Posts
Flapless Implant Surgery | OsseoNews Discussions on Dental Implants: "A volumetric scan is ideal but need not be essential provided you know your anatomy and make full use of whatever low tech but economical techniques that are available like what had been described. In many parts of the world, we may not have the scan and use of it may put it out of reach of almost everyone except the very affluent; not to mention a computer fabricated surgical stent.
As it is many who need implants cannot afford them. Optimal technology suitable for the context especially the economy of the local people should be used together with a large dose of common sense.
Dental implants are the best replacement of lost teeth. As such we should strive to bring its extraordinary life-changing benefits to as many people as possible. Having said that, we should continue to develop more and more accurate means, hightech or otherwise in order to place implants better and faster and more affordably."
Thursday, November 20, 2008
Flapless Implant Surgery | OsseoNews Discussions on Dental Implants
Flapless Implant Surgery | OsseoNews Discussions on Dental Implants: "The whole surgical world is moving towards minimal invasive procedures. I believe flapless surgery or transmucosal placement or just making an incision big enough to do the osteotomy is the natural and sensible progression in implant surgery provided no extensive bone grafting is required. Popular rhetoric that it is blind is untrue. It is partially-blind because we have the benefit of models, bone-mapping, Xrays and imaging techniques that give us a pretty good idea of the bone morphology especially when you can eyeball it in vivo albeit covered with a layer of mucosa. Added on to the tactile palpating remote sensing of our supersensitive finger tips, we actually can “see” quite well without flapping and compromising the integrity of surrounding tissues. Flapless unless choiceless is the way to go."
Mini Implants for Long-Term Use? | OsseoNews Discussions on Dental Implants
Mini Implants for Long-Term Use? | OsseoNews Discussions on Dental Implants: "Mini-implants have the advantages of low cost, simple surgical placement and high versatility, have moderate success rates and are easy to insert when anatomic measurements are carefully considered. When failures are noted, retrieving the loosened one and/then inserting another mini-implant has little discomfort and is usually well accepted by patients. A vast majority of clinicians believe that implants not requiring surgical preparation have higher failure rates, while implants with better stability require flap surgeries for insertion and removal. Whereas conventional or modified oral implants have been shown to successfully serve as anchorage for orthodontic appliances, mini-implants failed to reach these high success rates. When the high failure rates of mini-implants are under evaluation two main factors have to be considered. The biomechanical loading of peri-implant bone as well as the time schedule of loading have been shown to have a major impact on the peri-implant bone healing and can be assumed to determine the clinical fate of mini-implants. Therefore, mini-implants can serve as anchorage for orthodontic force systems when loads do not exceed a tolerable strain level. It is important to note that the amount of stresses and strains are dependent on the geometry of the screw as well as on the mechanical properties of the implant and bone. The"
FDA on Mini Implants | OsseoNews Discussions on Dental Implants
FDA on Mini Implants | OsseoNews Discussions on Dental Implants: "A well known one piece small dental dental implant or mini dental implant as some wants to call it is called “self-tapping threaded screws indicated for long-term intra-bony applications. Additionally, they ….. may also be used for inter-radicular transitional applications. These devices will permit immediate splinting stability and long-term fixation of new or existing crown and bridge installations, for full partial edentulism, and employing minimally invasive surgical intervention.”
