cronicaskaterbinas

K. F. Chow BDS., FDSRCS   says: October 23, 2009 at 11:26 am THE CASE FOR NARROW DIAMETERS/MINIS/REDUCED DIAMETERS/ MINIMIZED DENTAL IMPLANTS/MOSTDIS Narrow diameter dental implants are being increasingly used not only to stabilize dentures but also for long term applications like crowns and bridges. I agree with Carl in that there is no such thing as an absolute contraindication in medicine. Even botox which will kill you if injected into your bloodstream is used ingeniously and judiciously to extend the youthful looks of people. The key word is “judiciously”. Know your medicine well and know what you want to do with it and then you can apply it safely and usefully. It is significant that one of the doyens of implant dentistry has recognized that narrow diameters have their uses especially in narrow ridges and in suitable bone. I started out with conventionals and with the advent of minis, incorporated them into my treatment planning and in many complex cases have successfully integra

Mother had been searching all over the country for a dentist willing to treat her son. With some trepedition took it on. First visit refused even to open the mouth. Spoke with the patient and asked this 8year old to come  again. Gave him a small gift. Got these models only on the third visit. At 10 years old bracketed the two centrals and approximated the two teeth. By now patient has gotten used to visiting us and being comfortable in the dental chair. Parents and child becoming more positive and encouraged as they see the two centrals attaining a more natural position. Retained the centrals together with a flat wire and composite. What next ?!?! We raised the bite to a more normal vertical dimension with over crowns on the posterior molars. Observe the edentulous ridges. They have never ever hosted teeth before and cannot then be called alveolar bone. How are we going to restore this 13 year old's dentition? A pair of removable acrylic partial dentures with stabilizing stainless

The most distal mini seems to be hitting the IDN. However, because of the small diameter of the mini, little damage is done and most of the time, it is asymptomatic. If symptoms occur, it is a simple matter to remove the mini and the nerve recovers rapidly. Severance or neurometsis of a nerve by a mini is almost impossible, and this is a hugh advantage over conventional sized implants. In this particular case, the xray probably shows an overlap rather than an impingement onto the nerve. There was no sign or symptoms in this case. Thus, a long mini can usually be used even if it seems to enter the nerve canal because it is often only apparent and even if it does so, the nerve is not injured because the nerve occupies only part of the canal and you have to be pretty "lucky" to strike it right in the centre. Using the Buddy System as described in this blog, we placed mini implants and cemented on the buds. Immediately, we took an impression and sent it to the lab. And two weeks

Then, we use the MOSTDIMUM to make the composite BUD, around which we construct two composite laterals, giving this young man his first ever decent smile line which we hope will continue the process of transforming his life for the better. Wait till you see the final transformation!!!!!! After grafting the lateral labial surfaces, we place in the minis. Now, what do we do? We put in two implants for the laterals of course! What sort of dental implants? Ahhhhhhh......... Conventionals are out of the question. Minimized dental implants of course! Even then, we still had to graft the labial surfaces of the laterals to increase the thickness because there was only a wafer thin  layer of bone there...... having had no teeth there before at all.... congenitally missing. Here then is a classic case of minis being the treatment of choice! Open coil springs to upright the two peg shaped microdontic canines. Minis in the empty spaces to complete the case. Conventionals will require bone grafts t

Notice the "CLEANING GROOVE"  between the two abutment holes. This is to facilitate the threading of a bridge cleaner and floss in between and thus the undersurface of the crown can be flossed right to the surface of the implants. The ability to floss thus and the smallness of the emergence margin of the mini will arguably prevent any peri-implantitis in the long run. In contrast, a conventional implant with an aesthetic emergence profile that includes a large emergence margin cannot be flossed all the way to the surface of the implant proper. The emergence profile emerges out of a volcanic-like crater in the gums. The surface of the crater is usually slightly inflamed and together with the large surface will arguably be more susceptible to peri-implantitis as compared to a mini dental implant. Examine the pics below. Let's continue with the replacement of the upper molar by copying the anatomical/biologically ergonomical/natural/no-brainer/obviously correct positions o

K. F. Chow BDS., FDSRCS   November 16th, 2010 “Wolff’s law” states that bone models and remodels in response to the mechanical stresses it experiences so as to produce a minimal-weight structure that is ‘adapted’ to its applied stresses. The behaviour of bone according to Wolff’s law mirrors a fundamental trait of mother nature, i.e. optimal economic use of substance in the performance of a function. Thus to use a wide diameter implant because there is a wide hole seems to contradict this fundamental. A living organism deserves to be treated according to living rules of life, not static non-living engineering presumptions. Granted that we need to use a titanium screw, since the tooth germ implant is not yet available….. it does make more organic living sense to use the optimal titanium necessary to allow maximal living tissue around it and thus also minimize the perio pocket that inevitably forms around all dental implants. Minimized and optimized diameter implants should be the trend

You can see and hear the lecture on the three critical margins of implant dentistry..... boring though !! http://www.youtube.com/watch?v=N1GF_82dY1g Every dental implant ever placed has created an iatrogenic  periodontal pocket. Yap! Has created a pathology in the mouth that has a certain amount of inflammatory infiltrate around it that ranges from a low grade perimucositis to a full fledged peri-implantitis. This fact does militate against  the use of large and extra-large diameter implants . The periodontal pocket that accompanies every dental implant we place is  a reality that every implant dentist must accept and manage as an acceptable evil for the sake of the greater benefit of being able to replace a lost tooth almost as good as before.  The issue at hand is what is the best approach to managing this compromise for the sake of the larger good. The best replacement for a lost tooth of course is another tooth, and that will likely come in the future in the form of a tooth germ