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.

Your Body’s Struggle With Titanium

Your Body’s Struggle With Titanium

Your Grandpa’s Implant Material

Your Body’s Struggle With Titanium | Sammy Noumbissi DDS

It seems more and more people are becoming aware of and concerned with the myriad chemicals, compounds, and materials that are going into their bodies.  It’s a legitimate concern indeed, as new substances seem to be finding their way into our food, medicine and overall environment at an increasingly rapid rate.  With all of these new molecules popping up for us to check out, it can be easy to take for granted that the materials we’ve already been using for generations are inherently safe.  As we’ve seen in the cases of mercury, lead and asbestos, that is certainly not always the case; toxic materials can sleep through the cracks of public awareness and remain in use for very long periods of time.

Thankfully, there are no doctors to my knowledge that are placing asbestos dental implants.  There are different materials being used in the dental implant industry today, however, and it is extremely prudent to be aware of the potential risks involved with any material that is being permanently inserted into your body.

As with many biological prosthetics, titanium has been the primary material of choice for dental implants placed around the world for many years.  It was seen as an ideal choice due to its light weight and durability.  It is relatively less difficult to integrate with the body than a lot of other metals, and under normal environmental circumstances it was believed to be practically impervious to corrosion.

What We Know Now

It turns out, however, that titanium is susceptible to corrosion as a result of contact with saliva and other bodily fluids.  Corrosion can also occur in dental implants as a result of stress caused by bite forces.  There is a possibility that the same bacteria-borne acids that cause tooth decay may also have the potential to corrode titanium implants over time, though further research of this issue is still needed.

As titanium corrodes it creates an electromechanical disturbance in the body, causing pain and discomfort.  Ultimately it can lead to the body rejecting the implant all together.  The broken down titanium can cause metal toxication as it seeps into the soft tissue, blood stream, and even the bone.  Symptoms include irritation and burning sensation in the soft tissue, pharyngeal swelling, labored breathing, narrowed larynx and abdominal pain.  In addition, titanium oxide nano particles have been shown to induce emphysema and lung redness in adult mice.

The surface of the remaining metal structure becomes more abrasive as it breaks down, which can contribute to bone loss and can also be a factor in soft tissue irritation.  Compared with a superior implant material like zirconia, titanium has an especially difficult time bonding with your gum tissue.

Allergic sensitivity to titanium is also a concern.  Studies have shown that 20% – 25% of the population has some kind of metal allergy, and titanium allergies specifically are believed to occur in 4% – 10% of all people.  Symptoms include oral ulcers, hyperplastic gingivits, oral dryness and loss of taste.

The Newer, Better Implant Material

Ceramic dental implants made of zirconia have many positive attributes that stand on their own merits.  It is definitely worth noting, however, that none of the risks listed here regarding titanium are a significant factor with zirconia implants.  It is a bio-compatible, nontoxic material that is not a known allergen.  In fact, patients who had their titanium implants replaced with ceramic ones due to their titanium allergy have experienced full-mouth rehabilitation from their allergy symptoms.  It’s no wonder why Dr. Noumbissi has been placing ceramic dental implants in his patients for so many years.  The real question is, why isn’t everyone else?

Why Ceramic Dental Implants?


Ceramic Dental Implants, owing to their biocompatibility, high density and ability to withstand abuse, are a far superior product when compared to metal for implantation in the human body. Zirconia Implants are also an excellent choice as a dental implant material. Zirconia is a specialized Ceramic material used in many Holistic Dental Offices because it is metal free and does not have electronic properties.

All-ceramic dental crown placed over an all-ceramic dental implant look and function very much like the natural tooth and they provide a top-to-bottom metal-free teeth replacement solution. This eliminates concerns of allergies and biocompatibility issues thereby lessening potential for damage to the immune system and adverse health problems. The term ‘bioceramics’ applies to a wide range of materials that, when compared to traditionally used metal implants, are harder and have higher temperature resistance, strength, very high density and excellent resistance to corrosion. These properties make ceramics invaluable for use in the oral environment where high temperature, corrosion and constant abrasion is ever present.


While most dental implants are made of titanium, materials such as aluminum and vanadium are often alloyed or blended with the titanium which can create issues of allergy, galvanism and potentially impair the immune system in a number of ways. When differing metals are placed in the mouth or directly into the jaw bone as with a dental implant, those metals will eventually begin to release by-products from the oxidization process and are then circulated throughout the body.