The quotation is taken clean from the FDA K031106 certification. Note that the term used is “self-tapping titanium threaded screws” and not “implants”. It seems that the FDA has to date decided that any threaded titanium screw that is of diameter 3mm and more is called an implant but anything below that is called a titanium threaded screw. However, its uses appear to be close to, if not equivalent to the uses of conventional implants……….i.e.long-term fixation of new and existing crown and bridge installations. Additional uses are inter-radicular transitional applications, immediate splinting stability, full and partial edentulism…..and using minimally invasive surgical intervention to boot! So the one piece small dental implants, though not labelled as implants seem to be approved to function as implants and is more versatile in"
The quotation is taken clean from the FDA K031106 certification. Note that the term used is “self-tapping titanium threaded screws” and not “implants”. It seems that the FDA has to date decided that any threaded titanium screw that is of diameter 3mm and more is called an implant but anything below that is called a titanium threaded screw. However, its uses appear to be close to, if not equivalent to the uses of conventional implants……….i.e.long-term fixation of new and existing crown and bridge installations. Additional uses are inter-radicular transitional applications, immediate splinting stability, full and partial edentulism…..and using minimally invasive surgical intervention to boot! So the one piece small dental implants, though not labelled as implants seem to be approved to function as implants and is more versatile in"
Mini Implant Systems | OsseoNews Discussions on Dental Implants
Mini Implant Systems | OsseoNews Discussions on Dental Implants: "What is a transitional and what is a provisional and what is an implant and what are their differences? I guess a transitional and a provisional is synonymous and by definition means something temporary until something permanent can be placed. Its probably something like a temporary resin-acrylic bridge until a permanent ceramic bridge is placed.Though nowadays we are seeing more and more composite bridges which last a long time. What do we call them then…..long term use composite bridges? In the mentioned case the transitionals as they grow stronger and more lasting are gradually morphing into permanents! Or should we call them pretenders to the throne? If what Todd says is true, he has at least 2000 fixed crowns and bridges masquerading as permanents for the last 3 to 6 years.Are they now still transitional, longterm, temporary or permanent? Who is the authorised guardian of these terms? Maybe as professionals, we should be wary of being tied down to terms without understanding the rationale behind them. What is important seems to be will it work clinically without compromising basic science and material characteristics. Hope these does not confuse too much but bring about returning regularly to first principles to make sure we are not propagating some standard that was set some time ago and has remained static although the dynamics has changed"
Mini Implant Systems | OsseoNews Discussions on Dental Implants
Mini Implant Systems | OsseoNews Discussions on Dental Implants: "I find the FDA specifications for an implant if true very strange if not arbitrary. Is 3mm a magic figure or what? Why not 2.5mm or 3.5mm or 2.88mm? If that is really their criteria, then on what rationale have they came out with the magic number of at least 3mm diameter before a dental implant is called a dental implant? Would have thought that adequate osseointegration should be the primary criteria and the rest should be merely complementary. Can somebody from the FDA or privy to their line of logic please enlighten. Thank you."
Mini Implant Systems | OsseoNews Discussions on Dental Implants
Mini Implant Systems | OsseoNews Discussions on Dental Implants: "Mini implants are at the same stage of developement that conventional implants were in the 80’s. I have been doing mini’s for 6 years the reason being I realized that conventional implants can only help about 20% of my patient population. Like conventional implants I started slow and went to Victor Sendex’s course where I saw the true potential for these implants. Like with all implants you need to work back from the prosthetics. I have used 3 systems and have found that Intra-Locks MDL(2.0 and 2.5) and Milo(3.0) provide me with the versality to do single units, partial denture retention and the old stand by full denture retention. They are also most useful in the bail out case. Mini implants are the DUCT TAPE of implant dentistry. They have helped me salvage cases that I could have not done any other way and not have the patient declair bankrupcy. Intra-Lock is the only system that has looked beyond denture retention. The prosthetic elements will allow you to do cases that you may have not gotten to due because of the limitations of conventional implant size. Check out my website to see what I mean. Get over it! Mini implants are not just transitional and are here to stay! The secret is knowing the anatomy of where you are using them which I fortunately learned with my conventional implant experience. Like with conventional"
Mini Implant Systems | OsseoNews Discussions on Dental Implants
Mini Implant Systems | OsseoNews Discussions on Dental Implants: "Yap. A hollow tube is stronger than a solid tube provided you do not screw something into it intimately so much so that it is not just resisting forces from without but it is also fighting a third column of forces within that is persistently trying to force it to explode, and that is why one of the main drawbacks of 2 piece implants is connecting screw failure! A 1 piece solid implant of 2.5mm diameter is on measure still more advantageous to a 3mm diameter hollow implant with a screw tight inside trying to push it apart. So, maybe the FDA may begin to see the light and pontify down the magic number below 3mm as long as it is not hollow. By the way, whether Pluto is a planet or not depends on whether you are a faithful nolstalgic traditionalist or a sort of a curious gungho advancing experimentalist determined to improve and simplify things.Elegance should not be complicated but simple yet functional."
Mini Implant Systems | OsseoNews Discussions on Dental Implants
Mini Implant Systems | OsseoNews Discussions on Dental Implants: "I was first introduced to dental implantology in 1968 by Dr. Leonard Linkow, while doing a post graduate program working in the department of Prosthodontics at the Hebrew University in Jerusalem Israel. Dr. Linkow demonstrated his concepts of placing different shaped titanium fixtures into the existing residual jaw bone
( an assortment of “blades”, screws,endosteal stabilizers, intramucosal inserts, subperiosteal frames,and even a coined titanium “Star of David” into the jawbone of a rabbi, ; and he called them all dental implants.
