Dr. Joseph D. Chipriano, Jr., DMD, MAGD, FICOI, MIDIA

Computer guided implant placement surgery

With the advent of 3D imaging technology and surgical armamentaria and technique, our practice provides dental implant placement surgery. Dr. Chipriano uses the principle of computer guided implant surgery, also referred to as digitally navigated implant surgery.

Based mainly on patient demand, Dr. Chipriano invested significantly in nationally and internationally in dental continuing education implantology programs.

Within his dental implants surgery repertoire, Dr. Chipriano has been recognized with several fellowship and mastership awards within implant dentistry. The award criteria are centered on implant specific patient case presentations as well as continuing dental education credit hours specifically designated in the area of implant dentistry.

In 2015, he received fellowships with the International Congress of Oral Implantologists (FICOI) and The International Dental Implant Association (FIDIA). In 2017, he was elevated to mastership the status with the International Dental Implant Association (MIDIA).

In addition, to develop a precise implant surgical and restorative treatment plan and protocol, our 3D CBCT Imaging Technology offers patients a safe, predictable, and minimally invasive surgery. This is consistently followed by a comfortable and speedy postoperative recovery. To view our 3D CBCT Imaging capabilities, click this link.

Once a treatment plan is devised, a precise surgical guide is fabricated for the implant placement surgery.

Prior to the surgery appointment, the angular path of placement as well as the size(length and diameter) of implants are pre-determined from 3D CBCT scan analysis. This provides for greater predictability in avoiding anatomic structures(sinus cavity and nerves) as well as throughout evaluation of bone availability to allow for implant placement in optimum position and locations.

Four months following implant placement surgery, healing copings are placed to allow for a smooth transition from implant site to gum relationship to prosthesis(Crown, bridge, or implant supported denture).

The final prosthesis can then be constructed to allow the patient to regain aesthetics and function.

Because dental implants are often not covered by insurance, we do our best to make this treatment financially possible for our patients. We offer payment by cash, check, or credit card. In addition, third party financing through Care Credit. Through Care Credit, We offer 12 or 18 months no interest financing options available. These arrangements have been provided on behalf of our patients to prevent the best possible treatment from becoming cost prohibitive.

3D CBCT Imaging

Our practice utilizes state of the art imaging technology to help Dr. Chipriano diagnose potential issues more accurately and provide treatment with unprecedented confidence and precision. This innovative technology is of particular interest in the treatment planning and surgical placement of dental implants.

From the initial 3D image, a thorough treatment plan is established and a surgical guide is fabricated in order to allow for a minimally invasive, conservative, and predictable implant surgery. Click here to view our Computer Guided Implant Placement Surgery.

Our 3D CBCT system allows for precise, crystal clear digital images accompanied by minimal exposure to radiation. We have the ability to control our field of view or scanning area to allow for focusing on broad or specific areas of interest.

Hard Tissue Grafting (Socket or Ridge Preservation)

Following the extraction of a tooth, the remaining adjacent bone will shrink in width as well as the depth. Grafting is performed In order to maintain adequate bone levels for the adjacent surrounding teeth as well as to preserve ridge support to better support dentures or a dental implant.

Socket/ridge preservation procedures will allow for bone to be preserved and regenerated in order to facilitate the placement of dental implants. If the patient is remotely interested in restoring a tooth(or teeth) with dental implants, hard tissue grafting is strongly recommended at the time of extraction(s). If bone support is lost with resorption following extractions, a patient may no longer be a candidate for dental implants.

Digital Radiography

It is not only important to us to provide an exceptional level of care, but we strive to promote patient education and awareness as well. Digital X-rays provide reduced exposure to radiation, less waiting time, shorter appointments, involvement in co-diagnosis, and better understanding of treatment. Digital X-rays are also environmentally friendly. Our office has chair mounted 17" LCD Televisions which allow for images to be clearly displayed and reviewed. The impact is tremendous when a patient has the ability to see what has been occurring dentally as well as what has been done to address it.

