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Implant dentistry in today's highly esthetic environment

Jan. 25, 2010
The possibilities are endless with dental implants, especially in today’s esthetically demanding dentistry. Dr. Edgard El Chaar explains that the most important part in achieving both your and your patient’s goals is clear and ongoing communication.
By Edgard El Chaar, DDS, MSFor the past 35 years, dentistry for the most part has been a repair business with patients and dentists primarily interested in replacing or fixing teeth, removing cavities, and/or treating oral diseases. Today, dentistry has evolved into a broader field, driven by esthetics, beauty, and style, with images of models and sparkling smiles covering the pages of our magazines.A few summers ago, I was lecturing in South Carolina and I read the state’s motto on a license plate, “Smiling faces, beautiful places.” It was perfect timing as this was the essence of my lecture — how dental professionals can integrate implant dentistry into today’s heavily esthetically driven cosmetic dentistry. The most successful dental work I have seen happens when the patient and dentist work together as a team. For many patients, dental implants are often the best solution. With a dental implant, your patient can truly enjoy the freedom of permanent teeth. From simple flossing and better oral hygiene to a more natural look, dental implants are a great choice in making your patient 100% satisfied.Patients who lose teeth from an infection may experience surrounding bone loss. The bone and soft tissue that surrounds the dental organ after extraction can lose its volume and shrink, which can lead to “ridge deficiency.” With the advent of novel surgical grafting materials and advanced surgical techniques, the risk of ridge deficiency has now been reduced to nearly zero. Today’s grafting materials have evolved from the conventional particulate to moldable putty that can fill the entire space the tooth once occupied. New solutions, such as growth factors, can be used as a substitute to bone graft, or there is also a naturally occurring protein that exists in the bone called recombinant human Bone Morphogenetic Protein-2 (rh-BMP2), which can accelerate human bone formation by attracting stem cells and transforming them into bone-forming cells. Another cause of tooth loss can be tooth fractures that don’t have any loss of supporting bone around it. As such, rather than grafting the site, a dental implant can be used and placed immediately (and even implanted with a temporary crown) the day of the surgery. This is a highly successful and commonplace technique these days. The advantages here are many; the procedure preserves the normal aspect of the gum contour, provides a temporary crown that looks like a natural tooth, does not impede on the neighboring teeth, and also is a time savings by having the final crown in four months instead of waiting six to 12 months.Case showing dental implants for a failed root canal —
AfterCase showing dental implants for failed bridges —
AfterThe possibilities are endless with dental implants, especially in today’s esthetically demanding dentistry. The most important part in achieving both your and your patient’s goals is clear and ongoing communication. This means taking the time at the patient’s initial consultation to study the case carefully and gather all of the needed information either by dental models, cone beam tomography (radiographical digital 3-D image), or clinical images. The next step is evaluating all the information together and showing the patient a mock-up, called a “wax-up,” that can give the patient a better idea of what to expect and projected results. Patient understanding is important in these cases, as these procedures are both expensive and time demanding. This is why I am an advocate of further education for dentists and patients to improve their knowledge base of dental implants and how they can help.I established the EEC Institute for continuing education for this sole purpose — to give dentists access to continuous education including peer case review. This enables the dentists to master this treatment and return to their practices and where it is applied to their patient. This experience proves my theory that “the more details are covered in communication, the better execution.” For more information and/or upcoming EEC Institute courses, please visit:
Edgard El Chaar, DDS, MS, oversees a thriving private practice on Park Avenue in New York City that specializes in oral health, dental implants, periodontal and gum disease, and oral cosmetic surgery. In addition to his practice, Dr. El Chaar is a clinical associate professor of periodontics and implant dentistry and surgical director of the Continuing Education Dental Implant Program at the New York University College of Dentistry. He is also the surgical director at the NYU College of Dentistry and visiting professor at the Saint Joseph University in Beirut, Lebanon. Dr. El Chaar completed his postgraduate education in advanced periodontics and received his master’s degree in oral biology from NYU. Fluent in Arabic, English, and French, Dr. El Chaar is an internationally renowned educator in the field of dental implants and esthetic preservation. A major in the U.S. Army, Dr. El Chaar is also dedicated to the Army Dental Corps, providing continuing education within their specialty periodontics program. He has travelled the world performing live surgeries and seminars for medical professionals interested in the latest information and news in dentistry. A world-class teacher with more than a decade of experience in continuing education, Dr. El Chaar launched the EEC Institute in New York City, a CE program for general practitioners and specialists. The courses are taught in small groups and cover a range of topics, including clinical participation, lecture, and surgical/clinical observation. For more information and course listings, please visit In addition to being a diplomate of the American Board of Periodontology, Dr. El Chaar is also a member of the American Academy of Periodontology, the Academy of Osseointegration, and the American Board of Oral Implantology/Implant Dentistry. Dr. El Chaar’s practice offers patients advanced oral consultations and examinations, gum disease assessment, and oral cancer screening as well as the latest treatments and procedures for dental implants, oral cosmetic surgery, teeth whitening, and smile enhancement. For more information, please visit