An artificial device that can be embedded into the jawbone and protrude into the oral cavity such to support a tooth or teeth is, in my humble estimation, a dental implant. I can understand the point of view of the FDA to place a value on the engineering specifications of the strength of a fixture, and decide that anything less than 3mm in diameter is not strong enough to be considered a permanent fixture, and is therefore not considered a dental implant, in order to place guidelines to protect the public.
However, if dentists like Dr. Victor Sendax did not have the moxy and ingenuity to go beyond the “established guidelines” of definition, and help out a famous opera star when his permanent bridge was falling out of his mouth before a performance ( and steril"
( an assortment of “blades”, screws,endosteal stabilizers, intramucosal inserts, subperiosteal frames,and even a coined titanium “Star of David” into the jawbone of a rabbi, ; and he called them all dental implants.
An artificial device that can be embedded into the jawbone and protrude into the oral cavity such to support a tooth or teeth is, in my humble estimation, a dental implant. I can understand the point of view of the FDA to place a value on the engineering specifications of the strength of a fixture, and decide that anything less than 3mm in diameter is not strong enough to be considered a permanent fixture, and is therefore not considered a dental implant, in order to place guidelines to protect the public.
However, if dentists like Dr. Victor Sendax did not have the moxy and ingenuity to go beyond the “established guidelines” of definition, and help out a famous opera star when his permanent bridge was falling out of his mouth before a performance ( and steril"
Mini Dental Implants: Extensive Debate | OsseoNews Discussions on Dental Implants
Mini Dental Implants: Extensive Debate | OsseoNews Discussions on Dental Implants: "Dear NikkiB,
Your mum sounds like one of my patients. 4 mini implants were place on his lower ridge and his loose lower denture was fastened reversibly to the implants. Reversibly means that the denture can be fastened and removed at will for cleaning purposes. Generally, the existing dentures is used so that the patient need not have to get used to a new set of dentures. Once the patient is used to the implants, a new denture can be made if necessary. This particular patient was 82 years old. He was able to eat much better that very night. Hope your mum’s problem is solved soon. Mini implants are very forgiving in the sense that its easier to place than the conventional sized implants and if one fails, it can be removed easily and a new one placed immediately if necessary. warmest regards. Dr. kfchow"
Your mum sounds like one of my patients. 4 mini implants were place on his lower ridge and his loose lower denture was fastened reversibly to the implants. Reversibly means that the denture can be fastened and removed at will for cleaning purposes. Generally, the existing dentures is used so that the patient need not have to get used to a new set of dentures. Once the patient is used to the implants, a new denture can be made if necessary. This particular patient was 82 years old. He was able to eat much better that very night. Hope your mum’s problem is solved soon. Mini implants are very forgiving in the sense that its easier to place than the conventional sized implants and if one fails, it can be removed easily and a new one placed immediately if necessary. warmest regards. Dr. kfchow"
Mini Dental Implants: Extensive Debate | OsseoNews Discussions on Dental Implants
Mini Dental Implants: Extensive Debate | OsseoNews Discussions on Dental Implants: "Branemark generally copied the size and the shape of the tooth in designing his first implant which is logical and made sense at the time. Everyone copied him after that without too much thought about the validity of his assumptions because it works. The question today is how much osseointegration is required to support a tooth say, the premolar in the mouth. The answer to this question will determine how big an implant should be and therefore will determine whether we should continue to make root sized implant fixtures or reduce and minimise its size optimally. How much osseointegration in terms of surface area and quality of bone attachment is required to support a premolar satisfactorily in a functioning dentition needs to be examined closely anew. Lets assume the quality of osseointegration is uniform for most interfaces between the bone and titanium surface. Therefore looking at just the surface area required per se, it follows that if osseointegration aka ankylosis is say, twice as tough as the normal periodontal ligament, then my friends, it seems that the minimised diameter implant is going to triumph over the conventional sized implant as the main workhorse in dental implantology! To say it simply, if it is true as we all know that ankylosis is tougher than the periodontal ligament sq mm for sq mm, then the minimised diame"
Late Facial Swelling After Implant Placement? | OsseoNews Discussions on Dental Implants
Late Facial Swelling After Implant Placement? | OsseoNews Discussions on Dental Implants: "Insufficient information to clinch a diagnosis. A thorough systemic and localised history and localised examination is necessary. Site of implants, pain, swelling etc. is essential. Anything is possible from sarcoma to just a simple delayed hematoma…. and even a blocked salivary gland. Having said that, it is usually just something common and local like infection or denture trauma or part of the healing process since it is an immediate post extraction placement of implants. Maybe a loose screw on the fixture? We need to approach with a comprehensive overview, considering all the details before zeroing on the diagnosis. Thoroughness is essential
Cheers"
Cheers"
Possibility Implant Has Moved? | OsseoNews Discussions on Dental Implants
Possibility Implant Has Moved? | OsseoNews Discussions on Dental Implants: "Dear Anon,
What happened is obviously an alien abduction. While doing an extreme MRI on it, it moved. Please double check with your patient.
