Dr. Noumbissi was invited to present the first ever presentation in ceramic implantology at the scientific session of the 104th Meeting of the Philippine Dental Association in Manila. This one of a kind and well attended event took place at the SMX convention center in Pasay City.
Once zirconia dental implants have been placed in bone they need to be protected from early micro and macro movements. Furthermore during the four to five months of implant integration both for esthetic and functional purposes, clinician and patient have a need for protective appliances. Such appliances will vary based on multiple factors such as occlusion, finances and area of implant placement to name a few. The second aspect of teeth replacement with one-piece zirconia implants is the choice of adequate materials for cementation and definitive prosthetics. With a combination of lectures and live restorative demonstrations this course will focus on the prosthetic aspects of zirconia implantology. This course is designed to provide the clinician with the ability to predictably and confidently protect one-piece zirconia dental implants immediately after implant placement and during bone integration. The lecture material will cover selection of ceramics for predictable restoration of zirconia implants, how to select appropriate materials for priming and bonding of zirconia to zirconia and other ceramics leading up to cementation as well as cement selection.
This course will include in-depth coverage of:
This course will enable you to:
Thursday, March 28, 2013
| 7:30 am | Registration/Continental Breakfast |
| 8:00 am | Zirconia as an osseointegrated implant material |
| 10:15 am | Zirconia as a restorative material |
| 12:00 pm | Lunch (provided) |
| 1:00 pm | Prosthetically driven implant planning and selection |
| 3:00 pm | Temporization techniques and their indications |
| 4:30 pm | End of Day 1 |
| 7:30 am | Registration/Continental Breakfast |
| 8:00 am | Restorative materials and methods |
| 10:30 am | Review of multi level zirconia cases from start to finish |
| 12:00 pm | Lunch (provided) |
| 1:00 pm | Live Restorative case review: from surgery to permanent restoration |
| 2:30 pm | Live restorative demonstration |
| 4:30 pm | Discussion/ end of Course |
The Zirconia Implantology Program will be held at Miles of Smiles Implant Dentistry located in Silver Spring, Maryland. Sessions on both days will start at 8 a.m. and end around 5 p.m. Lodging information will be sent upon receipt of your registration.
Full refunds may be granted only if notification is received no later than March 20, 2012. Cancellation after this time will result in a $350 processing fee. We cannot assume responsibility for losses due to participant travel arrangements.
This is a two-day course, 12 CE (continued education) credits will be awarded and full tuition for both days is $599. International Academy of Ceramic Implantology Members (IAOCI) save $100.
Full Tuition: $599.00
IAOCI Member: $499.00
New IAOCI Members: FREE (With first time one-year membership $395.00)
If you are not yet a member of the IAOCI you can sign up for a one year membership ($395.00) at www.IAOCI.com/join. All IAOCI memberships will be verified before you are enrolled in the course. This course has limited space and only eight doctors will be able to attend this session.
For further information please call Christine at 774-992-4096 to register.
This article was written by Dr. Noumbissi and published in the January 2013 edition (International Section) for the Orofacial Chronicle Journal from Bhopal, India.
Since Dr. Brånemark first introduced titanium dental implants, a variety of materials have been used successfully for about 40 years. Today implants are made either of commercially pure titanium (cpTi) or titanium alloys. In addition to its biocompatibility, titanium was also initially believed to be inert, nontoxic and nonallergenic1,2. However, several drawbacks have been documented in the literature with the use of titanium and titanium alloys as implant materials in medicine and dentistry. High concentrations of titanium have been detected in tissue surrounding dental implants mostly as a result of wear or corrosion of the titanium implant surface. In an animal study Weingart et al.3 showed that nine months after titanium implantation, titanium particles had spread and were found in adjacent lymph nodes. This indicates the possibility that phagocytes could transport titanium particles to the lymph nodes without any initial or immediate inflammatory response and potentially cause later immunologic reactions.
