Frequently Asked Questions

Dental Implant

A dental implant is an artificial replacement of the tooth root that serves as an anchor to dental restoration.  The implants are made of titanium alloy and are inserted into the jaw bone.  Depending on the number of implants, the dental restorations they support can range from a single tooth (crown) to smaller bridges, dentures (overdentures) and full arch restorations.

We offer the full range of implant services from single tooth implant crowns, all the way to full arch (jaw) implant bridgework.  We do NOT offer mini implants as studies have shown that mini implants doe not offer the same level of success and functionality as traditional root form dental impalnts.

The short and simple answer is because they are the best option to replacing missing teeth.  Dental implants have many advantages when it comes to tooth replacement options.   Just to mention a few,  1)Preservation of tooth structure of neighboring teeth as opposed to traditional bridges where the teeth need to be capped; 2) Provide secure anchoring of bridges so patients don’t have to wear partials or dentures; 3) Unlike natural teeth which can get cavities, dental implants are made of titanium and do not decay

 

  • Dentures are bulky and cover the roof of the mouth- implant bridges are  closer to the size of teeth and do not cover the palate
  • Dentures rest on the gum tissue and cause soreness and bone loss overtime. Implant bridges are supported by the implants and do not cause undue pressure on the gum and bone
  • Implant bridges are secure and permanent compared to removable dentures
  • We see improved chewing capacity and nutrition with implant bridges as compared to the diet of denture wearers.

With proper care and maintenance, dental implants can last a lifetime. 

Dental implants enjoy a very high success rate compared to other treatment options.  Most studies show that the success rate of dental implants is in the 95%-97%.  As such, dental implant therapy, should be looked at more as an investment in health and longevity rather than an expense.  

Anyone with missing teeth is potentially a candidate for implants.  Whether it is a single missing tooth, multiple teeth, or all teeth. Every case is difference and your dental professional  can determine your candidacy for implants and make the proper recommendation after a thorough evaluation

Yes.  In some cases, temporary teeth can be made at the same time of implant placement.  It is referred to as “immediate loading”.  Unlike the traditional approach where a healing period preceeds the installation of the teeth, in the immediate loading protocol, the implants are “loaded” at the same time of implant placement or shortly thereafter.  The temporary crown or bridges is used during the healing phase until the permanent replacement is made.  Patients are asked to stay on a soft diet during this time.

Immediate implant placement is the procedure when a dental implant is inserted at the time of tooth extraction.  When a tooth is hopeless due to failed root canal or tooth decay and needs to be removed, a dental implant can sometimes be placed at the same time.  This saves the patient healing time and the need to sit in for two separate surgical procedures (extraction & implant surgery).  Your dental professional can recommended the best approach after a careful and thorough evaluation to achieve the most successful outcome.

Immediate implant loading is the process when temporary teeth are made and installed on the implant at the same time of implant surgery or shortly thereafter.  As such, the implants are “loaded” with a temporary crown or bridge “immediately” as compared to the delayed loading protocol where the teeth area installed many weeks after implant surgery.  There are certain conditions and requirements for the immediate loading protocol to be successful and your dental professional can make the judgement to determine your candidacy for such procedure.  With the immediate loading protocol, almost all the time, a temporary is installed on the implant during the healing phase.

The term All-on-4 is referred to a procedure when four (4) implants are used as anchors to support a full permanent bridge that replaces all the missing teeth in one jaw (arch).  The protocol started in Europe over 20 years ago and has since been modified and perfected with different variations. More appropriate terms would be All on X, All On, or Full Arch.  At our office, we do not believe in the one fit all approach.  The number of implants a patient receives at our office varies depending on the individual case and is determined based on what will yield the highest success rate.

An “arch” is dental jargon for jaw.  Upper arch means upper jaw  and lower arch means the lower jaw.  A full arch also means that all the teeth are being replaced in one jaw.  Double arch means upper and lower jaw/ teeth replacement.

In general, smoking results in higher complications rates after implant surgery.  While implants can done on smokers, we recommend that you not smoke after the procedure to allow the best possible healing to occur. 

The procedure can be safely performed on well controlled diabetic patients.  We will consult with your internist or endocrinologist to determine your suitability for the procedure with your condition.  As a general guideline, we would like to see HbA1c level around or below 7.  Also, the procedure will improve your diabetic control by eliminating the chronic inflammatory conditions in the mouth that can exacerbate your diabetes and by improving the quality of food and nutrition you will consume with healthier dentition.

Procedure

The procedure usually takes anywhere from one hour to three hours.  This depends on the need for dental extractions and whether one or two jaws are involved.

Yes.  Comfort is important to us and for this reason, we use IV sedation during the surgical part of the procedure.

No.  You will go to sleep and wake up when the surgical portion of the procedure is over.  By combining IV sedation and local anesthesia, we can ensure a comfortable experience.  There will be manageable discomfort after the numbing medicine wears off which can be overcome with pain meds.

If present, the hopeless teeth are removed along with infected bone and tissue.  After we ensure that all diseased tissue is removed, several implants are inserted into the healthy bone and secured. This is followed by scanning and measuring of the bite.  Our in house laboratory personnel will then custom design and fabricate your new implant temporary restorations.

