Thank you for creating and sharing this wonderful video. You have shared very important information with people who absolutely need this knowledge before any type of implant procedure. I am 31 years old and have decided to go forward with All-on-4 lower implants, which will finally be getting done in one week from today. I have a handful of very important questions that I will be making sure to ask before the surgery- but I wouldn’t have known what to ask without watching your video. Thank you kindly.
Your information on this subject is outstanding and most appreciated. Keep informing the public please. Most dentists and surgeons will not tell you this in such a comprehensive manner.
I wish I had heard and seen this video 10 years ago. I had a General Dentist who claimed he was an implant specialist but after 5 years and 10’s of thousands of dollars later my mouth looks worst than when he started. I was about to make the same mistake now but this video saved me from making the same mistake. Thank you so much!
I am a new dental implant sales rep. I came for. 20 years in the medical device world. I am SO grateful for you and all your videos. Implants and grafting are complex and there are so many choices. You make things understandable and have made my learning process so much more digestible. Thank you! Keep posting videos. They are all helping me!! I share them with my colleagues too!
My surgeon Dr Andrew glenn has told me I have bone loss after my $30,000 full implants With the dentures cracked in 3 places & off the posts he will not except me for an appointment Leaving me with 10 post sticking out of my gums. I ant eat, talk. Please help me
Good information and tips after surgery. I got root canal tooth removed and bone graft done today. The dentist explain quite well but not 30 mins detailed explanation. Thank you.
I don’t know if other people have noticed this but it seems like every root canal I have had done 10 or so years ago is the tooth that gets the cavity in the root area and the tooth usually has to be pulled. The fillings I had done in my twenties are still good and if I do get a cavity they just drill refill the tooth. I’m 70 now and feel like my back molars with the root canals are my problem. Has anyone else had this same problem?
Yes I have two root canals and believe that they are rotting and excreting secretions into my sinus cavity. I sometimes have a cough and sometimes bring up a lot of phelgm. It's called a post nasal drip but not all are caused by root canals. However I have started using a product called Xylitol as a rinse after brushing. What it does is change the ph of your mouth and is an antibacterial. Look it up. In any case I discovered that my coughing up stopped. Well mostly. I recently bought a nasal spray and feel that I'm combating the problem that the root canals are causing me. However I'm aware that at some stage I'll need to deal with them one way or another. It's a scary expensive business.
I had a root canal done over 10 years ago. A crown was placed on it. This week I went to an orthodontist and my crown was removed, molar pulled out and got the bone replacement graft. There was an infection underneath. Now I have to wait for the surgery.
Yes..crowns may be needed but risk damaging nerve. Root canal may be needed but makes tooth more fragile...and likely was already weak before and reason for root canal. Bottom line like you saud smallest restoration may be best for preventing crown or rootcanal
Yes, I have the same problem! Root canal tooth got an infection and tooth had to be removed or the endodontist said he could clean it up for another $1700 😏
my favorite video in the four part series so far! the part about the one part, two part and three part walls and its effect on successful bone grafting was a great concept to learn
I have an oral surgeon who wants to do bone graft, wait 6 months then do the implant, then I have a periodontist who wants to do bone graft at the same time he does the implant. How am I suppose to know who to trust if both are qualified specialists?
Both sound like great options now maybe looking at will you leave with teeth same day? What final teeth material is included in your pricing? Do you have warranty on the teeth implants ect., things like that! Congrats on just starting your journey!
I sure wish I could get implants. I've been broke forever and on disability, so can't work or drive. I know the place I want to go too and they do it all in one day. Under IV sedation, i won't be awake. Need to win the lottery, but can't afford to play. Good luck to all of you, able to have this done. 0:55
I'm literally sitting here with a recent upper front single (2nd tooth from the front) implant going through my invoices from the day of surgery checking off everything you've recommended - I completely lucked out that my dentist seems to have been well qualified, but DAMN!! I wish I had come across your invaluable videos PRIOR to surgery! I didn't think to research the procedure on the internet prior to surgery because: #1 my personal situation was that my tooth broke off (a clean horizontal complete break under the gumline from decades of complex PTSD grinding), and I thought I needed to make a quick decision THAT day while standing in the office with the 2D xray of my broken tooth. And #2 I don't trust just any information on the internet...or RUclips for that matter. However, I can engage my critical thinking and observation of information and professionalism such as you and your channel to find quality content and guidance. Fortunately, now after following your series of invaluable videos, I discovered: My dentist does have a doctorate in oral surgery ✅ He did take a CBCT scan ✅ He did perform a bone graft during placement of the implant ✅ But, what if NONE of those things happened, and I just discovered it today, 2 weeks after my implant?!! THANK YOU! I feel such peace of mind, and lesson learned; I'm for sure going to take a step back in any future instances of non-urgent medical procedures to do some RUclips research. Peace to you and your family, and continued success in your practice!
Thank you for these videos. My tooth cracked and I was initially misdiagnosed. By the time the crack was correctly diagnosed it was too late to save the tooth. So, now I am researching implants. I have had a dentist try to rush me to an implant, I perceive because he wants to do a procedure. However, he did not spend ANY time explaining 10% of what you have shared in your videos. Was shocked that I was doing my own research and angry I kept turning him down for an implant. After watching your videos I am glad I did. This surgical procedure is serious and should be performed by someone you trust who is uber qualified.
I am so appreciative of all the time and effort you put into providing such a wealth of information. You are correct being an informed patient is an advantage.
I haven't gone through all your videos yet but oh my goodness, Thank You for putting content like this out there. I had periodontal disease in the past and have seen a specialist for the past 7 years who helped get my pockets from 5-8 back to 2-3s. I trust him and he's wary of my wants to get braces because of my past conditions (which I believe is genetic as my dad had similar issues). I cannot wait to learn more to ensure that I am well equipped to ask the right questions. I've been so stressed about the aesthetics of my teeth and for sure it has impacted my self confidence.
@@fg9223 hi, find a good periodontist with a lot of experience. Mine has over 20 years. I did cleaning appts 4x a year in the beginning. I did bone grafting. I took my oral hygiene at home very seriously. It's been over 7/8 years and I've not had any issues. Nowadays, I reduced my cleanings to 3x a year.
Thank you so very much for all the time you spend on these videos. They are so helpful and informative. I'm at the 6 month mark getting the second ct and hoping I have enough bone to move forward with implant and also hope my surgeon does an excellent job since it's a front tooth.
