9/20/2015 5:15:05 AM

I often get asked about zirconia implants.  Patients have fear of allergic reactions to the traditional titanium implants.  There are societies that have formed that advocate the use of zirconia implants over titanium.  An allergic reaction to titanium is not impossible but extremely rare.  To date, I have not seen an allergic reaction.

However, there are companies that have formed that produce zirconia implants.  In a recent article in the International Journal of Oral & Maxillofacial Implants (2015; 30: 773-780), implant surgeons compared zirconia implants to titanium implants.  It was the finding of the study that the implant failure rate for the Zirconia implants was 3.5 times higher than that of the titanium implants.  This may also be the reason that zirconia implants do not have approval for teeth in a day.

If you have questions about dental implants and wonder what your options are for treatment, see John Freeman MD, DDS, FACs to see what choices you may have for #zirconia implants, traditional titanium implants, #teeth in a day, or #dental bone grafting.




8/9/2015 1:13:22 AM

The purpose of doing all on four implants is to provide immediate functioning implants without doing grafting.  But for some cases that is not possible.  Either there is not enough bone at the beginning of the case, while placing the implants the bone quality was not what was expected, or the implant failed during the integration phase of treatment.  Whatever, the situation, grafting is often needed to solve the problem.  In some cases a zygomatic implant can be placed instead of grafting.  In the case shown in the photo, a sinus lift and a ramus block graft was required in order to place the last implant.  If you have questions about doing (full arch implants) teeth in a day, please contact the office of John Freeman MD, DDS, FACS.




6/8/2015 3:51:21 PM

Implant surgeons may see cases where things did not go as expected.  It may be due to the fact that the patient was involved in trauma (i.e. fall, car accident, assault), did not heal as expected (because of systemic disease, smoking, chronic wear of denture, infection), or surgical error.  Regardless of the cause, it can be challenging to repair the site and replace dental implants.  These cases can be extremely frustrating to patients.  If you have a #dental implant failure, contact John Freeman MD, DDS, FACS for a consult to discuss what options that you may have.




5/26/2015 1:50:15 AM

At the 15th annual H. David Hall lecture at Vanderbilt Medical Center, Alan Herford, DDS, MD, FACS (chair of the Maxillofacial surgery program at Loma Linda Medical Center) presented options for rebuilding jaw defects prior to implant placement.  In his lecture he presented some cost effective techniques to utilize infuse with current bone graft techniques.    By using these techniques, a surgeon could affordable use infuse with large defects and utilize harvested bone graft from the patient to maximize bone regeneration.  Dr. Herford’s lecture exemplifies John Freeman MD, DDS, FACS commitment to providing #dental bone grafting options for dental implants.  Call today for a consult to discuss your options.




4/12/2015 8:06:44 PM

In a recent article in the International journal of Oral and Maxillofacial Implants (Int J Oral Maxillofac Implants 2015; 30:450-460), Italian surgeons discussed the utilization of fresh frozen human bone graft (cadaver) vs. using the patients own bone (iliac crest bone graft).  Not having to harvest bone from a patient can be very attractive.  The surgery can be preformed in an office OR vs. a hospital, the surgery is typically faster, and there is no need for a second surgical site.

However, the question is if it is as good or better than using your own bone.  One of the big questions concerning using cadaver bone is how long does it take to become part of the patients bone.  For this study they waited an average of 6 months before placing implants.  They noticed in some of their patients that the bone was not incorporated into the patient’s native bone.  This may be why some surgeons wait as long as 12 months.  With iliac crest bone grafting the block grafts are typically ready for implants in 4 months.

Utilizing iliac crest bone grafts from the patient has the greatest potential for healing and forming bone because it is from the patient.  The body does not see it as foreign.  There is also no risk of transmitting viruses such as hepatitis or HIV.

The conclusion of the study was that the success rate of implants placed in cadaver bone grafts was 90% which is OK.  The success rate of implants that most surgeons quote is 95-98% success.  However most of these implants are not placed in as difficult cases as those shown in this study.  In my practice, the success rate of implants placed in iliac crest bone graft appears to be higher than 90%.

