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THE BUDDY SYSTEM: A PROSTHODONTIC SOLUTION  FOR THE MINI DENTAL IMPLANT Dr. Chow Kai Foo BDS Singapore, FDSRCS England, Cert. of Implantology Germany, FICD THE STORY OF MINI DENTAL IMPLANTS Mini dental implants were initially used as transitionals. One of the first makers were Dentatus of the U.S.A.  They were placed in between conventional implants so that while the conventionals were osseointegrating, the transitionals were used to support the temporary bridges. However, when the time came to bring the conventionals into function and to remove the transitionals, some of them could not be unscrewed and were found to be osseointegrated. These osseointegrated transitionals were then cut off at the bone level and left in situ. The conventional 2 piece implants were then connected and the prosthodontics completed. It did not take long for some innovative dentists to decide to use the transitionals to support permanent crowns and bridges. One of them was Dr. Senda

The intention was to replace the lower left second premolar and first molar with two conventionals. After the 2 conventionals were placed and duly osseointegrated, the patient enquired as to why there is such wide space left between the distal implant and the second molar. Even though a cantilever in this case would be quite satisfactory, it was decided to place in a one piece dental implant from MOSTDI which allowed immediately loading provided the insertion torque was above 50 Ncm. This enabled the case to be completed quickly without having to wait another 3-6months for osseointegration. The last xray was taken 3 months after issue of the bridge.

A SIMPLE PRACTICAL APPROACH TO IMPLANT REPLACEMENT  OF  UPPER ANTERIORS SANS BONE GRAFTS  IN SPITE OF A NARROW RIDGE P2513 WERE USED. P STANDS FOR PROSTHODONTIC HEAD.  25 IS THE DIAMETER IN mm. 13 IS THE THREADED LENGTH OF  THE IMPLANT IN mm.  THE UNIVERSAL DESIGN OF THE  PROSTHODONTIC HEAD ALLOWS IT TO BE USED IN ALMOST  ALL CASES. THE PRINCIPLE OF ACCURATE PLACEMENT AKA  PROSTHODONTIC DRIVEN PLACEMENT OF THE IMPLANTS  MUST BE ASSIDOUSLY FOLLOWED. AN ALGINATE IMPRESSION IS TAKEN AND THE RESULTING  MODEL SENT TO THE LAB FOR THE FINAL PFM BRIDGE. THE EXISTING ACRYLIC PARTIAL TEETH ARE REMOVED FROM  THE PLATE AND TEMPORARY CROWN AND BRIDGE ACRYLIC IS  USED TO FASHION THE TEMPORARY BRIDGE IN THE MOUTH AND  CEMENTED AWAITING THE PERMANENT. VIOLA!!!

80 YEAR OLD GENTLEMAN VERY LOOSE LOWER DENTURES MARKED WITH INDELIBLE PENCIL REVERSED MARKS ON DENTURE TREPHINING A THROUGH HOLE USE A 4mm DIAMETER TREPHINE YES, IT IS THE SAME ONE WE USE FOR CUTTING A PRECISE HOLE IN BONE A 1.3mm DIAMETER PARALLEL DRILL FULL DEPTH IN THIS CASE TO A DEPTH OF 10-15 mm SINCE THE MOSTDI THREADED LENGTH IS 10mm A 2.1 mm DIAMETER DRILL JUST ABOUT 5 mm DEPTH IS ENOUGH TO GO THROUGH THE CORTICAL PLATE A MOSTDI  INITIAL PURCHASE INTO THE CORTICAL PLATE CONTINUE WITH A DRIVER AND RACHET WRENCH STOP AS SOON AS THE DRIVER REACHES THE GUM THE COLLAR OF THE IMPLANT SHOULD BE ABOVE GUM ABOUT 0.5mm to 1.0mm THIS IS TO FACILITATE CAPTURE OF THE DAD aka ORING AND HOUSING  WITHIN THE DETNTURE THE MOSTDI IS NOW AT THE CORRECT DEPTH OF INSERTION TO RECEIVE THE DAD AKA DENTURE ANCHORAGE DEVICE VITAL TO PLACE THE FIRST ONE ACCURATELY THE REST CAN THEN FOLLOW SUIT AFTER THE PLACEMENT OF ALL FOUR MOSTDIS FOUR CORRESPONDING THROUGH HOLES ARE TREPHINED INTO THE DENTURE CHECKED