“…first impressions are often correct…”

26 April 2016 § Leave a comment

The title of this post comes from Talking Heads’ song “Seen And Not Seen,” on their album Remain In Light.

It means that what you see is often what the object wants you to see, or what you see is often what is.

This objectivity is crucial in placing and designing restorations for dental implants. When it comes to the final tooth aesthetics, the task of matching color is purely subjective, but the underlying foundation needs to be exact.

Acquiring this exactness is the function of dental impressions. As I mentioned in my previous post, it is from impressions, the dental laboratory creates the foundation for the future tooth.

Below is a 3D rendering of my mouth created from a stone model – scanned and created from an impression.

CAD file

Within this digital world, the dental technician creates prostheses that perfectly match the real-world.

Next up…my new tooth is delivered.

Making a good impression

15 April 2016 § Leave a comment

So my first appointment to finalize my new tooth went without a hiccup.

My dentist, Lasse Almgen, was very pleased with the way things look and have healed; after determining the best color for my new tooth (based on my remaining teeth), he took impressions of my upper and lower jaws.

These impressions are used by the dental laboratory to fabricate a model of my mouth and the final components of my new tooth: an abutment and ceramic crown (see Final restoration in the diagram below).

Taking the lower impression was straight forward, and it will show how my lower jaw fits with my upper one. But before taking the upper impression, Lasse replaced the healing abutment with an impression coping or implant pickup (see Impression in the diagram below).

The impression coping is a special device that will remain in the impression, letting the dental laboratory know the position, rotation, and angle of the actual implant in my mouth. The impression was taken using an open-tray technique.

From the impressions, the laboratory will make positive models of my upper and lower jaws. Before creating the upper model, an implant replica will be attached to the impression coping (see Model in the diagram below). This replica mimics the implant in my mouth, and will remain in the model, providing a platform for the final abutment and crown.

Once all pieces are created, the laboratory will send everything back to Lasse. Since I am not involved in the laboratory process, I am glossing over many steps needed to produce the abutment and crown.

Below is a diagram of the restoration process for my case:

restoring on implant level 3

After the impressions were taken, Lasse reattached the healing abutment and sent me on my way. In total, yesterday’s procedure took only 40 minutes – less time than my drive to the clinic!

Next steps

13 April 2016 § Leave a comment

I realize that I never finished the story of getting my implant placed…oops.

Time does fly. So quickly in fact that tomorrow I’m heading in for the first of three appointments to finalize my new tooth.

I figure they will begin by examining the implant site to see how things have healed. And, most likely, they will take an impression from which the abutment and final tooth will be produced.

I promise to provide details later.

Together again

13 March 2016 § Leave a comment

A copy of weeks ago, my extracted tooth was returned to me.

I felt a sense of wholeness, uniting the missing pieces of my life.


Part 1: Out with the old…redux

27 January 2016 § 2 Comments

Well over a month ago my left upper premolar was removed because the tooth was irreparable.

Today, I thought everyone might like to see a couple of x-rays of the natural tooth before it was removed:

The bone surrounding the root was of most interest to Lars-Magnus Almgren, the clinician who placed my implant; he needed to know that there was enough bone present to support an implant. X-rays confirmed there was ample bone in the spaces between the surrounding teeth and the sinus cavity above.

To confirm the bone volume circumferentially, a different type of picture was taken. A CBCT, mine taken at the Brånemark Center in Gothenburg, is a sectional scan that provides clinicians with a 3D image of the entire jaw, which then used to plan dental implant placement.

Although not my case, the above screenshot gives you an idea of the planning control a clinician can benefit from, before actually performing surgery. Even for “routine” cases, this extra investigation goes a long way in avoiding complications. But this level of sophistication does come with a higher price tag.

Coming up next: Part 2: In with the new.

Resistance is futile

22 December 2015 § Leave a comment

Day two as a cyborg is unremarkable.

Despite all the hype of becoming part of the hive mind, receiving a dental implant is nothing short of unimpressive.

At least, that’s my impression so far.

Following a good night’s sleep, I awoke this morning refreshed from yesterday’s ordeal.

Since I barely remember the family shopping trip after the surgery is an indication that I sufficiently numbed.

Today, I feel quite normal – whatever that means.

I have no signs of swelling, and only minor soreness in my mouth.

This is good, because like everyone else, my plate is full in anticipation of the holidays.

Anyway, I’ll write again if my situation changes.


Stage one complete

21 December 2015 § Leave a comment

Whew! Today’s implant surgery went without a hitch.

I was taken care of very nicely, with the whole process explained forehand.

The implant is installed and instead of it being covered (sutured) during healing (hopefully 2-3 months), a healing abutment was placed instead.

Doing this eliminates the need for a second surgery to uncover the implant once healed. When I return in February or March, the healing abutment is easily unscrewed to expose the implant for stage two – the restoration phase.

Regarding discomfort and pain. I actually didn’t feel anything until the local anesthetic wore off around 5:30 p.m. Then I felt that I had been through something traumatic.

But a couple of Ibuprofen and a bag of ice have made me happy again. I was also warned that there could be swelling and possible bruising, thankfully I am experiencing neither.

I requested my old tooth, but I forgot it at the clinic; I’ll post a picture when I have it.

All in all, a great success, carried out beautifully by Dr. Almgren and staff.


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