I wish I had known 4 years ago, what I know now, and am learning here ! The doctor should also offer and talk about the LANAPLser bone regrwoth proceddure: I have many implants and like to stop and prevent boneloss around them. DDS treating with LANAP laser often feature implant sites, where bone receded, and grows back with that technology. So please, dear Doc: would you consider adding that to your treatment plans, where appropriate?
Thanks for a very informative video. I wish I knew all this years ago. I'm a 71 year old woman and just had my second implant placed last week, by an oral surgeon. He extracted the lower left molar 6 months ago and did a bone graft. ( Both of my implants were due to old root canals that developed broken roots and infection.) This oral surgeon also recommended l-PRF platelet therapy, done at the time of extraction, so I got sold that, too, lol. I don't have any gum disease, and everything healed well, and the bone grafting worked fine. My question is really about my other, 15 year old implant, on the other side of my lower jaw. I noticed on the 3D x-ray that the bone on one side of my old implant was almost gone, going down vertically in a straight line. This implant, which was done by a good periodontist, got crowned by a (now deceased) dentist who gave me a too-small crown, resulting in food collecting down in the gum there at every meal. Eventually, the tooth next to it developed a cavity on the side next to this crown, and the regular dentist filled it in a way that lessened the space between the teeth, so less food gets trapped now. My oral surgeon didn't recommend doing anything to it right now, and the implant isn't bothering me otherwise. But I think I might get a crown from the oral surgeon on the new implant, just to be safe, instead of having a dentist do it. What do you think?
your dentist probably has more experience crowning implants than your surgeon. that's what i'd probably lean towards. of course every person is different with their experience levels
I liked watching your video. It was very insightful. I would bet your money that you probably couldn’t fix my mouth but I don’t have any which is why my mouth is not been fixed. I went through several dentist over the years and some of them I’ve not returned to others I have, and they have given up on fixing my teeth, I would just like one time for an actual dentist to help me out. The main problem is like you said in this video the cost I do not have the money to fix my teeth and it’s embarrassing. I’ve been losing my teeth since I was 15 years old, I am now 35 and I still don’t have the finances to fix my teeth so for over 20 years I have not smiled confidently.
thanks for this. my mother has 4 missing teeth and she was going to postpone any further procedures due to cost. now with youtube research like this, i'm organising for her to get some implants. learning more about bone resorption has helped me know that this is time sensitive and procedures need to be done asap.
28:47 I'm a little concerned about the length of time the sutures should stay in place. My dentist is planning on removing my stitches on the 10th of April, which is only 14 days from when they were put in place. Should I say something? I don't want to undermine his expertise. I assume everyone's situation is different, of course.
I've just underwent upper right sinus lift and 3 implants, to eventually support a 4 piece zirconia bridge. The sinus lift intrinsically involves bone grafting. No crestal or lateral augmentation were done. The surgeon used a dissolvable suture, which is meant to go off in 2 weeks. I wonder if a non-dissolvable suture should had been used instead. Thank you.
Very informative video. Thanks for the great slides! I got a question.. So if recommended healing period for the bone graft before an implant can be placed in is 5-7 months, do you expect the patient not to chew on the op area during this whole time or just the few weeks post the bone graft op?
I just had bone grafting done , 3 days ago and my periodontist place dissolvable sutures, and I think member as well. Of course, I didn’t know any better, it sucks. He suppose to be great perio…it took me a number of times to find someone I felt comfortable with and now I made another mistake, thousands down the drain again. I am so sick of this suffering. Working my ass if to come up with the money and then being taken😡
Quoted $17000 for 4 lower implants with bone implant which i will definitely eventually need because i have low ridge and as i age it will only get worse.Lowers are working now with soft re lines,cushion grip and adhesive I am able to talk and chew reasonable well with some modifications to how i bite and chew.
Wow, your video is awesome! I just wish I had watched it before getting my bone grafting done. Its seems like my dentist did a good job but I would have liked to ask him a lot more after watching this video. I had a root canal done about 15 years ago on an upper molar unfortunately over time a gap appeared on the side of the crown which allow food substance to penetrate later resulting on an absese. The tooth was removed, infection cleaned out and the gap fill with bone graft. I expect to get an implant in about six months from now. Is it advisable to get a second examination from a different dentist after work has been done?
what if you're just getting a tooth pulled (last tooth nearest an already pulled wisdom tooth), and you're not going to get an implant. is a bone graft necessary?
It's true people. Please go to a periodontist/implant specialist when it comes to implants. In my case, I needed gum grafting around my front implants that a "regular general" dentist could not perform.
I have a bone implant ( no implant ) done with general dentist. I had a complication with the bone graft. The general dentist referred me to oral surgeon to evaluate the bone graft and the reason the gums underneath is dark red and not healing well. The oral surgeon let me swish the Magic 4 like mouthwash. He said he can clean the bone graft. When he look at the xray , it looks like there are particles of the graft is trying to exit the gums and it is irritating my gums.
What type of allograft material do you recommend? Just saw a video about a patient died from TB meningitis from the bone graft material (ViBone or Elutia)
Your video series is very well put together and I'm so lucky to have found it to be during my research stage of restoring my smile. As I hinted on the previous two videos I am going through a complete restoration and getting three dental implants although I trust my dentist very much and I believe he's the best I could find on island I am still looking for a second opinion and I believe you are the best candidate. I would like to set an appointment to come in for a consultation in the near future. I would like to call and set the appointment and possibly get any information that you would require to make the best possible assessment. Mahalo Nui Loa for your time, Metaverze Agent
I really enjoyed this video content. It is very informative. I recently had my front left tooth extracted due to a failed older root canal and a bone graft procedure placed by a local oral surgeon. It has been close to 5 months now, and I am really concerned about the way the gum in that area looks. Although I do not smile with my gums, there is an indention in front where the tooth was extracted. I have been back to the oral surgeon and he has said everything looks good. I will be going back in October for another visit and for consultation on the abutment and implant placement. Can you please make a video about the gum and distortion around it when the tooth is extracted and what is done to fix that area? Is this another procedure and does it cost more or is this a part of the implant procedure?
This is a very extensive video about dental bone grafting and very well done, It is nice of you to give these technical details, almost a Dental implant course, I had #14 tooth extracted and filled with bone graft, and this is week 3, at what point oral surgeon take an Xray to check on bone graft progress?