An increasing number of people who suffer some form tooth loss are choosing to replace their teeth with dental implants. For the last thirty plus years the only and highly successful option for freestanding tooth replacement available in the United States and other countries has been titanium and titanium alloy dental implants. There are increasing reports both in dentistry and medicine of individuals developing sensitivity and allergies to titanium and/or titanium alloys. Even of more concern some of these implants are corroding once exposed to body fluids such as saliva and developing electrical activity when they are coupled with prosthetic components made of other metal alloys. Titanium implants as they corrode are known to release metal ions which create low level electrical currents through the body but also weakens the structural integrity of the implants. With recent advances in implantable biomaterials research and technology, bioceramics such as zirconia (zirconium dioxide) are now available and a new generation of modern implants is made of zirconia. Zirconium Silicate (ZrSO4) is mined and is treated and transformed into zirconium dioxide which is also called zirconia. Zirconia is the crystal form of the material zirconium which is a transitional metal. After mining and processing of zirconium silicate, zirconium is isolated and further processed under high temperature and pressure. Zirconium then undergoes an oxidation and crystallization process which allows it to transition into a structurally stable and inert crystal. This bioceramic crystal is called Yttrium Stabilized Tetragonal Zirconium Polycrystal (Y-TZP) also called zirconium dioxide. Therefore zirconium dioxide is not a metal and presents exceptional physical and biological properties. Zirconia can sustain an extreme load capacity, features a very long service life, and presents no conductivity or interference in the body’s meridian systems; it is the most hygienic, non-electricity conducting and stable material for dental implantology and orthopedics. Zirconia implants also present no danger of corrosion, something that is often a serious problem with metal based dental implants. Corrosion of a titanium dental implant occurs when it is coupled with the metal framework or abutment of the crown which more often than not is a less noble metal or alloy than that of the titanium implant. The implant and crown assembly bathes in saliva which is an electrolyte and a good conductor of electricity; this leads to all sorts of chemical and electrical imbalances in the body and to a phenomenon called “battery mouth”. Another advantage of zirconia is its low affinity for plaque (picture#1). Clinical observations and studies show that zirconia implants compared to or next to titanium implants accumulate much less plaque and allow for superior gingival health (picture #2).
There is a controversial and highly misunderstood aspect of zirconium dioxide in terms of its radiological output. Zirconium Silicate (ZrSO4) depending where it is mined can be contaminated with natural radioactive isotopes including radium (226Ra) and thorium (228Th). This was a major concern in the early 1990’s because the ores selected were contaminated. Today zirconium dioxide processing plants have the technology to remove these contaminants and are able to yield and use very pure powders. For example, the radiation emitted by a 3 mol% Y2O3-ZrO2powder was the same order of magnitude as alumina powder, both of which were several orders of magnitude less than that typically measured for water, vegetables and livestock. Zirconia hip ball replacements weigh approximately 100mg and have a natural radiological output of 1mSv per year. The average weight of a zirconia dental implant is 1g, translating into a natural radiological output of roughly 0.01mSv/year. Therefore the radiation risk of zirconia bioceramics is negligible and given that the World Nuclear Association states that the typical background radiation experienced by most people in North America is 3.4mSv, there is little concern for adverse biological effects on the implant recipient.
Zirconia dental implants are a sensible and clearly a healthier alternative to conventional and titanium implant bridges, partials or Overdentures. Furthermore zirconia by virtue of its translucency and all-white color makes it the most aesthetically pleasing option available today for tooth replacement (picture #3 & picture #4). This is a new era in implant dentistry and the science of oral implantology.
1- Rabin, Steven I., MD; Calhoun, Jason H., MD, FACS, editor: Immune Response to Implants
2- Allauddin A Siddiqi, Alan G T AG Payne,Warwick J WJ Duncan. Titanium allergy: could it affect dental implant integration? Clin Oral Implants Res 22(7):673-80 (2011)
3- Weingart D, Steinmann S, Schili W, Strub JR, Hellerich U, Assenmacher J, Simpson J. Titanium deposition in regional lymph nodes after insertion of titanium screw implants in the maxillofacial region. Int J Oral Maxillofac Surg.1994 Dec:23 (6Pt2): 450-2
4- Scarano A, Piattelli M, Caputi S, Favero GA, Piattelli A. Bacterial adhesion on commercially pure titanium and zirconium oxide disks: an in vivo human study. J Periodontol. 2004 Feb;75(2):292-6
BACKGROUND:
The National Center for Complementary and Alternative Medicine at the National Institutes of Health (NIH), states that “Integrative Medicine combines mainstream medical therapies and complimentary and alternative medical therapies for which there is some high-quality scientific evidence of safety and effectiveness.” An alternative medicine that is used in conjunction with a conventional one is known as a “complementary” medicine. An example of such practice is when patients undergoing chemotherapy use natural ginger syrup to prevent nausea. In 2007 a comprehensive National Health Interview Survey was conducted on the use by American adults of complementary alternative medicine which is also known as CAM. The results showed that approximately 38 percent of adults surveyed use CAM. In dentistry dental implants are a “conventional” or a mainstream dental therapy and currently the vast majority of implant dentists use conventional medical therapies such as surgery, synthetic drugs and titanium implants to manage healing and achieve bone integration and effectively replace teeth.
