How Immediate Implants Saved “Refrigerator” Perry's Smile

How multiple disciplines in dentistry plan and manage your care

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Periodontist's Perspective — Dr. Marty Kolinski

A complete evaluation including a medical history, a comprehensive examination of his head, neck and jaws and an oral cancer examination revealed all were within normal ranges at the time.

Because of his advanced periodontal (gum) disease it was not possible to save his natural teeth. Although periodontal disease results in loss of tooth supporting jawbone, 3D x-ray evaluation revealed that Perry had sufficient bone left in both jaws to anchor and support dental implants. We decided that we could place a sufficient number of implants to support a full upper and lower set of teeth to replace his own natural teeth. Our plan was to place eight implants in the upper jaw and seven implants in the lower jaw — all in the same day.

Teamwork between a restorative dentist, surgical specialist and dental technician is critical for a successful result.

Laboratory Technician — The Third Team Member (Behind the Scenes)

The temporary bridgework as well as the final restoration is also a collaborative effort requiring an often silent, yet important third member of the team, the dental technician. As the artist in the group, he is responsible for not only fabricating natural looking teeth (restorations), but many times also making the surgical templates (guides) used by the surgeon to place the implants in correct position. Drs. Sutter and Kolinski had great confidence in working with Jade Dental Laboratory as the results show.

The Huddle — Coordinated Treatment Planning, A True Collaboration

Teamwork between a restorative dentist, surgical specialist and dental technician is critical for a successful result. This is no more evident then when doing an extensive and precise immediate implant supported upper and lower fixed bridge (reconstruction).

Photos provided by Dr. Vesna Sutter

The “Game Plan” Summary

Sufficient number of implants: In order for the implant supported bridge to be successful, there has to be adequate bone with enough implants to resist the pressure and forces of occlusal (biting) function. There must be a sufficient number of implants placed in exactly the right position to support temporary and ultimately permanent bridgework.

Control biting forces: The biting forces applied to the implant bridgework must be properly balanced so as to avoid placing undue stresses and even micro-movement.

A stable bridge: An unstable bridge, which transmits microscopic movement to the new implant-bone connection, will cause implant and consequently bridge failure.

These criteria must be met in order to allow the bone to heal by fusing permanently around the implants by a process called osseo-integration (osseo-bone, integration-fusion). After a period of two to six months, the temporary bridges can be replaced with final or permanent bridgework.

A Super Bowl Touchdown — Worthy Of A Champion

The “makeover” was completed four months after the implants were initially placed. The final result, the design and fabrication of which required skill, art and experience, was accomplished by an experienced team resulting in a predictable “touchdown.”

What you probably don't know is that “the Fridge” never liked having a space between his front teeth. While his famous persona was based on his gargantuan size and gapped tooth smile, he is thrilled with his new look.

We would like to acknowledge and thank William “Refrigerator” Perry for gifting us and our readers with his emotional story in the hope that it will inspire others not to neglect their dental and oral health. Changing a smile really can change a life. In June 2008, unconnected to his dental problems, William Perry was diagnosed with Guillain-Barré syndrome, a nerve disorder, which began a new fight for survival and his latest challenge. We wish him well.