jaw when bone loss occurs. It may be used as a particulate or a block (solid) graft.
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CALL
706-543-8377 or 1-800-277-5297
Bovine (Cow) Donor - Xenograft - A safe, effective bone graft material from specifically processed bovine sources. Because of its similarity to human bone, Bio-Oss is highly successful in helping new bone to form. It may be used for sinus or alveolar ridge grafting.
Plant Source - Red Algae - Bone fillers derived from mineralized marine red algae. This mimics the natural composition of bone and has a high enough surface area to support cell activity and stimulate bone repair. The material is designed to gradually resorb, leaving behind healthy bone.
Synthetic (man-made) resorbable - B tricalcium phosphate - R.T.R. (Resorbable Tissue Replacement) is the pure synthetic bone grafting material that helps to safely promote new bone formation following an extraction.
Synthetic Hydroxylapatite (man-made) non-resorbable - A particulate
bone graft to fill in, augment, or replace bone. It is often used to augment alveolar
(jaw) ridges to support removable partials and dentures.
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A Simple Procedure to Prevent Bone Loss
If you plan to have a tooth extracted and replaced by an implant, it is possible that
your socket will not fill in with a sufficient volume of bone and that you will need
a bone graft. To prevent this problem, grafting of the socket can usually be done
at the time of tooth extraction. This is known as site preservation and will help
prevent shrinkage of your bone and soft tissues in this area. Usually an implant
can be placed within 10-16 weeks.
Routine Extraction
Site Preservation Extraction
Gumline
Height of
New
Height of
Remaining
Bone
Jawbone
Jawbone
Replacement
bone
The empty socket
Area where your tooth
Socket after it has been
Treated area shown
that’s left immediately
was extracted showing
filled with replacement
after 6-12 months. Note
after your tooth has
loss of 40% to 60% of
bone.
the new bone that has
been extracted.
bone after 2-3 years.
grown to its original
height and width.
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CALL
706-543-8377 or 1-800-277-5297
Bone Loss
Bone grafting can be used to build up the jaw ridge where an implant is to be placed. Gum disease or trauma (an injury) can weaken and cause loss of the jaw bone ridge. It is also possible that you are naturally lacking bone in a specific area. When a tooth is extracted or missing, bone in that area may shrink. Studies have shown that many patients will lose approximately 40-60% of their volume of bone in an extraction site in 2-3 years.
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What Are The Basics of Bone Grafting?
If you do not have enough healthy jaw bone, a bone graft may be required before implants
can be placed. Grafting is the process of regrowing bone in a deficient area by using
prepared materials. The graft added to the deficient area may be particulate or in block
form. The materials may consist of a self-donated (autograft) bone, bone morphogenetic
protein (synthetic), cadaver (human) bone, bovine (cow) bone, red algae (plant source)
hydroxlyapatite, or synthetic bone substitute.
Guided Bone Regeneration Membrane (GBR) Technique
Bone grafting material is placed intoGBR membrane (callogen) is placed over theSutures placed to secure the gum
the bony defect.
bone grafted defect.
tissue over the membrane.
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CALL
706-543-8377 or 1-800-277-5297
Porous Sheet for Bone graft
MEDPOR
Containment
CONTAIN
Sheet
Soft Tissue Expansion
(Tent Pole) utilizing Polyeth-
ylene Mesh Membranes to contain Bone Grafting
Materials
(engineered or recombinant human bone
Bone
morphogenetic protein and particulate bone) to recon-
Graft
struct moderately to severely resorbed alveolar ridges.
Bone
The bone graft replaces the bone that has been lost
secondary to tooth removal.
Tacks
The Medpor contain implant is subperi-
osteally draped over the area of missing
bone and tacked or sutured into place
with the bone graft material incased
Medpor biomaterial allows for tis-
within it.
sue ingrowth because of its intercon-
necting open pour structure.
When the reconstructed alveolar
ridge bone achieves maturation,
the dental implant is placed. In
some cases the implant can be
placed at the same time.
