cronicaskaterbinas

Resorbed Mandible Case: Best Treatment Plan?.....A Reply to Dr John Carroll in Osseonews Dear John Carroll, Thank you for posting one reference to support your claim on having the numbers and facts on your side. Let me quote the full conclusion that was given in the study that you quoted...... “The results therefore support caution when considering the applicability of implants <= 3mm diameter for single tooth and FPD restorations. Standardized fatigue testing reports for commercially available implants is recommended.” The keyword is “caution”. The study does not proscribe or condemn outright the use of minis. Instead, it advocates caution because it realizes that its conclusion is deficient and inconclusive because of the following:- Insufficient data. Only 9 samples from Straumann 3.3mm NN, NobelDirect 3.0 and Hi-Tec TRI-N-13 were tested as prescribed. It is a simple overload test and not a cyclic loading test. A simple overload test is one in which you just k

                                                                                      THREE YEARS LATER This gentleman was 78 when he saw me. He was one of those dream patients who never quibbled about payment. He could not eat steak anymore and he wanted to eat steak. "Can you help me doc?" So we started our rescue of this dental cripple who could not eat, talk or smile properly without having his chrome denture falling down each time. He was rich though and paid me whatever I billed him.....no questions asked. First we placed conventional sized implants in all the posterior areas where it was necessary. When it came to the front, I had a difficult tussle with my conscience. If I placed conventionals, I would have to do bone grafts and wait from 3 to 6 months before completion. And I would be able to charge him top dollar for the conventionals and the bone grafts. What did I do? I placed in 4 minis.......yeah...just 4 minis and placed in a PFM bridge, all within a month in 2

The OPG shows the bridge failing with a fracture on the upper right canine. The bridge was removed and 2 minis were placed together with a new 4 unit bridge 5 years ago. 2 natural teeth were joined with 2 mini implants in a bridge. The patient did not come back for recall until recently, 5 years later. The bridge was still present and an xray showed healthy cortical bone and not only preservation of bone height but also some bone gain up the distal mini implant. In addition, the 2 natural teeth were preserved. The patient was already in the seventies five years ago.

The lower right first molar was extracted and after a short healing period, 2 minis were placed. A PFM was placed and the patient happily used it for 2 years but came back then to complain of a toothache which he assumed must be due to the implant we placed for him. An xray showed that the toothache was due to the second molar distal caries. The incidental finding was a very healthy and strong looking cortical bone around the minis. Amazingly also, bone has climbed at least 2 thread widths up the mini dental implant ! Is this, should this be the new standard of care in implant dentistry ? Should we then consider using minis more often ? Are minis  advantageous over conventionals in some areas ? These are questions that need to be asked objectively and scientifically without prior assumptions.