For over five years zirconia dental implants have been available in the United States as an alternative to metal implants and they have been used quite successfully in Europe for over fifteen years. The advantage of these implants is that they are ceramic, and thus there is no concern of corrosion, galvanic/electrical activity or response to electromagnetic radiation. Zirconia (Zirconium Oxide) is not to be confused with Zirconium which is a metal found just below titanium on the periodic table. Zirconium oxide is the product now being used for the production of dental implants, it is the ceramic phase of Zirconium and it is called Zirconia.


Biocompatibility: zirconium is an inert material with very low allergic potential.

Strength: The strength of the dental implant is exceptional compared to metal implants.

Metal-free: no corrosion, no galvanism effect, no metallic taste and no electronic disturbances.

Bone to Implant Contact:  Very high bone contact to the implant, above 75 percent.


When patients exhibit overall healthfulness and are generally of a robust constitution, they tend to tolerate implants very well, but before considering something as serious as an implant procedure, a full health assessment is in order. In conjunction with assessing the patient’s physical state and ability to heal from surgery, most holistic dental practices are also concerned about the acupuncture meridian upon which the implant is placed. Every tooth in the mouth is located on an acupuncture meridian, and therefore can potentially affect specific organs, muscles, vertebrae and tissues.  Zirconia implants are preferable over metal implants for their biocompatibility factors but also very importantly they do not interfere with energy flow along one’s acupuncture meridians. Electrical skin resistance tests  are used to assess an individual’s energy system by measuring the energy meridian flows at specific accupoints on the body. These tests have shown that zirconia implants unlike metal implants do not interfere with the energy meridian system.

Another consideration in whether or not to place implants for a particular patient has to do with whether or not they grind their teeth which might cause damage to the zirconia over time. In such cases nightguard is integrated in the overall treatment plan. Habits such as smoking or chewing tobacco may also negatively affect the long-term success of implants both ceramic and metal. And ultimately, patients with implants must be diligent about maintaining good oral hygiene.


A reproduction of a tooth’s root is inserted in the jaw and over time, the implanted “root” bonds with the bone of the jaw. In other words, ceramic dental implants readily allow the bone to grow right up to the implant surface and is held securely in place by the bone. This process typically takes four to six months to completely heal before the permanent crown can be made.

Implants are integrated into the mouth in two basic stages.

First, a dental implant root is placed in the mouth. This root is often shaped like a screw. After surgery, the root will slowly integrate with the jaw bone in a stage called osseointegration which can take four to six months before the restoration(crown) phase of the process. Zirconia Implants have a very high bone-to-implant contact and some studies have shown up to 80% bone attachment to the surface of zirconia dental implants.

Once the osseointegration is complete, the dentist will take an impression to make a mold of your implant and other teeth. The mold will be sent to the dental laboratory and a crown is made just like on a natural tooth. The process is complete when the crown is returned and cemented on the implant. Since this crown is also made of zirconia it is usually indistinguishable from the surrounding natural teeth.


During the entire process, it is important for the patient to follow to all of the dentist’s instructions regarding oral hygiene. Regular brushing and flossing are key to the success of the osseointegration, and sloppy oral habits can potentially compromise a dental implantation surgery and the ultimate success of the implant.

Once your implant is fully integrated, caring for your teeth is very much like taking care of your natural teeth. Correct oral care must be followed including brushing and flossing at least twice a day. Ceramic dental implants will give you many years of use if cared for properly.

Dr. Noumbissi At The Washington D.C. Green Festival: Sept. 29 & 30, 2012

Dr. Noumbissi At The Washington D.C. Green Festival: Sept. 29 & 30, 2012




Miles Of Smiles Dr. Sammy Noumbissi at Green Festival in Washington DCWelcome to the nation’s premier sustainability event — our 8th annual Washington, DC Green Festival. Come and celebrate with us!

Green Festival is about you, your family, your community and our planet.

Your Green Festival experience may be discovering how to find a green job, finding locally produced foods, or learning to detoxify your home. You’ll fin speakers, products and DIY workshops to inspire your actions everyday.

Green Festival is a celebration of what is working in our communities – it’s where your community comes together. Green Festival is about having fun!

Enjoy activities at the Green Kids Zone; screen documentary films; take a yoga class; listen to amazing presenters; sample organic beer and wine; feast on local, organic cuisine, and do your holiday shopping at the nation’s largest green marketplace.

