Study Club Member Robbie
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Robbie posted an update 4 weeks ago
4 weeks ago (edited)
Immediate #7
Thoughts on angulation, depth, F/L position? I feel like its too deep, but wanted to at least be bone level on the lingual. Use his old crown as a temp if I achieve enough torque?
Could tip apical lingually and go cementable
In planned position, the apical third awfully close to the cortical plate.
This is a 3.75 x 13. Will be placing…
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This is a neodent Helix aqua. Was curious about a 3.3 Roxolid using smile in a box as well. The last time I did this, I lost quite a bit of buccal plate.
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looks too deep
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Robbie posted an update a year ago
Vertical Loft or no? Whats the data on placing a couple mm into the sinus floor?
Lift to be safe? Enough residual height where I feel comfortable doing it.
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Definitely better to lift with less risk. Let’s discuss your case Monday!
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I’ll make an effort to log on. If you don’t mind 3 little humans running around and likely interrupting lol
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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!
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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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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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Robbie posted an update a year ago
Looking into 3D printing my surgical guides myself.
I know the book says AnyCubic, my buddy thinks I should go Phrozen?
Thoughts, advice?
thanks in advance
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Dr. Ivan has a great online course on guides that have been very helpful to other doctors getting into this. Our office has recently gotten of SprintRay 3-D printer and made you that in the future. I would love to know Ivan’s thought on this?
@ivan-chicchon your thoughts?
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Robbie posted an update a year ago
EXT 15, 16 today and grafted 15
Teeth came out great with luxation and forceps, grafted and just used a flattened collaplug over the top. and stuffed some into 16 as well.
That said is it a potential issue on the distal of the 15 site for the graft to drop into 16 during the initial healing phase?
Maybe a dumb question, just looking to…
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No issue at all. Many times in a case like that I will just graft both sites to help maintain gingival architecture better and maximize healing with less risks.
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Robbie posted an update a year ago
I EXT/grafted a #4 today. A) this little bugger did not just come out, had to cut down the root all the way to that laceration and some on the buccal. B) this caused me to make the mistake of perfing out the buccal plate like a 3mm sized hole or so. Something of that nature.
I cut a piece of membrane into a sort of ice cream cone and stuffed it…
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I would also apply the ice cream cone technique. But if you cannot see it could be quite challenging. If it was too apical i would open a flap with relieving incisions and access the fenestration area grafting it and placing a collagen membrane
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If the socket has good width and it’s very small perforation 1 to 3 mm you would be fine just grafting that with really having minimal negative effect to the outcome and you would just graft it and come back and place an implant and four months or so. If it was a much larger defect in the bone is very thin where would be best to do additional… Read more
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Robbie posted an update a year ago
Long story short. I inherited this.
But the previous crown had a plastic abutment under it. Did not get a pic if that. Its a Zimmer TVS implant.
The facial margin at the crown/PEEK abutment? Interface was open and full of plaque, no purulence from the gjngival tissue. The platform and threads are notched from a bur.
I took the crown off today,…
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I will be the first to drop the WTF: WTF!!!
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Have you considered referring for some soft tissue grafting? That’s the first thing that comes to mind
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Robbie posted an update a year ago
Hi! Happy to be here, thanks for being so welcoming. Minnesota
Neodent Helix Acqua 4.3 x 10
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Nicely done mate, thanks for sharing your case! Where did you go to school?
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Nice! Well done. Thanks for sharing Robbie👏👏👏
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