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  • How do you ensure your graft gets to the apex? I completed site preservation today and it is the first time I have done it since residency (2021). The graft in some areas that you see in the CBCT the graft didnt get to the apex? How will this effect implant placement later on? Do you place a little graft at a time, use perio probe then add…

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    barbarios
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    • For grafting I almost only use my curette and place a little at a time. This lets me pack apically as I go. I use cotton swabs for compression too. That being said there’s still been times where I have a 1-2mm void at the apex. Not ideal, but my implants turned out fine

      For the palatal release, I do a conservative envelope flap. Same on the…

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      • I wouldn’t worry about the graft getting to the apex, that area will fill with blood and turn into bone. There are even some techniques that use a collagen plug (not osteogen) then granulated bone on top. Still turns out great.

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      • As discussed in one of the previous posts on mini implants. For me they can be a pain to get out. I had this patient with bleeding and suppuration around these implants. I discussed with patient long term prognosis and she wanted to keep as ling as possible. So I did aome graftint and it actually turned out pretty good! Tissues are nice…

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        • I just removed some, I’ll see if i can edit the video and post it asap

        • Reply to Upper Anterior Implant Position

          The gingiva biotype looks thick type so, I don’t think you will have problem with the implant

        • Just received my box of implant ninja books at the practice! Excited to dig into some holiday reading. 😅

        • I was thinking yesterday, could I substitute Liquid Bandages for PeriAcryl? It could be a significant cost savings. Nowhere on the liquid bandage bottle did it say oral wounds are contraindicated. What do you think?

          • Our oral pathologist recommends liquid bandage to cover ulcers

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        • Reply to Upper Anterior Implant Position

          Thank you Joelle and Apolinar for the valuable input !

        • Reply to Upper Anterior Implant Position

          Hello Ivan, thank you for your reassurance. Here are some of the post operative one week photos. Good thing is patient has a low lip line. And yes, I could not relly see any exposure and I did place some bone graft with straumann xenoflex at the apical region. Have a great weekend !

        • Looking back at a case I did a few years ago, I’ve realized how much my approach has evolved.

          I placed two implants in the posterior region using guided surgery. At the time, I chose a tissue punch technique because there was plenty of keratinized tissue, and it felt like the most minimally invasive option. The implants healed well, and the…

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          Erick, Jedediah and 5 others
          2 Comments
          • Thanks for the reflection man. l am the same, I used to do more punches as well.

            Although this case in particular looks like there is loads of tissue! So I still might be lazy lol

            I am usually doing small flaps and placing a stock healing abutment. Per our discussion on a post a little while back, I got a Cervico set and am going to use it to…

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            • I have switched as well bone seats the tone but tissue is the issue

            • Rethinking Everyday Instruments: The Case of Minnesota Retractors

              Have you ever considered the everyday instruments we use that seem poorly designed or cause unnecessary discomfort? As someone who spends long hours in the operating room, I’ve certainly had my fair share of frustrations. One instrument that stands out to me is the Minnesota…

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                shingst, toothdoc3 and Ivan
                4 Comments
              • Hello everyone! I’m a recent grad so I have very little experience with implants. A pt came today and said their crown broke off. We got ahold of the implant system (Hiossen) and I got the correct driver but i could not even get the driver down the abutment hole. I use 5.5x loupes and im pretty sure I can see a screw down at the end. 1. Do I… Read more

                • Thanks for posting Richard, You can actually do it either way. However, the preferred way would be to:

                  1. access the screw channel and successfully remove the abutment.

                  2. Take an impression

                  3. Send the impression and abutment to the lab

                  Doing it this way would avoid extruding cement all around that implant.

                  It does take some care and some time…

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                  • I wrote a short article on the topic not too long ago. Maybe it helps! https://implantninjadojo.com/how-to-access-an-implant-crown/

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