Implant Ninja | 87madrigal | Activity

87madrigal posted a new activity comment

Fri, 24 Jan 2025 02:32:54 -0800

I have the Salvin screw removal kit… but stopped using it a while ago since I end up using the ultrasonic scaler most of the time. I find that it comes right out in about 1-3 mins. Just put on the highest setting.

In reply to - jorbrown posted an update

Patient had biomet 3I implant placed elsewhere. Had a cement retained crown #10. Its now completely covered by soft tissue. Any tips for removal of the screw?

87madrigal posted a new activity comment

Wed, 15 Jan 2025 23:58:26 -0800

Hey! There’s a lot of info out there so it can get a bit confusing with all the different protocols. each centrifuge does have its own settings, which can make things tricky.

For A-PRF (membrane), I use 1300 rpm for 8 minutes with a red tube. For CGF (sticky bone), you’re on the right track! Usually, i-PRF is prepared at 700 rpm for 3… Read more

In reply to - rez posted an update

HI Guys

i am a bit confused on PRF & CGF (sticky bone),mostly the RPM & time to prepare for sticky bone.

I understand A-PRF (PRF membrane) is 1300 rpm at 8 minutes (red tube), is the […]

87madrigal posted an update: Posterior implant placement with a surgical guide: a […]

Fri, 10 Jan 2025 03:58:09 -0800

Posterior implant placement with a surgical guide: a case that highlighted the value of precision, even in favorable conditions.

This patient had abundant posterior bone, which made planning and execution straightforward but no less important. Here are the lessons reinforced during this case:

1. Guided Surgery Refines Precision: Even with…

87madrigal posted a new activity comment

Thu, 26 Dec 2024 18:45:08 -0800

@suredds Hey Nick, even though I had good buccal bone, there was a large bone defect once I took out the granulated tissue, so there was no way would be able to get any initial torque here with a 3.5mm or 4.3mm implant. I did use 3-0 sutures to hold the Geistlich collagen membrane.

In reply to - 87madrigal posted an update

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 […]

87madrigal posted an update: Merry Christmas everyone!! Sometimes, patience is the […]

Wed, 25 Dec 2024 17:44:10 -0800

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…

87madrigal posted a new activity comment

Sun, 22 Dec 2024 04:06:25 -0800

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.

In reply to - jorbrown posted an update

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 […]

87madrigal posted a new activity comment

Sun, 22 Dec 2024 04:04:43 -0800

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…

In reply to - rez posted an update

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 […]

87madrigal posted an update: Looking back at a case I did a few years ago, I’ve […]

Fri, 13 Dec 2024 23:12:02 -0800

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…

87madrigal posted an update: Implant Placement - Lower Second Molar with a Focus […]

Wed, 04 Dec 2024 17:12:01 -0800

Implant Placement – Lower Second Molar with a Focus on Keratinized Tissue

This case highlights the importance of soft tissue management for long-term implant success. In this case, I placed an implant on a healed site for a lower second molar, and my approach focused on ensuring we have a thick keratinized band on the buccal side.

When dealing…

87madrigal replied to the discussion Upper Anterior Implant Position in the forum Implant Tx Planning

Mon, 02 Dec 2024 23:26:47 -0800

Reply to Upper Anterior Implant Position

I have actually seen a few studies about this, where the CBCT shows no to little bone but the implant is successful even after a decade. The main factor in these cases was the about of soft tissue. It being so apically I would not worry about it, learn from it and keep going. I see no reason why it would impact the success of the case. Like…

87madrigal posted a new activity comment

Mon, 02 Dec 2024 23:23:10 -0800

Sure can. I tend to lean on placing 6 on the Maxillary and only 2 on the mandible when it’s not fixed. I have had some cases not go as panned and having 6 makes a huge difference down the road.

In reply to - jorbrown posted an update

Can we use implant ninja for implant retained partial overdentures? How does this implant placement look?

87madrigal posted a new activity comment

Mon, 02 Dec 2024 23:21:02 -0800

I feel you, it happens to all of us. The start of a burnout, I’ve been there many times. Some cases just drain you when they don’t go as planned. What has helped me is setting times for work and leaving work at work. When you go home you are done, so take your mind off it and do something you enjoy. For me that’s going on long walks… 😅 37…

In reply to - Mic posted an update

When MLB players and athletes hit a slump, it’s often because their fundamentals are just slightly off. Does anyone ever feel that way clinically? Maybe things aren’t lining up quite […]

87madrigal posted a new activity comment

Sun, 01 Dec 2024 03:33:23 -0800

@RYAN I believe they come in as a kit and have different shapes “custom” so for posteriors you will have a few sizes and for anteriors as well. We’ll see if they are able to bring them to the US.

In reply to - Ryan posted an update CUSTOM HEALING ABUTMENTS

Hey folks! Hope everyone had a wonderful thanksgiving!

I went down a custom healing abutment rabbit hole yesterday and wound up with a few lingering questions. […]

87madrigal posted a new activity comment

Sat, 30 Nov 2024 17:28:05 -0800

I know iPhysio is coming soon to the US. It looks very promising.

