Dr. Roxana Saldarriaga is a newly certified specialist in Prosthodontics who will be joining our practice in May, 2010. She was born and raised in Lima, Peru. In 2000, she moved to Canada where she graduated from a four year programme at the University of Western Ontario School of Dentistry in 1995. She then moved to Minneapolis, Minnesota where she enrolled in a General Practice residency at Hennpin County Medical Center for one year. She then worked full time at the University of Minnesota School of Dentistry as an Assistant Professor in Restorative Sciences, then enrolled in the Prosthodontic programme. She graduated from the three year Prosthodontic programme this year.

This Web Site is offered as resource for information about complex dental restorative needs and about dental implants and dental implant supported restorations. In these pages and posts you will be able to see actual patient treatment examples and get answers to many of your questions about restorative dentistry and dental implants and dental implant restorations.

It is my hope that you will find this web site to be useful and that you will benefit from the information found within. If you have any questions about what is contained here, just click the “Contact Us” link in the header at the top and send me an e-mail request.

DPAN

Breakages are part of life in many arenas including the dental one. While Dental Implants are very strong, being made of titanium or titanium alloy, they are not indestructible. On rare occasions very skinny diameter implants have been known to crack, particularly when the implant support has been inadequate or under-engineered or when loading conditions are just too excessive. A cracked implant means removal and staring over again if possible. Patients however, should not be overly concerned about implant breakages because it does happen so rarely. A more common problem of breakages has to do with the chipping or cracking of the porcelain crowns that are attached to the implants. This is not a serious problem because the crown can be replaced or repaired, unlike the cracked implant. If the functional load is very high, the crowns can be designed to have stronger metal cuspal surfaces.

Dental Implants have the potential for a very long length of service and are on record for providing over fifty years of usefulness. This however, does not mean that every implant, every single time, will give unlimited longevity and uncomplicated service. Many things can affect the service life of dental implants including: general health, smoking, oral hygiene maintenance, the level of loading and wear and tear on and around the implants and even unknown and unexplained events. It is possible that as time goes on, progressive deterioration of supporting bone may occur. This of course will shorten the longevity and suitability of the dental implants. The good news is that Dental Implants are amongst the most dependable and longest lasting of all dental restorative systems that presently exist.

There are structures in the head including the jaws that are potential surgical hazards. In the back ends of the lower jaw (mandible), there is a main nerve trunk that has to be avoided during implant placements or during bone regeneration grafting. Compression of the nerve trunk or any kind of damage to it whatsoever will result in the possibility of having permanent numbness in the region innervated by the nerve. It is possible to accurately predict the position of the mandibular nerve canal by utilizing standard and specialized x-ray imaging so that where surgery is possible, it does so with very little risk.

Non-integration means an early failure of grafts or implants to take and is a reality that unfortunately exists, although in very small percentages.  In the case of grafts, bone regeneration may fail to take place.  In the case of implants, fibrous tissue adhesion may develop instead of bone attachment which means that the implant will not be able to support load and would need to be removed and if possible another implant could be placed.

When a graft or implant has not integrated successfully it can be for several reasons including poor health, poor oral cleansing, poor surgical insertion technique, smoking, or for reasons unknown.  When a dental implant fails to integrate for reasons unknown, the failure is sometimes erroneously referred to as rejection. The titanium material used in dental implants is considered to be so highly biocompatible that rejection because of the material seems quite unlikely.

Non-integration statistically runs at around 3% worldwide.  More experienced clinicians usually will get better percentage results than will novice clinicians.  All things considered, the placement of either regenerative bone grafts or dental implants, while not perfect, can be expected to have excellent success.

Both the oral cavity and the sinus cavities are teeming with bacteria so infection is always a concern whenever surgery is undertaken in these areas.  In spite of the very high bacterial presence, infections in the oral cavity happen very seldom in healthy individuals, particularly if precautions of careful sterility, careful technique and the judicious use of antibiotics are utilized.

Professional Qualifications:

-         DDS, (Doctor of Dental Surgery); University of Toronto, 1967
-         National Dental Examining Board Certificate; 1967
-         Certification in Prosthodontics (BC) 1979
-         (M)RCDS (Member, Royal College of Dental Surgeons of Canada);1980
-         FCDS(BC); Fellow College of Dental Surgeons of BC; 2001
-         FRCDS (Fellow, Royal College of Dental Surgeons of Canada);2005

Honours:

-         Fellow of the Academy of Dentistry International 1981
-         Fellow of the American College of Dentists 1990
-         James B. Wilmot Medal of Merit;  Faculty of Dentistry, U of T, bestowed in 2001
-         Alumnus of Distinction; University of Toronto, Faculty of Dentistry, bestowed in 2001
-         Fellowship, Can Academy Restorative Dentistry & Prosthodontics, 2006
-         Award of Merit, College of Dental Surgeons of BC, 2006
-         Award of Merit; British Columbia Dental Association, 2007

