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    jorbrown posted an update 4 days ago

    4 days ago (edited)

    Distance between implants? Do we still keep 3 mm of bone between implants?

    • The guideline of maintaining 3 mm between them is still widely recommended.

      Bone Health: Keeping 3 mm of bone between implants helps prevent bone loss. If implants are too close, it can lead to complications like bone resorption, which can jeopardize the stability of both implants.

      Soft Tissue Support: Adequate spacing is essential… Read more

      • That is what i figured, thank you!

      • 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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      • 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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        barbarios
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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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          • Case here for a maxillary partial overdenture. How do these positions look prosthetically in respect to their existing partial? I placed them as best I could. Also how far subcrestal should I am for? 1-2mm?

            • These positions look okay to me–but i might suggest some slight modification. So, because this is a partial, the implants don’t necessarily need to follow the angulation of the teeth.

              Instead, the things to try to optimize for aside from bone availability are:

              1. Parallelism between the fixtures. It would be great to try to get them…

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              • That said, you don’t want those anterior implants to come out too far on the palate because you’ll run out of restorative space. It’s a balance.

                One solution for the anterior might be to use some angled locators on those. They fix that up real quick.

                2mm subcrestal would be good. Hardest thing on this case will be making sure you have…

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

                • Yo! Great question @jorbrown , yes you can certainly use our implants for implant-assisted partials. You just pop some locators on them and you’re good to go!

                  Keep in mind that for implant assisted partials you want the implants to be axially placed (as straight as you can) to the bite force so that you dont have too much off axis loading on them.
                  <br…

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                  • 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.

                  • Planning implants 4/5 (singles) implant bridge 7-9, single implants 12/13. Best long term temp while implants heal? Flipper vs long term lab made temp? Im also crowning 6/10/11 so i could have nice lab made temp for him to wear for 4 months?

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                    dt-mert, Jedediah and Ivan
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                    • 100% long term fixed temp from lab.

                      I love these because you are basically previewing what the final will be, but you can still tweak it. I like acrylic, but some labs like to do zirc temps too

                      I would still use a flipper tho during the initial healing phases.

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                      • So for surgery day stick with just the implants. Let it heal for a little bit, then go back in and prep 6/10/11?

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                    • 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?

                      Nolan, Jedediah and 2 others
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                      • 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…

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                        • I love the idea of not charging for CBCT. Its a great lead generator for your implant cases.

                          However, not being a practice owner, we usually end up charging for it (because that’s how the practice does it) Some people argue that due to the liability of the CBCT, some fee should be charged. Others say that a serious patient will be willing to…

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