There is an overuse of synthetic drugs to manage patients recovery after implant surgery and this has led to many surgeons and other practitioners to underestimate their patients ability to self heal. This can only happen if they are detoxed and their immune system properly restored and empowered. Today an increasing number of people are choosing healthier lifestyles, alternative medicine and are more and more reluctant to accept metals to be implanted in their bodies. They also increasingly resist the idea of synthetic drugs-only options to treat or prevent health problems. Dental and medical research show there is increasing evidence that medical and dental metal implants will corrode and trigger various types of health problems in some individuals including metal sensitivity, metal toxicity, delayed healing after implant surgery, and even delayed implant failure many years after implantation.
COURSE OBJECTIVES:
Miles of Smiles Implant Dentistry is presenting this unique two-day course where multidimensional medicine and holistic dental implantology intersect. This program is designed to demonstrate the intimate correlation between multidimensional medicine and successful zirconia (ceramic) implant surgery. The first goal of this course is to enable the participants to understand and appreciate the critical interrelationship that exists between a clean body, a boosted immune system and optimal recovery from implant surgery. As such during consultation the doctor will be taught how to obtain relevant information from the patient and determine what type of pre and post surgical detoxification and immune boosting protocols to request from the multidimensional physician. Protocols as simple as timely IV administration of targeted vitamins and minerals make a significant difference in patient recovery allowing for optimal, fast healing and ultimate success of dental implants. The second objective of this program is also to present top to bottom natural, drug free protocols and methods of metal-free tooth replacement with ceramic implants.
This course will enable participants to:
SPEAKERS:
Dr. Sakiliba M. Mines, MD is an Integrative Family Physician. She has been a pioneer in Integrative Medicine, practicing for over 30 years. She obtained her Bachelor of Science in Biochemistry -Nutrition at Spellman College in Atlanta, Georgia, and her Medical Doctorate from Hahnemann Medical College in Philadelphia, Pennsylvania. She completed her specialty as a Family Physician at Howard University Hospital and currently holds a Doctorate of Integrative Medicine. She is a member and instructor with the International Association of Colon Hydrotherapist, and a member of the American Holistic Medical Association. Dr. Mines is the medical director and founder of The Institute of Multidimensional Medicine and Medical Spa. Dr. Mines utilizes extensive medical diagnostic testing, quantum physics assessments, genetic testing and detoxification and has developed natural and holistic protocols to optimize patients healing and recovery from medical and oral surgery procedures. Dr. Mines is a researcher who presents the newest information to her patients. Dr. Mines teaches at seminars and lectures nationally and internationally to educate the community and her colleagues.
Dr. Sammy Noumbissi, DDS MS obtained his Doctorate in Dental Surgery from Howard University College of Dentistry. After obtaining his DDS, he received formal training in Implant Dentistry at the three-year Graduate Dental Implantology Residency program at Loma Linda University in California. Dr. Noumbissi is a member of the editorial board of the Journal of Implant and Advanced Clinical Dentistry and a reviewer for the Journal of Oral Implantology and he is active in clinical research and in areas that further the science of Implant Dentistry. Dr. Noumbissi is also a published author and has published abstracts and articles in peer reviewed dental journals. Dr. Noumbissi is founder of Miles of Smiles Institute for Dental Implantology; he lectures extensively and trains dentists nationally and internationally on topics relating to diagnosis and treatment planning and the multiple applications of implants and ceramic dental implants in oral rehabilitation.
