Avoid A Bad Dental Implant Decision Based On Outdated Word Of Mouth

Avoid A Bad Dental Implant Decision Based On Outdated Word Of Mouth

Avoid A Bad Dental Implant Decision | Sammy Noumbissi DDSDecisions regarding to restorative and cosmetic dental procedures are not to be taken lightly.  There are long term implications with regard to health, functionality, finance and aesthetic.  This is probably most true when the choices relate to dental implants.  It’s imperative to get as much up to date information as possible when considering your implant options.

Patients coming in for implant consultations have been known to raise concerns about having heard that ceramic dental implants are more susceptible to fracture.  While this concern is essentially unfounded today, it does have some basis in fact.

Much of the data and research for ceramic dental implants has come out of Europe, where use of zirconia dental implants has a far more extensive and varied history.  Commercial use of zirconia implant materials in Europe began in 1987.  While zirconia immediately proved its worth as an implant material from the perspectives of osseointegration with the jaw bone and biocompatibility with gum tissue, it did in fact experience much higher rates of failure due to fracture.

Adjustments were made to the molecular composition of the ceramic.  The potential strength of a zirconium based ceramic was never in doubt.  The material is employed in the construction of spacecraft and nuclear reactors due to its exceptional fracture resistance.  The latest studies show that the strength of zirconia implants equals or exceeds that of titanium implants in virtually all applications,  and success rates in the latest generation of ceramic implants have been as high as 98%.

The newer, stronger generation of zirconia dental implants have now been in use across Europe for nearly 20 years, and almost 10 years in the U.S.  Patient enthusiasm along with endorsement from renowned experts such as Dr. Noumbissi have led to a continuous increase in zirconia use as a dental implant material, and this trend seems sure to continue into the foreseeable future.

Zirconia Use In Modern Products And Technology

Zirconia Use In Modern Products And Technology

Zirconia Use In Modern Products And Technology Silver Spring, MOZircomium is an element that can be found all around us.  In fact, it is the nineteenth most commonly found periodic element in the Earth’s crust.  While people have been aware of and handling zirconium for hundreds of years, it wasn’t until 1925 that large enough quantities could be extracted in pure enough form for practical use.

It is typically found in rock and sand deposits, from which it is mined and refined.  The few byproducts and waste materials that are produced during the refining process are naturally common in typical beach sand.  As such, disposal is generally cheap and easy with virtually no environmental impact.

Although zirconium is not as prevalent in mainstream vernacular as its cousin, titanium, its many virtues as a manufacturing material has caused its use to become rather widespread over the last 90 years.

In most cases Zirconium is converted to Zirconium dioxide which is also called zirconia. Because of zirconia’s chemical inertness and resistance to essentially all forms of corrosion, it is most commonly used as a protective element in nuclear reactors.  Along with the fact that zirconium dioxide remains stable at extremely high temperatures, these properties have increasingly lead to its use in heat exchangers and piping systems.  This trend is expected to continue, as components made with zirconia tend to increase energy efficiency while decreasing the need for costly building maintenance.

The applications don’t stop there.  Zirconium derived materials are used in a variety of spacecraft.  The stable electron configuration is yet another reason widely used as a refractory for purposes of metallurgy.

Zirconium is also used in the positron emission tomography imaging process.  Commonly known as PET scanning, this technology is at the cutting edge of cancer diagnosis and treatment today.  This is not zirconium dioxide’s first application in the medical field, however.

As mentioned, zirconium is exceptionally inert to both organic and inorganic compounds.  This makes it an especially biocompatible element. In fact, trace amounts or zirconium can be found in all biological systems.  For decades now, zirconia ceramics have been used as surgical prosthetics.  This is especially true in the field of dental implants, where ceramic zirconia tooth implants are now widely regarded as the highest available standard of care.

The abundant availability of zirconium, along with its environmental and biological inertness, indicate that its use in modern products and technology is not likely to wane anytime in the foreseeable future.  In fact, the unique physical and chemical properties of zirconia combine with mechanical durability to suggest that we have only begun to scratch the surface of technological applications for this benevolent element.

Europe’s Long Positive History With Ceramic Implants

Europe’s Long Positive History With Ceramic Implants

Europe's Long Positive History With Ceramic Implants | Dr. Sammy NoumbissiPeople have a surprisingly long history of permanently replacing missing teeth with artificial prosthetics.  While this is generally thought of as a modern practice, there is evidence of people at least attempting this medical endeavor which dates back thousands of years. Astoundingly, the earliest evidence we have of the osseointegration of dental implants dates back to 600 AD.

