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Dental Implants

We are only using proven dental implant system such as ASTRATECH, NOBELBIOCARE, STRAUMANN, BIOMET 3I, SWEDEN AND MARTINA. These companies have invested in research and development and charge us accordingly. They also assure long-term support with all parts on inventory.

Since we expect implants to last over 20 years it is imperative to choose an implant surgeon based on the implant system he or she uses instead of how low the price could be because the implants won’t be serviceable 10 or less years later. On several occasions, we sadly had to remove perfectly healthy implants which could not be serviced for lack of spare parts.


Technology has brought to implant surgery a phenomenal level of precision in diagnosis and execution. There is no justification for not endorsing it. The era of invasive surgery for access, freehand drilling, ballpark implant placement, are definitely over.

The old and traditional approach for implant surgery involves freehand implant placement leading to more swelling and discomfort. Besides the discomfort aspect, freehand implant position will be affected by parallax errors, bone hardness and lack of visibility. Treatment outcome can’t be optimal. Would anyone accept new kitchen cabinets with handles at different heights?

The new approach uses 3 dimensional radiograph technology as well as computed aided design. The 3D radiographic data and the surface scan data from a cast of your mouth (or a digital impression) are imported into a virtual replica of your mouth. Your periodontist, general dentist and laboratory technician will simulate on a computer your entire treatment. Implant positioning will be adjusted precisely according to your anatomy and your restorative needs. A custom 3 dimensional printed drilling template will be fabricated ahead of the surgery. You will receive the implants in the exact intended position, in a very short surgical session. Because the surgery is minimally invasive, your discomfort level will vary from slight to none.

Drs. Gantes and Costandi are using minimally invasive guided surgery on all their patients.


If you don’t have enough bone in an implant site does not mean that you had bone loss. You possibly did not have the bone in the first place. Humans are different in shapes and forms. It is very common to be born with small jaws. In this cases, your teeth are planted only half way in the jaw bone. If you lose such a tooth, your bone will need to be augmented before an implant can be placed. If you had periodontal disease before more likely than not, your bone has disappeared. In the upper molars region, there is an air cavity called sinus. The sinus cavity extends sometimes at or between the roots of the molars. In these cases your periodontist will need to gain space for a bone graft by surgically lifting the floor of the sinus cavity. The implant placement will be simultaneous with the graft or delayed depending on your condition.

Based on published research and our own data base analysis (over 5000 patients followed up to 30 years), Drs. Gantes and Costandi are using two type of grafting which have maintained the highest success rate.

For vertical and horizontal ridge augmentations, we are using autogenous block graft harvested in the anterior or posterior regions of your lower jaw. The graft is attached with a fixation screw for 3 months before receiving the implant.

For sinus elevation and grafting, we have elected xenograft particles (bovine bone). The particles induce your own bone formation and the original bone graft is replaced completely by your own bone in 7 to 10 year-period.


Drs. Gantes and Costandi prefer to use guides for implant surgery for all the reason listed below:

  • It allows a minimally invasive surgery.
  • Implant surgeries are quicker.
  • Placement of implant is consistent and ideal.
  • Drilling errors are prevented.
  • The one drill approach is more gentle for the bone
  • Flapless technique speed up healing
  • Most patient report no post-operative discomfort.


Immediate provisionalization of implant is largely advertised in our days but rarely achieved. Drs. Gantes and Costandi are experts on the topic but are not claiming that it is the only way. I some selected cases, it can help patients maintain function during the healing phase.

Here are two examples :

Single tooth Replacement

This public person experienced a broken tooth

At the same appointment, extraction, an guided implant placement took place

A custom abutment was also delivered

We were able to temporize the implant with a temporary crown during the 3-month healing time


This patient is wearing a full removable denture

We planned a fixed bridge and were able to fabricate a surgical guide

The implants were placed with a minimally invasive technique without gum flap

The custom abutments were delivered the same day

This patient went home the same day wearing a fixed temporary bridge