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Dr. started the discussion #19 in the forum Implant Tx Planning a year ago
Hi,
These are images of a recent scan.
This is 5 months after #19 implant was explanted (failed 2 weeks after placement) and simultaneous grafting was done.
I have currently planned for a Hiossen 4.5x7mm with buccal veneer grafting. This will be placed relatively deep due to ridge atrophy. What are your thoughts on this deep placement…
Jedediah, Hanna and Erick -
Dr. replied to the discussion Surgical guide and fixation pins? in the forum Implant Tx Planning a year ago
Reply to Surgical guide and fixation pins?
Thank you for the advice!
Jedediah and Erick -
Jedediah replied to the discussion Surgical guide and fixation pins? in the forum Implant Tx Planning a year ago
Reply to Surgical guide and fixation pins?
Many ways you Can design to help improve your stability. Seeing that it is tooth born guide it should be very stable and you could do one screw fixation towards the gingiva side of the guide close to where you’re placing the implants. You also could have three fixation screws to have a more robust fixation one on the lower left and lower right…
yash0803 and Erick -
Dr. started the discussion Surgical guide and fixation pins? in the forum Implant Tx Planning a year ago
Surgical guide and fixation pins?
Hi,
I am concerned with not having a distal tooth stop on LL and UR of my surgical guides. Would placing a fixation screw(s) help stabilize them? If so, where? If not, then is there any other way to stabilize it better?
I have used a guide before without a distal tooth stop but only one tooth distal to a real tooth (e.g. #30 implant next to…
Erick and Jedediah -
Robbie posted an update a year ago
3.5 x 13mm Immediate #7
Thin facial plate. I’m going to do my darndest to get that out atraumatically, but if, which is a high risk I’d say, that facial plate fractures, flap, membrane, graft come back in 4 months? I cant imagine membrane and grafting without a good facial wall would be indicated here.
Pro tips welcome!
Erick, Adis and Jedediah4 CommentsView more comments-
Not a pro here, but I’ve done a few similar cases. Use periotomes or a thin luxator on the M/D/L and get the root loosened up, often times I’m surprised that there is more bone on the buccal than the CBCT showed. Carefully feel all the way down to the apex to check for fenestrations. If there is a thin plate, try not to flap to not disturb…
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Dr. Adis has some great words of wisdom. All of those points would be very helpful. Your Digital plan looks great. I love the angulation and the overall placement other than I would definitely go slightly deeper so you are more subcrestal. Typically, I prefer my implants to be 2 to 3 mm below the crest of the bone
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Jedediah posted an update a year ago
Here’s a case of what you should expect to see when you don’t value bone, biology, and proper space around your implants.
This was a second opinion/consult from a new patient regarding her lower treatment and implants. These all were removed and reversed out with an implant removal driver and a torque wrench. All of the sites were grafted for…
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Whoa…
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Did you GBR the facial then after?
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Adis posted an update a year ago
I’m starting to plan this case for a full arch fixed mandibular implant prosthesis. She has great bone between the mental foramen once reduction is complete.
She has a severe deep bite and bites into the incisive papilla with the lower incisors. She usually postures forward and when you tell her to bite she’s on the incisal edges.
How do you…
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It is best to achieve their VDO and VDR ideally before you start if it is not already established through full or partial dentures depending on the situation. You can use radiographic markers as CBCT is taken to help better plan those cases if needed.
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Justin posted an update a year ago
Hello All,
I have placed 15 free handed implants so far but they have been on very straight forward cases with a lot of bone and far proximity of the sinus. This patient is a family friend and I would be doing the case for free. I’m contemplating testing my abilities with this case. It looks like I can sneak in an 8mm implant but may have…
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Well, that’s a decision. You definitely have to make especially with the family friend. Bit of advice is I would definitely charge even if it’s just a little bit. You don’t wanna get in habit of giving those away for free. You should be able to squeeze it in there, but you wanna make sure that you do not place it too far to buccal cause you…
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Jedediah posted an update a year ago
Here is one of two ways in which we assess stability of a dental implant at time of surgery. After we received our torque value, we place a smart peg in the implant to receive another value from our beacon device. This is what is called an ISQ value which stands for implant stability quotient. It essentially is measuring the bone to…
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What ISQ range do you want to be in at the time of surgery and at the time of restorative?
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Robbie posted an update a year ago
Guided #4 Neodent Helix Acqua 4 x 10
Curious when we are deciding length if folks like to engage the sinus this way or just lay up and do an 8mm length implant?
I am beginning to argue with myself about this. Longer is better? Is there no difference? Play it safe? Im sure this has been discussed before, but I could use advice on this case…
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Generally speaking if there’s not much difference in implant length, I would rather have higher reward less risk. An 8 mm implant that’s integrated is going to be just as good as a 10 mm integrated implant. There’s great research out there that shows short implants which are generally 8 mm or less. I’ve almost the same success rate as…
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