To view this, you need to install the Flash Player 8. Please go to here and download it.
The Dental Implant Center at Tischler Dental
To view this, you need to install the Flash Player 9. Please go to here and download it.
Launch our Video Website now!
2 of the Specially Equipped Surgical Suites, at The Dental Implant Center at Tischler Dental. The Center also contains a CAT Scan, it's own sterilization area, surgical lighting, and surgical supply areas.
Michael Tischler, DDS is a nationally recognized lecturer and author on dental implants and bone grafting. He is a leader in the field and has been awarded by Dentistry Today, the nations leading clinical dental news magazine since 2004 as one of the Top Dentists in the United States in providing continuing education to his dental colleagues. In 2007 he was awarded the Feltman- Hunn Medal Of Merit from the 3rd District Dental Society a component of the New York Dental Association. This award is given by the Society for leadership and perfection in dentistry.
Our new facility is set up specifically for ideal dental implant surgery and restoration and bone grafting with a separate Dental Implant Center. An in office CAT Scan , 2 surgical suites, and seperate sterilization/ storage area allows for this. Our state of the art Center is equiped for dental implant surgery, restoration and is also a teaching facility for other doctors. Each surgical suite is set up for ideal lighting, organization, access, and sterility. A full aseptic surgical protocol is adhered for every surgical procedure performed in our office. A customized surgical pack is utilized.
Computer Planned Implant Surgery- Safer, Faster
We plan implant cases with a computer guided surgical and prosthetic program. Dr. Tischler teaches this technique to other dentists.
With one of the only in-office Cat Scan machines in the Hudson valley, implant surgery is done in a safer and faster manner. The I Cat CT machine allows us to visualize anatomy, and plan implant cases better, faster and safer. Often implants can be loaded the same day they are placed. This teeth in a Day or teeth in an our protocal is only availble because of the pre planning available from the I Cat machine and Sim Plant software.
Through visualizing our patients anatomy on a 3D level, we can plan both the surgical and final prosthetic end result to a much higher level than has been previously seen. There is no reason not to look at an implant surgery in this light, and in fact we always do utilize this technology available right here in our office.
Dr. Tischler's articles on this topic can be found at these PDF links:
In Office Cone Beam Computerized Tomography: Technology Review and Clinical Examples
Our I-Cat CT machine and software
Click here to see a video demonstration of our CT planning software
Click Here to see a PDF Presentation about Dental Implants
Click Here to see a PDF Presentation Of Dental Implant Cases By Dr. Tischler
Quotes from patients of Dr. Tischler: "Dental implants have changed my life" J.E. "I could not imaging living with my denture ever again" S.U. "The bone grafting and implant placement was painless" N.L. "My entire psychological outlook has changed, I feel young again" S.K. "Dr. Tischler's credentials and the experience he offers made my decision easy" T.P. "Just do it, you owe it to yourself to live your life like it should be lived" M.M. |
If you are missing teeth, dental implants are the best option for tooth replacement. Over the years, Dr. Tischler has rehabilitated many patients traveling from across the United States. Over and over again patients have communicated how easy and painless the process is and how their lives have changed for the better. Not having to wear a denture or not having to disturb healthy teeth are the main reasons our patients love their dental implants.
Your Missing Teeth Can Possibly Be Replaced In One Appointment. Call For a Complimentary Consultation To See If You Are A Candidate.
What is a dental implant? Implants consist of a titanium cylinder placed into the bone that approximates the function of a natural tooth. An implant can replace a single tooth, multiple teeth, or support or replace a denture. Dr. Michael Tischler performs both the surgical and restorative aspects of implant dentistry. The advantages of a dentist performing both the surgical and restorative aspects of implant dentistry are numerous. For example, when the placement of dental implants is done by the restorative dentist, the implants can be placed directly in an ideal aesthetic and restorative position. Dr. Tischler lectures on the topics of bone grafting and dental implants to other dentists and authors articles in dental journals.
Michael Tischler, DDS Performing implant surgery utilizing guidance from an interactive Cat Scan Program. This virtual surgical protocol is routinely used by Dr. Tischler and is something he lectures to his colleagues and has published on.