  • DIY sessions on home brewing, green remodeling, winter gardening, bike repairs and backyard chickens
  • At the Green Kids Zone, check out the music, eco-crafts and kids yoga
  • Stop by the Green Pet Stage to find the newest green pet products and services
  • At the Eco-Fashion Showcase, see the latest in sustainable fabrics, designs and trends
  • At the Community Action Stage, join local leaders, youth and artists to see the happenings with neighborhood solar coops, sustainable transportation and local food initiatives
  • Stop by the Green Business Stage for great ideas to inspire a green workplace
  • You won’t want to miss these special events:
  • Test drive one of Ford’s new green hybrid and electric vehicles
  • At the Good Food Stage, see local chefs prepare easy, healthy food that works for you family and your wallet
  • See amazing recycled art installations throughout the festival
  • On the Main Stage, catch Amy Goodman, Dr. Benjamin Chavis, Ralph

Nader, Medea Benjamin, John Perkins, NAACP’s President, Benjamin Jealous, and Congressman Dennis Kucinich and Elizabeth Kucinich

Have fun, learn a lot and make sure to support all the local green businesses.

Sports And Energy Drinks Can Damage Tooth Enamel

Scientific studies are now revealing the full extent of damage a person can inadvertently cause to their tooth enamel by consuming highly acidic beverages. With a reported 30- 50 percent of U.S. teenagers consuming popularized energy drinks on a daily basis, it is important that parents and young adults as well as fitness enthusiasts, understand the disadvantages these drinks can pose to oral health.

A recent study cited in General Dentistry; the Academy of General Dentistry’s clinical, peer-reviewed journal has revealed that fitness-minded adults and adolescents who routinely consume sports and energy drinks have an alarming increase in irreversible damage to teeth, damage that specifically targets the tooth enamel; the thin, outer layer of the tooth that helps preserve the tooth’s structure and prevent decay. Damage caused to sensitive tooth enamel is almost always irreversible, and without the protection of enamel, teeth become highly sensitive, prone to cavities, and more prone to decay.


People who pursue active lifestyles ironically may avoid colas or sugary drinks in favor of what they believe to be a ‘healthier’ alternative and so they tend to rely on sports or energy drinks to rehydrate after exercising. But, with the results of recent studies pointing to the fact that regular long-term use of such highly acidic beverages can lead to irreversible damage to dental enamel, athletic types are best advised to take precautions to protect their teeth by either choosing an alternative or adopting a habit of rinsing after consuming acidic drinks.

To determine the true acidic properties researchers examined the levels of acid in 13 sports drinks and nine energy drinks. To test the effect of the acidity levels, samples of human tooth enamel were immersed in each beverage for 15 minutes, followed by immersion in artificial saliva for two hours. The test was repeated over five days, four times each day. The goal of the test was to simulate the same type of exposure teeth are subject to by someone who drinks an average of one beverage every few hours. The researchers found that damage to enamel was evident after only five days, and energy drinks in particular showed a significantly greater potential to damage teeth than sports drinks – in fact, up to twice as much damage.

From this test and others of a similar type we can now conclude that enamel damage associated with all beverages ranging from greatest (1) to least (6) damage to dental enamel are as follows:

  1.  lemonade
  2. energy drinks
  3. sports drinks
  4. fitness water
  5. iced tea
  6. cola

Most cola-based drinks contain more than one type of acid, generally phosphoric and citric acids, both of which contribute to enamel damage. Sports beverages contain a range of other additives and organic acids that further exacerbate dental erosion. Organic acids also erode dental enamel as they break down calcium, which is needed to strengthen teeth and prevent gum disease.


The best way to avoid damaging your dental enamel is to exercise caution when using sports drinks and similar beverages on a routine basis. Alternating sports drinks with water or low-fat milk after a workout can help to preserve tooth enamel and ultimately protect teeth from decay, but the best alternative is to minimize the intake of sports and energy drinks altogether. If you must drink acidic beverages it is advisable to chew sugar-free gum or rinse the mouth with water following consumption of the drinks as a way to increase saliva flow, which naturally helps to normalize acidity levels in the mouth. To avoid spreading acid onto the tooth surfaces thereby increasing the erosive action, it is a good idea to wait at least an hour before brushing after consuming sports and energy drinks.