Hi Dr Choi, do you work with zirconia implants and could we possibly get your expert opinion on the pros and cons of the material versus the tried and tested titanium alloy?
Thanks for the videos! So small bone graft for the front teeth, is it better to be done at the same time as the teeth extraction, or at the time of the implant? Thank you.
My question is ,what is basically the difference between a bone graft and sinus lift. Thank you. GREETINGS from a former Clevelander living in Germany .
OUTSTANDING VIDEO SIR! Very much appreciate the breakdown and explanation. I am in Southern California and had recommendations to head across the border to Mexico for more cost effective. Do you have any opinion on the quality of work or have patient experience with similar? Also on side note, I just sent your video to my cousin living in Texas and hopefully he may be able to utilize your services. I am sorry I am so far - but again thank for the video / post!
Great deep dive! 👏🏻👏🏻🙏🏻 My question is hard to find info about. Re tooth #2, I have a cross bite. My oral surgeon says (summary) he'd index and use some kind of angle abutment, which would be some form of compromise regarding strength I know the details matter, but do you see this much? How successful is this overall?
All 28 teeth extracted , every extraction will have bone graph performed. 1 extraction site will require a bone graph to repair from a broken tooth with an infection that would require root canal. Iv sedation, 2 sets of temp arches, and 1 final Zirconia set arches 6 months until permanent bridges. Quote: $38,000 Do you think this seems like a reasonable price to pay for this procedure? Dr. Who is performing the surgery owns dental implant institute that teaches Dentist how to perform Implant surgeries so i have confidence in who i picked to move forward with. Would really appreciate your professional opinion and maybe a suggestion of really important questions or question that needs to be asked. Thank you and your videos are very helpful. I would definitely say you sit well within the top 3 Doctors doing content like this!
My recommendation would be to see multiple periodontists and or oral & maxillofacial surgeons for multiple consultations...if you have done this already, then great, you made an informed decision....if not, what is your reference point for gauging if this implant specialist is the right specialist to drop $38k on....btw,DO NOT use a dentist for dental implants....have it done by a periodontist or oral surgeon
What would you charge for molar #30 I just had extraction and bone graft I had plenty of bone but added it for extra support. I had a massive infection and abscess failed Endo one year after a root canal. I am in Cleveland Ohio and prices are very high here best price I see is $3500. Why is it so many places say you have to pay just to get evaluation ? Why when you have CBCT and you know what you need you can’t get upfront price and come in when it’s ready . This is my first socket preservation it was extremely painful 5 stitches (5 days of hell). I hope the actual implant isn’t as painful . Bottom Molar I would love to have you do my dental implant it’s hard to find an expert that knows what they are doing. I have extreme dental phobia PTSD for dental stuff. I also would like to have Zirconia not cheap porcelain and why can’t you buy Solid Gold? Many dentist I have seen refuse to do metal when statistics say that gold lasts 50 years vs 5-20 years with ceramic or porcelain. I got human cadiver bone for my socket preservation. I’m scared of someone drilling to deep and causing me a pinch of pain or using to thick of implant post . So right now I’m on day 5 so I have 4+ months before I could even start this . Bone graft was not terribly expensive mine was $550 with the extraction. Now the implant is $3500-4500 is the best I’m getting here. Sorry for the long rant but implant has been my worst fear ever in dentistry because of Post Op Pain and Long Recovery and messing with my Jaw
My friend has two dental implant single and is giving her problems and wanted it remove. She said the costs per removal of implant is approximately $2,500 each. Please people research first before undergoing implant.
@StraightLooie95 What happen to the bone graft and your gums ? What is black triangle ? I got my bone graft from a general dentist and i want it remove because the underneath of the gums where the membrane was placed is still dark red and looks raw.
@@gratitudetouniverse777 Well unfortunately I had an inexperienced untrained periodontist Dr. Ida Zarrabi. A black triangle is what’s supposed to be the slither of gum tissue in between your teeth. It kind of looks like gap but the bottom half of teeth still collide. It looks scary and ugly. It happened during my orthodontic treatment I was referred to Pacific Northwest Periodontics to schedule a bone graft for my loose upper left canine. I met with Dr. Zarrabi and she explained the procedure of the bone graft. She also mentioned that she wanted to clean the surface of the tooth so it can adhere to the gums better. I agreed to this surgery in hopes of saving my tooth but was very unaware of the potential risks, ramifications, or materials. I did research before my surgery and I could not find an example where a person had a mildly loose tooth got a bone graft and they were good as new. Anything I looked up that had anything to do with a bone graft usually had AN IMPLANT coming right after it NOT THERE SAME TOOTH! I was adamant that I wanted to keep my original tooth even though it was slightly loose. This was frustrating to my orthodontist at the time Dr. Angolkar. They just wanted to end the 3yr. treatment and had felt that I was prolonging it. Even though they were planning on giving me a fixed retainer which would have EASILY could have took care of my slightly loose tooth at the time. Had I’d known what a fixed retainer was during my treatment. She told me that this surgery will work. Even though this seemed very UNPRECEDENTED to me (especially when you do the research.) I put my TRUST in the periodontist and went on with the surgery. Before the surgery I asked her what she would using for the graft material. I thought it would be animal bone. No she said it is HUMAN CADAVER. Not knowing the neurological effects from human consumption. I was very dubious but decided to leave it to the professionals which in turned would be the VERY WORST mistake I will ever make. She drilled two holes into my gums then took a scaler and scraped an extremely deep line down behind my tooth. Resulting in a cavity that she did not inform me until I discovered it and it showed her. Surprisingly she denied any wrongdoings and I had to fix it on my own costs. The surgery had horrible results. I came in with just a slightly loose tooth. I still had braces on so she almost severed my tooth out. She couldn’t because it was connected to wires. But that didn’t stop her from REMOVING A 1/4 OF GUM TISSUE from the left corner of the roof of my mouth. With the unknowingly removal of my gums this left my tooth FAR MORE LOOSER than it was. I can’t even clinch without my mouth without my canine scraping or hitting my lower canine. I push my jaw back to try to avoid scratching my teeth. All of my FACIAL MUSCLES have deteriorated I now look like a skeleton. I get comments about my appearance every single day I wake up! All from an unnecessary and unprecedented procedure. FYI just because someone says they’re a doctor should NEVER grant them your 100% trust.
My 4th tooth back is an infected root canal. I want it gone, I don’t want an implant, I can’t afford one. My dentist is still recommending a bone graft, do I need a bone graft if I’m not having an implant?
