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  • Tough tough overall case. Patient is a 15yo female with aggressive perio. Cases like this take careful planning and consideration because youre trying to plan for the next 60+ years.

    I’m partnering with a prosthodontist for this case and we have a tentative tx plan but I’d love to hear outside opinions!

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    Nolan, 87madrigal and 4 others
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    • I simply refuse to believe they are 15 🙁 that’s so sad!

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    • That is so tough! Definitely not your run-of-the-mill case! I would love for you to share some of the options we should be considering here.

      Specifically your thoughts on implants in a person so young!

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    • Reply to #10 implant site

      You’re on the right track with your planning. Prioritizing at least 1.5mm of buccal bone is crucial, and having over 2mm in the incisal 4mm is definitely a positive. As for the thinner palatal bone, you’re right that the thicker palatal tissue and improved blood supply can compensate to some extent.

      However, when palatal bone starts getting…

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      Jedediah and Ivan
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      Ivan replied to the discussion #10 implant site in the forum Implant Tx Planning a year ago

      a year ago

    • Reply to #10 implant site

      You are totally right that palatal bone is less likely to get resorption or peri-implantitis and that most problems occur on the buccal. However, as a periodontist I often get cases sent to me where they went too palatal and now there’s no palatal support for the implant. 1.5-2mm buccal and palatal is a recipe for success in my book.

      drcajee and Jedediah
    • Profile photo of Dr.

      Dr. started the discussion #10 implant site in the forum Implant Tx Planning a year ago

      a year ago

      #10 implant site

      #10 is planned for a 3.2x10mm implant. The socket was grafted about 4 months prior to the CBCT. I skewed it more towards the palate to ensure the 1.5mm buccal bone (which I believe is more important to have that thickness on buccal rather than the palate). I do have 2+mm buccal bone in the incisal 4mm of the implant. My concern still is…

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      Jedediah and Ivan
    • Hey Guys. I have an immediate implant for site #7 with a signif PARL, prob cystic. pt has no significant reported med hx. As this case approaches im asking myself weather physical debridments and pre/post op abx are enough to prevent infection/early failure. Thankfully in general after 8 years of placing implants ive only had a few of…

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      Jedediah, jostanger and Ivan
      5 Comments
      • Because CHX can inhibit fibroblasts and osteoblasts I’m always wary of using it in these cases. I go the systemic abx route.

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      • I find peridex to be highly effective in infected extraction sites and use it regularly with great success of many immediate implants. I don’t find the negative effects to be clinically significant b/c the site to continually bleeding. I don’t use it for healing post op and many other situations but after extracting infected teeth and those…

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      • Profile photo of Ivan

        Ivan posted an update a year ago

        a year ago

        🚀 Motivation Monday 🚀

        ⭐️ What is a routine, ritual, or habit that has helped you to be your best self lately?

        Jedediah and 87madrigal
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        • I’ll go first. Switching away from coffee to matcha has been a game changer for me. Also running at least 1 mile every day has helped me stay on track in terms of mindset.

          For some reason after turning 35, I had to develop some new routines and rituals to be my best self. Maybe it’s due to parenthood, or maybe I’m gettin old haha 😅 (I’m 37 now)

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        • I have found yoga helps my back to stay loose. I do not do anything else. I feel they have me running around the office so much I get a good cardio workout most days. 😂

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      • Profile photo of Ivan

        Ivan posted an update a year ago

        a year ago (edited)

        Whats up yall. Lets get to know eachother!

        Share what your plans are for this weekend! Big plans, small plans, or even no plans! 👇🏼

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        • I’ll go first, first stopping by the vet to get these guys their shots. They’re only 3 months but soon they’ll be absolutely massive. Got them so they can protect our property from coyotes and mountain lions!🐶

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          • Working on giving my website a facelift. 😬

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        • Profile photo of Ivan

          Ivan posted an update a year ago

          a year ago (edited)

          Break in at our practice today 🤦🏻‍♂️ our new practice is still under construction so luckily no dental equipment was stolen. They stole tools and a compressor.

          Have you guys had any vandalism in your practices? What do you do for prevention?

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          Jedediah
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          • Boss I don’t know the prices for such services in Cali for you, but for us if the practice is relatively not small and can afford it – we just hire night shift guards and we sleep well knowing there’s a dude guarding the practice with a licensed gun that’s ready to fire some bullets if need be.

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          • That sucks I’m sorry to hear that. Hope your day gets better.

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        • Not the best outcome… dont really know why. So I completed this implant with sinus bump using the Densah system about a month ago. Everything went pretty straightforward. Got my little lift and placed the implant with great (maybe too great) insertion torque it measured out at about 60ish but i remember wanting the implant just a little more…

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          Jedediah, Ivan and Erick
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          • What size was the implant?

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            • And what was the torque when it went in? Randon stuff happens but I’d graft and come back in after a few months. Keep 1.5 mm around the implant with good irrigation

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