OK OK, I am just joking!
It could be that after you placed the healing abutment, the patient accidentally bit on a hard piece of nut or some such thing that is hard and large which we sometimes insist on placing into our stoma in order to masticate and consume it. The hefty crunch was so hefty that it actually caused the bone to give way, but not the periosteum though…… and the whole implant moved 2mm. After that horrid experience, the patient decided to give it a prolonged and careful rest and ate on the other side most of the time and lo and behold, the implant reosseointegrated again in its new location. Over the extended time that you mentioned, the patient selectively forgot about it or chose not to mention it in case you blame him/she for any residual problem. I could have sworn that that is what happened to one implant I placed several years ago.
Cheers!"
What happened is obviously an alien abduction. While doing an extreme MRI on it, it moved. Please double check with your patient.
OK OK, I am just joking!
It could be that after you placed the healing abutment, the patient accidentally bit on a hard piece of nut or some such thing that is hard and large which we sometimes insist on placing into our stoma in order to masticate and consume it. The hefty crunch was so hefty that it actually caused the bone to give way, but not the periosteum though…… and the whole implant moved 2mm. After that horrid experience, the patient decided to give it a prolonged and careful rest and ate on the other side most of the time and lo and behold, the implant reosseointegrated again in its new location. Over the extended time that you mentioned, the patient selectively forgot about it or chose not to mention it in case you blame him/she for any residual problem. I could have sworn that that is what happened to one implant I placed several years ago.
Cheers!"
Drilled Too Deep when Preparing Hole for Implant Insertion: Should I Be Concerned? | OsseoNews Discussions on Dental Implants
Drilled Too Deep when Preparing Hole for Implant Insertion: Should I Be Concerned? | OsseoNews Discussions on Dental Implants: "Having 1 or 2 mm extra depth to your implant is okay provided it did not traumatised any vital structures like the sinuses or the idn or the linqual or labial plates. Even so, if the implant does not impinge excessively into these structures, the body’s unrivalled healing abilities will cover up our misdemeanour. Of course we should rely primarily on our skill and foresight via thorough treatment planning to avoid these misdemeanours and only rely on the bodiy’s built in smart healing powers as a failsafe device. If in doubt about sterility, it does no harm to cover the patient with antibiotics. Might be helpful to also advice the patient to take some yogurt for those few days and some days after to replace any good bacteria in the gut that may have been destroyed.
Cheers."
Cheers."
Monday, October 6, 2008
Numbness After Implants | OsseoNews Discussions on Dental Implants
Numbness After Implants | OsseoNews Discussions on Dental Implants: "Dr Amayev September 11th, 2006
No matter what kind of surgeons you are anything could happen .Of course we must try to ovoid any possible complication to our patient and treat them with respect but sometimes complication may happen. In order to avoid any possible complication we should just stop what we are doing as been previously mention by Dr Kfchow. I don’t believe that there is a dentist or another type of medical professional or any other profession who never had a complication. We all humans and if we did something we have to try to resolve and help that patient in any possible way if we can. From what Lerry or Ben told us, I don’t know you are a doctors or not but if you are it seems like you both the best and never had any complications in your practice. If you didn’t I am very happy for both of you. Never say this may not happen to you ,look in a future you still practicing. Think about that. May be you don’t have enough experience that why you so positive about your self . I’ve been practicing for 15 years and my practice is limited to implants dentistry only and I still can get complications, but I know how to manage them if I don’t i always ask. There’s no human been in this wold who will know everything. Take your time both of you, and slow down. Good Luck....