Appointments:

-         Chairman of Economics Committee, College of Dental Surgeons of B.C. 1978-82
-         Chairman of Dental Technicians Board Liason Committee, CDS, BC, 1980-84
-         Convention Chairman for the B.C. College of Dental Surgeons 1983
-         Chairman for College of Dental Surgeons of BC, Courts of Inquiry, 1982 -1984
-         Vice–President College of Dental Surgeons of B.C. 1982 –1985
-         Scientific Programme Chairman, Canadian Academy of Restorative Dentistry, 1984
-         President,  British Columbia Society of Prosthodontists 1984 – 1985
-         Honourary Sessional Lecturer;  Faculty of Dentistry, University of BC  1986 – 2000
-         Founding President of Dental Specialists Society of BC 1986-1987
-         Founding President of Association of Dentist Owned Laboratories 1985 -1986
-         Vice-President of the Canadian Academy of Restorative Dentistry 1986 – 1987
-         Convention Chairman Canadian Academy of Prosthodontics, 1984
-         Convention Chairman Canadian Academy of Prosthodontics, 1988
-         Director of the Canadian Academy of Prosthodontics, 1988 – 1989
-         Vice–President of the Canadian Academy of Prosthodontics 1989 – 1990
-         President of the Canadian Academy of Prosthodontics, 1991 – 1992
-         Chairman of Nominations Committee, Canadian Academy of Prosthodontics, 1992-93
-         Director of the Canadian Academy of Restorative Dentistry and Prosthodontics, 1994-95
-         Member of the Review Committee, CARDP, 1995-96
-         Convention Chairman CARDP 1996
-         Chairman of the Constitution Committee for the CARDP, 1999-2010
-         Convention Chairman for  CARDP, 2002
-         CARDP Corporate Liaison Chairman 2000-2004
-         President, Canadian Academy Restorative Dentistry & Prosthodontics; 2006-7
-         CARDP Corporate Liaison Chairman 2007-2010
-         CARDP Nominations Committee 2009-2010
-         Associate Editor, Journal Canadian Academy of Restorative Dentistry and Prosthodontics

Organizational Memberships:

-         College of Dental Surgeons of BC
-         Canadian Dental Association
-         American Academy of Fixed Prosthodontics
-         American College of Dentists
-         Royal College of Dentists of Canada
-         British Columbia Society of Prosthodontists
-         Federation of Prosthodontic Organizations
-         Dental Specialists Society of BC
-         Pacific Coast Dentist-Owned Laboratory Association
-         Canadian Academy of Restorative Dentistry and Prosthodontics
-         International Academy of Gnathology
-         Academy of Osseointegration
-        International College of Oral Implantologists

Articles and Publications:

-         Tape Cassette Programme, CDA, Contouring Crowns for Periodontal Health, 1976
-         Tape Cassette Programme, CDA, Application of Non-Rigid Connectors, 1976
-         Journal of Prosthetic Dentistry, Pin-Retained Porcelain Bonded to Metal Facings, 1979
-         Quintessence International, Pin-Retained Porcelain Bonded to Metal Facings, 1980
-         Above translated and reprinted into Japanese and German.
-         Seven Module Teaching Videotape Series on Complete Oral Rehabilitation, for UBC
-         Video Tape of Restoring Mis-angulated and Mis-aligned Implants, Dentsply Int. /96
-         Work in progress: a textbook, Fundamentals of Occlusion,  est. 800 p. (Quintessence)

Special Projects:

-         Developed the original standardized Fee Guide for the College of Dental Surgeons of BC
-         Negotiated Fee Schedules with BC Provincial Govt.
-         Developed a national standardized Fee Coding in association with the CDA
-         Developed the Constitution and By-Laws for Dental Specialists Society of BC
-         Co-developed DACUM Curriculum upgrade for the Dental Mechanics/BC for the CDS
-         Developed briefs to Gov’t. to argue against abolishing the “Oral Health Certificate”
-         Wrote Constitution and By-Laws for The Pacific Coast Association of Dentist-Owned Labs
-         Developed and presented briefs to Gov’t.  re:  Denturists expanding services to the public.
-         Co-developed the Constitution and By-Laws for CARDP
-         Developed the Constitution and By-Laws for the International Academy of Gnathology
-         CARDP Operations Manual, 58 pages

Mentoring Activity:

Over the past 30 years more than 200 dentists have been member participants in extended term Study Group seminars which Dr. Nimchuk has mentored.  These seminars consist of both a didactic and clinical component structure and provides close personal instruction.