Logicon Caries Detection Software

It is our goal to provide conservative and appropriate treatment to all of our patients. In some cases, cavities can be deceiving. We do not want for decay to go unmonitored, undiagnosed, or untreated, so Logicon Caries Detection Software was integrated into our digital x-ray imaging software to provide an electronic second opinion. If decay does not penetrate through the harder enamel surface of a tooth, it is monitored and attempts to remineralize through fluoride is recommended. By using Logicon, we try our best to treat areas of decay which deserve treatment (while they are smaller) and also closely monitor those areas which do not require treatment.

Intraoral Camera

We are pleased to announce that our practice has invested in the state-of-the-art CS 1500 intraoral video camera – the latest word in intraoral imaging technology. This innovative camera is the ideal tool for any oral health practitioner. It offers a superior level of image quality, allowing Dr. Chipriano to capture the perfect shot easily and quickly. The camera allows Dr. Chipriano to easier communicate treatment options to the patients, as well as share images with referring practitioners.

Seeing the clearest possible images helps Dr. Chipriano diagnose and treat patients effectively. Having highly detailed images helps Dr. Chipriano provide quicker and more accurate diagnoses, improved treatment planning and better patient care. The precise level of anatomical detail is essential in determining the best method of treatment.

Benefits include:
    •High-resolution images - Dr. Chipriano can view your teeth more clearly
    •Wi-Fi connectivity - freedom of movement and better service
   •Improved patient care - Dr. Chipriano can perform a wide range of diagnoses, helping you reduce multiple office visits, therefore saving you time and money

We are here to provide you with superb oral care, every time. If you have any questions regarding our technologies, feel free to ask Dr. Chipriano

Root Canal Treatment

Through the use of rotary endodontics (machine driven instruments to remove problematic nerve tissue from the tooth), computerized measuring devices, and digital x-rays, many root canals can be preformed in one visit, often requiring less than an hour's time. Often in about an hour, a tooth can be treated with root canal therapy and restored with a post and core buildup. Variables include: complexity of the root canal, extent of inflammation or infection, and severity of restorative procedures necessary. By the utilization of warm root canal filling materials, the once problematic nerve canal space is sealed air-tight dramatically reducing chances of re-infection. Root canal treatment by this technique boasts success rates over 90%!

Our office utilizes tooth colored fillings as an alternative to metal fillings. This allows for a more attractive, natural, and healthy smile. These materials are known to be very safe and they precisely matched to the natural color of the enamel. This material is extremely popular among our patients and is almost always requested! Composite fillings allow for dentistry to be secretive. Placement of white fillings or removal of defective silver fillings can provide a patient with a pleasing and natural, healthy smile.

In addition to esthetics alone, patients benefit from composite dentistry by the property of bonding to natural tooth structure. This allows for tooth preparation to be generally more conservative than needed for silver fillings. High bond strengths replace unnecessary removal of tooth structure for retention. All of these factors make a tooth with a white filling less likely to fracture than a silver filling, avoiding more extensive and costly dental care.

White fillings can be utilized to restore the presence of decay, broken teeth, leaking fillings, tooth wear from over aggressive tooth brushing (abrasion), or tooth wear from clenching or grinding (attrition).

Dental bondings utilize composite filling materials to improve the appearance of teeth affected by minor spacing, chips, cracks, or discoloration. Bonding is of lesser expense in comparison to other cosmetic services such as crowns, but usually will not have comparable longevity. Bonding is a relatively quick procedure, often accomplished in a single appointment, depending on the number of teeth involved. Bonding is also a conservative process, often requiring little removal of existing tooth structure. If large areas of white decalcified or brown hypocalcified tooth structure are present, or if stains cannot be masked or removed by professional whitening, more tooth structure may need to be removed to reestablish a natural appearance. A wide array of shades are available to match virtually any tooth precisely.