No matter what kind of surgeons you are anything could happen .Of course we must try to ovoid any possible complication to our patient and treat them with respect but sometimes complication may happen. In order to avoid any possible complication we should just stop what we are doing as been previously mention by Dr Kfchow. I don’t believe that there is a dentist or another type of medical professional or any other profession who never had a complication. We all humans and if we did something we have to try to resolve and help that patient in any possible way if we can. From what Lerry or Ben told us, I don’t know you are a doctors or not but if you are it seems like you both the best and never had any complications in your practice. If you didn’t I am very happy for both of you. Never say this may not happen to you ,look in a future you still practicing. Think about that. May be you don’t have enough experience that why you so positive about your self . I’ve been practicing for 15 years and my practice is limited to implants dentistry only and I still can get complications, but I know how to manage them if I don’t i always ask. There’s no human been in this wold who will know everything. Take your time both of you, and slow down. Good Luck....
Numbness After Implants | OsseoNews Discussions on Dental Implants
Numbness After Implants | OsseoNews Discussions on Dental Implants: "Rhonda September 11th, 2006
Dear Dr.KFChow-Thank you for your perspective on repairing of damaged nerves..it is greatly appreciated. For 3 months gums, chin and lips completely numb. Every night I would massage my face, do facial exercises smiles, frown, puff out my cheeks and teach myself to chew on that side without biting my lip. Bascially, physical therapy to get circulation, feeling and life back to my face. I will never give up and I refuse to take medications because it is uncomfortable. After 3 months, the prickling, tingling and itchy feelings started to occur, Now that I have read your information that these are goods signs as my regular dentist has also stated, It is much more tolerable!!! Ben & Larry thank you also -There is much truth in what you write the Dr. that did my implant has been in my family for many years - he has removed my childrens impacted teeth with success and no problems…He is really a good person, he had no intention of causing me this problem, it was successful for my right sided implant.. just not for my left side. I did choose him and choose this surgery and knew of complications,I am trying to deal with this the best way for me. I hope in someway this helps someone who maybe going through the same situation."
Dear Dr.KFChow-Thank you for your perspective on repairing of damaged nerves..it is greatly appreciated. For 3 months gums, chin and lips completely numb. Every night I would massage my face, do facial exercises smiles, frown, puff out my cheeks and teach myself to chew on that side without biting my lip. Bascially, physical therapy to get circulation, feeling and life back to my face. I will never give up and I refuse to take medications because it is uncomfortable. After 3 months, the prickling, tingling and itchy feelings started to occur, Now that I have read your information that these are goods signs as my regular dentist has also stated, It is much more tolerable!!! Ben & Larry thank you also -There is much truth in what you write the Dr. that did my implant has been in my family for many years - he has removed my childrens impacted teeth with success and no problems…He is really a good person, he had no intention of causing me this problem, it was successful for my right sided implant.. just not for my left side. I did choose him and choose this surgery and knew of complications,I am trying to deal with this the best way for me. I hope in someway this helps someone who maybe going through the same situation."
Numbness After Implants | OsseoNews Discussions on Dental Implants
Numbness After Implants | OsseoNews Discussions on Dental Implants: "kfchow-mostdi-msia August 29th, 2006
I had a patient who experienced numbness of the lower right lip after placement of dental implants on the right molar area. Xrays showed one of the implants impinging on the inferior dental canal. That implant was removed 2 days later and the patient recovered full sensation after about 3 weeks. I think the patient suffered from neuropraxia i.e. compression of the nerve. I guess speed of recovery if at all will depend on the extent of the damage…. is it just compression injury or incision injury….partial incision or full incision. However, since the nerve is running within a well defined channel in the bone, chances of some recovery and even full recovery may be high even in cases of neurometsis. I hope Dr. Joglekar has a full recovery eventually.
Regards. Dr. kfchow Malaysia"
I had a patient who experienced numbness of the lower right lip after placement of dental implants on the right molar area. Xrays showed one of the implants impinging on the inferior dental canal. That implant was removed 2 days later and the patient recovered full sensation after about 3 weeks. I think the patient suffered from neuropraxia i.e. compression of the nerve. I guess speed of recovery if at all will depend on the extent of the damage…. is it just compression injury or incision injury….partial incision or full incision. However, since the nerve is running within a well defined channel in the bone, chances of some recovery and even full recovery may be high even in cases of neurometsis. I hope Dr. Joglekar has a full recovery eventually.