-         G & N I Study Group:  Co-Founded by Dr. Dennis Nimchuk and Dr. Harry Gelfant in 1974 with 14 members.  This group continues to function to the present day.  This group is mentored exclusively by Dr. Nimchuk and Gelfant and has met for continuing studies for 200 complete days and 15 evenings.  Eighty percent of the original group are still active with only 20 percent having been replaced.  The orientation of this group is for improvement of all restorative and practice venues.

-         G & N II Study Group: Co-Founded and mentored by Dr. Dennis Nimchuk and  Dr. Harry Gelfant in 1974 with 15 members; was active for 5 years and met for a total of 39 days.  The orientation of this group was occlusal studies.

-         G N L Study Group:  Co-founded and mentored by Dr. Dennis Nimchuk, Dr. Harry Gelfant and Dr. Bernie Linke:  This group of 14 dentists was active for 3 years and met for 24 days.  The focus of this group was on Fixed Prosthodontics.

-         Victoria Restorative Study Club:  Co-founded and mentored by Dr. Dennis Nimchuk and Dr. Harry Gelfant in 1980.  This group of 12 dentists was active for 3 years and met 21 days.  The orientation of this group was Fixed and Removable Prosthodontics.

-         Kamloops Restorative Study Club:  Has had rotating Mentors.  Mentored by Dr. Dennis Nimchuk for 2 years in 1985 and 1986.  This group of 15 dentists met for 14 days with Dr. Nimchuk to have instruction in Fixed Prosthodontics.

-         West Kootenay Study Club:  Has rotating mentors.  Mentored by Dr. Dennis Nimchuk for 3 years in 1998, 1999 and 2000.  This group was mentored by Dr. Nimchuk for 18 days.  The focus was on general Prosthodontics and Implant Prosthodontics.  Dr. Nimchuk will be mentoring this group again in future.

-         Western Restorative Seminars:  Mentored by Dr. Dennis Nimchuk for 8 half days in 2001.  This is a group of 15 dentists which will continue to meet for successive year programmes.  The principle subject material is Fixed Prosthodontics and Implantology, 2001-2010

-         Quintessence Continuing Education Seminars:  Mentored by Dr. Dennis Nimchuk in 1998, 1999, 2000 and 2001 and committed to 2002.  Each year is theme based evening study and enrols 25 to 40 dentist per year.  Each year consists of seven evenings. The subjects have been Implant Prosthodontics, Esthetic Restorative Development, Occlusion, and Fixed Prosthodontics with next years programme on Implant Prosthodontics.

Standard of Service:

Dr. Nimchuk is honoured to have provided private practice dentistry to over 75 Dentists as patients as well as many of their family members.

Community Activities:

-         Fund raising committee member for Vancouver Art Gallery.
-         Sponsor for Chanel Gala event for Vancouver Opera fund raising.
-         Founding sponsor Canadian Institute for Ukrainian Studies.
-         Event host for Gordon Campbell, Liberal Party Leader of BC
-         Promotional organizer for Ukrainian-Canadian Artists
-         Volunteer for Reach Emergency Health Clinic
-         Sponsor for Vancouver and District Dental Society fund raising for Breast Cancer.
-         Sponsor for Fraser Academy
-         Sponsor and provide musical equipment and practice studio for Kerrisdale youth group.

Dental implants are made of pure titanium or titanium alloy. Titanium is very strong and is biologically inert and unlike most metals is readily accepted by the body. Implants come in different shapes and sizes. There are many designs and manufacturers of dental implants but most are cylindrical or somewhat tapered like a natural root. Most implants made by reputable companies have comparable success rates.

To be a candidate for a dental implant a number of criteria must be met in order to successfully support an implant. Most importantly, you should have good general health and your oral tissues should be clean and healthy and there must be enough bone volume present having adequate density.

Following an extraction of a tooth the supporting bone quickly begins to shrink in height and in width. The longer a tooth or teeth have been missing, the more likely it will be that a greater amount of bone loss will have occurred. Today however, even if bone shrinkage has been extensive, dental implants may still be an option. Depending on the situation, it is most often possible to regenerate deficient bone or graft bone so that an implant or implants can be placed.

For pictures of Implant Restorations, link to the Treatment Examples heading in the menu bar at the top of this page.

After implant integration there will be additional procedures and costs for the titanium or zirconium post that inserts into the implant plus the cost of the crown that goes onto the post. The inclusive post-crown combination can cost range from a low of $1300.00 to a high of $2400.00. Where different specialists are used to do the surgery and the prosthetics the aggregate fee may be higher.
As the number of implants increase and the complexity of the surgery increases, so generally will the costs.

In Dentistry fees can vary significantly as can quality, particularly when it comes to implant services. The comparative fee chart below is unofficial. It is not based on a scientific collection of data but is based on my impressions on the fees out there as have been generally described to me. They should not be used as an absolute basis for comparison but as an overview of expectations. Specialists will normally charge more than General Dentists.