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BLOCK GRAFTING
If your tooth was lost many years ago and your jaw bone ridge is very thin,
you may require a block graft (a small solid piece of your own bone or donated
processed cadaver bone) to reconstruct the area for an implant(s). This graft
is usually held in place with two metal screws and covered with a guided bone
regeneration membrane before closure with your gum tissue. After approximately
20 weeks this area is re-entered to allow removal of the screws and placement of
the implant(s). If the previously mentioned computer generated abutment system
(custom support post for the implant crown) system is being used then you will
have your temporary crown placed in approximately 4 weeks. Your final implant
crown will be placed in approximately 16 weeks by your dentist. If the computer
generated abutment system (mostly used for front tooth replacement) is not used
then you will be ready for your final implant crown impressions in approximately
12 weeks and crown placement at approximately 15-16 weeks.
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CALL
706-543-8377 or 1-800-277-5297
Sinus Grafting
When teeth are lost in the posterior (back) upper jaw, the bone often shrinks (when teeth have been removed many years previously) causing the sinus cavity to enlarge and encroach on the tooth-bearing area. This may result in the need for a sinus graft. By grafting bone under the sinus lining, the bone height of your upper jaw is increased. This graft creates an ad equate bone foundation for the implant(s). The materials used to graft the sinus may consist of the previously mentioned materials in this section. The Infuse bone graft (engineered or recombinant human bone morphogenetic protein) has shown excellent results in clinical trials (published reports). Generally, the implant can be placed within 4-6 months and be restored 12-16 weeks later with the final implant crown.
Bone loss
A small opening is created in the bone to
access the sinus cavity
The sinus is gently lifted
The grafting material is
The grafting material is
Depending on the procedure you need,
using a small instrument
placed beneath the sinus
stabilized with a protective
sometimes the implant can be placed
membrane alongside the
membrane and the gum is
simultaneously with the Sinus Graft.
existing bone.
closed with stitches
Otherwise your doctor will allow
approx. 4 to 9 months for healing.
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MOST COMMON PROBLEMS AFTER SURGERY
DISCOMFORT: May require prescription pain medications. Persistent soreness is often
present for several days.
SWELLING: Takes about 2-3 days to reach its peak. Then, subsides over the next week.
DECREASED MOUTH OPENING: The jaw muscles often become stiff and limit the amount of mouth opening for several days. Rarely, the jaw joint itself is affected. Mention it to Dr. Satterfield if it is persistent.
BLEEDING: Some mild oozing is normal for up to 24 hours. There may be slight bleeding
from the area when you brush your teeth for the first week.
INFECTION: Infections are rare during the first few days after surgery. If an infection does
occur, it is more likely 4 to 8 weeks after surgery. Treatment is usually uncomplicated, but
you should see Dr. Satterfield.
NUMBNESS: Dental implants may be placed in close proximity to the nerves that supply
sensation to the teeth, gums, tongue, cheeks, chin and lips. Occasionally these nerves are injured when the implant is placed, causing numbness and tingling. If this happens, the nerve usually repairs itself. In very few cases, numbness is permanent. Please notify Dr. Satterfield if you have persistent numbness.
SINUS INJURY: People who lose their upper (back) posterior teeth may have an enlargement of the sinus cavity, the placement of dental implants in this area may cause an opening (hole) in the sinus cavity. The sinus usually heals without serious consequences, but further treatment may be necessary.
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CALL
706-543-8377 or 1-800-277-5297
When will I be able to go back to normal activities?
Most patients having a single implant may be able to go back to work or school
the next day. For multiple implant and bone grafting patients, there may be a 2
or 3 day delay in going back to routine activities. Those involved in sporting or
strenuous activities will have to gradually return to peak performance over a period
of 7-10 days as tolerated.
Remember: You should not drive a car, operate machinery or sign
a legal document for 24 hours after your anesthesia and surgery.
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PRE-OPERATIVE AND PRE-ANESTHETIC INSTRUCTIONS
If you are having I.V. SEDATION or a GENERAL ANESTHETIC, please do NOT eat, drink or smoke for at least SIX HOURS before your appointment time. This is very important. PLEASE DO NOT VIOLATE HIS RULE OR WE WILL HAVE TO RESCHEDULE YOUR SURGERY! If your mouth and throat become dry, cool water may be used as a rinse (BUT DO NOT SWALLOW)! HOWEVER, PLEASE TAKE YOUR ROUTINE DAILY MEDICATIONS (EXCEPT BLOOD THINNERS AND DIABETIC MEDICATIONS) WITH A SMALL SIP OF WATER ONLY.