  • Single point of care and responsibility
  • No need to bounce around between different offices and imaging center
  • On site dental lab with all the necessary equipment
  • More efficient 
  • Cost savings
  • Better quality control

In most cases we are able to provide the teeth on the same day of the implant surgery.  Depending on the case, we sometime prefer to have our patients go home 

No.  It is best if we see you before you have your teeth extracted.  Many times, when teeth area extracted without plan or an end game, the patient ends up with serious bone loss.  Extracting the time ahead of time results in added healing time and surgery that may be avoided. Last but not least, the remaining teeth can give us some clues as to how to design your future smile in terms of shape and size.  

We had many patients that were told they didn’t have enough bone for implants who successfully received full arch implant treatment.  With CT scans and careful evaluation, the full arch protocol opens up many possibilities that were not possible before by avoiding bone grafts and relying on strategic areas of available good and healthy bone.

We offer a 10 year guarantee on the implants and restoration as long as you adhere to our recommended maintenance and follow up protocol. Our recommended follow up includes a bi-annual professional cleaning at our office and the use of a bite guard in addition to daily appropriate home care and hygiene.  Your first cleaning/follow up visit and bite guard are even  included in your treatment cost.

The implant bridge is guaranteed to 10 years as long as you adhere to our recommended maintenance and follow up protocol. Our recommended follow up includes a bi-annual professional cleaning at our office and the use of a bite guard and appropriate home care and hygiene.  Your first cleaning/follow up visit and bite guard are even  included in your treatment cost.

We recommend a bi-annual care visit.  Each visit will include an evaluation by Dr. Jandali or one of his associates and a professional cleaning by our registered dental hygienists.  In some cases, we may have to remove the bridge for a more thorough cleaning and evaluation or may recommend a 4-month follow up (three times per year) depending on your medical and dental health conditions.  The home care includes routine brushing, flossing, and the use of a waterpik irrigator in addition to the use of a bite guard.  Adherence to this follow up protocol will ensure our 10 year guarantee on the implants and bridgework.

The procedure is called “immediate implant placement”.  In many cases if the dental extraction is done in a careful manner, a dental implant can be inserted at the same time.  There are many studies that validated this approach with very high success rates.  

Recovery

Like any dental surgical procedure, there will be manageable discomfort during the first few days following the procedure.  This is usually successfully controlled with prescription pain medications which will be prescribed to you ahead of time.

Yes.  In most instances, you will be prescribed anti-biotics,  pain killers, and an anti-septic mouth wash.  Additionally, you may be given medications in the IV during the procedure to help with the recovery process.

The initial recovery period usually lasts for about a week.  At this point, a follow up visit is made and sutures may be removed.  You will continue to heal over the next several weeks.

We recommend a soft/liquid diet  for the few days immediately after the procedure.  This includes smoothies, ice cream, protein shakes, scrambled eggs, and the like.  As the gum heals and after the first two weeks, you can slowly progress to a more solid diet.  During the entire healing phase  we recommend no hard or chewable foods be used with the immediate temporary bridges.

We recommend you take one or two days off after the procedure for maximum comfort.

During the first two weeks, you will only rinse with salt water and any mouth wash we may prescribe.  After the initial healing phase, we recommend gentle brushing with a soft tooth brush and the use of a Waterpik device.  It is important to maintain good hygiene during the healing phase for a successful outcome.  We will monitor your  healing progress at follow up visits and make appropriate recommendations.

More FAQs
General-Logistical-Financial

In some cases having 6 implants is better than 4.  This depends on the size and shape of the jaw and the location of vital structures like the sinuses and nerves.  For this reason, at our clinic, we do not limit your treatment to  the traditional All-on-4 protocol.  Some of our patients receive 6 implants while other may receive 5 or 4 depending on their particular customized situation.  In short, we place as many implants as necessary tp provide the most successful outcome and  to get the job done well.  After all, it is in our interest to maximize success.  A successful case translates to a happy patient and less complications we have to deal with. There are no additional costs to you as the number of implants increases as we have a fixed All Inclusive fee structure for this procedure.

An “arch” is dental jargon for jaw.  Upper arch means upper jaw  and lower arch means the lower jaw.  A full arch also means that all the teeth are being replaced in one jaw.  Double arch means upper and lower jaw/ teeth replacement.

The full arch dental implant bridge is secure and permanently affixed to the implants.  Unlike dentures or snap on denture, it does not come out every night.  Moreover, the upper bridge does not cover the roof of the mouth.  The teeth are made of zirkonia ceramic material which has the feel and texture of natural teeth.  

Corporate dental centers are usually owned by investment firms and operate on a franchise model.  They employ a dentist, staff, laboratory technician, and contract with an oral surgeon to help with the surgical part of the treatment.  These facilities need to send their work out an outside lab to make the teeth and pay for laboratory services.  Moreover The out-of-state corporate office needs to collect its share of the treatment fees. All these inefficiencies results in higher fees to the patient. 

