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Dr. started the discussion Prolia and medical hx in the forum Implant Tx Planning 4 months ago
I have a 76y.o. female patient who is currently on prolia, actemra and prednisone for a year or so. She was dx with giant cell arteritis this past year which prompted her to be on these meds. She needs an extraction of #19. She has had implants in the past so she is interested in an implant to replace this tooth. Conveniently enough,…
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Dr. started the discussion Vertical grafting or not? in the forum Implant Tx Planning 4 months ago
Hi,
I’m planning for #30 implant (5×8.5mm virtually planned here). My concern is there is a vertical bone deficiency (about 3.62mm depression compared to the adjacent bone peaks) and that without vertical augmentation, the implant appears to be too submerged…which also appears to lead to a greater than ideal distance from the gingiva to the…
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jorbrown posted an update 4 months ago
Socket preservation Question. Had a trauma case for intruded #9 as part of 4 unit bridge. I extracted it and i had difficulty relieving palatal tissue to tuck the membrane. And there was no buccal shelf. He had extremely deep vault with very thick vissuen The socket apex felt like it was near his nose do i ended up placing collagen plug in…
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jostanger posted an update 4 months ago
Practice question— does anyone have a partner or work in a group practice? I might be buying into one and id love any advice on how to handle partner dynamics!
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👋 Is there a specific aspect of partnerships you have a question regarding?
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I prefer being the boss and not having a partner. Make the decisions yourself, keep all the profit. If experience is what you need good consultants can help and don’t take away from your equity.
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87madrigal posted an update 4 months ago
Merry Christmas everyone!!
Sometimes, patience is the best treatment plan.
As much as I love placing implants right after an extraction, sometimes biology needs a little time to work its magic. Here’s a case of an anterior tooth extraction where we decided to graft and wait rather than placing an implant immediately. Why? Because sometimes the…
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What about the case made you leery to do an immediate? What membrane did you use? Did the site require sutures? Thx
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I love that. Patience is the most difficult skill to master tho! haha
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drgene1 posted an update 4 months ago
Merry Christmas Ivan, and have a Happy implant ninja New Year
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Hey there @drgene1 Thanks man! I was out sick for a little while! Seems like everyone was taken out by a crazy flu this year. I’m back at it now. I hope you had a nice time with your loved ones!
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rez posted an update 4 months ago
I understand that we have to place the implants in the ant. areas ideally at the cingulum area, is that the same you do for the Mandibular anterior as well? i am wondering since the upper & lower Ant have limited bone availability & we have to place them in a projection angle that gives screw access on the palatal (of course there those…
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For mandibular anterior implants, I try to also place them at the cingulum area with a slight lingual tilt to optimize screw access and functional loading. Just look at your pre-op CBCT to avoid the lingual concavity. Sometimes this is difficult though, so I place them wherever there is more bone stability. I prefer to do screw retained, even…
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So I agree that we all want screw retained crowns. In the end we have to place the implant where the bone so not all cases are ideal
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rez posted an update 4 months ago
Hi
i was wondering if you can tell me where you buy your angled abutments & locators (as you mentioned for $30-40), Also the non engaging abutments are the same as temp cylinders or any specific ones that non engages for implant Bridges or fixed all on x, where to buy to purchase them?
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I have 2 vendors to recommend:
Edison Medical (they used to be called Dibay and were a better company IMO but they still offer the same parts)
https://edisonmed.com/?srsltid=AfmBOopw7hBVOfLpNsMyXTw7RXJpgO9xQw_imrfz7EIrBunJHh5YCBWH# -
Also this one: Dess Abutments.
It’s hard to beat Dess. They offer abutments for everything. And they do it…
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jorbrown posted an update 4 months ago
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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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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jostanger posted an update 4 months ago
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
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