Those ancient implants were made of sea shell.  From a medical standpoint, that material was as effective as any other implant material human beings could come up with, until the first titanium dental implants were placed in patients during the 1960s.  At that point titanium had already been used in various other surgical implant procedures due to its propensity to integrate with bone structure.

While titanium implants had unprecedentedly high success rates, it does have some less than ideal attributes as a dental implant material. One is the manner in which titanium decays, as it results in titanium oxide particles being dispersed into the soft tissue, the bone, and the blood stream.  People have varying levels of sensitivity to titanium in their body.  Titanium oxide contamination in the body can cause myriad health complications, but some people’s sensitivity to the metal is so acute that it causes their body to reject the implant itself.  Additionally, people with especially visible implants often find that the grey titanium post can be seen through their tooth colored crown.

Today there are currently about 600 different dental implant systems produced by over 140 different manufacturers around the world. Virtually all of those implant systems are made with either titanium or zirconia.  Zirconia-based ceramic material was first created in 1975 by a British physicist named Ron Garvie.  It was found to be a highly biocompatible material, and a few years later it was being used to make hip joint replacements.  It wasn’t long before people were looking to zirconia as a potentially superior dental implant material to titanium.  Zirconium dioxide, or zirconia, was first used as a dental implant material by professor Sami Sandhaus in Geneva, Switzerland.

The tooth colored ceramic immediately proved a better cosmetic option for front teeth replacement.  Soon the material was being used to create durable, tooth colored crowns that were attached to existing tooth structure.  It was quickly discovered that, unlike titanium, zirconia facilitated the growth of soft tissue as well as bone.  Zirconia implants are also less susceptible to corrosion, and the material is commonly used in spaceship construction due to its resistance to fracture and heat damage.

While zirconia quickly proved in various clinical trials to have multiple short term advantages over titanium as an implant material, some American skeptics have pointed to a lack of long term data regarding the success rate of ceramic dental implants.  While zirconia implants have only had FDA approval since 2007, the ceramic material has been used to make dental implants in Europe since 1987.  Just as technology and methods have evolved with metal implants and indeed the field of dentistry at large, many adaptations have been implemented to the concept of ceramic implants that have significantly improved the standard of care.  Even without adjusting for these improvements, however, there is more than enough long term data from Europe to attest to the long-term viability of zirconia dental implants, even by conservative standards.

Three million people in the U.S. currently have dental implants, and that number is growing by an estimated half a million people each year.  Since an increasingly large number of these patients opting for metal free implants over recent years, the amount of long term data from the U.S. will soon increase dramatically, and there is no reason to believe that the results will be notably different from the positive outcomes observed in Europe.  Fortunately for prospective implant patients, the number of doctors who are gravitating toward and being trained in ceramic implant technology is also increasing rapidly.