You are such definitely above the rest of dentists, very excellent spirit. I wish I can give this video a hundred likes!!! Do you think women tend to have less bone than men, maybe also less dense than men?
Interesting my dentist did dissolvable sutures and a dissolvable membrane on socket preservation. I hope it works I had them do X-ray and can still see it on day 4 how long until I’m in the safe period I gave all 4 walls and thick bone type ?
Hey Dr. Choi, what are your thoughts on some of these new synthetic type grafts that are being sold as usable for a buccal defect graft without a membrane like Osteogen Tape or Ossix Volumax? Are there situations you would considering using them, or are they so far from traditional materials that they wouldn't be worth considering in your practice?
good question. havent used them. a lot of times i see products being marketed as the next best thing but frankly with good technique, you can get amazing results.
Do you know of someone in my area that holds to the same quality you do? I'm in Bakersfield California. Would appreciate it. There are so many speedy implant places here. I dont know how they can do same day implants without all the proper healing time. Much appreciated!😊
Great information from a true professional, can you recommend a qualified periodontist certified in Virginia Beach, Virginia or provide your office info to contact you, thank you for providing these informative videos
hi! I had a dental implant installed on my front tooth without a bone grafting, do you think it would be possible to remove the implant and redo the whole procedure properly since the implant (grey area) is very much visible?
Ja ik droom van mijn tanden te herstellen daar ik ongeval op 16 jaar had en nu zijn mijn tanden gebroken ik heb een vurg probleem met gewone tanden dus ik heb nooit aan inplanting maar ja de prijs zal weer heel deur zijn 😢
My front tooth needs extracting it's loose, I've lost bone and have gum recession due to periodontal disease. My dentist has told me I can't have a bone graft at time of tooth extraction because he wants infection to clear up before he does bone graft. He's worried the graft will fail. Is he right?
I'm going through this at the moment and this advice is exactly what my periodontist gave me. He is very reputable so I'm definitely following his procedural advice.
getting dental implant on My right molars , been taking ppi's for the last 4 years dentist suggesting bone grafting dont know if my implant will work......
I’m watching this while trying to make a decision on having permanent implants installed, on my upper jaw line only. I was told by two other dentistries that I didn’t have enough bone for permanent implants. Or I wasn’t a candidate without a few precautions. However, I recently visited another dentistry and was told they could complete the procedure. He stated he could place an implant(s) at an angle in order to avoid bone grafting. Listening to you now, his actions sounds very suspicious. I do not want any future complications. I just want to be able to enjoy eating and not shy away from smiling. 😢
Had tooth 27 extraction, dentist filled socket with bone graft. He did not tell me what kind. I have Alpha-gal, so cannot have mammal sourced stitches. He had no nonresorbable synthetic stitches and sent me home with only an immediate denture over my "bone graft" ...no membrane, no sutures. On week post extraction and graft material is very exposed, gum is loose around socket. I am counting on my body's ability to heal.
And just because they are specialized in this field doesn't mean they are great at their job, either. Besides looking at the specialized dentistry, you need to research that doctor, too! Don't assume anything.
I have #3 tooth, a old root canal with slight infection. My Endontist quoted me $10,000. No insurance. And that's is there aren't any major complications along the way cause the path to getting that final crown is a long one.
@Dr. Choi I actually live in Texas and relatively close to your office. I am missing 4 of my teeth. All Of the teeth that are gone or missing every ounce of bone. I got shot in 2019 of May and had to have jaw reconstruction surgery. I have 2 metal plates in my lower jaw. I refuse to get anything else but an autograft I don't feel comfortable putting anything else in my mouth besides my own bone. I have done a lot of research over the you seem really smart and know what you're talking about. So I hope you can respond to this. Comment last four and a half years of my life have been really tough and I really wanted to know if If you're able to do an autograph, I've seen 7 oral surgeons that say I need it. Please please let me know if you're able to do that. Type of procedure and I will book an appointment to get a 3D X-ray done so you can see for yourself. But if you can't do that procedure , i'm just gonna have to see somebody else but I would really like it if I saw you so hopefully you , can I hope I get an answer from yeah , thanks for all the videos , doctor choi
Thank you for creating and sharing this wonderful video. You have shared very important information with people who absolutely need this knowledge before any type of implant procedure. I am 31 years old and have decided to go forward with All-on-4 lower implants, which will finally be getting done in one week from today. I have a handful of very important questions that I will be making sure to ask before the surgery- but I wouldn’t have known what to ask without watching your video. Thank you kindly.
Your information on this subject is outstanding and most appreciated. Keep informing the public please. Most dentists and surgeons will not tell you this in such a comprehensive manner.
I need to see you MD. D it will be gravely appreciated. I am really to come Texas. Please
Can I have your office number to make an appointment.
I wish I had heard and seen this video 10 years ago. I had a General Dentist who claimed he was an implant specialist but after 5 years and 10’s of thousands of dollars later my mouth looks worst than when he started. I was about to make the same mistake now but this video saved me from making the same mistake. Thank you so much!
That sucks....the dental industry is full of big promises and bad results
..I hope it all worked out for you in the end
Thats why you do your research!
I am a new dental implant sales rep. I came for. 20 years in the medical device world. I am SO grateful for you and all your videos. Implants and grafting are complex and there are so many choices. You make things understandable and have made my learning process so much more digestible. Thank you! Keep posting videos. They are all helping me!! I share them with my colleagues too!
Glad to help!
@@northtexasdentalsurgeryI really need your help 😢
What a presentation.....absolute masterclass in scope covered yet still keeping it simple for the average person. I learnt so much
Glad it was helpful!
I have changed my mind on starting to reconstruct my mouth 66 year old
My surgeon Dr Andrew glenn has told me I have bone loss after my $30,000 full implants
With the dentures cracked in 3 places & off the posts he will not except me for an appointment Leaving me with 10 post sticking out of my gums. I ant eat, talk. Please help me
Good information and tips after surgery. I got root canal tooth removed and bone graft done today. The dentist explain quite well but not 30 mins detailed explanation. Thank you.
Haha I had the exact same thing done today!!
Same here
I am very impressed. I am in my 1st consult with CTS scan. Doing the research. I have a really good feeling with Dr. Daniel Choi. Wow!
