Dr. Robert Sorrentino, DMD
Quality Periodontics on Staten Island, NY
New Patient Frequently Asked Questions - FAQ
Insurance / Payments
We accept the following insurance and payment methods.
- Delta Dental
- CIGNA Pro
- Aetna PPO
- Dental Care Network
- Premium Care PPO Network
- Specialist PPO 100/200/300 Fee Schedule
- Careington Reduced Fee Program
- First Ameritas
- Dental Save Reduced Fee Program
- American Express
- Master Card
- Care Credit
Why do people choose dental implants?
Dental implants are the most natural-looking and natural-feeling replacement for missing teeth. Unlike many other tooth replacement options, dental implants do not slip or click when talking, laughing or eating, making for greater confidence in social situations. Dental implants are also considered a healthy option because they help to maintain the jawbone, keeping the facial structure intact.
What are dental implants?
A dental implant is a cylindrical and/or tapered post, usually made of titanium, that serves as a substitute for the tooth root. A connector, known as an abutment, is placed on, or built into, the top of the dental implant, to connect the implant to the replacement tooth or teeth. Finally, a crown, a replacement tooth, is custom made to match your natural teeth, completing the dental implant. Learn more...
What is the process for getting a dental implant?
Your dentist, who should be a credentialed dental implant expert, will place the implant into the jawbone. As you heal, your implant will fuse with your natural jawbone. Once the implant bonds with the jawbone, a small connector is placed on top of the dental implant to connect the implant to the replacement tooth or teeth. Learn more...
Are dental implants right for me?
Do you want the most natural-looking smile? Do you want a hassle-free smile? Do you want a smile that won't embarrass you? If you answered "Yes" to one or more of the questions, then dental implants are the right choice for you. Learn more...
What is a gum graft?
A gum graft is a surgical procedure used to repair and replace missing gum tissue. Gum grafts are used for a variety of reasons, but the most common is root exposure due to recession.
Root Exposure: Gum graft surgery can be performed to cover and protect an exposed root surface from decay. Because tooth roots are not covered by enamel, they are prone to developing root decay. Root decay starts more quickly and spreads more rapidly than enamel decay. If not properly treated, exposed roots may lead to root canal treatment.
Hypersensitivity: An exposed root surface may cause painful, hypersensitivity to hot and cold liquids. Covering the root surface will minimize these sensations.
Appearance: The appearance of exposed roots is often darker in color than tooth enamel. The root surface can be covered for aesthetic reasons, creating a healthier smile.
What is Gum Recession?
Recession is the exposure of a tooth’s root. Healthy teeth are surrounded by thick gum tissue that protects the roots and covers the jaw bone. Various conditions can damage or destroy the gum tissue and result in root exposure.
The tissue used in your gum graft is harvested from another area of your mouth referred to as the donor site. Most frequently this is the roof of the mouth. The tissue is then transplanted to the area missing gum tissue, known as the recipient site.
How long will it take for my mouth to heal from Gum Grafting?
Soft tissue healing generally takes 4-8 weeks. Healing time varies on how much tissue was taken from the donor site and whether you have any bone exposure after the procedure.
Often the tissue is harvested from another area of your mouth (donor site), most frequently the roof of the mouth. It is then transplanted over the area of missing gum tissue (recipient site). The donor site usually within 7-10 days. Sometimes it is possible to use processed skin and other tissue products as the donor tissue.
What Is It?
A sinus lift is surgery that adds bone to your upper jaw in the area of your molars and premolars. It's sometimes called a sinus augmentation. The bone is added between your jaw and the maxillary sinuses, which are on either side of your nose. To make room for the bone, the sinus membrane has to be moved upward, or "lifted." A sinus lift usually is done by a specialist. This could be either an oral and maxillofacial surgeon or a periodontist.
What It's Used For
A sinus lift is done when there is not enough bone height in the upper jaw, or the sinuses are too close to the jaw, for dental implants to be placed. There are several reasons for this:
Many people who have lost teeth in their upper jaw — particularly the back teeth, or molars — do not have enough bone for implants to be placed. Because of the anatomy of the skull, the back of the upper jaw has less bone than the lower jaw.
Bone may have been lost because of periodontal (gum) disease. Tooth loss may have led to a loss of bone as well. Once teeth are gone, bone begins to be resorbed (absorbed back into the body). If teeth have been missing for a long time, there often is not enough bone left to place implants.
Tooth loss may have led to a loss of bone as well. Once teeth are gone, bone begins to be resorbed (absorbed back into the body). If teeth have been missing for a long time, there often is not enough bone left to place implants.
The maxillary sinus may be too close to the upper jaw for implants to be placed. The shape and the size of this sinus varies from person to person. The sinus also can get larger as you age.
