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Overwhelming case!!!
New patient exam. 62 yo female no remarkable medical history.
Patient’s CC: “My top teeth are failing, I want to fix them but I want something that is not removable”
Maxillary arch: 5 implants – 3 restored
Mandibular arch: Kennedy class 2, severe anterior attrition
Implants were placed by a periodontist.
Maxillary teeth…
Jedediah, Nolan and Ivan8 CommentsView more comments-
Wow, this looks like a challenging case!
Definitely needs a full mouth restoration and getting back that lost vertical dimension. How did the patient feel about going for a full arch prosthesis on the maxilla?
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This one is very tough, but also a very solvable case.
Right off the bat, to start a case and see it through properly, I would ballpark the cost to be about $50,000 at least for her to complete treatment for both arches.
Not to say that she has to do the FULL treatment for everything right away. She can surely do the upper arch to ideal…
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Justin posted an update 7 months ago
Hello,
I recently placed an implant that I’m worried about the prognosis. My previous cases have all been free handed. I had my lab make a guide for this case. I ended up relying too much on the guide and placed the implant too close to the adjacent tooth (0.8mm). Has anyone else placed one this close and had it fail or be successfull? Im…
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Anecdotal Suggestion
While this situation can be super stressful, it doesn’t necessarily mean disaster.
Anecdotally, I have at times, and many others have placed implants closer than we wish we would have to adjacent teeth. It’s happened once or twice. And aside for a few sleepless nights, I (and the patient) have had zero issues from it.<br…
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Appropriate Next Steps?
In my humble opinion, the first thing is to take a step back and not stress too much. Thing will be okay.
Now, here are some potential options:
Option A: Take the implant out and re-do the implant placement. You still have time if you wan to do this.
Yes, it does feel stressful to explain to the patient why you want… Read more
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Here’s the recording from this afternoon’s case review! @Lori @RYAN we discussed the cases you guys shared with us. Nice meeting ya @chasec_dds , @DrS !
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So sorry I missed it! Some of us have to work 😉
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I appreciate the conversations that were had!
I especially like what you said about maybe we lean on implants too much when we could just make good dentures to begin with 😂
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Youssef posted an update 8 months ago
Hello everyone, wanted to ask a question that came to my mind. My colleague was doing a lateral window sinus lift after elevating the membrane, he mentioned he saw a small perforation in the mesial aspect. He then placed a resorbable collagen membrane like a parachute and compacted a little bit of bone not applying to much pressure. He did a…
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Hello Youssef, thank you for posting the question. Do you have any pictures of the CBCT?
My understanding is that if the sinus membrane was stabilized, and you grafted it, and the patient has low contraindications, blood clots are likely to turn into bone.
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I agree I think bone will form but it will take a long time to mature. If you wait only 6 mo the density may still be low. It is also possible to loose some height.
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Ivan posted an update 8 months ago
Reminder: We’re doing a LIVE case review session TOMORROW. If you want me to answer any particular questions or look at any x rays or pictures, drop them HERE in the comments ASAP! I’ll review and dive into your questions and post up the video here in the community.
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Ivan posted an update 8 months ago
In know we’re all dentists and dental students here, BUT lets celebrate who were are outside of dentistry.
Share a picture or video showing what you like to do not related to teeth!
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I’ll go first. I spend most of my time outside of work being on daddy duty. I just made some dirt ramps for the kids to ride their ATVs. I also just recently got into wine making. 🍇
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We love dirt biking with the fam at Restored Smiles Ranch 🙂
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Ivan posted an update 8 months ago
Ridge Split video: For those whe saw this on Instagram, but the video got clipped short… Here’s the rest:https://youtu.be/8lpNF0Dvkrw?si=LLT4BKUo-Js0DfJz
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how can you manage if you crack the buccal plate of bone?
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Lori posted an update 8 months ago
Hello just a few questions.
1. After extraction ans socket preservation are complete , how long do you wait until you take a cbct and plan the implant?
2. What do you do when the IAN canal is NOT visible at all on the CBCT? How can I forward the cbct to you for review?
Thank you!
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Thanks for the questions Lori! You can record a little video clip on your phone and post it here! Or you can take pics and share it directly here 🙂
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Hello Lori,
I typically wait 4mo. On a healthy patient when there was no real defect at the site. If I have to repair a missing buccal wall then it’s usually 5mo. Or so. Also, typically the easiest way to identify I difficult nerve is to start at the mental Foreman which is much easier to identify and then follow the nerve more posterior to…
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Ivan posted an update 8 months ago
🔥 ALRIGHT, NINJA NATION! It’s FEEDBACK FRIDAY! 🔥
Today’s the day to get some eyes on your work. Drop your cases, X-rays, and questions in here by 3 PM PST. This is your chance to get real, no-BS feedback.
👉🏼We’ll dive deep and give you a insightful review of your case/question on Monday. 🎥
You in? Let’s make this happen! 👊💥
#FeedbackFriday…
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Jedediah posted an update 8 months ago
What in the Trauma is going on? Ok, you all wanted implants and bone grafting so here ya go…
This was a challenging case to say the least, especially when it’s your mother. She fell and fractured 3 of her front teeth amongst other things. A few hours later I had 3 teeth extracted, extracted sockets grafted, ridge augmentation complete, 8…
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Bro, those are some CRAZY gains
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Is this basically done in two stages? One for graft and one for implant placement?
Dude you bulked that up considerably. I am always cautious about overbulking to much—just due to nervousness on my end. But you totally disprove that. Do you just go HAM on the amount of allograft as long as you can get passive closure?2- View 1 reply
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