I don’t know if other people have noticed this but it seems like every root canal I have had done 10 or so years ago is the tooth that gets the cavity in the root area and the tooth usually has to be pulled. The fillings I had done in my twenties are still good and if I do get a cavity they just drill refill the tooth. I’m 70 now and feel like my back molars with the root canals are my problem. Has anyone else had this same problem?
Yes I have two root canals and believe that they are rotting and excreting secretions into my sinus cavity. I sometimes have a cough and sometimes bring up a lot of phelgm. It's called a post nasal drip but not all are caused by root canals. However I have started using a product called Xylitol as a rinse after brushing. What it does is change the ph of your mouth and is an antibacterial. Look it up. In any case I discovered that my coughing up stopped. Well mostly. I recently bought a nasal spray and feel that I'm combating the problem that the root canals are causing me. However I'm aware that at some stage I'll need to deal with them one way or another. It's a scary expensive business.
I had a root canal done over 10 years ago. A crown was placed on it. This week I went to an orthodontist and my crown was removed, molar pulled out and got the bone replacement graft. There was an infection underneath. Now I have to wait for the surgery.
Yes..crowns may be needed but risk damaging nerve. Root canal may be needed but makes tooth more fragile...and likely was already weak before and reason for root canal. Bottom line like you saud smallest restoration may be best for preventing crown or rootcanal
Yes, I have the same problem! Root canal tooth got an infection and tooth had to be removed or the endodontist said he could clean it up for another $1700 😏
my favorite video in the four part series so far! the part about the one part, two part and three part walls and its effect on successful bone grafting was a great concept to learn
I have an oral surgeon who wants to do bone graft, wait 6 months then do the implant, then I have a periodontist who wants to do bone graft at the same time he does the implant. How am I suppose to know who to trust if both are qualified specialists?
Both sound like great options now maybe looking at will you leave with teeth same day? What final teeth material is included in your pricing? Do you have warranty on the teeth implants ect., things like that! Congrats on just starting your journey!
I sure wish I could get implants. I've been broke forever and on disability, so can't work or drive. I know the place I want to go too and they do it all in one day. Under IV sedation, i won't be awake. Need to win the lottery, but can't afford to play. Good luck to all of you, able to have this done. 0:55
I will get native bone to repair the future implant area . This dentist does a native bone treatment ruclips.net/video/udclVIJKNZ4/видео.html
How’s recovery.
Sad you never got an answer to your question. I hope you made the right desicion
Make one on failure of bone grafting
I'm literally sitting here with a recent upper front single (2nd tooth from the front) implant going through my invoices from the day of surgery checking off everything you've recommended - I completely lucked out that my dentist seems to have been well qualified, but DAMN!! I wish I had come across your invaluable videos PRIOR to surgery!
I didn't think to research the procedure on the internet prior to surgery because: #1 my personal situation was that my tooth broke off (a clean horizontal complete break under the gumline from decades of complex PTSD grinding), and I thought I needed to make a quick decision THAT day while standing in the office with the 2D xray of my broken tooth. And #2 I don't trust just any information on the internet...or RUclips for that matter.
However, I can engage my critical thinking and observation of information and professionalism such as you and your channel to find quality content and guidance.
Fortunately, now after following your series of invaluable videos, I discovered:
My dentist does have a doctorate in oral surgery ✅
He did take a CBCT scan ✅
He did perform a bone graft during placement of the implant ✅
But, what if NONE of those things happened, and I just discovered it today, 2 weeks after my implant?!!
THANK YOU! I feel such peace of mind, and lesson learned; I'm for sure going to take a step back in any future instances of non-urgent medical procedures to do some RUclips research.
Peace to you and your family, and continued success in your practice!
Same
Thank you for these videos. My tooth cracked and I was initially misdiagnosed. By the time the crack was correctly diagnosed it was too late to save the tooth. So, now I am researching implants. I have had a dentist try to rush me to an implant, I perceive because he wants to do a procedure. However, he did not spend ANY time explaining 10% of what you have shared in your videos. Was shocked that I was doing my own research and angry I kept turning him down for an implant. After watching your videos I am glad I did. This surgical procedure is serious and should be performed by someone you trust who is uber qualified.
I am so appreciative of all the time and effort you put into providing such a wealth of information. You are correct being an informed patient is an advantage.
I haven't gone through all your videos yet but oh my goodness, Thank You for putting content like this out there. I had periodontal disease in the past and have seen a specialist for the past 7 years who helped get my pockets from 5-8 back to 2-3s. I trust him and he's wary of my wants to get braces because of my past conditions (which I believe is genetic as my dad had similar issues). I cannot wait to learn more to ensure that I am well equipped to ask the right questions. I've been so stressed about the aesthetics of my teeth and for sure it has impacted my self confidence.
sure. email us at contact@northtexasdentalsurgery.com and we can help you out
Hi. I have also periodontal disease. How you treated it? Thank you
@@fg9223 hi, find a good periodontist with a lot of experience. Mine has over 20 years. I did cleaning appts 4x a year in the beginning. I did bone grafting. I took my oral hygiene at home very seriously. It's been over 7/8 years and I've not had any issues. Nowadays, I reduced my cleanings to 3x a year.
I would like to see more video you implants and bone grafts so people understand it . Thank you so much
Is it possible to rebuild bone in patients with severe bone loss? :(
Thank you so very much for all the time you spend on these videos. They are so helpful and informative. I'm at the 6 month mark getting the second ct and hoping I have enough bone to move forward with implant and also hope my surgeon does an excellent job since it's a front tooth.
I wish I had known 4 years ago, what I know now, and am learning here ! The doctor should also offer and talk about the LANAPLser bone regrwoth proceddure: I have many implants and like to stop and prevent boneloss around them. DDS treating with LANAP laser often feature implant sites, where bone receded, and grows back with that technology. So please, dear Doc: would you consider adding that to your treatment plans, where appropriate?