Dental implants offer our patients that have lost teeth a "second chance." With dental implants, a patient can turn back the clock, and live their life with "teeth" again. 29% of people who wear dentures eat only soft or mashed food, 50% avoid many foods and 17% claim they eat more efficiently without their teeth. For those who wear complete dentures, there is 66% less chewing efficiency as compared to natural teeth. Realize about 10% of the US adult population is totally without teeth. Missing teeth translates to less nutritional intake and accompanying systemic health problems according to the literature. Our practice philosophy involves looking at our patients over all health. By replacing these missing teeth, you can avoid being one of these statistics. Once a person has lost a tooth, only a dental implant will stop the bone from being lost. The stimulation that a dental implant offers will approximate a tooth, and stop bone loss. A denture actually stops blood supply and will only cause further bone loss. Dentures also impede speech and decrease chewing ability.
It is important for a patient to understand that for a dental implant to be placed, there must be enough bone available for the dental implant to be placed in. If there is not enough bone, procedures can be done in our office to restore your bone level. These procedures include sinus grafting, and bone augmentation, which are performed in our office. Michael teaches advanced bone grafting techniques throughout the US to his dental colleagues. Please read below for more details on these procedures.
Michael has utilized one dental implant system for the past ten years exclusively. The Biohorizons dental implant offers so many advantages over the other systems available.
There are many dental implants that Michael could use but through understanding the biomechanics of implant dentistry, Biohorizons is the only choice. This commitment to utilizing one system for so long, has made Michael a leader in utilizing this system. Michael trains other dentists in techniques with Biohorizons that have offered such success over the years.
To sum up the main reason that Biohorizons has offered so much success for Michael, is in the thread design of the implant itself. Think of it this way. A dental implant is successfull because the bodies bone grows around it and stabilizes it to support missing teeth. Wouldn't you want as much surface area on the implant that allows bone to grow around it? Biohorizons is the only implant system with a square thread instead of a tapered thread. This square thread creates a dramatically increases the surface area for the implant. There are other reasons Biohorizons offers such success in their design, but the surface area alone is the most important. As a patient you can be confident that the dental implant being used has been researched by Michael and is the best for replacing your missing teeth. If you are interested in more information on this implant system please go to the Biohorizons website.
Michael Tischler, DDS
Dr. Tischler was the first and one of the only dentists between NYC and Albany to have an in-office CAT Scan machine. This shows his commitment to delivering ideal implant placement in a three dimensional view. Dr Tischler was also one of the first dentists in the Hudson Valley area to utilize Platelet Rich Plasma as an adjunct to bone grafting and surgical healing. Platelet Rich Plasma (PRP) is a concentrate of a patient's blood platelets that are added back to a surgical grafting site to enhance healing and quality of bone. A small amount of a patients blood is processed in an FDA approved device called a centrifuge. The processed blood is then utilized to help a patients own body help themselves in a safe manner.
Dr. Tischler is a Diplomate of The American Board Of Implant Dentistry Oral Implantology, Diplomate of The International Congress of Oral Implantologists, Fellow International Congress of Oral Implantologists Fellow of The Academy of General Dentistry, Fellow and graduate of the renowned Misch International Implant Institute, and Fellow of The American Academy of Implant Dentistry. Each one of these credentials requires the passing of rigorous exams and presentation of cases under exam conditions.
Michael Tischler DDS receiving ICOI Diplomate award from Carl E. Misch.
As an adjunct to his surgical training, Dr. Tischler is also certified to perform IV Sedation to ease your dental treatment experience. Certification in basic life support and advanced cardiac life support also supports Dr. Tischler's surgical background. Surgical procedures in our office are performed in a surgical suite that is specifically equipped for implant surgery, periodontal surgery and bone grafting procedures. A strict aseptic surgical protocol is adhered to at all times.
Cases Of Dr. Tischler's Patients
PDF File of Implant Cases Before and After
Case One
Patient presented with a removable partial denture that she "couldn't wear." Four dental implants were placed along with crowns and bridges to rebuild her bite.
Case Two
Patient presented with missing front tooth. A dental implant was placed to restore aesthetics and function.
How do dental implants prevent bone loss?