Continued education hours: Twelve (12) CEU will be awarded.
Course fee: $599 before February 10, 2013.
Registration: Please call Ms. Ronetta Jones at 301-588-0768
Lodging: Lodging information will be provided upon completion of registration.
On November 30, 2012, Dr. Noumbissi spoke at Columbia University School of Dental Medicine. In attendance were the faculty and postgraduate students from the department of Periodontics and Implant Surgery, Prosthodontics and from the International Implant Program. Professor Charles Berman one the the elder statesmen of implant dentistry and the faculty in the periodontics program facilitated this event. I would like to thank all that were in attendance and their high interest in this revolutionary area of dental implantology .
When it comes to options for tooth replacement patients are increasingly opting for dental implants over the usual dental prostheses such as dentures or conventionally placed bridges. Since implants sit securely in the jaw and look like natural teeth, they offer superior durability and outstanding aesthetics when compared to conventional bridges. However there is an increasing resistance to metals among people and in implant dentistry there is a shift away from metal or metallic based crowns, partials and implants.
There are four major categories of restorations available for tooth replacement:
Bonded dental bridges use the teeth adjacent to the empty space to help support the missing tooth by using a very thin piece of metal or tooth-colored material to overlay and bond to the back of the adjacent teeth. A tooth replacement or “dummy tooth” is set between these two bonded pieces in order to fill in the empty space. Failure rate is about 25 percent after just five years of use. Furthermore the gap widens because the bone recedes as a result of no longer having a tooth in place. This ultimately results in the weakening of the adjacent teeth which can become loose and eventually fall out.
A cantilevered restoration uses the closest tooth next to the empty space to support the missing tooth using the either the back of the neighboring tooth or a full crown to help support the missing tooth. Success rate is higher than with a bonded bridge depending on how much pressure the actual replacement endures due to grinding and normal wear. This method of tooth replacement has fallen out of favor because the supporting tooth gets torqued and fatigued and more often than not eventualy fractures.
Getting fitted for a dental bridge requires shaving down and modifying of the teeth on either side the space where the tooth or teeth are missing. This is done in order to fit a conventional bridge. This is a process that significantly weakens the ground teeth and sets them up for fracture and root canals in the future. Unfortunately conventional dental bridges predictably fail at a range from 20 percent over 3 years to 3 percent over 23 years. With dental implants the dentist does not need to affect the health or longevity of neighboring teeth at all. Once placed, implants are firmly set into the bone making them more natural than dentures or conventional bridges, with none of the shifting that dentures normally display.
A ceramic dental implant is created from a high performance material (zirconium oxide) that is inserted into the bone to act like a natural tooth root. Zirconium oxide also called zirconia is a crystal phase of zirconium and due to its nonmetallic construction the ceramic dental implant does not interfere with the body’s immune or meridian systems and therefore significantly reduces the potential for rejection. Furthermore ceramic implants do not interact with electromagnetic fields such as those emanating from cell phones, cell phone towers and microwaves. Once inserted into the jaw, the implant integrates directly into the bone to give firm support to the artificial replacement that it is built to hold and should last the lifetime of a patient. Routine maintenance of a dental implant is exactly the same as a person would follow for normal teeth.
Patients who prefer dental implants say that they are more comfortable and provide a more secure fit than fixed bridges or removable dentures. However all implants are not equal and ceramic implants unlike metal implants are made in one piece from the root to the top just like a natural tooth. Therefore ceramic implants do not have joints and do not retain plaque and harbor billions of bacteria like two-piece metal implants. For those who no longer have any natural teeth, ceramic implants can be placed to support and retain dentures and eliminate the embarrassment and discomfort they can cause in social situations when they slip and click. Loose and ill-fitting dentures hamper the everyday pleasure of eating comfortably.
Anyone who is missing one or more of their teeth may be a candidate for implants. If more than a few of the teeth are missing, implants in supporting a crown or bridge can replace those teeth and function as normal teeth without concern for loss of bone and decay. If all or most of the teeth are missing, then implants may be placed to fix in place a full-mouth non-removable set of teeth.