Thanks for a very informative video. I wish I knew all this years ago. I'm a 71 year old woman and just had my second implant placed last week, by an oral surgeon. He extracted the lower left molar 6 months ago and did a bone graft. ( Both of my implants were due to old root canals that developed broken roots and infection.) This oral surgeon also recommended l-PRF platelet therapy, done at the time of extraction, so I got sold that, too, lol. I don't have any gum disease, and everything healed well, and the bone grafting worked fine. My question is really about my other, 15 year old implant, on the other side of my lower jaw. I noticed on the 3D x-ray that the bone on one side of my old implant was almost gone, going down vertically in a straight line. This implant, which was done by a good periodontist, got crowned by a (now deceased) dentist who gave me a too-small crown, resulting in food collecting down in the gum there at every meal. Eventually, the tooth next to it developed a cavity on the side next to this crown, and the regular dentist filled it in a way that lessened the space between the teeth, so less food gets trapped now. My oral surgeon didn't recommend doing anything to it right now, and the implant isn't bothering me otherwise. But I think I might get a crown from the oral surgeon on the new implant, just to be safe, instead of having a dentist do it. What do you think?
your dentist probably has more experience crowning implants than your surgeon. that's what i'd probably lean towards. of course every person is different with their experience levels
Dr you are awesome good and trueful thank you so much for your video.
I liked watching your video. It was very insightful. I would bet your money that you probably couldn’t fix my mouth but I don’t have any which is why my mouth is not been fixed. I went through several dentist over the years and some of them I’ve not returned to others I have, and they have given up on fixing my teeth, I would just like one time for an actual dentist to help me out. The main problem is like you said in this video the cost I do not have the money to fix my teeth and it’s embarrassing. I’ve been losing my teeth since I was 15 years old, I am now 35 and I still don’t have the finances to fix my teeth so for over 20 years I have not smiled confidently.
Can Allograph contain graphene oxide, if the cadaver it was harvested from had graphene oxide in them?
What are your thoughts on having the bone graph done at a college of dentistry?
thanks for this. my mother has 4 missing teeth and she was going to postpone any further procedures due to cost. now with youtube research like this, i'm organising for her to get some implants. learning more about bone resorption has helped me know that this is time sensitive and procedures need to be done asap.
28:47 I'm a little concerned about the length of time the sutures should stay in place. My dentist is planning on removing my stitches on the 10th of April, which is only 14 days from when they were put in place. Should I say something? I don't want to undermine his expertise. I assume everyone's situation is different, of course.
I've just underwent upper right sinus lift and 3 implants, to eventually support a 4 piece zirconia bridge.
The sinus lift intrinsically involves bone grafting.
No crestal or lateral augmentation were done.
The surgeon used a dissolvable suture, which is meant to go off in 2 weeks.
I wonder if a non-dissolvable suture should had been used instead.
Thank you.
Very informative video. Thanks for the great slides! I got a question.. So if recommended healing period for the bone graft before an implant can be placed in is 5-7 months, do you expect the patient not to chew on the op area during this whole time or just the few weeks post the bone graft op?
I don’t even want the all on4 now I am afraid I’m going to just waste the money. Any suggestions? I’m in New York.
I just had bone grafting done , 3 days ago and my periodontist place dissolvable sutures, and I think member as well. Of course, I didn’t know any better, it sucks. He suppose to be great perio…it took me a number of times to find someone I felt comfortable with and now I made another mistake, thousands down the drain again. I am so sick of this suffering. Working my ass if to come up with the money and then being taken😡
I did the same 2 days ago hoping things come out good 👍🏼
How can I make an appointment to see you.
Could you please show what snap on upper denture with chrome bar looks like and if this is preferable to normal plastic. Thanks kate
Quoted $17000 for 4 lower implants with bone implant which i will definitely eventually need because i have low ridge and as i age it will only get worse.Lowers are working now with soft re lines,cushion grip and adhesive I am able to talk and chew reasonable well with some modifications to how i bite and chew.
Hello Doctor, what is the likelihood of getting implant for two gaps if there is mild periodontal disease?
Wow, your video is awesome! I just wish I had watched it before getting my bone grafting done. Its seems like my dentist did a good job but I would have liked to ask him a lot more after watching this video. I had a root canal done about 15 years ago on an upper molar unfortunately over time a gap appeared on the side of the crown which allow food substance to penetrate later resulting on an absese. The tooth was removed, infection cleaned out and the gap fill with bone graft. I expect to get an implant in about six months from now. Is it advisable to get a second examination from a different dentist after work has been done?
19:02 The roots look like legs
🦵🦵
I wish you were close to Nashville Tn
what if you're just getting a tooth pulled (last tooth nearest an already pulled wisdom tooth), and you're not going to get an implant. is a bone graft necessary?
awesome content
Great informative video. Guess I'm leaning towards dentures now as my gum bone is very thin and deterioating. Osteoporosis
It's true people. Please go to a periodontist/implant specialist when it comes to implants. In my case, I needed gum grafting around my front implants that a "regular general" dentist could not perform.
I have a bone implant ( no implant ) done with general dentist. I had a complication with the bone graft. The general dentist referred me to oral surgeon to evaluate the bone graft and the reason the gums underneath is dark red and not healing well. The oral surgeon let me swish the Magic 4 like mouthwash. He said he can clean the bone graft. When he look at the xray , it looks like there are particles of the graft is trying to exit the gums and it is irritating my gums.
What type of allograft material do you recommend? Just saw a video about a patient died from TB meningitis from the bone graft material (ViBone or Elutia)
Just had my implant done 5 days ago seems like its ok, i wish i would have seen these videos first to be be ready
Your video series is very well put together and I'm so lucky to have found it to be during my research stage of restoring my smile.
As I hinted on the previous two videos I am going through a complete restoration and getting three dental implants although I trust my dentist very much and I believe he's the best I could find on island I am still looking for a second opinion and I believe you are the best candidate. I would like to set an appointment to come in for a consultation in the near future.
I would like to call and set the appointment and possibly get any information that you would require to make the best possible assessment.
Mahalo Nui Loa for your time,
Metaverze Agent
Thanks 4 the valuable infomation!
I really enjoyed this video content. It is very informative. I recently had my front left tooth extracted due to a failed older root canal and a bone graft procedure placed by a local oral surgeon. It has been close to 5 months now, and I am really concerned about the way the gum in that area looks. Although I do not smile with my gums, there is an indention in front where the tooth was extracted. I have been back to the oral surgeon and he has said everything looks good. I will be going back in October for another visit and for consultation on the abutment and implant placement. Can you please make a video about the gum and distortion around it when the tooth is extracted and what is done to fix that area? Is this another procedure and does it cost more or is this a part of the implant procedure?
Thank you for this very informative video!!!
This is a very extensive video about dental bone grafting and very well done, It is nice of you to give these technical details, almost a Dental implant course, I had #14 tooth extracted and filled with bone graft, and this is week 3, at what point oral surgeon take an Xray to check on bone graft progress?