In contract, our facility is full owned and operated by Dr. Jandali.  Our clinic is custom designed and built for efficient delivery of care.  By having all the needed imaging equipment,  design, and milling capabilities and our in house digital dental lab, we can provide a superior product and control costs.  This results in savings that we pass on to our patients.  

The All-on-4 or full arch treatment is a complex procedure and requires specialized trainings and skills beyond those obtained in ordinary dental school training.  Moreover, there is specialized equipment that is needed for proper diagnosis and planning such as a CT.  Most dentists do not have such training or equipment to handle the entire phase of the treatment under one roof.  For this reason, you may be sent to an imaging center for CT scan, or to another specialists that your dentist can team up with to handle your case.  While this is a possible solution, it is inefficient and can result in extended treatment time, delays, and added costs and inconveniences.

We deploy the latest technology available for planning and executing these cases.  Our 3-d face scanner records 3-d images of your face and this is “merged” with dental scans CT scans to allow realistic visualization of the result in real time. Moreover, during the healing time,  we rely on your feedback from the temporary bridges to make more detailed touch-ups to perfect the result and arrived at the desired outcome.

No.  We document most of our treatments and photos and face scans are a routine part of the treatment process.  However, it is not expected that you appear in public videos or brochures our clinic promotes. 

A good number of our patients need to get this procedure because they avoided routine dental care for years due to fear, anxiety, and frustration.  We are fully aware of this and helped many change their lives over the years.  We offer IV sedation which make the procedure comfortable and worry free.

The treatment timeline is as follows:
-Consultation Day
-Procedure Day (temporary delivery)
-3-4 months of healing time
-1 month to make the permanent set

It is not uncommon for implant treatment to last 12-24 months.  Many times bone grafting procedures and sinus lifts are needed before implant placement. The full arch protocol relies on implant placement in strategic areas of available bone and is therefore considered a graft-less solution.  This saves a considerable amount of time waiting for healing.  Moreover, if the patient has teeth, the implants are inserted the time of extraction thus reducing the healing time needed for the extraction before implants.  

At our clinic, we charge an all-inclusive fee for Full-Arch dental implant procedure.   This includes the  extraction of the teeth (if needed), placement of needed implants whether 4, 5, 6, or more, IV sedation,  bone grafting and management, same-day temporary,  second prototype, and final prmanent bridge made of Prettau® zirkonia material.  Additionally, we offer a free bite guard and first follow up /cleaning visit. When itemized, the cost of this procedure can easily exceed $40,000 per arch.  However, due to our large volume of cases, we purchase out implants and components in bulk and are able to 

The short answer is efficiency and technology.  No middle man, no corporate fees, and no outside lab bills.  We are fully integrated facility with the best available technology in the world which allows us to offer this treatment at very fair and competitive price while maintaining the highest standards of quality and care.

When you come for your consultation you will be presented with your treatment plan and costs.  Our financial coordinators are very knowledgeable and will help you navigate your way to secure the necessary funding for the procedure. Please refer to our financial section pages for more information about different options.

Yes.  The procedure can be paid for using Flexible Spending Account (FSA) or Health Savings Accounts (HSA) funds.  Our financial coordinators will help navigate this process when you come for the consultation.

In some instances, the IRS allows for penalty free IRA hardship  withdrawals for qualified medical expenses that do not exceed 10% of your adjusted gross income.  The full arch dental implant procedure is considered a qualified medical expense. We recommend that you consult with your financial adviser or custodian of your IRA account for definitive answers.

The IRS allows for certain medical procedures to be tax deductible as long as some conditions are met.  In general, the procedure has be a a qualified unreimbursed medical expense and the amount of has to exceed 7.5% of the adjusted gross income (AGI) for the tax year.  The full arch All-on-4 or All-on-X procedure is considered a qualified medical expense.  For example, assuming a treatment cost of $15,000 for the tax year and an adjusted gross income of $70,000, the entire procedure cost can be deducted for the year. We advise that you consult with your accountant or tax advisor for a definitive answer regarding your particular situation as tax rules continue to change.

If you have recent x rays or CT scans we will be happy to evaluate them to determine your candidacy for the procedure.  If we feel that more detailed imaging is needed, you will receive a new 3-D CT scan at your consultation at no additional cost.

We proudly use Prettau® Zirkonia by ZirkonZahn for the final bridge.  Prettau® Zirkonia is the highest quality and most expensive zirkonia material in the world. The material is milled on our M4 5-axsis milling machine in our in-house digital dental laboratory.  This ensures the highest quality standards and control. Some clinics offer an acrylic (plastic) bridge that is reinforced with a titanium bar.  While this was an acceptable approach years ago, the acrylic resin teeth will wear prematurely requiring replacement in the short term.

We do not provide hotel stay.  However, we have negotiated good discounted rates with nearby hotels to accommodate our out-of-town patients. Our office staff can help make arrangements and recommendations on where to stay.

You will need to make your own air travel arrangements including airfare.

If flying commercially, we recommend you book your flights to Detroit Metropolitan Wayne County Airport (DTW).  Private flights can be to either Coleman Young International Airport formerly Detroit City Airport (DET), Oakland/Troy Airport (VLL), or the Oakland County International Airport (PTK)

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