cronicaskaterbinas

K. F. Chow BDS., FDSRCS   May 7th, 2017 Dear Dr A, I guess you are another fictitious Doc with an alphabet. Nevertheless, it is an interesting question. If you do not want to do a sinus lift, any reason will do though it might not be a good one. I myself once did not want to do it because I hated having to make a large opening into the sinus! And if I can avoid it, I did. So I tried crestal lifts invented by Summers. Works, but often found myself having to spend more time than if I just did a lateral window which is more sure and definitive. There are various ingenious ways nowadays, the latest seem to be the “hatch” technique with a special off centre drill. However, if you want to avoid all these, there are several ways to avoid a sinus lift altogether:- * Do a conventional bridge on adjacent teeth. Use the tooth in front and the tooth behind the edentulous space. Or a cantilever might work. * Place an implant in the tuberosity where there is usually more than eno...

Ken Clifford, DDS   October 24th, 2009 Dr Chow - Amen to all your comments. There is absolutely no reason not to use mini implants. I have been cementing full arch mini implant hybrid bridges as a denture alternative for the past two years. My opinion is that a CEMENTED bridge on mini implants is an affordable alternative for patients unwilling or unable to pay for the all on four bridges, or the conventional implant porcelain/metal solutions. Cementation to minis eliminates the micromovement responsible for most implant failure in a full arch situation. By using quality denture teeth and a quality denture acrylic with high flexural strength, I can quickly construct a highly aesthetic denture alternative which can be loaded immediately. Patients go home happy, and so do I! Paresh B Patel   October 27th, 2009 Dr. Chow, thank you for your well organized and eloquently articulated thoughts on the current state of mini implants. I look forward to reviewing your t...

K. F. Chow BDS., FDSRCS  October 23rd, 2009 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 integrated them both into my treatment planning taking into consideration the patient’s expectation...

K. F. Chow BDS., FDSRCS   November 13th, 2009 Thanks for the kind words guys. While I am yet feeling elated and therefore a little brash, let me push the debate a little further. We all know that the transmucosal passage of the dental implant when compared to the transmucosal passage of an actual, real, original living tooth is actually a pathetic imitation of the real thing. The real thing has a nice epithelial attachment with a nice drain around the tooth constantly flushed with antibacterial substances and prohealth nutrients for the gingivae. Not only that the gingival cuff has circular fibres, connective tissue to tooth fibres, bone to tooth fibres , connective tissue to bone fibres etc. that gives each tooth a nice firm resilient yet elastic cuff around the it. Go review your periodontology texts and see for yourself. The dental implant has only a pseudo epithelial attachment and a few if any specialised soft tissue fibres and at best is actually an iatrogenic and...

A direct impression was then made with a high quality precision type of alginate or silicone/rubber base material. The resulting models were then sent to the dental laboratory to construct the necessary three unit bridge 654 /. Alginate is more than adequate because we are not dealing with real teeth but implants and the accuracy obtained is adequate. A temporary bridge may or may not be placed since aesthetics is not a concern here. In this case, no temporary bridge was placed. The BUDs acted as comfort caps over the implants since they were designed to be rounded and smooth. Once the bridge was constructed, the patient was recalled and after testing in the mouth and adjusting the bite where necessary, the bridge was cemented over the BUDs with a suitable cement. In this case, glass ionomer was used. A temporary cement may be used for the sake of retrievability. Once the excess is removed, the crown and bridge is then...

A PROSTHODONTIC SOLUTION FOR THE MINI DENTAL IMPLANT As a result of the current less than satisfactory prosthodontic solutions for the mini dental implants, a new solution has been developed. This method is called the “BUDDY METHOD” and is described as follows for replacing the right upper premolars and first molar. It can also be used in all parts of the mouth. The method is described as follows:- Mini dental implants were inserted parallel to each other with 4mm sticking above the gums. This will include the O-ball head and neck with about 0.5 to 1.0mm of the collar sticking above the gum. Minis from Imtec or Intralock or others of similar design can be used. The BUDs{Bridge Underpinning Devices} were snapped onto the 56 / mini dental implants. The snap-on and snap-off function is simple, repeatable, precise and lends itself to impression taking without easily coming loose or shifting. They are checked to make sure the base of the BUDs ar...

      2. IMPRESSION AND ANALOGUE METHOD A more elegant technique developed with the use of an impression coping on the mini implant head. The coping came off with the impression and then analogues were fitted into the impression copings before pouring the cast models. The crowns and bridges were then built overt these analogues or over the copings which were then incorporated into the prosthesis. A recurring problem with this technique is the tendency of the impression copings to shift or come loose during the impression taking, resulting in inaccuracies. 3. COMPOSITE/GLASS IONOMER/CEMENT BUILDUP METHOD A sticky material like composite, glass ionomer or a dental cement can be applied on to the mini implant head. The implant head should be etched beforehand with an acid similar to the one used to etch porcelain. Once set, the build-up can be trimmed into the shape of an abutment. A direct impression can be taken for crown and bridge construction in th...