Day One
Louis comes into the office early on Day One to begin surgery. His day begins by taking a CT scan of his mouth. This will help Dr. Gibney know the best locations for the dental implants. It is important to place implants in enough bone and away from nerves.
Dr. Gibney takes some time before the surgery to review the CT scans. He plans his case and digitally places the implant posts within the patient's scan.
There are many different types of implants and the ones that Dr. Gibney uses are available in the CT software. This allows Dr. Gibney to choose the implant and manipulate the placement to be most compatible with the patient's anatomy.
Louis' denture and lower prosthetic
Below is Louis' surgical guide. It is premade by Dr. Gibney.
There are predrilled holes in certain teeth to help guide implant placement. This guide stays in place while Dr. Gibney drills the holes for the implant posts.
Typically he uses a surgical guide for all upper cases, not lowers.
After Dr. Gibney drills holes using the surgical guide, he removes the guide. He uses a drill to place implant posts to the left.
To the right, Dr. Gibney uses a hammer to place an implant post.
Bone Graft
In some implant surgeries, a bone graft is required. Louis is one of these cases.
This happens when a patient doesn't have enough bone to insert an implant post.
A bone graft is done by cutting to create flaps in the gums and then inserting bone. It is packed in to give support.
The upper implants have all been placed. Now surgery will begin on the lower arch.
Surgery on the top and bottom is done! Louis has 19 implants now; 10 on top and 9 on the bottom. Surgery lasted for approximately 2 1/2 hours.
After taking post-surgical impressions, Louis is sent home for to rest. We'll see him later in the day for delivery of his bottom arch.
While Louis is home resting, lab work begins.
Using the impressions just taken, Dr. Gibney pours a cement mix into them. They are left for some time to harden.
These impressions are scanned into computer software to design temporary teeth for Louis.
After the scan is complete and uploaded to the computer, the teeth can be designed.
Each tooth is designed individually to custom fit the patient's anatomy.
Once the teeth are designed, the file is transferred to the mill.
The mill begins creating the temporary 24 Hour Teeth. First, Louis' lower arch will be milled.
The mill normally takes a few hours to create a full arch of teeth.
Louis returns to the office at the end of the day. Dr. Gibney injects cement into the newly created lower arch and places them on the lower implant posts.
Not only are these temporary teeth pleasing to the eye, but they act as a cast to the implants for the next 4-6 months while the sites heal.
After cemented in, Dr. Gibney will take impressions. This helps him create the upper arch. The process is split like this so that the bite between the two arches matches comfortably and functionally for the patient. Dr. Gibney will create the upper arch the same way the lower was with the box scanner and then send the digital design to the mill. The upper arch will mill overnight.
Day Two
Day Two begins with Dr. Gibney removing the upper arch from the mill.