Hi Dr Choi, do you work with zirconia implants and could we possibly get your expert opinion on the pros and cons of the material versus the tried and tested titanium alloy?
great education
Thanks for the videos!
So small bone graft for the front teeth, is it better to be done at the same time as the teeth extraction, or at the time of the implant?
Thank you.
For patients that may have 1 wall versus 2 or 3 what would the recommended option be for them? Would it still be a bone graft?
My question is ,what is basically the difference between a bone graft and sinus lift. Thank you. GREETINGS from a former Clevelander living in Germany .
OUTSTANDING VIDEO SIR! Very much appreciate the breakdown and explanation. I am in Southern California and had recommendations to head across the border to Mexico for more cost effective. Do you have any opinion on the quality of work or have patient experience with similar? Also on side note, I just sent your video to my cousin living in Texas and hopefully he may be able to utilize your services. I am sorry I am so far - but again thank for the video / post!
Hi Dr Choi, I've heard the swiss implants are superior to other types, in your experience have you found this to be true?
What are the codes for this bone graph that you mentioned?
Great deep dive! 👏🏻👏🏻🙏🏻
My question is hard to find info about. Re tooth #2, I have a cross bite. My oral surgeon says (summary) he'd index and use some kind of angle abutment, which would be some form of compromise regarding strength I know the details matter, but do you see this much? How successful is this overall?
Thak you so much for the detailed explanation
I wish I could get snap on denture’s but can’t afford them since I live off ssi retirement
All 28 teeth extracted , every extraction will have bone graph performed. 1 extraction site will require a bone graph to repair from a broken tooth with an infection that would require root canal. Iv sedation, 2 sets of temp arches, and 1 final Zirconia set arches 6 months until permanent bridges. Quote: $38,000
Do you think this seems like a reasonable price to pay for this procedure?
Dr. Who is performing the surgery owns dental implant institute that teaches Dentist how to perform Implant surgeries so i have confidence in who i picked to move forward with.
Would really appreciate your professional opinion and maybe a suggestion of really important questions or question that needs to be asked. Thank you and your videos are very helpful. I would definitely say you sit well within the top 3 Doctors doing content like this!
My recommendation would be to see multiple periodontists and or oral & maxillofacial surgeons for multiple consultations...if you have done this already, then great, you made an informed decision....if not, what is your reference point for gauging if this implant specialist is the right specialist to drop $38k on....btw,DO NOT use a dentist for dental implants....have it done by a periodontist or oral surgeon
What would you charge for molar #30 I just had extraction and bone graft I had plenty of bone but added it for extra support. I had a massive infection and abscess failed Endo one year after a root canal. I am in Cleveland Ohio and prices are very high here best price I see is $3500. Why is it so many places say you have to pay just to get evaluation ? Why when you have CBCT and you know what you need you can’t get upfront price and come in when it’s ready . This is my first socket preservation it was extremely painful 5 stitches (5 days of hell). I hope the actual implant isn’t as painful . Bottom Molar I would love to have you do my dental implant it’s hard to find an expert that knows what they are doing. I have extreme dental phobia PTSD for dental stuff. I also would like to have Zirconia not cheap porcelain and why can’t you buy Solid Gold? Many dentist I have seen refuse to do metal when statistics say that gold lasts 50 years vs 5-20 years with ceramic or porcelain. I got human cadiver bone for my socket preservation. I’m scared of someone drilling to deep and causing me a pinch of pain or using to thick of implant post . So right now I’m on day 5 so I have 4+ months before I could even start this . Bone graft was not terribly expensive mine was $550 with the extraction. Now the implant is $3500-4500 is the best I’m getting here. Sorry for the long rant but implant has been my worst fear ever in dentistry because of Post Op Pain and Long Recovery and messing with my Jaw
My friend has two dental implant single and is giving her problems and wanted it remove. She said the costs per removal of implant is approximately $2,500 each. Please people research first before undergoing implant.
Could I sue my periodontist she never told me the ramifications of the graft. She removed way too much gum tissue. Left me bad black triangles.
@StraightLooie95 What happen to the bone graft and your gums ? What is black triangle ? I got my bone graft from a general dentist and i want it remove because the
underneath of the gums where the membrane was placed is still dark red and looks raw.
@@gratitudetouniverse777 Well unfortunately I had an inexperienced untrained periodontist Dr. Ida Zarrabi. A black triangle is what’s supposed to be the slither of gum tissue in between your teeth. It kind of looks like gap but the bottom half of teeth still collide. It looks scary and ugly. It happened during my orthodontic treatment I was referred to Pacific Northwest Periodontics to schedule a bone graft for my loose upper left canine. I met with Dr. Zarrabi and she explained the procedure of the bone graft. She also mentioned that she wanted to clean the surface of the tooth so it can adhere to the gums better. I agreed to this surgery in hopes of saving my tooth but was very unaware of the potential risks, ramifications, or materials. I did research before my surgery and I could not find an example where a person had a mildly loose tooth got a bone graft and they were good as new. Anything I looked up that had anything to do with a bone graft usually had AN IMPLANT coming right after it NOT THERE SAME TOOTH! I was adamant that I wanted to keep my original tooth even though it was slightly loose. This was frustrating to my orthodontist at the time Dr. Angolkar. They just wanted to end the 3yr. treatment and had felt that I was prolonging it. Even though they were planning on giving me a fixed retainer which would have EASILY could have took care of my slightly loose tooth at the time. Had I’d known what a fixed retainer was during my treatment. She told me that this surgery will work. Even though this seemed very UNPRECEDENTED to me (especially when you do the research.) I put my TRUST in the periodontist and went on with the surgery. Before the surgery I asked her what she would using for the graft material. I thought it would be animal bone. No she said it is HUMAN CADAVER. Not knowing the neurological effects from human consumption. I was very dubious but decided to leave it to the professionals which in turned would be the VERY WORST mistake I will ever make. She drilled two holes into my gums then took a scaler and scraped an extremely deep line down behind my tooth. Resulting in a cavity that she did not inform me until I discovered it and it showed her. Surprisingly she denied any wrongdoings and I had to fix it on my own costs. The surgery had horrible results. I came in with just a slightly loose tooth. I still had braces on so she almost severed my tooth out. She couldn’t because it was connected to wires. But that didn’t stop her from REMOVING A 1/4 OF GUM TISSUE from the left corner of the roof of my mouth. With the unknowingly removal of my gums this left my tooth FAR MORE LOOSER than it was. I can’t even clinch without my mouth without my canine scraping or hitting my lower canine. I push my jaw back to try to avoid scratching my teeth. All of my FACIAL MUSCLES have deteriorated I now look like a skeleton. I get comments about my appearance every single day I wake up! All from an unnecessary and unprecedented procedure. FYI just because someone says they’re a doctor should NEVER grant them your 100% trust.