After tooth bondings have been completed, it is very important to avoid parafunctional habits such as nail biting or placing foreign objects between the teeth. If unnecessary stresses or repetitive everyday function over a period of years may result in wear or fracture of bondings, requiring treatment to be redone.

A veneer is a very thin layer of ceramic that is added to the surface of a patient's front tooth. The need and degree of reduction of tooth structure vary from one patient to another. Through the use of digital scanning and milling technology, IPS e.max veneers are made from a single piece of porcelain called lithium disilicate. This material allows for optimal translucency, optical properties, and superb esthetics. This provides for our practice to precisely match tooth color, size, and anatomic form. A smile portfolio is available for our patients to view in smile design planning. This allows for patient interaction and smile design input in creating the smile of their dreams.

Crowns

Crowns can provide many benefits in restoring a tooth. When a tooth becomes over filled, the chances of the tooth irreparably breaking becomes significantly higher.

In this case, simple restorative care is no longer feasible or predictability is questionable. Only so much filling will fit inside a tooth before a crown needs to be made to fit over and around the entire tooth. Crowns are almost always necessary following a root canal to restore form and function and prevent breakage. Crowns also restore teeth which are misshaped, discolored, or badly worn. If a previously placed crown is mismatched in color, broken, or if excessive change has occurred where the crown and gums meet, an esthetic crown mimicking a natural tooth would be an appropriate treatment.

E.max Metal Free Crowns and Bridges

Metal-Free All-Ceramic Crowns

With IPS.emax lithium disilicate glass ceramics, dentistry has been revolutionized. With our practice utilizing new fabrication technologies, crowns have surpassed the durability and strength of preceding generations of metal free crowns. In addition, with enhanced optical properties, translucency, and light diffusion, a truly beautiful and natural restoration is available for our patients. E.max is the #1 all-ceramic restoration used today. E.max has more than 10 years of clinical evidence with a 98.2% success rate.

Bridges

Bridges can replace one or more missing teeth and can be supported by natural teeth or dental implants. This treatment is non-removable and is fabricated to restore function and provide a natural appearance. Teeth and the bite can be stabilized by bridgework, thus preventing the shifting of teeth.

In addition to regular brushing and flossing, special home care is required with bridgework supported by natural teeth. The use of floss threaders is absolutely necessary to clean underneath the bridge and prevent cavities from forming on the teeth supporting the bridge.

Mini Implants are a great service for patients who have difficulty in wearing and/or functioning with full dentures, especially lower dentures. Advantages of mini implants include a lesser invasive surgical procedure and reduced treatment costs as compared to conventional dental implants.

Titanium implants are placed into the jawbone and allowed to heal. These implants have ball shaped head attachments which protrude from the gum tissue. Metal housings are then incorporated and processed into a denture along with a rubber o-ring. This assembly provides exceptional retention and in many cases the denture snaps down over the mini implants and attaches tightly to them. This allows for increased functionality and comfort while minimizing the need for messy adhesive products.

When someone experiences severe pain in a tooth it is often nerve related. A root canal is a procedure which can be done to save the tooth and eventually restore the tooth to its natural appearance and function. Damage to the nerve of the tooth can result from: heavily/deeply restored teeth, restored teeth with abnormally large nerves, infected, inflamed, swollen, broken, chipped, and traumatized teeth. The majority of our patients comment that the procedure is painless, and the hardest part is keeping their mouth open for a little while.

Because Dr. Chipriano was aware that no endodontists (root canal specialists) were closer than 40 miles from his hometown of Pottsville, he was motivated to become proficient at root canal therapy so his patients did not have to travel out of the area for treatment unless necessary. Thanks to invaluable experience gained during his General Practice Dental Residency at Abington Memorial Hospital, Dr. Chipriano gained a wealth of knowledge and experience in the area of root canal therapy.

Often in an hour, a tooth can be root canal treated and restored with a post and core buildup. Variables include: complexity of the root canal, extent of inflammation or infection, and severity of restorative need. With the technique utilized, success rates are well over 90%!

