Joseph Deatherage, D.M.D., M.D., considers himself lucky. Well, sort of. Deatherage, medical director of the Oral and Maxillofacial Surgery Clinic on Highway 150 in Hoover, has been where many of his patients find themselves — on the receiving end of a new tooth.

Joseph Deatherage (top) and his partner, David Roden, are experts on dental implants and offer a high-tech procedure that enables implant reconstruction with the latest 3D computer imagery and guided surgery techniques.

Deatherage went on to get a tooth implant, one that he still wears today. “It looks and feels like a regular tooth,” he says. “I bet you can’t tell which one it is.”

Deatherage and his partner, David Roden, D.M.D., M.D., are experts on dental implants and offer a high-tech procedure that enables implant reconstruction with the latest 3D computer imagery and guided surgery techniques.

The guided dental implant surgery procedure delivers permanent, fully functional teeth to a patient with just one two-hour surgical procedure.

“With the guided technology there are two phases: the fabrication of the prosthesis and the surgery,” Deatherage says. “When the patient comes in, we image and scan the patient with a 3D CT scan that is then generated into computer models. With that we can develop a 3D view of the jaw, sinuses and the nerves so we can see exactly where we have room for the implants and whether or not we’ll have to place bone grafts.”
The data is then transmitted to Nobel Biocare, creator of the first dental implants more than 40 years ago. The company fabricates the prosthetic teeth and a template that is identical to the patient’s jaw line. The template gives Deatherage and Roden a surgical guide to assist in precise placement of the implants. 

“Nobel Biocare uses computer-generated technology to make a model of the jaws and teeth, and then they make the stent that precisely fits on the patient’s gum tissue,” Deatherage says. “The stent is held in place with little screws. Then we can drill using that guide as a template knowing based on the computer radiographic data that we’re not going to go into the sinuses, and we’re going to stay away from the nerve. We can very precisely place the implant exactly as we had planned it on the computer.”

Some patients will have their prosthetic teeth placed the same day as the stent, Deatherage says. Others return for a single, one-hour surgery under local anesthetic.

The procedure is much less invasive than traditional teeth implant surgery and has much less trauma for patients.

“The old-fashioned way, we’d put the implants in and let them heal, then we make some models and impressions,” Deatherage says. “That took months. With this it can be done quickly — and in most cases all in the same day — and with the guided technology we don’t have to make any incisions. We just drill right through the soft tissue using the template as our guide, and the implants look and feel identical to real teeth.”

Who are candidates?
Guided dental implant surgery works best for full-mouth implant rehabilitation.

People who suffer from long-standing tooth loss due to their jawbones dissolving away are candidates for the procedure. Those who have suffered a traumatic face injury that resulted in tooth loss or had jaw bone reconstructed after battling cancer also are candidates, as are those who have lost teeth and bone due to gum disease or other factors.

Deatherage says bone loss is common for those who lose teeth, saying the teeth are needed to keep the bone in shape.

“Bone is a dynamic tissue, so for bone to maintain its mass it has to have a functional stimulus,” Deatherage says. “If you put your arm in a cast and don’t use it for a few years, you’ll still have bone there but it shrinks in mass and density. In the jawbones, the teeth, every time you bite it stimulates the maintenance of that bone. So when you lose the tooth through disease that causes bone loss, then that bone atrophies away.”

Some patients can have so much bone loss that there’s no bone in the upper jaw to place the implants. Bone grafting then becomes a must.

Bone can be harvested from the other jaw, the tibia, the hipbone and, in extreme cases, from the skull. Some patients also opt for cadaveric bone because it’s less expensive and doesn’t require a second surgery.

Good for your health, self-esteem
Numerous studies in recent years have lauded the positive impact healthy teeth can have on the rest of the body.

Deatherage points to a study at a Veteran’s Administration hospital in Texas that examined the consequences of having no teeth. It revealed that patients with no or few teeth reported digestive problems among other systemic health problems.

When the patients were given implants it improved their chewing function and had a profound effect on their self-esteem — a key component for why many want to have implants.

Deatherage comes from a family of dentists. His father, both of his brothers, and some of his uncles and cousins are dentists. He had never had any complicated dental work prior to losing his tooth, but says the experience hammered home the effect the cosmetic part of tooth loss can have on his patients.

“I was fishing in Alaska with one of my brothers and I hadn’t told him about losing my tooth,” Deatherage says. “I’m not very vain, but my brother sees it and says ‘You’re missing a tooth!’ Then I could see what my patients felt like when someone looks at them funny because they’re missing a tooth.

“It was actually a good experience for me. I was courteous to my patients and sympathetic before that, but it definitely gave me a new appreciation for what they are going through.”

The 3D computer imagery and guided surgery also is available at the Oral and Maxillofacial Surgery Clinic at The Kirklin Clinic.

Contact Deatherage for more information at jddmdmd@uab.edu or call 987-1173 for appointments.