Dr Choi, can two implants that are healthy, be incorporated in a zirconia all on 4 upper arch? It seems crazy to toss them. They are solid .
Great job
Thank you very informative
My 4th tooth back is an infected root canal. I want it gone, I don’t want an implant, I can’t afford one. My dentist is still recommending a bone graft, do I need a bone graft if I’m not having an implant?
Why is it infected??
You are such definitely above the rest of dentists, very excellent spirit. I wish I can give this video a hundred likes!!! Do you think women tend to have less bone than men, maybe also less dense than men?
If after a bone graft there are no follow up X-rays before the implant, is that concerning?
Whay yiu can not doing bone graft after implant done? Any fiziologic reasion?
How long after the bone grafting can wear a temporary denture?
that must be a relief
Why I never see some videos from your treatment
Prior proper planning prevents piss poor performance
Happy ⚖️ Friday..thanks a lot...Remembering..another Big Hospital's in New-York city "wood hall "...so are you satisfied?!
Is inflammation normal after a month of bone grafting .
Interesting my dentist did dissolvable sutures and a dissolvable membrane on socket preservation. I hope it works I had them do X-ray and can still see it on day 4 how long until I’m in the safe period I gave all 4 walls and thick bone type ?
Thank you sir
Hey Dr. Choi, what are your thoughts on some of these new synthetic type grafts that are being sold as usable for a buccal defect graft without a membrane like Osteogen Tape or Ossix Volumax? Are there situations you would considering using them, or are they so far from traditional materials that they wouldn't be worth considering in your practice?
good question. havent used them. a lot of times i see products being marketed as the next best thing but frankly with good technique, you can get amazing results.
@@northtexasdentalsurgerywhat kind of grafts do you use ?
Do you know of someone in my area that holds to the same quality you do? I'm in Bakersfield California. Would appreciate it. There are so many speedy implant places here. I dont know how they can do same day implants without all the proper healing time. Much appreciated!😊
Heard horror stories about bone graphs from cadavers (disease like TB).
Dr im told i lost 100% of my upper front bone and theres no bone there to graft to? What should i do?
Great information from a true professional, can you recommend a qualified periodontist certified in Virginia Beach, Virginia or provide your office info to contact you, thank you for providing these informative videos
hi! I had a dental implant installed on my front tooth without a bone grafting, do you think it would be possible to remove the implant and redo the whole procedure properly since the implant (grey area) is very much visible?
What if I already have a set of dentures Would the device be used to cover the area of bone graft?
Ja ik droom van mijn tanden te herstellen daar ik ongeval op 16 jaar had en nu zijn mijn tanden gebroken ik heb een vurg probleem met gewone tanden dus ik heb nooit aan inplanting maar ja de prijs zal weer heel deur zijn 😢
My front tooth needs extracting it's loose, I've lost bone and have gum recession due to periodontal disease. My dentist has told me I can't have a bone graft at time of tooth extraction because he wants infection to clear up before he does bone graft. He's worried the graft will fail. Is he right?
I'm going through this at the moment and this advice is exactly what my periodontist gave me. He is very reputable so I'm definitely following his procedural advice.
Do you not use Infuse?
getting dental implant on My right molars , been taking ppi's for the last 4 years dentist suggesting bone grafting dont know if my implant will work......
I’m watching this while trying to make a decision on having permanent implants installed, on my upper jaw line only. I was told by two other dentistries that I didn’t have enough bone for permanent implants. Or I wasn’t a candidate without a few precautions. However, I recently visited another dentistry and was told they could complete the procedure. He stated he could place an implant(s) at an angle in order to avoid bone grafting. Listening to you now, his actions sounds very suspicious. I do not want any future complications. I just want to be able to enjoy eating and not shy away from smiling. 😢
Had tooth 27 extraction, dentist filled socket with bone graft. He did not tell me what kind. I have Alpha-gal, so cannot have mammal sourced stitches. He had no nonresorbable synthetic stitches and sent me home with only an immediate denture over my "bone graft" ...no membrane, no sutures. On week post extraction and graft material is very exposed, gum is loose around socket. I am counting on my body's ability to heal.
I would only trust a periodontist to place my implants! 😁
Why?
@@TeeTee-zm2rebecause they specialize in such
And just because they are specialized in this field doesn't mean they are great at their job, either. Besides looking at the specialized dentistry, you need to research that doctor, too! Don't assume anything.
It can have a impact on your pocket book to
I have #3 tooth, a old root canal with slight infection. My Endontist quoted me $10,000.
No insurance. And that's is there aren't any major complications along the way cause the path to getting that final crown is a long one.
Is it possible to have an AO4 (with 4 Titanium Posts) and have 14Teeth on the Upper and Lower Arches vs 12?
I know I need to Bone Dance up on my uppers I need a good dentist would do it or you could do it
Hay dos tipos de huesos no es uno solo, ahora hay dientes inmediatamente colocados, muy finos que lo colocan el mis
No dia
@Dr. Choi I actually live in Texas and relatively close to your office. I am missing 4 of my teeth.
All Of the teeth that are gone or missing every ounce of bone. I got shot in 2019 of May and had to have jaw reconstruction surgery. I have 2 metal plates in my lower jaw. I refuse to get anything else but an autograft I don't feel comfortable putting anything else in my mouth besides my own bone. I have done a lot of research over the you seem really smart and know what you're talking about. So I hope you can respond to this. Comment last four and a half years of my life have been really tough and I really wanted to know if If you're able to do an autograph, I've seen 7 oral surgeons that say I need it. Please please let me know if you're able to do that. Type of procedure and I will book an appointment to get a 3D X-ray done so you can see for yourself. But if you can't do that procedure , i'm just gonna have to see somebody else but I would really like it if I saw you so hopefully you , can I hope I get an answer from yeah , thanks for all the videos , doctor choi
How long after bone graft can someone wear temp dentures?
Ça n'est pas remboursé dommage avec une bonne mutuelle en plus les dents nous en avins besoin c'est essentiel