Do not ignore a HEAD or CHEST COLD when having surgery. Call immediately if you have any
symptoms, as a change of appointment may be necessary. We have reserved this time for you, so
please give us a 48 hours notice if you cannot keep your appointment.
If you wear CONTACT LENSES, whether soft or hard, please REMOVE THEM. Please wear conven-
tional glasses on the day of your surgery.
Your mouth and teeth should be WELL-CLEANSED (brush and floss) before your surgery to help avoid
infection.
(Do not swallow the saliva or toothpaste while brushing your teeth).
If you have ever had a SEVERE ILLNESS of any type or if you take any medications or are ALLERGIC
to any drugs, please let us know (please bring all your medications).
A responsible adult should ACCOMPANY YOU on your surgery day and take you home. You may
under NO CIRCUMSTANCES drive an automobile for at least 24 HOURS following your anesthetic
and surgery (Nor can we release you to a public transportation service).
PLEASE LEAVE all jewelry at home including watches, rings, necklaces and earrings.
Please wear a SHORT-SLEEVED SHIRT and loose clothing, as this will make taking your blood pressure, starting an I.V. and placing cardiac monitor leads easier (WEAR OLD CLOTHES). Women should not wear hose or slips since they may interfere with placement of EKG leads. Please remove finger nail polish and any nail enhancements so that our oxygen detection devices will be accurate for safe anesthesia.
Appointments are made for an exact time, but delays are sometimes unavoidable because of emergencies. We appreciate your patience and will try our best to see you on time.
If you have any questions, please call us!
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CALL
706-543-8377 or 1-800-277-5297
DENTAL IMPLANT AND BONE GRAFTING
POST-OP INSTRUCTIONS
GENERAL ANESTHESIA OR SEDATION
  • Do not drive or operate machinery for 24 hours.
  • Do not consume alcohol, tranquilizers, sleeping medications or any non-prescribed medication for 24 hours.
  • Do not make important decisions or sign any important papers in the next 24 hours.
  • You should have someone stay with you at home for the next 24 hours.
  • If your face, jaws and tongue are still numb for 7 to 12 hours (and beyond), then it is probably due to the long acting local anesthesia (Marcaine). This is part of the pain control.
ACTIVITY
  • You are advised to go directly home. Restrict your activities and rest for a day. Resume light to normal activity for the next few days.(Remove gauze when you get home and replace only as needed.)
  • Avoid excessive physical exertion and fatigue during the first few days following your surgery. Obtain adequate sleep (rest).
  • If the surgery involved your sinus or nasal cavities, avoid smoking, sneezing or blowing your nose until further notice. If you have to sneeze do it through an open mouth.
FLUIDS AND DIET (Drinking a lot of fluids is critical because dehydration is a serious problem requiring hospitalization for IV fluids.)
NOTHING HOT TODAY! Begin with clear liquids (e.g. Gatorade, ice tea, apple juice). If not nauseated, you may go to a full liquid diet (e.g. cold, liquidy milk products such as milkshakes, fro zen yogurt or a smoothie). A homemade milkshake, using skim milk or soy milk, frozen yogurt or ice cream and fresh fruit blend into an excellent source of nourishment. HELPFUL TIPS: Additional foods you may eat the day of surgery - yogurt with fruit, applesauce, puddings, Jell-O, popcicles, fudgecicles and ice cream. The day following the surgery you can begin to eat regular soft foods for the next 5 days or so (e.g. eggs, omelets, spaghetti, meat loaf and well cooked vegetables). It is important to maintain a diet high in protein and complex carbohydrates. Do not skip meals. Please take a potent multi-vitamin and at least 500 mg of Vitamin C per day. Avoid big, hard and chewy foods for 5 days or until jaw stiffness and discomfort have resolved (e.g. no steaks, triple decker sandwiches or chewing gum).