Ceramic dental implants are recommended to patients because:
Considering the overall advantages patients can expect to benefit from as a result of choosing a dental implant, they are better able to enjoy a healthier and greener lifestyle without the restrictions many denture and bridge wearers face. The more secure foundation offered by a dental implant, the better biting pressure becomes, making it possible to enjoy the foods that a patient probably would not be able to eat using a dental prosthetic. As a result improved chewing ability leads to better nutrition and improved overall health.
On April 18 and 19 2013, The holistic Dental Association (HDA) will be hosting its 36th annual conference in Herndon Virginia in the United States. Since its foundation in 1978, the HDA ‘s mission has been to promote an awareness of dental care as it relates to the entire person. The HDA also brings together dentists who have a common interest in treatment modalities that are not included in dental school curriculum. Furthermore in recent years more and more people have heighten their awareness in their own health and regard good health to be more than just the absence of disease. Dr. Noumbissi is a member of the Holistic Dental Association and limits his dental implantology practice to metal-free implant dentistry. Over the last thirty years the only and most popular method of teeth replacement has been titanium metal dental implants and research is increasingly proving that implantation of metals can lead to systemic health problems in areas of the body remote from the oral cavity. Dr. Noumbissi will be one of the podium speakers at this annual conference and will be presenting clinical evidence of the safety and health benefits of metal-free dental implants.The topic to be covered will be “Zirconia a Viable and Sometimes Necessary Alternative for Teeth Replacement”.
For more information on this conference please follow: http://www.holisticdental.org/Default.aspx?pageId=1460693
The first of its kind, the Metal-free Implant Dentistry Summit will be held in Miami Florida at the Hilton Bentley in South Beach. Dr. Noumbissi will be one of the main podium speakers at this conference. The summit will be held December 7 and 8, 2012, zirconia as an implant material will be presented in multiple aspects of implant dentistry including prosthetic and surgical. Aesthetic, single and multiple top-to-bottom metal-free teeth replacement cases will be presented and discussed. Dr Noumbissi will present his ongoing clinical evaluation of zirconia implants for full mouth reconstruction.
It’s unlikely that if you popped a light bulb socket into your mouth that it would light up, but did you realize that your teeth may actually be conducting enough electrical current to short circuit your brain?
Teeth that have been treated, repaired or replaced using any type of metal alloy contain all the necessary ingredients to create an environment akin to a charged battery … in your mouth. Titanium or metal implants are one of the types of dental repairs that can create what is called ‘oral galvanism’ or ‘the battery effect’ in the mouth.
As it turns out creating a battery is a fairly simple process of immersing two or more different metals into a liquid (in this case, saliva) and they automatically conduct electricity. Saliva acts as and is an excellent ‘electrolyte’, while metal dental implants provide the dissimilar metals to make the magic happen. An electrical current is generated when metal ions from the dental metals are conveyed into saliva. This phenomenon is called “oral galvanism,” which literally means that this unique oral environment acts like a miniature electrical generator producing measurable electric currents in the mouth.
Oral galvanic toxicity, as it is known, creates several major complications to the human body, including:
Through the process of oral galvanism titanium implants release metal ions into the mouth and jaw bone constantly. This type of chronic exposure may very likely trigger inflammation, allergies and autoimmune disease in susceptible individuals and slowly weaken the immune system is healthy adults.
With an increase in people receiving titanium dental implants these days, cases of intolerance to these types of oral repairs is on the rise. A recent study that followed 56 patients who developed severe health problems after receiving titanium-based dental implants described medical problems including muscle, joint and nerve pain, chronic fatigue syndrome, neurological problems, depression as well as skin rashes and inflammation.
When intolerance occurs the most logical treatment is to have the metal implant removed and/or replaced with a more biocompatible and bioinert material such as a ceramic implant. Patients who have had metal implants replaced have reduced metal sensitivity overall and report long-term health improvement in the majority of cases.
Ceramic dental implants have proven to be highly biocompatible to the human body and due to their poor electrical conductivity they do not exhibit ion release (or galvanism) when compared to metallic implants. Studies have shown that the way an implant is integrated into the surrounding bone (osseointegration), whether it is made of ceramic or titanium is very similar. But ceramic implants have a comparable, if not greater rate of performance and durability, making them an excellent alternative to titanium implants.