Regards. Dr. kfchow Malaysia"
Numbness After Implants | OsseoNews Discussions on Dental Implants
Numbness After Implants | OsseoNews Discussions on Dental Implants: "Dear Rhonda,
I am sorry to hear of your problem. However, nerve damage is one of the possible complications to placing dental implants on the lower jaw molar area. No matter how experienced the dentist or oral surgeon is, sometimes it happens. This is the same in every field of surgical intervention. Such incidences happily are rare when reasonable care is taken, but like I said, it happens even to the best of doctors. But to the patient it happens to, such knowledge brings only a little consolation. From your account, I would agree generally with what your regular dentist has told you. The damage has already been done at the time of surgery and the backing out of the implant was the right step. But nerves have a notoriously unpredictable pace of recovery. It depends on exactly how much damage was inflicted. The accurate assessment of such damage however is very difficult even with the most advanced imaging systems. Also, the healing of nerves is still not completely understood. Lots of research has been done on the healing of nerves and the factors involved together with stem cell research. Christopher Reeves(Superman)’s saga highlighted to the whole world how hard we are trying to understand nerve healing and conversely how little we actually know and how helpless we are when it comes to repairing damaged nerves. The overall lesson is to try your best not to damage them and when the damage is done, remove the causative factors as quickly as possible within reason. I agree with your regular dentist in that totally removing the implant at this stage will not improve the situation significantly. Also, the tingling and itchy sensation is a sign of healing. How complete the healing is, only time will tell. But it is encouraging to observe that it is improving with time. All the best and my best hopes for a complete recovery.
Dr.KFChow Malaysia
I am sorry to hear of your problem. However, nerve damage is one of the possible complications to placing dental implants on the lower jaw molar area. No matter how experienced the dentist or oral surgeon is, sometimes it happens. This is the same in every field of surgical intervention. Such incidences happily are rare when reasonable care is taken, but like I said, it happens even to the best of doctors. But to the patient it happens to, such knowledge brings only a little consolation. From your account, I would agree generally with what your regular dentist has told you. The damage has already been done at the time of surgery and the backing out of the implant was the right step. But nerves have a notoriously unpredictable pace of recovery. It depends on exactly how much damage was inflicted. The accurate assessment of such damage however is very difficult even with the most advanced imaging systems. Also, the healing of nerves is still not completely understood. Lots of research has been done on the healing of nerves and the factors involved together with stem cell research. Christopher Reeves(Superman)’s saga highlighted to the whole world how hard we are trying to understand nerve healing and conversely how little we actually know and how helpless we are when it comes to repairing damaged nerves. The overall lesson is to try your best not to damage them and when the damage is done, remove the causative factors as quickly as possible within reason. I agree with your regular dentist in that totally removing the implant at this stage will not improve the situation significantly. Also, the tingling and itchy sensation is a sign of healing. How complete the healing is, only time will tell. But it is encouraging to observe that it is improving with time. All the best and my best hopes for a complete recovery.
Dr.KFChow Malaysia
Flapless Implant Surgery | OsseoNews Discussions on Dental Implants
Flapless Implant Surgery | OsseoNews Discussions on Dental Implants: "Dr. KFC January 25th, 2007
The whole surgical world is moving towards minimal invasive procedures. I believe flapless surgery or transmucosal placement or just making an incision big enough to do the osteotomy is the natural and sensible progression in implant surgery provided no extensive bone grafting is required. Popular rhetoric that it is blind is untrue. It is partially-blind because we have the benefit of models, bone-mapping, Xrays and imaging techniques that give us a pretty good idea of the bone morphology especially when you can eyeball it in vivo albeit covered with a layer of mucosa. Added on to the tactile palpating remote sensing of our supersensitive finger tips, we actually can “see” quite well without flapping and compromising the integrity of surrounding tissues. Flapless unless choiceless is the way to go."
The whole surgical world is moving towards minimal invasive procedures. I believe flapless surgery or transmucosal placement or just making an incision big enough to do the osteotomy is the natural and sensible progression in implant surgery provided no extensive bone grafting is required. Popular rhetoric that it is blind is untrue. It is partially-blind because we have the benefit of models, bone-mapping, Xrays and imaging techniques that give us a pretty good idea of the bone morphology especially when you can eyeball it in vivo albeit covered with a layer of mucosa. Added on to the tactile palpating remote sensing of our supersensitive finger tips, we actually can “see” quite well without flapping and compromising the integrity of surrounding tissues. Flapless unless choiceless is the way to go."