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Medications
You should resume your daily prescription medication schedule per your physician’s instructions. If you are diabetic, you may need to stay on a sliding insulin scale (based on your blood glucose level and your doctor’s advice) until you are back to your normal caloric daily intake. If you are on a blood thinner (Warfarin, Plavix, etc.), then you may start back on it the same evening of your surgery if there are no bleeding problems.
Common Medication Instructions:
  • Naproxen (Aleve) - [your daily maintenance pain medicine] - Analgesic/anti-flammatory drug for mild to moderate discomfort. This medication must be taken consistently to be effective every 10-12 hours with food (preferably after meals) for the first week postoperatively. You should use your refill if needed. This is an excellent analgesic to take for those patients who must go back to school, work or operate machinery such as cars. Take as directed on the bottle. (You may choose to take OTC Aleve.)
  • Narcotic analgesic [your rescue pain medicine ] - Norco (Hydrocodone 10 and acetaminophen) or Ultram (Tramadol 50 mg.) - This analgesic should be taken (only as necessary) for moderate to severe pain not controlled by the Naproxen (Aleve). Take 1⁄2 to 1 tablet every 4 to 6 hours with food. You should use your refill if needed. You should not take this medication if you are driving a car or operating machinery. You may experience dizziness and drowsiness. Do not drink alcohol while taking narcotics. This medication requires a prescription. Take as directed on the bottle.
  • Antibiotics (e.g. Amoxicillin, Clindamycin, Cephalexin or Metronidazole) - These medications will help prevent infection and should be taken as directed on the bottle until they are all gone. This medication requires a prescription. Take as directed on the bottle.
  • Zofran ODT 4 mg - This medication controls nausea and vomiting associated with anesthesia and surgery. It may cause drowsiness or dizziness. Do not drive or perform other possibly unsafe tasks while using this medication. Doses may be repeated at 8 hour intervals. This medication requires a prescription. Take as directed on the bottle.
  • Chlorhexidine Glucate Oral Rinse (Periogard) - This antibacterial rinse should be used every 12 hours for 16 days. This rinse requires a prescription. Use as directed on bottle (rinse for 30 seconds undiluted and spit out).
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706-543-8377 or 1-800-277-5297
ANESTHESIA/MEDICATION SIDE EFFECTS (NAUSEA)
  • Please call us immediately if you have any side effects (e.g. nausea, vomiting, diarrhea, headaches). Please call us immediately if you have an allergic reaction (e.g. rash or swelling). Do not take the offending drug again. If you are not sure which drug caused the problem, then discontinue all medications and call us immediately. If you are having difficulty breathing or swallowing - then call 911 immediately.
  • If nausea occurs, try an antacid (over the counter), such as Mylanta or Maalox, before continuing with some bland foods (i.e. cereal, soft crackers, flat soda drink or milk).
  • If your bowel habits become irregular, it is suggested you take a mild laxative (over the counter), such as Milk of Magnesia or Metamucil. Please call us if constipation becomes a problem.
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706-543-8377 or 1-800-277-5297
Wound Care
Swelling:
Facial swelling after surgery is normal. It usually takes three days for swelling to reach a peak before beginning to subside. Most of the swelling will normally resolve within the first 7 to 10 days. Ice packs are used for the first 24 to 48 hours. Plastic bags filled with crushed ice and wrapped in a towel or a commercial ice bag are convenient forms of application. Apply for 20 minutes - each hour while awake (on 20 minutes/off 40 minutes). After discontinuing ice, you may switch to moist heat (warm water bottle or warm wash cloth) using the same time periods.Bone Morphogenic Protein (bone graft) will often double the amount of swelling, but not increase the pain.
Bruising:
Black and blue marks on the face are caused by bleeding internally. This appears first as swelling, but often on the second or third day, it may discolor the face black or blue then yellow. It will usually disappear within 10 days. Make-up tips are as follows: Mint Tint - Conceals redness; Lavender Tint - Conceals yellowish bruising; Yellow Tint - Conceals blue or lavender bruising.