Upon completion of root canal therapy, the tooth will need to be resorted adequately with a post and core buildup and crown to property restore the tooth into function and make the tooth look natural and untouched again.

If a tooth is broken or decayed, Dr. Chipriano will try to save the tooth with a root canal, filling, or crown if restorable. If the damage is too severe and there is no other option, an extraction becomes the treatment of last resort.

Although Dr. Chipriano has gained additional surgical training in his residency program, he is not an oral surgeon. There are some teeth that may need to be referred to an oral surgeon for treatment. Factors include: difficult tooth positioning, impacted teeth, teeth close to sinuses or nerves, insufficient tooth structure remaining, and excessively long or curved roots.

If Dr. Chipriano decides to refer a patient to an oral surgeon, he respects the patient enough to be honest with them and admit that the specialist has a higher level of experience to manage the situation better.

Professional dental cleanings are essential to promote and maintain oral health. Even those who practice meticulous brushing and flossing daily, there is NO way possible to remove all of the deposits which form on teeth between cleaning visits. This is why current standards of dental care recommend having two dental cleanings per year. Personal and professional dental hygienists will provide gentle and thorough care in our office.

At the cleaning appointment, health of the teeth and integrity of any existing fillings are checked. An extremely thorough head and neck examination/oral cancel screening is performed as well. Health of the gums and supporting structures of the teeth are examined. In patients with healthy gums, cleanings biannually are suggested. If patients have conditions where advanced bone loss around the teeth has occurred, additional treatment for periodontal disease may become necessary. This may involve a maintenance cleaning every three to four months in order to professionally treat compromised areas unable to be reached or maintained despite one's best effort. In some instances, a periodontist (gum specialist) is required to treat a patient's needs in cases of moderate to severe periodontal disease.

It is at the cleaning appointment when routine dental x-rays are performed. Modern dentistry promotes prevention, early detection, and conservative treatment. Our practice emphasizes this as our vision in taking care of you. Without taking the proper dental x-rays at appropriate time intervals, we would be incapable of providing appropriate and necessary care. Once cavities become large enough to visibly recognize as holes in teeth or pain, treatment needs have already progressed to move involved treatment.

Head and Neck Examination: A Personal Experience

My reason for performing an oral cancer screening and head neck examination is very personal to me. I was serving as a dental resident at Abington Memorial Hospital and it was my first few months in practice. A patient had come to the clinic for pain in a broken tooth. Upon examining the patient, I had noticed a white irregular spot under the patients tongue. My mind began to race about how to tell this patient this probably is cancerous. Because I was very green at the time, I called the attending doctor to take a look and then we stepped away privately. Before I could ask my attending "how do you tell someone that you may have just identified oral cancer", he said to me, "Do you realize that if this patient didn't come in here with this toothache and you did not discover that white spot, it may not have ever been diagnosed?" As a result, the patient had undergone appropriate treatment for having the cancerous lesions removed completely and treated and last I had been told, was doing well.

I learned a lot through that experience. At an early point in my career, I realized that if you don't look, you will never find anything. This is why at regular cleaning appointments, I examine the glandular areas of a patient's head, face, and neck. I also thoroughly examine the tongue, cheeks, lips, and gums. I hear all too often, "I was wondering what you were feeling for", "This is my favorite part of coming in", and "I never had that done before. Thank you very much".

In our practice I remember in aiding in the diagnosis of a four your child with mononucleosis, parotid gland tumor, thyroid nodules and tumors, sebaceous cysts, basal cell carcinoma, and sublingual carcinoma-in-situ. This examination is a service included with a comprehensive or periodic dental examination because I feel so strong about providing it.

Dentures are an extraordinary way to reshape and reestablish one's face and smile by either restoring missing teeth. All of our dentures are custom made to fit each patient's dental and facial proportions. We receive so many compliments on how natural our dentures look, fit, and feel.

