Study Club Member Ivan
Study Club Member
21
Articles
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Let’s examine some of the potential possibilities:
- The implant could have been non-integrated and spinning.
- The healing abutment could have been binding on bone.
- The healing abutment could have been the platform size.
- The healing abutment could have been the wrong design.
- The healing abutment could have been the correct size and design, but a different manufacturer that uses different width screw thread.
- The healing abutment was being inserted in the wrong way (wrong path)
- There was debris inside the implant that was preventing the healing abutment screw from going all the way in.
- The healing abutment thread was a damaged.
As an implant doc, the task at hand is to go through all of these possibilities and rule them out one by one.
Do you have any pictures of the parts that you used? Let me know the brand and the type! Happy to help!
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Hey! I took a look at your case and attached my thoughts. I hope this helps!
4:24
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I’m not familiar with BSB anymore but they would have to have the library for it, I’d be kind of shocked if they didn’t
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Glad you got it! BSB can read DICOM datasets as is
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Coming up on six months would love to see a followup as well!
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Wouldn’t be concerned if tissue is good but you’ll likely have some crestal bone loss. As long as stable, healthy tissue, and does not develop mucositis address restoration should be fine. Just monitor as usual recall schedule. Radiographs will tell you if anything is an issue at this point.
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Heck yeah glad it went so well!
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This is a great case to extract flapless and then do a semilunar vestibular mucosa flap (imagine you’re doing an apicoectomy). Clean it all out, place resorbable membrane and bone and close with small 5-0 sutures.
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Isn’t it amazing how truly few “ideal” or easy implant cases there are!
In case 1 you correct to assume you are limited by the interproximal dimension, but added length to narrower implants can help (think more about the total surface area in contact with bone, also why short but wide implants still can work, biology permitting).
I would be okay placing a 3.0 or 3.2 in that space, almost certainly using a guide to help with angulation. In protected occlusion, no occlusal pathology and it’s not the terminal tooth, I would keep it just out of occlusion for final restoration.
Case 2 I think you’re likely being a little over cautious with the mental, it seems you have a measurement of 12mm or so and are still probably 4mm above the mental. My safety space is 2mm, however (if you’re able to place traditional width implants like 4.0+) there is a limited return on additional length beyond 9-10mm. So I wouldn’t bother placing longer than 10mm just because you can, and that will also keep you so far from the nerve it shouldn’t even be a concern!
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Hey man, here’s the hiossen catalog, let’s take a look at it together. Also, Thanks for chiming in @alankatende !
1:53
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Hey conner, did you get this resolved?
Luckily it’s a simple fix. BSB has a library of almost every implant out there. BUT just in the off-chance that they don’t have the exact implant you are using, it is safe to pick an implant that is similar in size. Or you can create a custom implant size for your planning. In general, try to match up the dimensions–manufactureres largely use the same implant sizes so you will probably be able to find something that matches up well.
Also, if in doubt, select an implant in BSB that has the same platform as the one you are placing. If you have trouble, I’m happy to hop on a zoom call with you.
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I suppose you could! Would be a similar time frame, but also maybe cost the patient more money? Might be nice to not try to do ‘too many miracles’
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Awesome dude!
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Allograft corticocancellous mix, 6 months would be plenty and I agree older patients longer healing
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Graft is stable because its in the bony envelope, so the membrane that spans to healthy bone on all four sides of the defect is enough. Would be hard to tack or suture it down and probably unnecessary