Oral Hygiene:
This is the single most important thing that you can do on your behalf to minimize the possibility of wound infection following oral surgery. Please use a soft bristle toothbrush with a toothpaste without whiteners (along with dental flossing) to keep the teeth clean. The recommended routine will be as follows: After meals, brush and floss your teeth being very careful around the surgical wound; then rinse with a diluted mouthwash (1/2 water and 1/2 Listerine) for 30 seconds. Be very careful during the first 24 hours following the surgery - Do not be too vigorous in your rinsing as this may stimulate bleeding. In addition, we want you to rinse with Chlorhexidine 0.12% (Periogard) mouth rinse every 12 hours (hold in mouth for 30 seconds and spit out) for 16 days. IMPORTANT: DO NOT use a mechanical toothbrush or Waterpik for 10 weeks.
Oral Bleeding:
Gauze was placed over the surgical site to serve as a pressure bandage when you bite down. Replace the gauze when you get home (if needed only). Remove the gauze when sleeping, eating or taking medications. A small amount of oozing is normal for the first 24 hours. You may wish to cover your pillow with a towel to avoid staining. Rest with your head elevated by pillows at least 35 degrees. Avoid vigorous rinsing, spitting, smoking, carbonated soda drinks, toothpaste and mouthwashes with whiteners, drinking through a straw and alcohol containing mouthwashes (unless diluted) for the first 7 days as this may interrupt the clotting process. Please limit your talking for several days to help reduce bleeding and swelling.
AVOID: Please avoid the tendency to touch your oral wound with your tongue or fingers. This may cause significant problems with healing.
Note: Typically, pain and swelling will peak on the third day post-operatively. If the pain medications are keeping you comfortable and the swelling is not severe, then you are probably doing as we would expect.
NOTICE: If you have been given a temporary partial (AKA:flipper) or a denture to wear following your surgery, it is OK to resume wearing when you feel comfortable. You must take it out during meals (no chewing allowed).
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Continued from page 42
You must leave it out for the first two weeks following bone graft surgery to (prevent damage to the wound) allow for swelling to resolve. Please bring it with you (for evaluation and any needed adjustment) to every follow-up appointment. THE TEMPORARY PARTIAL OR DENTURE SHOULD NOT CONTACT THE DENTAL IMPLANT (for at least 12 weeks) OR THE SOFT TISSUE OVER THE BONE GRAFT (for at least 20 weeks).
Sinus Instructions:
Blowing the nose, sucking liquid through a straw, and smoking, all of which create negative pressure, should be avoided for 4 weeks after surgery. Coughing or sneezing should be done with the mouth open to relieve pressure. Pressure (gauze) at the surgical site, ice, elevation of the head, and rest are also recommended.
Specific Complications to Watch for - Contact Dr. Satterfield (Call 911
if problem becomes urgent or life threatening).
Possible allergic reaction - rash, sudden swelling, difficulty breathing.
You have severe headaches or notice changes in your vision.
You develop difficulty seeing, become dizzy or pass out. You have difficulty speaking, breathing or swallowing.
Fever over 101 degrees by mouth.
Pain not relieved by pain medication.
Unexpected swelling around the surgical site.
Increased redness, warmth and hardness around the oral wound.
Increased and progressive drainage from the surgical wound.
Increased redness, warmth, hardness of the IV site.
New numbness or tingling in your face (persistent numbness beyond 24 hours).
Inability to urinate.
Continued nausea, vomiting, diarrhea or constipation.
Jaw stiffness is expected after jaw surgery and usually begins to improve within 5 to 7 days. Notify us if it does
not improve.
Foul taste and odors are commonly reported after oral surgery. Good oral hygiene measures can help eliminate this problem.
Any other unusual or abnormal symptoms.
Follow-up Care:
You were given a follow-up appointment card (check in your post-op bag or call us if you cannot find it). Dr. Satterfield will need to re-evaluate you (to check your progress) in approximately 2 weeks.
After office hours and weekends our answering service (706-543-8377 or 706-475-9852) picks up 24 hours a day/7 days a week. There may be a brief delay in returning your call if the doctor (on-call) is busy in the emergency or operating room caring for another patient. Please place your call again if there is not a timely response.
