Main Line periodontist, prosthodontist and implant dentist Dr. James Vito restores form and function to patients’ smiles
by Bill Donahue
For 25 years James Vito, D.M.D., has been applying his comprehensive brand of dentistry to all facets of patients’ smiles in Philadelphia and along the Main Line.
As a periodontist he diagnoses and treats gum disease, while as a prosthodontist he specializes in making replacements for missing teeth and other structures of the mouth. He is also among the region’s elite in the surgical placement and restoration of dental implants, using titanium substitutes to replace the missing roots of one’s natural teeth, paired with single crowns or dental bridgework.
Dr. Vito was trained and received his certification in Periodontics and Prosthodontics at the University of Pennsylvania’s School of Dental Medicine and from its prestigious Periodontal Prosthesis-Fixed Prosthodontics program. He holds three fellowships and is dual board certified in implant dentistry through the American Board of Oral Implantology/Implant Dentistry and the International Congress of Oral Implantologists. He also is a Clinical Professor of Periodontics and Implant Dentistry at Temple University’s Kornberg School of Dentistry Temple University and is on the teaching faculty of the Misch International Implant Institute.
Suburban Life sat down with Dr. Vito to discuss the delicate nature of dental implants, their increasing popularity and what implant patients can do to ensure a healthy smile—both functionally and aesthetically—that can last a lifetime.
Suburban Life: Tell me about the growth of dental implants.
James Vito, D.M.D.: When I first started placing dental implants 1987, if you mentioned dental implants to patients, many of them looked at you apprehensively. Now people are very receptive to modern-day dentistry when it comes to solving a missing-tooth problem. In 2006, there were an estimated 5.5 million implants placed, and this number has grown exponentially since. I read something recently about dental implants being a $3-billion-a-year industry.
That being said, more dentists who have had very minimal training are now placing dental implants. As a result, we are seeing more complications developing from having implants placed in the wrong position, in poor bone or in infected sites where the dental disease was not resolved prior to implant placement. As time goes on, I think we’re going to see more and more issues. You wouldn’t want a general surgeon doing heart surgery on you. In the case of dental implants, sometimes you have dentists doing this highly technique-sensitive procedure with little more than a one-day training course.
SL: What kind of complications can arise from implants that haven’t been well thought out or well executed?
JV: Everything we do is custom tailored to the patient’s unique situation because every case is different: bone density, gum tissue, how someone responds to surgery, the patient’s medical history. You don’t pick up a crown out of the box and it’s one size fits all. Success is dependant on the skill level of the dentist. Is the dentist selecting the proper implant for the situation? Is the dentist sure he/she has the right environment in terms of bone and gum tissue in order to have it be successful or is he/she pushing the envelope of the technique?
Implant dentistry can cost $5,000 to $6,000 per implant, and that’s not including bone or gum grafting. Implant dentistry becomes even more expensive when it isn’t done right the first time and it has to be redone. A failed implant creates more damage than a failed tooth because the body is much more aggressive at getting rid of something that is not natural—in this case, a titanium implant. When this happens the hard (bone) and soft (gum) tissues need to be repaired in addition to having the implant replaced. Therefore, dentists placing dental implants have to ask themselves if they have the right skill sets, training and technology in their office to undertake the scheduled implant procedures they have planned.
We have one patient who has had an implant that failed twice and is now coming to us for a third one. This gentleman has a prominent position within his company, and it’s a front tooth so he’s very self-conscious about it. The previous surgeon put the implant in an infected tooth site. When the first implant failed, the surgeon removed the first implant and immediately placed a second implant. That didn’t work either and resulted in a hard and soft tissue defect in the front part of the mouth. So now we have to evaluate and have a frank discussion about how many reparative procedures the patient is willing to undergo to repair this failed implant site because it was not planned for properly.
SL: What is the patient’s role in limiting complications after implant surgery?
JV: There are issues that the dentist can control and issues that the patient can control. Patients need to realize that this is a highly sensitive technique. They also have to realize that if they want everything to look perfect that sometimes this means doing hard and soft tissue procedures prior to implant placement. If the patient limits the number of procedures that can be performed then this will compromise the final result and the patient must be accepting of the compromise.
Another key component is the patient’s oral hygiene and how compliant the patient is in terms of follow up appointments and keeping these appointments and their mouth as clean as possible following the implant procedure and as healing takes place. All these things help determine whether an implant is going to be successful.
SL: How do people who might benefit from dental implants seek the right dentist to perform the surgery?
JV: They should look for someone who has had additional training—either fellowship training or additional training at dental school or an accredited institute—as well as someone who has been doing it for a while. Ideally, you’d want somebody who has been certified by the American Board of Implantology or the International Congress of Oral Implantologists. Both organizations offer Board Certification upon successful completion of written and oral exams by ones peers. When you’re a specialist, you are more geared towards handling a variety of complicated issues.
SL: Why did you decide to get into this field?
JV: I’m always trying to be the best I can possibly be, and Periodontal-Prosthesis and dental implants allow me the opportunity to be creative and restore a patient’s health, function and aesthetics that without implants would otherwise be impossible. Dental implants allow me to now provide my patients with a third set of permanent teeth.
Dental implants have different properties and different dynamics than teeth, and bone and gum tissue respond differently to them than they do to teeth. Yet with the right education and the right technology, you can arrive at same aesthetic restorative solution as you would with a natural tooth.
James Vito, D.M.D.
523 E. Lancaster Ave., Wayne
Rob Hall is a photographer based in Plumsteadville.