Researching Your Dental Implant Decision

Researching Your Dental Implant Decision

Researching Your Dental Implant Decision | Sammy Noumbissi DDSWe live in an age when people have the luxury of being able to research virtually any potential purchase before make it.  In many ways, “buyer beware” has been replaced by “buyer be well read.”  If you want to, you can spend 5 hours gathering information to aid in your next shoe purchase.  You can see the view from your seat before buying a ticket to a basketball game. If you’re shopping for a new body part, that research tends to take on a whole new level of significance.  This is more or less the situation when one considers getting a dental implant.  Though many people don’t think of it this way, each of our teeth is an individual body part with specific purpose and functionality.  Like many other systems in our bodies, the mouth functions most optimally when each of the individual components are in healthy, working condition. Dental implants are different from many other body prosthetics, however.  For one thing, they are nearly identical from a functional standpoint to the original body part (whether they are visibly identical to the original tooth depends largely on your choice of implant).  Unlike many other body prosthetics, implants are not designed to be removed, refit, or replaced.  They also differ from procedures like joint replacements in that much of the hardware being installed can be visible to the patient as well as others. Because so many different factors go into making a good dental implant decision, and due to the somewhat permanent nature of the procedure, researching the various available options is an essential part of the process for any prospective dental implant patient.  When exploring one’s tooth replacement options, there are three primary areas of focus to be concerned with. Are Dental Implants the Right Option for Your Particular Situation? Obviously the first step is to determine whether you are a good candidate for an implant to begin with.  As we’ve just discussed, there are many things to consider about dental implants.  Generally speaking, an implant is the best, longest lasting option for replacing a missing tooth.  They can also be an excellent alternative to extensive root canal treatment, which is prone to almost inevitable failure.  Implants tend to be stronger, more functional, and more hygienic than bridges and partials. It’s important to ensure that you as the patient have sufficiently healthy gum and bone tissue to support and espouse the implant.  Ultimately this is something that your doctor will need to advise you on; more on that in a moment.  Thankfully, modern advancements in bone reconstruction and guided bone regeneration have significantly improved the standard of implant care and widened the field of potential implant candidates.  With regard to gum tissue, some materials are more conducive to the maintenance of healthy gingiva. What are the Best Implant Materials to Use? While there are myriad options available when it comes to dental implant material, they basically all fall into one of two categories:  metal implants and ceramic implants.  Metal and alloys were the only option for the first decade or so following the advent of the modern dental implant before ceramic implants began to slowly make their way on to the scene.  While titanium is still the most commonly used implant material, titanium implants do carry a higher risk of a plethora of complications.  Metal free implants made from zirconia have been used with increasing frequency over the last two decades, and are now widely considered to be the highest standard in dental implant care.  This is due primarily to zirconia’s higher rate of biocompatibility in addition to its being an aesthetically superior material. Choosing the Right Doctor for You Carefully choosing your doctor is the most crucial aspect of making this decision.  This is of course because the right doctor will be paramount in helping you to make informed decisions on all of the other pertinent factors.  Many general practice family dentists offer dental implants as part of their wide range of offered services.  As we have discussed here, however, dental implant surgery and treatment entails an exceptionally high number of critical variables; the management of which requires extensive expertise. Finding a doctor whose primary area of focus is implantology will give you the best chance of receiving the best advice and treatment with regard to issues of material choice, implant planningbone augmentation, and more. Dr. Sammy Noumbissi is one of the country’s foremost experts on pre and post op dental implant care.  His office, located in Silver Spring, Maryland, employs the latest techniques and most advanced technology in order to ensure that all of his patients receive the highest standard of care possible.  Contact the office today to schedule a free consultation.

Things To Consider About Dental Implants

Why Get Implants at All?

There are a number of options out there for tooth restoration and replacement.  Is an implant really worth the expense and the surgical placement procedure?  Actually, you may be surprised at how much trouble can be averted by filling that oral vacancy with a dental implant.

Longevity is something else you should look at in deciding on your tooth restoration.  Even well maintained bridges and crowns typically need to be replaced every ten years or so.  Plus a natural tooth that acts as a post for a crown is very susceptible to additional decay, making more extensive treatment a likely eventuality.

Perhaps you’re a minimalist.  You still have plenty of good teeth left to chew with.  Why not just have your problem tooth pulled and carry on with the rest of your life?  Before deciding on that course of action, you should understand that empty tooth sockets are an ideal environment to harbor infection.  In addition the vacancy in your jaw where the tooth was anchored can be a catalyst for bone deterioration and muscle atrophy.  This leads to additional dental and orthodontic complications as well as sagging of the facial features.

One obvious benefit on dental implants is the practical functionality that is unmatched by other form of dental prosthesis.  You can eat, kiss and play the kazoo just the same as you did with all of your natural pearly-whites.  You don’t have to take them in and out, and there are no new daily maintenance or cleaning regimens to learn.

Concerns Related to Dental Implants

Despite the many virtues of getting dental implants, it is not a procedure to be undergone without proper consideration.  There are a number of factors to evaluate when deciding what kind of implant to get, or whether it is a good option for you at all.

The primary concern is that of integration with bone and soft tissue.  The act of bonding with the bone is called osseointegration.  While the vast majority of dental implants osseointegrate successfully, failed osseointegration can lead to the implant failing or coming out.  Integration with the gum tissue is a more common complication.

Dental implants have traditionally been comprised of a porcelain crown that sits atop a titanium abutment.  The micro gap that exists between these two pieces can be a source of inflammation to the gums.  Furthermore, the porous nature of porcelain and the rough texture of titanium make both materials ideal for plaque to glom on to.  There is also evidence that the titanium abutments begin to break down overtime, depositing trace amounts of the metal into your jaw bone.  People who are sensitive to the metal are vulnerable to additional complications.

Then there is the issue of aesthetic appeal.  As mentioned, porcelain is a porous material.  As such it stains rather easily.  It is also fairly common for the metallic grey of the titanium to show through the porcelain or even the gum tissue.

Lastly we have the matter of strength.  An implant that is too weak has obvious drawbacks; keeping your implant intact is clearly ideal.  While it’s important for an implant to be strong, it is also essential that it not be too hard.  Porcelain is very capable of causing wear and abrasion to the natural tooth that opposes the implant.

