Dr. Uri Zilberman: The result being that the patient no longer has a plastic-made palate that he 'received' along with the denture. His speech becomes clear, the easy bite doesn't hinder eating and the mouth feels completely natural"

To date, G never managed to become accustomed to the removable dentures, either physically or mentally. "Every time that I sleep with someone, I am afraid that he will feel that I have this foreign object in my mouth," she says. "I am cautious around food, in restaurants and in the presence of other people, I eat only soft foods. Even then, crumbs get stuck in the dentures and this is extremely embarrassing and unpleasant."

Yedioth Ahronot - Sunday, 18.11.2007 8 Kislev 5768

Teeth

The Implants That Are Taking Root

A revolutionary method threatens to abolish all removable prostheses which, until recently, had been the primary solution to anyone who lost their teeth. The innovation: Dentures that are custom-tailored through a computer and affixed to the jaw through several implants. The result: non-removable permanent dentures that spare patients the feeling that they have something foreign in their mouths.

Ariela Ayalon

The rapid technological developments taking place in the various medical sectors in recent years have also sparked a revolution in dentistry. Young and old people alike who lost their teeth and were forced to use dentures can now change their removable dentures to permanent ones that are attached to the jaw. In other words, live with dentures but feel like you are not. Twenty Israeli dentists have already been trained in the new method, developed by Dr. Paolo Mallo in Portugal.
The removable denture is generally unstable, moves from its position and frequently causes embarrassment, unclear speech and difficulties eating. The new method permanently affixes the dentures to the jaw, thereby eliminating all side effects of removable dentures.
Dentist Dr. Uri Zilberman explains how Dr. Mallo's computerized method works: "The patient arrives at the dental clinic. The dentist removes the patient's dentures from his mouth and performs a CT scan on it as well as on the jaw. The computer quantifies the results of the two scans and 'places' the denture on the screen on a simulated jaw. The dentist observes the screen and determines the optimal position for the implants, which will be drilled into the jawbone through the dentures in order to affix them.
After the dentist determined the location of the implants with the help of the computer, the computerized scan is sent to the implant company in Sweden, where technicians there impose the scan onto a template. The dentist in Israel receives a precise template that was built from the patient's data – a denture with four to six holes designated for the implants (screws). In the next stage, the dentist affixes the denture with the implants onto the gums. "The procedure is carried out under local anesthesia, and during which the doctor 'dresses' the template onto the jaw, and uses the implants to affix them to the jaw," says Dr. Zilberman.

Implants Without Opening the Gums

Another innovation of the new method is that the implants are fixed to the jaw diagonally. Until recently, according to Dr. Zilberman, the dental community widely believed that implants had to be inserted straight rather than diagonal because the latter would create too much strain and would cause the implant to fail. Experience that has been accumulated to date regarding the new method has caused doctors to understand that they erred in their basic assumption.
Dr. Mallo's method spares the need to open up the gums. When discussing the upper jaw, the new method also spares the need to lift the sinus, and all that entails. "The result being that the patient no longer has a plastic-made palate that he 'received' along with the denture. His speech becomes clear, the easy bite doesn't hinder eating and the mouth feels completely natural", says Dr. Zilberman. "It is also suitable for people suffering from a partial absorption of the jawbone."
Another treatment instills in 48-year-old G great hopes. After long years of a combination of neglect, smoking and poor genetics from both parents, G lost most of her teeth, and the ones that are left have turned black and yellow. "Several years ago, because I had no choice and with a great deal of crying, I agreed to have the ugly teeth extracted, to replaced by two prosthetics – upper and lower dentures" she says.
To date, G never managed to become accustomed to the removable dentures, either physically or mentally. "Every time that I sleep with someone, I am afraid that he will feel that I have this foreign object in my mouth," she says. "I am cautious around food, in restaurants and in the presence of other people, I eat only soft foods. Even then, crumbs get stuck in the dentures and this is extremely embarrassing and unpleasant." Now G is about to undergo a new procedure, which costs NIS 50-80 thousand per jaw. The procedure can also be carried out on only one jaw.
When we asked for her consent to be photographed for this article, G became frightened. "I am willing to pose nude or in any other angle but just not my dentures. A similar response was also heard from other people whom we contacted.
To date, 50 Israelis have undergone this procedure. Forty-year-old Mazal is one of them. "I underwent an oral reconstruction that included the insertion of implants into both jaws but the procedure failed and all of my teeth had to be extracted," she says. "For three years, I was walking around with dentures and it was hell. I then heard about the new method and arrived at Dr. Zilberman. Today, I am absolutely happy."
Chairman of the Israel Dental Association, Dr. Yitzhak Chen, welcomes the new method: "Every procedure that improves the quality of life is a welcome move. The innovative technology is pushing oral reconstruction ahead, and what once was awkward and uncomfortable, such as full dentures, is disappearing."
But there are those who have expressed reservations about the new method. Dr. Yossi Nissan, Director of the Implant Unit at Tel-Aviv University's Dental School and an expert in oral reconstruction: "In this method, a limited number of implants support 12 'teeth'. The problem is that when one implant fails, the entire denture collapses. There then is a need to repeat the entire procedure. This is a worthy and effective treatment procedure that is suitable for a certain percentage of patients who suffer from a loss of teeth and who require dentures. It should be noted that additional studies are required to establish the efficacy of the method."