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CALL
706-543-8377 or 1-800-277-5297
DENTAL IMPLANT CARE FOR THE PATIENT AT HOME
1. The success of the implant depends on the hygiene care by the patient. Both home-care and office-care are very important. A patient should visit the dentist at least once every 3-6 months for a professional cleaning. Radiographs will be needed every 18-24 months (more often if indicated).
2. Patients should brush their natural teeth and implants as often as possible to decrease the plaque
accumulation. (At least twice each day, morning and night). MAINTAIN EFFECTIVE PLAQUE CONTROL!
3. Use a soft, nylon, multi-tufted toothbrush, such as: “Colgate Total”, “Butler”, “Oral-B”, “Reach” or a mechanical
tooth brush such as the “Sonicare” DIPPED IN PERIOGARD! A gentle soft, sweeping motion should be used. (Your
dental hygienist can instruct you in the correct method). IMPORTANT: DO NOT use a mechanical tooth-
brush or Waterpik for 12 weeks following your surgery.
4. Clean around each implant with one of the following:
• “Superfloss” by Oral-B
• Floss threader with floss
• Butler’s “Nylon-Coated Proxabrush”
• Butler’s “Perio-Pic Interdental Cleaners”
• Butler’s “Go-Betweens Cleaners”
• Nylon yarn
• Long strip of cotton gauze dipped in Periogard
Your dental hygienist can instruct you in any one of the above methods.
5. Use of cotton swab, Q-tips, etc. at soft tissue/implant junction - DIPPED IN PERIOGARD! This maybe especially
indicated if you have composites, tooth colored filling material and staining from rinsing with chlorhexidine (Periogard). (If you are experiencing staining of teeth and or restorations, then use Colgate Peroxyl rinse prior to using Periogard).
6. Use of other interdental aids as they become available - Oral-B has a new foam ID (interdental) brush for implant maintenance.
7. The best time to clean your dental implants is before going to bed at night. After cleaning with brushing and flossing, go over the dental implant - gingival interphase with a clean Q-tip dipped in chlorhexidine (Periogard) rinse. Do not eat or drink anything else before retiring.
PLEASE DO NOT USE A HARD RIGID TOOTHBRUSH, SAFETY PINS, PAPER CLIPS, OR
OTHER METAL OBJECTS TO SELF-CLEAN THE IMPLANTS OR INSERTS.
BE METHODICAL AND THOROUGH
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WRITTEN FINANCIAL POLICY
Thank you for choosing the Athens Dental Implant Center. Our primary mission is to de-
liver the best and most comprehensive oral surgical care available. An important part of
our mission is making the cost of optimal care as easy and manageable for our patients
as possible by offering several payment options.
Payment Options:
You can choose from:
• Cash, Check, Visa or Mastercard
(We offer a 10% courtesy discount to patients who pay for their treatment with
cash or check prior to or the date services are rendered. ¹)
• Convenient Monthly Payment Plans from CareCredit²
• Allow you to pay over time
• No annual fees or pre-payment penalties
Please note:
For patients with insurance we are happy to work with your carrier to maximize your benefit and
directly bill them for reimbursement for your treatment.³
If you have any questions, please do not hesitate to ask. We are here to help you get the treat-
ment you want or need.
PLEASE NOTE: We reserve the right to bill patients for 50% of our scheduled procedure fee when they fail to give us a 48 hour notice of cancellation.
¹Courtesy discount does not apply if insurance is being filed on your behalf.
²Subject to credit approval
³However, if we do not receive payment from your insurance carrier within 60 days, you will be responsible
for payment of your treatment fees and collection of your benefits directly from your insurance carrier.
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CALL
706-543-8377 or 1-800-277-5297

Dental Impant Fees Include:

  • Initial implant consultation and Cat Scan including virtual placement of the implant for diagnostic and educational purposes
  • Surgical Placement of a Single Dental Implant and Temporary Healing Cover
  • CAT Scan/Computer Guided 3D Surgical Stent
  • Each additional Implant and Cover placed at the same time

Fees Include:

  • An initial implant consultation and Cat Scan including virtual placement of the implant for diagnostic & educational purposes and the fabrication of the CT/ computer guided surgical guide.
