Up Front with Dr. Jack Hahn

![]Hahn](http://osseonews.blogs.com/.shared/image.html?/photos/uncategorized/hahn.jpg)Dr. Jack Hahn was recently interviewed by the Cincinatti Enquirer. What follows are some brief excerpts from this interesting history provided by Dr. Hahn.

For those who may not know, Hahn is one of the pioneers of modern dental implantology. He invented the "Replace Select" dental implant system – a system for replacing missing teeth with artificial ones that have tapered ends and are anchored in the gums or jawbone.

"Hahn invented his system nearly three decades ago after a female patient walked into his North Avondale office and inspired him to develop his own substitute for dentures. The patient brought with her 17 sets of dentures in a box, none of which fit correctly. Hahn remembers her as a "dental cripple." "She had no quality of life," he said. "She couldn’t go to restaurants. She couldn’t go to parties." Hahn couldn’t do implant work then because he didn’t have the training. So he referred the patient to a doctor in New York for implants, and upon her return Hahn realized her life had been transformed. That was the impetus for Hahn to learn about implants by studying from the same doctor that performed the surgery."

"Though modern implants date to the 1970s, Hahn’s system simplified the process so that more dentists can perform them. His patented system works much like a step-by-step "paint by number" kit. Color-coded implants make placement easier, the tips are tapered to be less invasive, and temporary tooth surfaces allow for immediate use. Once the tapered root forms have bonded to bone, patients get permanent surfaces."

"There are 44 million denture wearers in the U.S.," Hahn said. "People sneeze them out, they swallow them, the dog eats them. Dentures may irritate gums and many wearers have trouble eating."

Advances in implant surface techniques also allow for quicker healing and immediate function have helped boost the number of implant surgeries, he said. Hahn says implants are less expensive than bridges and dentures in the long run because they are more durable.

Note: To read the full interview, conducted by ANNA GUIDO, you can visit the Enquirer online by clicking here.

8 Comments on Up Front with Dr. Jack Hahn

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Mollie Winston
I would like to comment regarding synthetic materials in extraction sites. Teeth have been being removed forever with no bone replacement with excellent healing. I have been placing implants for over twenty years and rarely place any kind of substitute in sockets. Patients heal extremely well with their normal healing process and do not need the expense of all the substitutes. I feel these are being inappropriately pushed by the companies who market them and patients are suffering by being overcharged for unecessary procedures.
Healing may indeed occur without the addition of a graft material however, what type of healing? I for one want regeneration of good mature bone for my future implant patients. If a denture is the goal, then scar tissue repair in the socket is fine.
Barry P. Levin, DMD
The healing events of an extraction socket are well documented. One only has to read Cy Evian's 1982 article to understand the timing of bone maturation. The difference between knowing that a socket will fill with bone and knowing that a ridge is preserved to facilitate prosthetically-driven fixture placement is apples and oranges. Since the work of Carlsson in the 1960's, the volumetric changes in alveolar bone and lingual/palatal position of the crest following extractions is well-documented. The recent article by Nevins demonstrated how "socket-preservation" allows for implant-placement with out the need for additional grafting. The question of grafting materials is another issue altogether. The use of autogenous or allograft bone to preserve the dimensions of an extraction socket are tried and true methods (see Mellonig and Nevins). Bovine bone is also well documented for serving this purpose. Purely synthetic bone grafts are not equal. Materials such as synthetic TCP are quite efficacious. Other materials, such as HTR lack clinical documentation of predictable osseointegration. Additionally, The proper augmentation procedure almost always requires a barrier (GBR). Proper flap-management, debridement, graft-selection and barrier placement can make all the difference when the SURGEON re-enters the site for implant-placement.
Residual ridge resorption has been well documented in the literature dating back to 1935 with Deebach's article on the healing process following the removal of teeth. Incomplete bone fill in sockets after tooth extraction has been reported on for over 70 years. Misch et al can be quoted as saying "During the first year after tooth loss, 40 - 60% of the width of the alveolar ridge resorbs after tooth extraction". I certainly agree with Dr Levin's post. The type of graft material CAN make the difference. Alloplasts are available in a variety of types. Resorption kinetic studies show TCP resorbing faster than new bone can remodel. HTR never completely resorbs nor do the dense HA products. But I have found OsteoGraf/LD to be the economical answer for patients that do not anticipate implant placement in less than 12 months after tooth removal and for those patients that are strictly interested in ridge preservation for conventional restoration such as C&B or dentures. LD is a pure resorbable HA that will maintain the architectural structure of the alveolar ridge and, importantly, will remodel to vital bone.This is not just the company line but rather the histological reports I have seen on LD showing dense trabeculate with areas of bone marrow. Cores have been taken in these reported cases anywhere between 12 and 16 months post graft. They showed no evidence of residual material. There are certainly materials that will offer faster resorption and bone remodeling times but in the allograft catagory, my choice is OsteoGraf/LD. It is predictable, dependable and the most economical choice for socket grafting and ridge preservation.
Joseph Margarone III DDS
I'm a practicing oral surgeon, and I don't see what the big deal is about the need for grafting after extraction in most cases. I agree with Mollie Winston's succinct statement above. The other comments listed mention the amount of alveolar bone loss after one or two years after extraction. How about putting an implant in place after 6-8 weeks of healing and preserve the ridge with the implant? I cannot see placing any foreign material into a surgical site when the likelihood is high that there is some type of pre-existing infection. This is usually why the tooth is being removed in the first place. It is against basic orthopedic surgical principles to place hardware or bone grafts into an infected area. Secondly, since the implant will occupy a large percentage of the volume of the extracted tooth, there is usually no need for complete bone fill or maturation in this area. If if a small osseous defect is seen at time of flap reflection during implant placement, autogenous bone can be easily collected during the drilling procedure via suction trap and used as an excellent quality graft to pack into any defects around the placed implant prior to soft tissue closure. Bone filling materials have their place in selected cases, but there is simply no need for them in the routine extraction case when implant reconstruction is planned in the near future. It adds extra cost as well as increased complexity of the surgery as well as increased risk for post-operative complications. Let nature do its thing.
nothing like old school medicine!
Dr. Bill Woods
I think each clinical situation and the associated biology with each patient is different. To me, conservative is better but I do sense that grafting has its atvantages over nothing most of the time. If there is a mild dehiscence, what can happen if nothing done? Does it repair itself? What if the patient isnt totally committed? What about the plate? The width? The height? Infection? Bone type? Biotype?medical history? I think that grafting does preserve the alveolar ridge and gives you a little longevity to boot. I personally like primary closure at placement and grafting gives a better crestal situation bonewise and tissuewise. For me. Bill
I believe implants are the best solution to missing teeth- I have an implant bridge that was placed 20 years ago, my father had one 20 years and my sister has one 20 years- we have been chewing and eating better due to these implants- all the research that has been done is validation that the doctor Hahn has worked the longest in this field is the most qualified and is lecturing and working hands on with patients around the world. I work with many professionals who have had implants done from actors to teachers, and they would do it again in a second if needed. The implants are as good as your natural teeth and require the same care. In one hour I had the implant placed 20 years ago. This year In 10 min I had front implant placed. It does not take a genius to understand implants are the solution- to poor root canals that eventually all go bad- or fillings with mercury that cause more problems-although gold is the only safe filling- the new materials today are safer- it costs to get the best-but it costs you more to get the other plus pain and replacements since partials and fillings are only temporary--that is why insurance replaces every 5 years.

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