If a patient has, any teeth requiring extraction due to either extensive decay or periodontal disease, there are two options in the denture fabrication process. These include conventional and immediate dentures. A conventional denture is the preferred treatment route. This allows for a patient to have the necessary teeth extracted and heal post-surgically for a period of 6-8 weeks prior to the initiation of making dentures. This allows for the gums to resorb and shrink enough that the fit of the denture(s) will be much more predictable. In addition, during the sequence of denture fabrication, there is the ability to try in a wax-tooth setup. This allows for denture measurements to be reviewed and verified to the patient's satisfaction BEFORE the patient receives the dentures. Although post insertion adjustments are almost always necessary, there is considerably less need for adjusting in making a conventional denture. The disadvantage to this treatment is that while healing and denture fabrication take place, a patient is without teeth unless they have a set of dentures they had previously worn.

Denture fabricated by conventional means

In immediate denture fabrication, impressions are taken prior to extractions and the denture is fabricated. Immediately following surgery, this denture is inserted directly into the patient's mouth. The advantage to this treatment is that the patient does not have any time without teeth. Because the gums will shrink significantly, there is an increased need for post-insertion adjustments. Soreness is commonly experienced once the fit of the denture becomes looser due to gum shrinkage. Because of this, there is almost always a need for relining an immediate denture at least 6 months after its delivery. This involves refitting and remaking the inner aspect of the denture so that it may fit where the gums have shrunken and resorbed. Additional fees are involved in reline procedures. There is also a period of a day and half where the denture is sent to the laboratory. So, for a short time the patient is without teeth. In addition, there is NO way to have a wax try-in to check measurements and tooth positioning in immediate denture fabrication. This is because the denture cannot be tried in until the time of insertion immediately following extraction of the teeth. This limits or reduces predictability in comparison to fabricating a conventional denture.

A dental sealant is a white, flowable material which is applied to deep grooves on the chewing surfaces of posterior teeth. This material "seals" the deep groove system on the chewing surface of the tooth. It is an extremely beneficial measure to protect the tooth from decay in a very cavity prone area.

It isn't right to judge a book by its cover, but your smile says a lot about you. Your smile shows how you present yourself to the world in making a first impression. Whitening can make you feel great about how you look, and make you want to smile more. Whitening is one of the most popular cosmetic dental procedures currently available.

The most effective whitening procedure our office utilizes is custom made whitening trays to be used in the privacy of your own home when your schedule permits. By taking impressions of your top and bottom teeth, custom whitening trays are fabricated and prescription strength whitening gel is dispensed. With the whitening kit, easy step by step instructions are reviewed and in about a period of one week patients can see a remarkable difference in their smiles becoming lighter. After the desired result has been achieved, a touch-up application can be done as needed. This need may vary from once every few weeks to once every few months, depending on one's habits such as smoking, tea, coffee, wine, etc. consumption.

Unless major dental treatment has been performed after custom trays for whitening have been made, they are often reusable for extended periods of time. Whitening gel refill tubes are able to be purchased as needed at our office.

A dental emergency will never happen at a good time. Thankfully, Dr. Chipriano has experienced and successfully treated dental trauma during his general practice dental residency program at Abington Memorial Hospital. Covering trauma call for the hospital at the time of his residency allowed him to treat chipped teeth, teeth knocked loose, teeth knocked out, and displaced and mal-positioned teeth.

We love children at our office! All of us have children of our own. It means the world to us that you trust us enough to allow us to treat your child. Our goal is to teach children that our office is a warm, caring, and COOL place! Oh yeah, and dentistry can be FUN! As parents and a father of three, we also understand that each child is different. We try to provide care in a non-intrusive manner where trust is gained through a gradual process. If a child has reached his/her limit, we try not to push beyond that because one experience is not worth developing lifelong dread or fears of dentistry. If a child has had experiences which were not very positive or if cooperation is an issue, a referral to a pediatric dental specialist may become a necessary option for a child until they are ready to allow us to treat them willingly. It makes our day when a first visit ends in smiles, hi-fives, hugs, and "that was easy, Dr. Chip!"