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LOWER FULL DENTURE STABILIZATION IN A RESORBED REPAIRED MANDIBLE

Gambar
This is an elderly lady in the seventies. Not only is her mandible resorbed, it is also repaired due to a fracture in the right body of the mandible. Conventional sized implants will be risky and unnecessary because minimized aka mini implants can be used. It is a 1-2 hour job and is the treatment of choice in this case. In fact, it should be the treatment of choice in most if not all lower denture stabilization cases. DONE IN 2007 NOTE THE DIFFERENT MAKE OF MINIS ANY BRAND WILL DO THESE PHOTOS WERE TAKEN FIVE YEARS LATER IN OCTOBER 2012. THE PATIENT WANTED A NEW PAIR OF DENTURES NOTE THE PLAQUE !! ARE THE SURROUNDING GUMS HEALTHY ?? YOU BET !! AS SEEN AFTER CLEANING OFF THE PLAQUE. NOTE HOW HEALTHILY KERATINISED THE MUCOSA IS AROUND THE EMERGENCE MARGINS OF THE MINIS AFTER FIVE YEARS,  THE O-RINGS AND HOUSING ARE STILL THERE BUT VERY LOOSE. THE TWO CENTRAL ATTACHMENT DEVICES ADAPTED FROM SNAP-ON FASTENERS MADE OF STAINLESS STEEL WIRES HAS CORRODED AWAY. WATCH THIS SPOT FOR THE NEW DEN

A KNIFE EDGED RIDGE CASE

Gambar
This gentleman wanted to be able to chew again on his right jaw. A very narrow ridge. We placed in the implants and usually in such cases, the bridge is cemented permanently within a month. The bridge was cemented. As a result, the patient was able to chew his food again. It encouraged him so much  that within six months,after a successful removal of bladder stones, he began to exercise regularly and cut down in his smoking. The last time we saw him, he was hale and hearty and telling his friends about how dental implants changed his life for the better. ANOTHER CASE OF KNIFE EDGED RIDGE This is a patient who already had a conventional in place from another dentist and came back from another country. We placed in a Mostdi and a mostdibud and cemented a two unit bridge over it. Yes. We practise lipping over the mucosa liberally. It is a practice which every dentist have used successfully over the years with conventional bridges built on natural teeth. The main problem then were and are

WHAT IS A SAFE DISTANCE BETWEEN MINIS?

Gambar
A rule of thumb would be 2mm. We can do it closer than conventionals because of its smaller diameter. The basic principle is to ensure optimal living tissue around the implant to maximize healing potential. I think you should have a very rational way of doing things and that should keep a dentist within the limitations of any form of treatment modality. We should stop looking at minis emotionally but scientifically. I say emotionally because many criticisms are based on the suspicion that the dentist cannot do conventionals... therefore resort to enter into the game via minis. While true sometimes, what is wrong with that?..... and what do you say to a dentist who is adept at using both and yet still use minis successfully and rationally in situations where conventionals just will not do?? We should move on and just accept that dental implants come in all forms of shapes and sizes and materials etc. etc. and as professionals and scientists, use them based on principles and common sense

MOSTDIS: A SOLUTION FOR BLACK TRIANGLES.... TREATMENT OF CHOICE ! ? !

Gambar
In upper anterior cases where the use of conventionals usually result in black triangles due to its large size, I am increasingly convinced that minis should be the treatment of choice because their narrow diameters allow plenty of nutrients for the inter-implant tissues so much so that initial black triangles rapidly get filled up with living tissue, and aesthetically to boot. BLACK TRIANGLES ! A month or so later, they have disappeared. This particular patient was a total dento-phobic ++++. He had never seen a dentist for years. He called me on the phone and outlined his fears. His first visit, all I did was talk to him, took an impression and an OPG. If I were to offer to do conventionals only, I gravely doubt that I would ever see him again. With minis, I had great confidence to treat this patient with the minimal of trauma and pain and delivered his teeth fast and in a very satisfactory way. He completed a questionnaire in which he said that he was very happy with the results exce

IMPLANTATION AND EXPLANTATION ON PATIENT'S INSISTENCE

Gambar
We placed in the upper anterior implants carefully and everything healed uneventfully.  However, when the patient returned, he insisted that we remove them, the reason being that, "He just could not accept them as part of his mouth and body!" This was a realization that he had only after he had the implants placed. After numerous attempts to persuade him otherwise, we finally accepted the fact that the patient for some reason beyond us, cannot accept the dental implants as part of his mouth and body. By then, the implants were fully osseointegrated and ready for harvesting and prosthodontics.  So near, yet so far!!!! Rest assured, we tried our level utmost to convince the patient how simple the prosthodontics were and how much he already paid and what a boon a set of fixed teeth as compared to his dentures were. With all the preliminary exercises in persuasion and explainations done conscientiously, we got the patient to sign a carefully worded consent form indemnifying us fr