Bone needs stimulation to maintain its form and density. That is why the astronauts lose bone mass while they are in space -- their bones lack the stimulation that results from our everyday resistance to gravity. The bone in your jaw is constantly reinforced by the force applied by your teeth.
The teeth transmit force to surrounding bone, so when you lose a tooth, the lack of stimulation results in bone loss or "resorption."
Dental implants are inserted into the jawbone in place of missing teeth. Then prosthetic restorations, like porcelains, bridge-work, or dentures are attached to a post or abutment placed inside the implant. So when you chew, the implant acts like the root of a tooth - it transmits force to the jaw and stimulates the bone.
It is as if implants "trick" the bone into thinking there is still a tooth present. By transmitting the natural forces of chewing to the jaw, implants increase bone density. Dental implants have been proven not only to stop bone loss, but in some cases actually to reverse bone loss and restore the health of the jaw. BioHorizons' implants are the first dental implants to be specifically designed to take into account the varying strength requirements of the different bone densities found in the human jaw. That means better health for you over the long term. Another health advantage that implants provide over conventional bridgework is that implants prevent the necessity of having other teeth cut down, in order to build a bridge or crown, which is necessary in certain clinical situations.
Please read below from the Academy of General Dentistry to learn more:
Tooth loss can have a far-reaching effect on your dental health and personal appearance. When you lose one or more teeth, your remaining teeth can drift out of position. This can lead to a change in your bite, the loss of additional teeth, decay, and gum disease.
Dental implants can be an effective method to replace one tooth or several teeth. Each implant consists of a metal anchor that is inserted into the jawbone, and a protruding post, which is outfitted with an artificial tooth. Implants can also support a bridge, replace a partial denture, or secure a fixed denture. The process requires surgery and may take up to six months to complete.
The Procedure
Several steps are usually necessary to place an implant. Depending on the type of implant, the steps may vary. The placement of a single-tooth endosteal implant is illustrated below: Several steps are usually necessary to place an implant. Depending on the type of implant, the steps may vary. The placement of a single-tooth endosteal implant is illustrated below: Several steps are usually necessary to place an implant. Depending on the type of implant, the steps may vary. The placement of a single-tooth endosteal implant is illustrated below: Several steps are usually necessary to place an implant. Depending on the type of implant, the steps may vary. The placement of a single-tooth endosteal implant is illustrated below:
Several steps are usually necessary to place an implant. Depending on the type of implant, the steps may vary. The placement of a single-tooth endosteal implant is illustrated below:
In the first procedure under anesthesia, a metal anchor, or artificial root, is placed into the jawbone. Bone grows around the anchor. This takes about three to six months.
Next, a healing cap is placed when the implant is uncovered.
Then, the healing cap is removed and a metal post, or abutment, may be attached to the anchor.
An impression is made of the area.
When your gums and jawbone have healed, an artificial tooth is constructed, then screwed or cemented to the post. Fitting your new tooth properly may take several appointments.
Click on the thumbnails for popup of larger images.
Brush and floss your implant at least twice daily, just like your natural teeth. Be sure to brush the back of the abutments and floss around the front, back and sides. Avoid chewing on hard objects or extremely sticky food. Proper dental care will help keep your implants and your mouth healthy.
Source: The Academy of General Dentistry
Frequently Asked Questions
Are implants always successful?
Modern implant techniques have been in use since the 1950's. Improvements in procedures and materials have given implants a ten year average success rate of 93 percent or better. This enviable success rate is improving every year!
Can failed implants be replaced?
In the unlikely event an implant fails, it can usually be replaced by another. In fact, most patients wouldn't have it any other way!
Is everyone a candidate for implant treatment?
In general, anyone healthy enough to undergo routine tooth extraction or oral surgery is probably able to receive an implant. There are some health conditions that warrant special consideration. Certain chronic diseases, heavy smoking or alcohol abuse may contraindicate implant treatment. After careful evaluation of your health history, your dentist will alert you to any conditions that may effect your treatment. Remember, age is not a factor.
Will others know I have dental implants?