  • The surgeon and facility fees, infectious disease control, anesthesia, and antibiotics during surgery.
  • All post-operative examinations (including x-rays) for routine follow-up and necessary implant reevaluations for 12 months following surgery.
  • Direct communications between your dentist and our office throughout the treatment process to coordinate post-operative crown, bridge, or denture placement.

* These fees do not include any reconstructive surgery that may be required to provide sufficient bone and soft tissue needed to accept an implant.
** Also please note that you will be charged separately by your general dentist for construction of the dental prosthesis (crown, bridge, partial or denture) on the implant(s).

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Mission Statement
Our mission is to provide the best quality surgical care for our patient family in a
personalized, compassionate manner. We respect the needs and value the dignity
of every individual. Through team work with your dentist and utilizing the most
up to date techniques available, we will continue to provide progressive oral and
facial health care to improve the lives of all we serve: our patients, our referral
doctors, our co-workers and our community.
Our values are founded in the healing mission of Jesus Christ. We welcome His
presence in human life and in the challenges we face so that His love might be
experienced through us. We give God the credit for all of our success.
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706-543-8377 or 1-800-277-5297
Meet our Team
DR. STAN SATTERFIELD
Dr. Stanley D. Satterfield, Oral and Maxillo-Facial Surgeon, has been in private
practice in Athens, Georgia since July, 1981. He is a native of Athens and the son
of the late Dr. E. Wayne Satterfield (a well-known dentist and sports figure). His
mother, Bobbie Satterfield McDonald is a life-long resident of Athens. Dr. Satterfield
received his undergraduate education at the University of Georgia (1971-1974)
and his D.M.D. degree from the Medical College of Georgia (1974-1977). He
completed his internship and residency in Oral and Maxillo-Facial Surgery at the
Medical College of Virginia (1977-1981).
Dr. Satterfield graduated first in his Dental School class and was selected into OKU, the national dental honor
society. He is a Diplomate of the American Board of Oral and Maxillo-Facial Surgery (board certified) and the
International Congress of Oral Implantology. In addition, Dr. Satterfield is a Fellow of the American Association
of Oral and Maxillo-Facial Surgeons and The American College of Oral and Maxillo-Facial Surgeons. He has
also published articles in professional journals. Dr. Satterfield is the inventor of a surgical instrument fabricated
by Walter Lorenz, Inc. He has formerly served as president of the Clarke County Dental Society and in leadership
roles for the Georgia Society of Oral & Maxillo-Facial Surgery. Dr. Satterfield is also the team oral surgeon for
the University of Georgia athletic program.
Dr. Satterfield began teaching Sunday School in 1981 and became a deacon in 1983. He is a member of Prince
Avenue Baptist Church. He has also served on the Board of Directors of the UGA Fellowship of Christian Athletes
and the Athens YMCA (past President). He is currently serving on the Board of Directors of the Mercy Health
Center (Dental Director). He along with Office Manager Kellie England, started the Challenger Division of the
Athens Little League program for special children in 1991. In addition, he coached Little League for eleven years
and served on the Board of Directors.
Dr. Satterfield is married to the former Tracey Lynn Dow of Virginia Beach, Virginia. Tracey is a wonderful home-
maker and decorator. They have three daughters and two sons. The family calls Athens, Georgia home.
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OUR TEAM
We are very proud of our team which includes the following: Steve Shelton Jr., Paramedic; Kellie England, Offfice Administrator; Cindy Smith, Paramedic; Mandy Phillips, Financial Coordinator; Kathy Depriest, Front Desk Coordinator; Trista Gilliard, Surgical Assistant
OFFICE HOURS
For your convenience we are open Monday-Thursday from 8:00 a.m. to 5:00 p.m. On Fridays, Dr. Satterfield performs hospital surgeries and volunteers at Mercy Health Center. We offer 24 hour, 7 days a week emergency service.
Our phone number is (706) 543-8377. If no answer, call (706) 475-9852.
Our e-mail address is: office@athensoms.com
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706-543-8377 or 1-800-277-5297





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