If you are in the situation of needing a large bone graft to place dental implants, don’t be discouraged because implants can greatly improve the quality of your life.  You should talk to your implant surgeon and discuss what options that you have and make an informed decision about surgery.




3/22/2015 6:47:04 PM

Medication-related osteonecrosis of the jaws is seen more and more with the treatment of certain cancers and osteoporosis.  It can be painful and difficult to treat.  In a recent article in the Journal of Oral and Maxillofacial Surgery (73: 437-442, 2015), surgeons described a technique of healing using the buccal fat pad.  If you are having the issues contact the office of John Freeman MD, DDS, FACS for a consult.




1/27/2015 5:41:05 AM

Dr. John Freeman will be name in the upcoming May issue of the Houstonia Magazine as one of the top oral and maxillofacial surgeons in Houston.  This honor is based on a peer-review survey of the doctors throughout the Houston area.  Dr. Freeman has been serving the west Houston, Katy, Memorial, Sugar Land area for over 14 years.  With the utilization of dental bone grafting, Dr. Freeman has converted patients that thought their removable denture was the best they could have to full fixed teeth supported by dental implants.  If you have ever been told you were not a candidate for dental implants, call Dr Freeman today to see what your options may be.




1/24/2015 9:16:36 PM

When patient’s loose a front tooth, they often look into the option of a dental implant.  There is often times a significant discussion about the final crown and the surgical placement of the dental implant.  But many times the abutment is not mentioned until it is time to pay for it.

An abutment is a connection from the dental implant to the crown.  Without it the crown connect attach to the dental implant.  The majority of crowns today are cemented to the abutment.  If cement gets trapped below the gingiva (“gum tissue”), it can cause inflammation and loss of the dental implant.  Custom abutments allow for the crown margins to be place exactly into a position that minimizes the risk of the cement being trapped.  Custom abutments allow for maximum retention so that the crown is less likely to come off.  Abutments can also be fabricated out of metal or zirconia (tooth colored material).  This allows the dentist to choose a material that will transmit light similar to the adjacent teeth, giving the most natural appearance as possible.  Custom abutments do cost more than a stock abutment as one may expect.  With all the advantages, it may be worth it!  If you have questions about dental implants, contact the office of Dr. John Freeman.  He has been serving the West Houston and Katy area for over 14 years.




1/6/2015 3:35:36 AM

When patients come to discuss dental implant replacement of missing teeth, they often ask: “how long do implants last”?  The first dental implant was placed in the 1960’s.  Therefore, we have a 50+ years of experience with dental implants.  The general rule for dental implants is that the success rate ranges from 95 to 98%.  It has dramatically changed the face of facial reconstruction.  But what about the 2 to 5% that has problems with dental implants.  This is where the term: “peri-implantitis” comes up.  Peri-implantitis means that there is inflammation around the dental implant.  A common cause of this is cement from the placement of the dental crown.  The extra cement will need cleaning from the implant surface to prevent bone loss.  If the bone loss is greater than 50% of the surface area of the implant or there is loss of bony fusion of the implant then the implant has failed.  This will require replacement of the dental implant.    However, many cases of peri-implantitis can be treated and the implant saved.  This was shown in a recent article in the Journal of Oral Implantololgy (A Two-Stage Surgical Approach to the Treatment of Severe Peri-Implant Defect:  A 30-month Clinical Follow-Up Report).  If you have problems or concerns with your dental implants, give Dr. John Freeman a call to schedule a consultation.  He has been serving the West Houston area for over 14 years.




12/29/2014 9:13:10 PM

It has been a sad week in the world of implant dentistry.  The founder of the first implant that was place 50 years ago has past away.  He has historically developed teeth in a day, implants to support facial prosthetics (false ears, noses, eyes), and zygoma implants.  His contribution goes unmatched in the field of dental implants.  Luckily the company that he founded-Nobel BioCare will continue developing his research.  In the office of Dr. John Freeman, Nobel BioCare is one of the implant systems used in the placement of dental implants.





John P. Freeman Oral & Maxillofacial Surgery
705 S. Fry Rd., Suite 200 Katy, TX 77450
Phone: (281) 599-9445 URL of Map