Today's implant treatment enables you to have your new teeth look, feel, and function like your own. Even though others will be unaware you have dental implants, many patients are so pleased they tell everyone they know. Dental implants offer some of the finest restorative results possible in modern dentistry.
How long does complete treatment take?
Depending of the type of implant and replacement teeth selected, the total time can be as little as a few weeks to six or more months. If bone grafting is necessary, further time may be needed. Your dentist will discuss your options with you and advise you of the time requirements.
Will I need to be hospitalized?
Most implant procedures are performed in the dental office under local anesthesia. Some patients may desire pre-medication or IV sedation to control apprehension. This is offered in our office through Dr. Tischler's certification. Hospitalization may be necessary for complex surgical procedures or general health reasons.
Is there pain or discomfort?
Many patients report implant surgery less troublesome than having teeth removed. With modern anesthesia and close attention to post operative care you can expect minimal discomfort.
Will I be without replacement teeth at any time?
Immediately following surgery you may be instructed not to wear replacement teeth in the surgical area. If required, this period is usually short, and temporary teeth are soon provided so you can quickly "get on" with your life.
How much does implant treatment cost?
The cost of implant treatment depends upon the number and type of implants placed and the type of replacement teeth needed. For example, replacement of a single tooth with implant treatment costs about as much as a dental bridge. The bridge necessitates "cutting down" adjacent teeth for crowns. Implant treatment does not. More complex treatment, such as bone grafting, will add to the cost. The cost can vary in different countries, so it's is best to consult your dentist. The improvement in your self confidence, comfort, eating habits and appearance will make dental implant treatment one of the best investments you've ever made!
Are implant supported teeth as strong as my natural teeth?
Yes. Research shows that in many cases implants are actually stronger then natural teeth. Compared to removable teeth, studies show implant supported teeth have 100 percent or better chewing efficiency. Dental implants can make it possible for you to enjoy your favorite foods, improve your nutrition and your appearance!
Source: World Center For Implantology
Bone Grafting - Bone grafting procedures are performed by Dr Tischler.
Dr. Tischler lectures nationally and publishes articles on the subject of bone grafting.
Why Bone Grafting?
In many instances, a potential implant site in the upper or lower jaw does not offer enough bone volume or quantity to accommodate a dental implant of proper size or in the proper place. This is usually a result of bone resorption that has taken place since one or more teeth (if not all) were lost. Bone Grafting procedures usually try to re-establish bone dimension, which was lost due to resorption. A bone graft normally takes at least six months to heal before a dental implant can be placed into it. There are times also that multiple grafts may be needed to produce the amount of bone needed. This is dependent on a persons health and amount of bone being grafted.
Years ago the lack of bone posed a considerable problem and sometimes rendered implant placement impossible. Today, however, we have the ability to grow bone where needed. This not only gives us the opportunity to place implants of proper length and width , it also gives us a chance to restore the aesthetic appearance and functionality of natural teeth.
Grafting Material:
With respect to the Bone Graft material used, we have to differentiate between several choices. All materials can be categorized into five different categories:
- Autograft or autogenous bone graft
- Allograft or allogenic bone graft
- Xenograft or xenogenic bone graft
- Alloplast or alloplastic bone graft
The Autograft is considered the Gold Standard. It is defined as tissue transplanted from one site to another within the same individual. It is basically your very own bone taken from a donor site and placed somewhere else in the body, into the recipient site. The best success rates in bone grafting have been achieved with autografts, because these are essentially living tissues with their cells intact. There is no immune reaction and the microscopic architecture is perfectly matched. The only disadvantage of the autograft is that it has to be harvested from a secondary site in your body, which usually means more morbidity and a more complicated surgery overall. For most grafting purposes confined to Oral Implantology we can use another part of the jaw (e.g. chin or back portions of jaw) as an acceptable donor site. This way, we stay surgically inside the mouth and avoid any extraoral wounds and scarring. Sometimes, however, when there is not enough bone volume available intraorally, we have to get bone from other parts of the body, usually your hip bone or your tibia (shin) bone, since these are the most accessible areas to get larger quantities of bone. Often Dr. Tischler will simply "shave" some autogenous bone with a specified device for this. This alows inclusion of autogenous bone in addition to other materials in a simple and safe way.
