Dental Implants

Referred for a Dental Implant Procedure

Periodontists are dentistry’s experts in the surgical placement of dental implants. There are two important reasons for your general dentist to refer you to a periodontist:

  • Within the dental profession, periodontists are known as the masters of both hard tissue (teeth and bones) and soft tissue (gums, cheeks, etc.). Placing a successful dental implant requires extensive knowledge of both tissue types.
  • Placing a dental implant is a surgical procedure, and the extra three years of education periodontists receive beyond dental school includes in-depth surgical training that most general dentists don’t receive.

Here are some possible reasons a periodontist might be required to place your dental implants:

  • You need a front tooth implant where the aesthetic outcome is critical.
  • You need multiple implants, which is a more complex procedure with several optional approaches to consider.
  • You have limited bone structure into which the implant can be inserted.
  • You have multiple complex dental problems and comprehensive treatment planning is required to determine the optimal compromise.
  • Your implant will be placed in the upper back jaw near the sinus, which requires sinus augmentation to raise the sinus floor, develop enough bone for the implant, and create adequate space between the implant and the sinus.

Experience and Training

Dr. Nightingale has been performing dental implant placement and bone regeneration procedures since 1987. As a Periodontist, he possesses a unique clinical skill set with education and experience in both regenerating soft tissue and bone and in the long term maintenance and repair of the restored implant. This background is essential to meeting your expectation of an attractive, comfortable and long lasting implant supported restoration.

The Team Approach

There is no officially recognized specialty in dental implants.  The reputation of dental implants as highly successful replacements for natural teeth is due in large part to use of the team approach in which the implants are placed by a surgical specialist in close collaboration with the restorative dentist and dental laboratory who are ultimately responsible for the final restoration placed upon the implant. Dr. Nightingale understands the value of the team approach and works closely with your general dentist and laboratory to help insure that the restoration of your implant goes according to plan. Close rapport with both the patient and the restorative dentist is essential to maintaining healthy periodontal tissues around both teeth and implants.

Implant Site Development

Adequate quality and quantity of healthy bone is necessary for successful implant placement.  The most ideal way to ensure this is to preserve existing bone at the time that a failing natural tooth is removed. This is usually done with a socket preservation bone graft at the time of extraction.  In other situations, ridge modification or sinus augmentation may be necessary  For more information click Implant Site Development.

Replacing a Missing Tooth

A natural tooth is anchored into the jawbone by its tooth root. Tooth roots attach firmly to the jawbone and keep your teeth stable when chewing solid foods.


Traditionally, if you were missing a tooth or if one needed to be extracted, the healthy teeth on either side of the missing tooth would be cut down and all three teeth replaced with a “bridge”.


Dental implants are the modern alternative. Instead of cutting down two perfectly healthy teeth, the Periodontist inserts a dental implant fixture into the jawbone to replace your missing tooth root. In many cases, the implant can be placed directly into the empty socket at the time of tooth extraction.  The implant becomes solidly fixed into your jaw (like a natural tooth root). After healing, your general dentist places a crown onto this artificial tooth root that looks, feels, and functions like your natural teeth. Quite simply, dental implants are the most natural and reliable replacement available for missing teeth.

Replacing Several Missing Teeth

Dental implants can be used to replace several or all of the teeth which traditionally might have been replaced with removable dentures. Implant fixtures are used to replace the missing natural tooth roots and rigidly anchor the replacement crowns to the jawbone. The result is permanently attached replacement teeth that look and function just like natural teeth.  By contrast, removable dentures have to be taken out and soaked at night. During the day, they can also look unnatural and rub painfully. Dentures and partials make it difficult or impossible to eat certain foods. Replacement of teeth with dental implants can contribute greatly to an individual’s sense of well being and confidence.