Why Zirconia is the Implant Material of the Future

The vast majority of implants placed by Dr. Noumbissi are comprised of a single piece of zirconia ceramic.  Zirconia is a much stronger material than porcelain and nearly as strong as titanium.  At the same time, zirconia implants are less abrasive to the natural teeth that they bite against than porcelain is.

The solid piece of tooth-colored zirconia is much more natural looking than the grey titanium abutments.  It isn’t a porous material like porcelain is, which means it is not only stronger, but far less susceptible to staining.  An added bonus is that the texture of zirconia makes it a much more difficult surface for plaque to adhere to than titanium and porcelain are.

When zirconia implants first came into the market, the primary concern was with osseointegration.  Thankfully, new implant technology has made the successful osseointegration of zirconia implants every bit as probable as that of titanium.

Gums attach better to zirconium than to porcelain or titanium, and the gum tissue tends to remain healthier over time.  This is due in part to the lack of a micro gap in the the one piece design, but zirconia is simply a more bio-compatible material.  You don’t have to worry about metal seeping into your body.  Allergies and adverse reactions are much less common also.

Dental implants are a revolutionary technology that has only been available for a few generations.  An implant can do wonders for your self image as well as your overall health.  It is a major decision however; we’re talking about something that will be a permanent part of you. Thoroughly researching the doctor you use and the materials that go into your body is the most essential step toward ensuring that your implant is successful and effective.

Course & Training: Advanced Dental Imaging And 3D Diagnosis When Treatment Planning Dental Implants.


This two-day course is designed to provide implantologists of all levels the ability to confidently integrate three dimensional diagnosis and treatment planning in their daily practice.  The program will consist of lectures and case presentations, over-the-shoulder hands-on computer software training, practical hands-on exercises and a live-surgery demonstration during which use of the computer generated surgical guide and accessories will be demonstrated. In addition, anatomical interpretation and sequential diagnostic protocols for implant planning and placement will be taught and explained. On the second day simulated surgical implant placement will be practiced on computer generated models from the scans submitted by attendees. In the afternoon there will be a live surgery demonstration during which a computer generated surgical guide and accessories will be demonstrated.


Upon completion of this course, attendees will be able to:

  • Understand the importance and advantages of cone-beam imaging.
  • Assess implant recipient site anatomy three-dimensionally.
  • Differentiate abnormal findings versus artifacts.
  • Identify vital structures and tagging them on a CBCT study.
  • Utilizing software tools to enhance visualization and diagnostics.
  • When to refer to an ENT for further evaluation.
  • Identify the prosthetic need for site preparation and/or preservation.
  • Cone beam CT evaluation using a sequential diagnostic protocol.
  • Perform interactive treatment planning on your own computer.
  • Utilize CBCT and virtual implant planning software to increase case success.
  • Know how to order and customize surgical guide design for each case.
  • Understand the workflow from obtaining a scan, to ordering surgical guides.
  • Utilize the In Vivo surgical guide drill handle kit.
  • Decision making when purchasing a CBCT unit.
  • Medico-legal ramifications of CBCT.



  1. Submission of a basic dental implant case you plan to treat in your practice after attending the course.
  2. A laptop computer with enough processing power to download and utilize the InVivo software during and after the course.
  3. All participants to this course will receive a free 60-day fully functional version of InVivo 5 implant planning software installed on their laptop computer.

Please contact Charles Banh for more information on the above listed items at 408-885-1474 or by email at charles@anatomage.com.



7:30 am Registration/Continental Breakfast
8:00 am CBCT Technology
9:30 am Patient case review (Scanning to surgery)
10:30 am Live surgery demonstration
12:00 pm Lunch (provided)
1:00 pm Treatment planning (Clinical, Radiographic, Adv planning methods)
2:30 pm Implant selection
4:00 pm Temporization techniques –case review



8:00 am Interactive treatment planning (on your computer)
9:30 am Actual cases planning (case submitted by attendee)
10:30 am Simulation order of a surgical guide
1:30 pm Lunch (provided)
2:30 pm Hands-on implant placement with surgical guide and 3D model
4:30 pm End of Course


This 3D diagnosis and treatment planning program will be held at Miles of Smiles Implant Dentistry located at 801 Wayne Ave, Suite #G200 in Silver Spring, Maryland. Sessions on both days will start at 8 a.m. and end around 4 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 May 20, 2013. 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

           First-time IAOCI Members: $199.00 (Must sign up by May 17, 2013)

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 ten (10) doctors will be able to attend this session.