Dental Implants can be the doorway to renewed
self-confidenceand overall health
TEXOS October 2012 Newsletter
X-Ray of Dental Implant on top teethX-Ray Dental Implant on bottom Teeth

By Larry R. Stewart, D.D.S., M.S.

As an Oral and Maxillofacial Surgeon who has been actively involved in the field of implant dentistry for over 28 years, I have had the pleasure of seeing many patients’ self-confidence restored with dental implants. Today, dental implants are frequently the best option to replace failing or missing teeth. They are secure, long-lasting, and promote dental and general health. Dental implants can improve the quality of life for virtually everyone missing one or more teeth with the general exception of growing children. I have patients in their 80’s and 90’s who have benefited from dental implants!

I would like to highlight a few reasons why implants are beneficial and then specifically address how the “Bar Attachment Denture” technique enhances patients’ lives. Statistics show that 69% of adults ages 35 to 44 have lost at least one permanent tooth to an accident, gum disease, a failed root canal or tooth decay. Furthermore, by age 74, 26% of adults have lost all of their permanent teeth. Dental implants eliminate a patient’s concern about slipping dentures or whether they can eat their favorite foods. Implants not only look and function like natural teeth, they help prevent bone loss in the jaw structure; a potentially serious complication for patients with missing teeth. Multiple studies over the last 20 years document that dental implants have at least a 95% success rate at 10 years – contrast that with fixed bridges and dentures that have approximately an 85% success rate at 10 years and 66% at 15 years.

At Texas Oral Surgery Group our approach to a successful dental implant begins with all parties following a coordinated plan of treatment. This includes the patient, the restorative dentist (who fabricates the prosthesis for the implant) and the oral and maxillofacial surgeon (who surgically places the implant). Our desire is that all members of the implant team stay in close communication to make sure everyone clearly understands what needs to be done to meet the patient’s expectations. To that end, we have an Implant Coordinator who is tasked with assuring that each step of the planning, treatment and follow up phases of care are discussed with the patient and referring doctor’s office.The process begins when the patient meets with members of our implant team to discuss treatment options and to give the patient the opportunity to ask questions. We have found that this “one on one” dialogue with our implant team is very informative for the patient and helps all parties clarify treatment goals. Once it is decided that a dental implant is the correct treatment option, our team may take x-rays (Panoramic and/or CBCT) and run other diagnostic tests as required. Preparation and planning for implant surgery may take several weeks to coordinate all parties, but optimal treatment results are achieved!

Dental Implant Bar Attachment for DenturesX-Ray of Bar Attachment Dentures

The dental community is aware that dental implants have become the “treatment option of choice” in many situations. Dental implants are long-term replacements that are surgically placed in the jawbone rather than resting on the gum line like removable dentures, or using adjacent teeth as anchors like fixed bridges. Implants are composed of titanium metal that “fuses” with the jawbone through a process called “osseointegration”. They never slip or make embarrassing noises that advertise the fact that a patient has “false teeth” and never decay like teeth anchoring fixed bridges. On top of the implant is the abutment, which extends above the gum-line. The crown, the visible part of the tooth, fits onto the abutment. Sometimes a temporary crown can be placed at the completion of implant surgery, but this procedure is not appropriate for every patient.

After surgery, and while the implant is undergoing osseointegration, there may be a healing abutment visible in the mouth. If the case permits, a temporary crown may be placed, especially in the anterior esthetic zone. A temporary prosthesis, (“flipper”, “Snap on Smile”, etc.) is another option following surgery. Once the site is healed, our office will coordinate an appointment with the patient’s restorative dentist, who will place the permanent crown on the implant abutment.

In the case of single-tooth extractions, often it is possible (and preferable) to place the implant the same day as the extraction. In cases where multiple teeth are to be removed and replaced with dental implants, multiple procedures may be required, including: image guided surgery (CBCT), bone grafting and the use of Bone Morphogenetic Protein (rh/BMP2). Normally, most patients experience very little discomfort after surgery. My expertise in administering office based anesthesia enables us to offer several options to relieve anxiety and pain concerns.

If patients are considering implants,they must have a thorough oral exam, x-rays and a review of their medical and dental history to determine if they are a candidate. If their bone structure is not ideal for implants, bone grafting may be recommended in addition to the use of platelet rich plasma (PRP) and bone morphogenetic protein (rh/BMP2). PRP is a by-product of blood (plasma) that is rich in platelets and permits the body to take advantage of the normal healing pathways at a greatly accelerated rate. The use of rh/BMP2 (either alone or in conjunction with other alloplastic bone graft materials) has been shown to induce and greatly enhance the formation of new bone. These products have greatly diminished the necessity for, and morbidity of, obtaining autogenous bone from the patient. In many cases, this results in reducing costs and accelerating treatment time. By adding PRP, and rh/BMP2, to the implant site, we are able to grow bone more predictably and faster than ever before.


I specifically want to highlight the major advantages of the “Bar Attachment Denture” dental implant process. This comprehensive treatment protocol allows the patient who has suffered with a failing dentition, to go from failed teeth to a totally implant supported prosthesis in just a few hours. It is no longer necessary to place 6-10 implants to support the prosthesis. Long term studies over the past 15 years, document the safety and efficacy of utilizing just 4 specifically planned implants to support either an upper or lower fixed bridge. By working closely with the restorative dentist and specially chosen dental labs, we can offer a comprehensive plan at a substantial savings over the sites advertised on television.

  • Major Advantages of “Bar Attachment Denture” Implants
  • The “Bar Attachment Denture” implants are fixed and do not need to be removed after meals or at bedtime,and are easyto clean with brushing of the teeth and gums for better oral health.
  • Because we are replacing a full arch(s) of teeth at one time, esthetics and function is enhanced and they fit comfortably with every contour of the mouth, for a more youthful appearance.
  • The patient’s oral gratification of food and the ability to taste is not compromised, as no part of the roof of their mouth has to be covered.
  • The patients have improved masticatory force and efficiency and can start eating the variety of nourishing foods they may have stopped eating before the implants; therefore, overall health increases.

“All-on -4” treatment is a process that requires close coordination between our office and the restorative dentist. We would welcome the opportunity to discuss this exciting protocol further!

photo7Teeth after Dental Implants

We, at Texas Oral Surgery Group, are pleased to bring you some insights into the rapidly changing world of dental implants. Thank you for taking time from your busy schedules to read my views on the benefits of dental implants to increase self-confidence and overall health. You may find more information on our website Feel free to contact our team with any questions

About Larry R. Stewart, D.D.S., M.S.

Dr. Stewart has been practicing oral and maxillofacial surgery since 1982, with an emphasis on implants, bone grafting and computer image guided surgical procedures. Dr. Stewart obtained his Doctor of Dental Surgery from Baylor College of Dentistry and then did his specialty training, obtaining his Masters of Science in Oral and Maxillofacial Surgery at the University of Texas Health Science Center-Houston, in 1982.

Dr. Stewart is a Diplomat of the American Board of Oral & Maxillofacial Surgery, a Fellow of the American College of Dentists, a Fellow of the International College of Dentists, and is a past-president of the Texas Society of Oral and Maxillofacial Surgeons. Since 2005, Dr. Stewart has been featured in D Magazine’s “Best Dentists” and Texas Monthly’s “Texas Super Dentists” in Oral and Maxillofacial Surgery.

Dr. Stewart is an active staff member of the Medical Center of Plano and has lectured extensively on dental implants and bone grafting procedures. He has volunteered his time to medical mission trips to Kenya and Guatemala, and is an avid amateur photographer.