Sinus lifts have become common during the last 15 years as more people get dental implants to replace missing teeth.
The bone used in a sinus lift may come from your own body (autogenous bone), from a cadaver (allogeneic bone) or from cow bone (xenograft).
If your own bone will be used in the sinus lift, it will be taken from other areas of your mouth or body. In some cases, the surgeon removes bone from your hip or tibia (the bone beneath the knee).
You will need X-rays taken before your sinus lift so the dentist can study the anatomy of your jaw and sinus. You also may need a special type of computed tomography (CT) scan. This scan will allow the dentist to accurately measure the height and width of your existing bone and to evaluate the health of your sinus.
If you have seasonal allergies, you should schedule the procedure when they are not active.
How It's Done
Your surgeon will cut the gum tissue where your back teeth used to be. The tissue is raised, exposing the bone. A small, oval window is opened in the bone. The membrane lining the sinus on the other side of the window separates your sinus from your jaw. This membrane is gently pushed up and away from your jaw.
Granules of bone-graft material are then packed into the space where the sinus was. The amount of bone used will vary, but usually several millimeters of bone is added above the jaw.
Once the bone is in place, the tissue is closed with stitches. Your implants will be placed four to nine months later. This allows time for the grafted material to mesh with your bone. The amount of time depends on the amount of bone needed.
What is bone grafting?
Bone grafting is a surgical procedure where the clinician replaces your missing or inadequate bone volume with biomaterials of different sources. The procedure involves placing these materials in contact with bone to augment its dimensions. This allows for successful implant osteointegration in the future.
Some instances when grafting is necessary:
- Following tooth extraction, in order to maintain the dimensions of the alveolar socket.
- For "sinus augmentation" procedures. Sinus augmentation procedures are performed in cases that require additional bone in the vertical direction in the posterior region of the upper jaw. The placement of an implant without sufficient bone in this area would cause the top portion of the implant to come in contact with the interior of the sinus causing irritation and inflammation. The area with insufficient bone is replaced with graft material.
- For "lateral ridge augmentation" procedures. Cases with insufficient bone surrounding the implant site require the use of graft material placed in all horizontal directions so that 2 mm of future bone is obtained prior to implant placement.
Why is bone grafting necessary?
Following tooth extraction a clot forms inside the tooth socket. In time, this clot remodels leaving behind bone. During the remodeling process the clot shrinks and the resulting bone height and width will decrease. Replacing missing teeth with implants is the most common procedure. Successful implant osteointegration and esthetic outcome are dependent on bone availability prior to implant placement. Bone grafting procedures aim to restore the alveolar bone to suitable dimensions in order to support a future implant.
What options do I have for graft materials?
An autograft involves bone collected from other parts of the patient's body. This type of graft has the possibility to induce bone formation with no host response from the patient's body. The main disadvantage with an autograft is that it requires a second surgical site that can lead to additional pain, infection and bone related complications.
Allograft bone is bone collected from another patient or cadaver. It eliminates the need for a second surgery; however, there is a chance of disease transmission from the donor. Since allografts lack protein components due to sterilization, the healing time is increased. The most common allograft in use is Demineralized Bone Matrix (DBM). Many studies have reported contradictory reports on its efficacy. The quality of the donor bone can cause variability in the material. Xenografts are graft materials obtained from animal bone.
Synthetic alloplast materials have been developed to confront the issues brought on by the other types of grafts. Alternative materials can be ceramic-based (calcium phosphates, calcium carbonates, calcium sulfates), natural or synthetic polymers. Growth factors can be added to these materials in order to mimic the properties of autografts. Calcium sulfate-based materials are inexpensive, biocompatible and resorb completely leaving behind native bone. Calcium sulfate stimulates the formation of blood vessels, which provide nutrition for growing bone. Calcium sulfate can be used alone or in combination with other graft materials, drugs or growth factors.
What is the difference between synthetic grafts and other grafting materials?
Synthetic materials aim to mimic bone structure and composition. Ceramic-based materials are used for their similarity to bone mineral, a component that provides mechanical support and acts as a matrix for bone cells. They can act as carriers for growth factors or drugs. Their resorption rates can be modified to allow for a more rapid or slower dissolution, depending upon which procedure is used. There are no risks for disease transmission with synthetic materials, and they eliminate the need for a second surgical site.
Bone regeneration vs Bone replacement
Bone regeneration refers to instances when a material used to fill a bone defect resorbs completely and stimulates new bone formation.
Bone replacement refers to cases where a bone defect is filled with a material that does not resorb, filling the space without stimulating new bone growth.
It is important to have direct contact between host bone and the implant, as implants placed in native bone have higher rates of osteointegration and success. It has been shown that the higher the bone-to-implant contact, the higher the success rate.