“The iphysio® Profile Designer is screwed into the implant during the 1st or the 2nd surgical intervention. It remains in place throughout the bone and gingival healing process as well as during the taking of an impression irrespective of the implant sector, whether aesthetic or…

In reply to - Ryan posted an update CUSTOM HEALING ABUTMENTS

Hey folks! Hope everyone had a wonderful thanksgiving!

I went down a custom healing abutment rabbit hole yesterday and wound up with a few lingering questions. […]

87madrigal posted a new activity comment

Thu, 28 Nov 2024 21:08:26 -0800

First thing that comes to mind is the upper lip and gingival display. Make sure you do enough bone reduction to cover up the transition line or it will be a nightmare.

In reply to - mikeissak posted an update

First time as a surgeon restoring an AOX case, please send me with recs based of this limited pictures/PANO

87madrigal posted a new activity comment

Wed, 27 Nov 2024 23:40:11 -0800

I used to place almost all Neodent, now I have been placing more and more Implant Club 😅. Still placing Zeramex for Zirconia Implants.

In reply to - jostanger posted an update

What implants is everyone using? And what made you choose that system?

When I was in perio residency, we used about 5-6 systems just to get a feel for them all and see how […]

87madrigal posted a new activity comment

Wed, 27 Nov 2024 23:36:59 -0800

I think at this stage your best ally is going to be thick connective tissue and a well polished (not glazed) crown with good profile. It is a concern, but not enough to remove the implant. I have actually seen some cases fill in later if the crown, hygiene and tissue is ideal.

In reply to - chris posted an update Hi nice to meet you guys. I am new to implant crowns and just wanted your opinion. I have a case for the 14 15 for impressions this Tuesday. I noticed on the radiographs there is quite a […]

87madrigal posted an update: Tip I am grateful to have been taught early by my […]

Wed, 27 Nov 2024 23:32:50 -0800

Tip I am grateful to have been taught early by my mentor: Check Your Pilot Drill Angulation Early.

When placing implants, taking a PA X-ray of the pilot drill is a crucial step that’s often overlooked. This simple check can save you from a lot of headaches down the line.

The pilot drill sets the foundation for the entire implant trajectory. If…

87madrigal posted a new activity comment

Tue, 26 Nov 2024 16:22:52 -0800

87madrigal posted a new activity comment

Mon, 25 Nov 2024 23:41:38 -0800

I have ben trying to get back to the gym 5-6 days a week. Currently only doing 1-2 because of the cold 😅.

In reply to - Ivan posted an update

What are some goals and challenges that you are working on?

87madrigal replied to the discussion Tightened inplant which starts spinning in the forum Complications

Sat, 23 Nov 2024 18:54:43 -0800

Reply to Tightened inplant which starts spinning

Hi Ash, as you continue to place more implants you will run into this. Like Ivan said, the reason is because the implant just can’t go lower (even if it’s tapered it needs a bit of osteotomy). I tend to use a 11.5 drill for my 10mm implants as I like them to be a little subcrestal. When this happens just take the implant out, set it aside, drill…

87madrigal posted a new activity comment

Thu, 21 Nov 2024 14:43:12 -0800

We don’t charge at our office for the CBCT. I see it as a tool I need and it costs me nothing more to take a scan. But then again we do a 3D scan on all our new patients.

We always give 3 options:

Good: removable partial.

Better: Fixed Bridge

Best: Implant

We have models of all three and put them in front of the patient.

We tell them advantages…

In reply to - jorbrown posted an update

Question, what does implant planning and presentation look like in your office? Do you charge for the CBCT? How do you present the implant as the best option for patients?

87madrigal posted a new activity comment

Wed, 20 Nov 2024 19:10:17 -0800

Wow, that’s a tough one. My first instinct is to just maintain as long as possible to allow for growth. Hopefully she can be stabilized long enough to be able to get some implants in there. I had a patient come in who had all her teeth removed at 16 and had been in dentures for 40 years, unfortunately no bone left for all on x. 😞

In reply to - jostanger posted an update

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. […]

87madrigal posted an update: When I started my implant journey, I primarily […]

Wed, 20 Nov 2024 19:07:14 -0800

When I started my implant journey, I primarily placed implants at the bone level. It was straightforward, and at the time, I thought it was the best approach for most cases. As I’ve grown in my understanding and experience, I’ve transitioned to placing implants subcrestally in many cases—and the benefits have been significant.

Placing…

87madrigal replied to the discussion #10 implant site in the forum Implant Tx Planning

Tue, 19 Nov 2024 17:44:16 -0800

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…

87madrigal posted a new activity comment

Sun, 17 Nov 2024 22:41:05 -0800

Working on giving my website a facelift. 😬

In reply to - Ivan posted an update

Whats up yall. Lets get to know eachother!

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

87madrigal posted a new activity comment

Fri, 15 Nov 2024 16:40:42 -0800

This has happened to all of us. We place the “perfect implant” and something goes bad. You’ve taken the right steps with debridement and bone grafting—just ensure strict post-op instructions moving forward. This happens even in the best cases—stay encouraged! Give it some time and re-implant.

In reply to - andanbcx posted an update

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 […]