Dr. Vigna is both a dentist and an Oral & Maxillofacial Surgeon. He did five extra years of surgical training after dental school. His training included cancer surgery, reconstruction and trauma surgery. Dental implant surgery requires surgical skills and experience. Planning and preparation prior to the implant surgery is critical for a good result. Poor planning, lack of surgical skills and lack of experience can often lead to poor results and unsatisfied patients. Dr. Vigna is able to perform all procedures and would be happy to provide you with your best option based on your desires, budget and bony anatomy.
Yes. Everyone requiring surgery is required to have a consultation prior. This is for many reasons. Firstly, Dr. Vigna needs to assess if surgery is required. Your medical history needs to be thoroughly reviewed since any surgery is a medical procedure. Dr. Vigna will review your anesthetic options which include:
1. general anesthesia
2. sedation with intravenous
3. nitrous oxide sedation
4. local anesthesia alone (single tooth extraction can usually be done same day with local anesthesia and/or nitrous oxide sedation).
Dr. Vigna needs to determine if the procedure can be performed in the office. Instructions for surgery need to be given such as need for escort and when to stop eating and drinking prior. You may need antibiotics prior to surgery if you have an infection in your mouth or if you have certain heart conditions such as a prosthetic heart valve. The consultation also allows for a proper informed consent process.
No, continue taking your current medications until you are advised by your family doctor or Dr. Vigna. We will work directly with your family doctor to determine what is best for you.
Yes, if you have had a simple extraction you will be okay to drive yourself home. However, if having multiple extractions it is best to have a driver with you. If having a General Anesthetic, you will ALWAYS need to have someone to drive you home.
Yes, we are wheelchair accessible. We have a side entrance with a ramp leading to our ground floor suite.
No, OHIP does not cover consultations in our office.
Everybody is different, typically when having a routine extraction you can expect to be uncomfortable for 2-3 days. With wisdom teeth extractions you may require 3-4 days of recovery time.
Yes, there is plenty of free parking.
With a routine single tooth extraction you will be able to return to work the next day.
Pain is variable with all patients. Medication will be given to keep you comfortable.
You can start eating soft foods the same day. It is advised to eat on the opposite side of extraction site for a few days.
Freezing will last 2-3 hrs following a procedure. With wisdom teeth removal, the freezing typically lasts 6 hrs following the procedure.
No, you will be fully asleep and comfortable with no recall of the surgery. You will wake up frozen with no pain.
Teeth can be permanently screwed in the same day of surgery (All on Four) if all the teeth are being replaced. If a single tooth is being replaced, typically 3 to 4 months is required. Early restoration options are now available under certain conditions.
Typically if you need a single tooth removed the procedure can be done the same day as your consultation unless you are medically compromised. When needing your wisdom teeth removed, it will never be done the same day.
During a General Anesthetic you are fully asleep monitored by a medical anesthesiologist. With Intravenous Sedation you may or may not be aware of the procedure.
Nausea occurs less frequently today with modern medications but can occur after having a general anesthetic. This can be treated with gravol.
Occasionally medications can cause severe nausea. If this happens discontinue the medication and contact our office.
It is important to keep your mouth clean with gentle brushing with a soft toothbrush. Allow for bleeding to stop. The day after surgery you can start rinsing with warm salt water rinse which will aid in healing and also commence brushing. A clean mouth is less likely to become infected.
The stitches normally dissolve internally and then fall out. If you lose a stitch early it does not need to be re-stitched.
Swelling can be common and is normal after surgery. Swelling usually peaks on the 3rd day following the surgery. Using an icepak for 20 minute intervals will reduce swelling. Refer to instruction sheet.
It is normal to have some bleeding for 4-6 hours after surgery. However it can be prolonged. If severe bleeding occurs contact our office immediately. If Dr. Vigna is unavailable go to your nearest hospital.
If having surgery in our office it can be done quickly, however we do our best to prioritize people who are in pain.
We work with your insurance company. You are responsible to pay the difference that is not covered.
Yes, no referral is needed. Dr. Vigna will treat your concerns and help you find a dentist.
All on Four means all 12 teeth are secured to only four implants immediately at the time of surgery. It provides a permanent screw retained, same day replacement of all teeth. The four implants act as pillars to the bridge that supports the teeth. This technique takes advantage of the available remaining bone and avoids painful and unpredictable bone grafting procedures. The back two implants are placed at an angle to gain separation between the implants and to avoid vital structures; such as nerves. The All on Four treatment provides stable teeth that are easy to maintain and eat with. In addition, you will have a great new smile. This procedure is typically performed in the lower jaw. Dr. Vigna performs All on Six if possible in the upper jaw, typically with the aid of Zygoma implants.
A Zygoma implant is a long titanium dental implant used in the upper jaw (maxilla). It is used when bone is lacking in the posterior aspect of your upper jaw and bone grafting is not desired. The Zygoma implant is placed through the upper jaw bone, passes through the maxillary sinus and is secured to the Zygoma (cheek) bone of your face. This provides the anchorage and stability to the new teeth. This implant is used for the All on Four or All on Six total rehabilitation of the upper jaw. This implant requires immediate cross arch stabilization and is used in the Teeth the Same Day technique. The Zygoma implant can not be used as a isolated locator attachment due to its angle of insertion. In cases where the upper (maxilla) bone is severely resorbed, a Quad Zygoma – 4 Zygoma implant technique is used for immediate upper jaw rehabilitation. Teeth are secured the same day with screws to these 4 implants. Dr. Vigna will analyze your bone and review the cone beam CT images and recommend your treatment options.
My team of denturists fabricate the initial denture teeth that are converted to permanent teeth on the day of surgery. These are worn 3 to 6 months before the final teeth are made. The final teeth are metal framework supported and can be either acrylic or porcelain. The final teeth are permanently screwed in. You never go without permanently screwed in teeth at any stage of the procedure.