Considering that titanium dental implants can provoke metal sensitivity, inflammation, autoimmune disorders (among other things), while ceramic dental implants are completely metal-free while providing increased durability and a higher level of aesthetics, there is no logical reason for the average person to consider anything other than a biocompatible alternative; ceramic dental implants.
Be Very Careful When Replacing Teeth http://articles.mercola.com/sites/articles/archive/2009/08/08/Be-VERY-Careful-When-Replacing-Missing-Teeth.aspx
Z-Systems – For a Healthy Bright Smile http://www.z-systems.biz/en/7349/patients.html
Electromagnetic Biology and Medicine, 25: 349–360, 2006
Labome.com — Intraoral electrogalvanism – http://www.labome.org/topics/dentistry/intraoral-electrogalvanism-17918.html
While both dentures and implants will fill the gaps left by missing teeth, there are other important considerations to be aware of when making a choice for dental repairs:
The higher cost of dental implants can be the biggest obstacle for many patients to overcome when it comes to replacing one or more missing teeth. Despite their aesthetic and greater functional superiority the initial price of dental implants can cause many people to lean towards more conventional and less expensive options like bridges or dentures.
Second to cost, another attractive aspect to dental bridges or dentures is the quick turnaround time since they can be ready and fitted at about 2 weeks, while dental implants take longer to become fully integrated into the mouth and jaw before they reach their peak performance level
However, there are a few additional costs associated with dentures and bridges which can include:
The actual physical structure of a jaw without teeth will initially shrink quite rapidly most particularly during the first six months — and more slowly over time for the remainder of the patient’s life. Consequently, when a denture is made to fit a person’s jaw it will need to be remade and refitted as the jawbone shrinks.
The teeth in a denture appliance eventually wear down and become less effective at chewing food. Worn denture teeth naturally cause a person to bite and chew with more force, pushing the denture into the jawbone, causing the bone to shrink at an even faster rate. Jawbone deterioration and loss is the major problem with removable dentures, a problem that also works to increase the speed of a person’s aging process. Grinding of the teeth will decrease the life of a denture also.
When a dental bridge is used to replace missing teeth, the supporting or adjacent teeth have to be ground down in order to make room for the support post of the bridge. Once the adjacent teeth have been altered in this way they become susceptible to damage and tooth decay. It is quite difficult for patients to properly clean the areas around and under dental bridges, which causes an accumulation of dental plaque and an increased susceptibility of tooth decay and gum disease. As in the case of dentures, the jawbone in the area where teeth are missing will shrink, weaken and deteriorate over time, which can cause the surrounding teeth to become loose, change position and even fracture in some cases. This mobility of the teeth will then create a situation where the structural integrity of the bridge is at risk.
The average long term success rate of dental implant surgery in a healthy patient with good bone structure is over 95 percent. This figure can change to between 85 and 90 percent in patients who require bone grafting to increase density and to ensure that the implant will anchor well. For smokers, the failure rate of dental implants is about two times higher compared to non-smokers. Experienced implant dentists have success rate records as high as 99 percent for patients with healthy jawbone and gums. One of the most appealing aspects of a dental implant is that it works just like a natural tooth, without requiring any special care and without causing any damage to adjacent teeth. The only requirement to ensure the long life of a dental implant is for the patient to continue to maintain good dental health and proper daily oral hygiene – exactly as they would for natural teeth.
Once a dental implant has been placed and has properly integrated into the bone (a process called osseointegration) that implant can be expected to last for a lifetime, whereas dental bridges require replacement every ten years on average (due to bridge failure or adjacent teeth failure). Dentures also need to be replaced or modified about every five to ten years due to improper fit and bone loss. Therefore, although the initial expense for dentures and bridges may be relatively low, over time that cost will rise as repairs and replacements are needed, and as oral treatments are required due to gum disease and repair or loss of surrounding teeth. General health will also be affected as ill-fitting dentures do not allow for proper and efficient chewing.
Dental implants provide a much better aesthetic and functional results compared to alternative dental restorations. They help to ensure that a patient will be able to maintain their usual eating habits, keep a natural appearance and speak and chew without the embarrassment often caused by removable dentures.