Apple Periodontics & Dental Implants of Dorel Onea, DDS, MS

MANSION FLATS DENTAL Since Dr. Bonilla joined our team earlier this year our practice is significantly enhanced by focusing more on each doctor’s areas of expertise. Dr Carlos E. Bonilla graduated from Boston University Dental School in 1993. He joined the US NAVY as a dental officer and served as part of First Dental Company, First Dental Battalion, Camp Pendleton CA until 1997, gaining experience in general dentistry and surgery. While in California he started working ...as a civilian in private practice. Now with 25 years of experience doing all aspects of general and cosmetic dentistry, he also has training in implant placement and restoration. Dr. Bonilla is married to Dr. Diaz and is the proud parent of two young men aged 17 and 21. He coached them in baseball for some 8 years. He enjoys sports, water sports and baseball. His passion is dentistry and serving the patient first. Our Downtown Sacramento office is located in an area called Mansion Flats, so it was decided to rename the office to reflect its specific location. Hope to see you soon at Mansion Flats Dental. We’ll take good care of you See more

GUM RECESSION REPAIRED WITH MINIMALLY INVASIVE SURGERY Unstable gum recession sites can be repaired by grafting the defect with soft tissue rich in collagen fibers. The goal is to thicken the epithelium, and, fully or partly, cover the exposed root surface. In this case the patient opted to have grafting done using her own tissue harvested from the roof of her mouth vs. using material purchased from a tissue bank. The advantage is that the outcome is more predictable and the disadvantage is a second surgery site. However, since the connective tissue is harvested underneath the epithelium, when the site is sutured it looks like one single incision with minimal discomfort

EXPANSION OF NARROW JAW BONE RIDGE BEFORE IMPLANT PLACEMENT When I looked at the schedule a few days ago this case was supposed to be the easiest (as most premolar dental implants are) out of the seven dental implants I placed that day. However the width of the bone ridge was too narrow for typical implant placement, so a deep slot was created to expand the width of the ridge using a wedge like instrument. Sounds easy, but if the bone doesn’t want to cooperate, and it deci...des to fracture, the planned treatment (implant placement) needs to be aborted. Everything went well, and the slot opening was grafted after the dental implant was successfully placed See more

ABOUT THE CARE PART IN HEALTHCARE Ann has been a patient of ours for a few years now, and I knew that she was diagnosed with stage four breast cancer and that she is on chemotherapy medication. A small detail, however, was missing from her medical history, and she casually mentioned that to me a couple of days ago; the fact that she was diagnosed with inoperable stage four cancer twenty years ago I don’t think that it’s a coincidence that her son is an Oncology Pharmacist with a major hospital in the area. He recommended adjustments and changes in his mom’s medications, and he was able to turn this feared diagnosis into a manageable chronic disease

SINUS LIFT BONE GRAFTING When the available bone between the maxillary sinus and the oral cavity is insufficient dental implants may be placed using a technique named Sinus Lift. The pictures show a case that I started a few days ago where I placed two dental implants in the second premolar (the natural tooth was extracted the same day because it was fractured) and first molar areas. The dental implant in the molar area was placed by surgically drilling an opening close t...o the floor of the sinus followed by gently tapping an instrument to raise the floor of the sinus as a pole would raise a tent. To prevent this raised sinus membrane from collapsing a bone grafting material was used. This material also distributes forces when the membrane is raised to prevent it from being ruptured. The patient’s own osteoblasts (bone making cells) will turn this slowly dissolving graft material into solid bone. In this case the dental implant was placed in the grafted area the same day, since the available bone could support it until healing is complete. It would be interesting to read the captions for the pictures of the dental scientific articles. See more

There are quite a few things that I like about my job, and socializing with patients / friends during dental visits is somewhere close to the top of the list. Here Richard describes his encountering a shark while he was diving a few years ago, when he was in his twenties

RESCUE OF A $6000 DENTAL IMPLANT RESTORATION A failing dental implant that helps support a three unit bridge was saved surgically by removing exposed threads, grafting bone and creating a cleanable environment to avoid further bone loss. See picture captions for additional info :)

YOU NOW HAVE A CHANCE TO HELP THE FUTURE OF DENTAL IMPLANTOLOGY Ceramic dental implants have been in use for over a decade, and like titanium dental implants at their dawn about half a century ago they have a slow and cautious start. The advantages of ceramic dental implants when used in the esthetic zone (front teeth) are clear, and the advances in shape design with material surface treatments that enhance bone integration will certainly increase their use exponentially in... the future. You now have a chance to help the advancement of the dental science by becoming one of the first patients in your area to have all ceramic dental implants and crowns. The implant placement protocol is the same as that for traditional implants with which we have experience since 1998, so we'll take good care of you. The ceramic implant materials and instruments are about twice as expensive as those used in traditional titanium implant systems. However, for a limited time your cost for ceramic implants will be equal to that of traditional titanium implants. Call our office or send a text to (916) 917 5057 to make an appointment for a free consultation, and please mention this posting Looking forward to meeting you in Cupertino or Sacramento.

FAILING DENTAL IMPLANTS Bone loss around dental implants is more problematic than bone loss around teeth, since the exposed threads are a trap for bacterial plaque. This causes further bone loss and more threads to be exposed, ultimately leading to the loss of the dental implant. Dental implant threads are impossible to clean not only because of their shape, but also because the surface of most dental implants is treated by particle blasting and acid etching, making it rou...gh so that bone making cells ( osteoblasts ) can adhere to this modified surface. Unfortunately, once this rough surface is exposed above the bone level, bacteria also adheres to the surface of dental implants in a way that makes it impossible to remove. Even when the bacteria is killed by antibiotics the endotoxin in the bacterial wall triggers an inflammatory process and bone loss. Therefore, the only predictable treatment is to surgically treat bone loss around dental implants by removing the contaminated surface of dental implants , including removal of threads, when necessary. Grafting the bone craters that have formed during the bone loss process is also necessary in most cases. The goal of treatment is the creation of a cleanable environment around dental implants that prevents inflammation and further bone loss. In addition to the initial treatment all patients are given special home care instructions and are seen periodically in our office for follow-up and maintenance dental cleanings. Dental implants are a significant investment, both financial and time in a dental chair, so their maintenance is just as important as the initial treatment. Regular maintenance cleanings in an office that is familiar with dental implants can prevent the need for expensive treatments in the future. Our office has experience with placement of most dental implant systems since 1998, and we’d be glad to see you when you need help with your dental implants.

Memorial Day Sincere Respect for our fallen heroes!

AVOID DENTAL BONE GRAFTING The pictures below show successful treatment of advanced chronic periodontitis with osseous surgery and bone grafting. The lateral incisor with the curved root was very close to being lost before treatment due to lack of bone support and severe mobility. It is always more predictable and cheaper to treat disease, including periodontal disease, before it gets to advanced stages. The importance of a correct early diagnosis of disease should not b...e underestimated. This case would have been easier and less expensive to treat a few years ago at an earlier stage, but "Better late than never" :) While most of our patients are referred by their general dentist, some self-refer for their peace of mind. In our office we take approx. 30 min. to take a digital panoramic x-ray and complete a full periodontal exam. See more