The Allograft is defined as a tissue graft between individuals of the same species (i.e., humans) but of non-identical genetic composition. The source is usually cadaver bone, which is available in large amounts. This bone however has to undergo many different treatment sequences in order to render it neutral to immune reactions and to avoid cross contamination of host diseases. These treatments may include irradiation, freeze-drying, acid washing and other chemical treatments. In the U.S. virtually all donors are being prescreened for infectious diseases before their bone is even accepted into the tissue banks. After that the processing of the bone would eliminate virtually any chance of cross-infection. To read more and inform yourself on the processing of donor bone products. Go to The American Association of Tissue Banks http://www.aatb.org/
The Xenograft is defined as a tissue graft between two different species (i.e. bone of bovine origin). Tissue banks usually choose these graft materials, because it is possible to extract larger amounts of bone with a specific microstructure (which is an important factor for bone growth) as compared to bone from human origin.
The Alloplast usually includes any synthetically derived graft material not (coming) from animal or human origin. In Oral Implantology this usually includes Hydroxyapatite or any formulation thereof.
A favorite product of Dr. Tischler is C-Graft. C-Graft is a product derived from Sea Algae . More information can be found at http://www.cp-grafting.com/CGraft_Product.asp
Each of the bone graft materials is usually developed with a specific purpose or advantage in mind. Some claims made by tissue banks about a certain bone graft material may sometimes have to be taken with a grain of salt, until independent research can verify those claims. The main purpose of using the latter four of the above graft materials is usually to avoid a secondary surgery for harvesting autogenous bone. Your surgeon will make a decision with respect to the bonegraft material, based on your individual needs and the latest research in that field.
Sinus Augmentations
One of the most frequently applied grafting procedures is the Sinus Augmentation. This procedure is restricted only to the upper jaw.
As we get older our sinuses grow larger in volume and literally take away valuable bone from the jaw ridge as shown below on the x-rays. This is not a pathological condition, on the very contrary, it happens to almost every one. This process is called Pneumatization of the Para-nasal sinuses.
Once teeth are lost in that particular area it makes it difficult if not impossible to place endosseous implants in that area, as you can see on the right image above. For this particular problem a grafting method was developed to literally raise the bottom of the sinus back up, graft bone underneath and, thus create enough space for one or more dental implants.
This procedure has been performed successfully for over two decades now and is considered an accepted and predictable method of bone grafting. The grafting material being used can be of either of the above mentioned categories. Again, autogenous bone will give you the best and fastest results. However, it would take a considerable volume of bone (5cc to 10cc per side) to perform a typical sinus augmentation; usually more than can be harvested form intraoral donor sites. Therefore, we sometimes downsize to an alloplast or xenograft or a combination (sometimes mixed with a little autograft) and take into account a longer maturation time.
Sinus Augmentations and implant placement can sometimes be performed as a single procedure if enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant well. If not enough bone is available, the Sinus Augmentation will have to be performed first, then the graft will have to mature for several months (depending on the graft material used). Once the graft has matured the implants can be placed.
Sometimes a "Summers Lift" can be performed where the sinus membrane can be simply pushed up in a very conservative manner.
Source: Robert Gougaloff, DMD
Onlay Grafts
This type of grafting procedure is designed to re-establish bone, which has been lost in a particular area due to resorption (which again, has been brought on by previous tooth loss in that area). For our purposes this procedure is considered an autogenous graft procedure. A piece (or several pieces) of autogenous bone (usually from the chin or the very back of the lower jaw) is attached to the site with the bone deficiency. Then the area is closed up and after a certain healing and maturing period, this piece of bone will eventually be incorporated into the host bed and become solidly fused, so that at a later time implants can be placed in that same area.
Larger areas of resorption will need to be augmented with more pieces of autogenous bone. For those cases we need to go to the patient’s hip or tibia to get more quantity of bone. This, however, is not a very frequent occurrence, unless the patient had lost all of his or her teeth for a long period of time (several decades) and bone resorption is very severe. At that point, however, other implant modalities can sometimes be chosen to circumvent this rather aggressive surgical approach.
Source: Robert Gougaloff, DMD