Mini Implant Systems | OsseoNews Discussions on Dental Implants
Mini Implant Systems | OsseoNews Discussions on Dental Implants: "true believer November 13th, 2006
Who brings progress to man? The playitsafers or the reachupfortheskyers? The very fact that we are practising the blessed art of dental implantology is because of people like Linkow and Branemark who in their time were vilified and branded as a bit of their heads. Linkow was labeled a “mad dentist”. But today we are thankful for them and their ability to accept critism with magnanimity."
Who brings progress to man? The playitsafers or the reachupfortheskyers? The very fact that we are practising the blessed art of dental implantology is because of people like Linkow and Branemark who in their time were vilified and branded as a bit of their heads. Linkow was labeled a “mad dentist”. But today we are thankful for them and their ability to accept critism with magnanimity."
Mini Dental Implants: Extensive Debate | OsseoNews Discussions on Dental Implants
Mini Dental Implants: Extensive Debate | OsseoNews Discussions on Dental Implants: "kfchow-mostdi-msia June 28th, 2006
Branemark generally copied the size and the shape of the tooth in designing his first implant which is logical and made sense at the time. Everyone copied him after that without too much thought about the validity of his assumptions because it works. The question today is how much osseointegration is required to support a tooth say, the premolar in the mouth. The answer to this question will determine how big an implant should be and therefore will determine whether we should continue to make root sized implant fixtures or reduce and minimise its size optimally. How much osseointegration in terms of surface area and quality of bone attachment is required to support a premolar satisfactorily in a functioning dentition needs to be examined closely anew. Lets assume the quality of osseointegration is uniform for most interfaces between the bone and titanium surface. Therefore looking at just the surface area required per se, it follows that if osseointegration aka ankylosis is say, twice as tough as the normal periodontal ligament, then my friends, it seems that the minimised diameter implant is going to triumph over the conventional sized implant as the main workhorse in dental implantology! To say it simply, if it is true as we all know that ankylosis is tougher than the periodontal ligament sq mm to sq mm, then the minimised diameter implant is sufficient to hold a normal tooth! Has anyone done a comparative study between a normal periodontally held tooth and an ankylosed titanium implant? Its beginning to make more and more sense to me that a small diameter implatnt is actually sufficient to hold a tooth and if true, its good news for everyone because implantology is going to be cheaper, easier and more versatile than it is now.
Branemark generally copied the size and the shape of the tooth in designing his first implant which is logical and made sense at the time. Everyone copied him after that without too much thought about the validity of his assumptions because it works. The question today is how much osseointegration is required to support a tooth say, the premolar in the mouth. The answer to this question will determine how big an implant should be and therefore will determine whether we should continue to make root sized implant fixtures or reduce and minimise its size optimally. How much osseointegration in terms of surface area and quality of bone attachment is required to support a premolar satisfactorily in a functioning dentition needs to be examined closely anew. Lets assume the quality of osseointegration is uniform for most interfaces between the bone and titanium surface. Therefore looking at just the surface area required per se, it follows that if osseointegration aka ankylosis is say, twice as tough as the normal periodontal ligament, then my friends, it seems that the minimised diameter implant is going to triumph over the conventional sized implant as the main workhorse in dental implantology! To say it simply, if it is true as we all know that ankylosis is tougher than the periodontal ligament sq mm to sq mm, then the minimised diameter implant is sufficient to hold a normal tooth! Has anyone done a comparative study between a normal periodontally held tooth and an ankylosed titanium implant? Its beginning to make more and more sense to me that a small diameter implatnt is actually sufficient to hold a tooth and if true, its good news for everyone because implantology is going to be cheaper, easier and more versatile than it is now.
Search on for Way to Grow New Teeth | OsseoNews Discussions on Dental Implants
Search on for Way to Grow New Teeth | OsseoNews Discussions on Dental Implants: "Kai Foo Chow FDSRCS October 6th, 2008
Meanwhile, lets be thankful for dental implants. Yes, the current holy grail in dental implantology is the tooth germ implant or MOTGI: Made to Order Tooth Germ Implant. However, Motgis will probably take at least another 10 years, maybe more. The hurdles involved are growing the toothgerm in the lab, twitching the genetic switches to develop the toothgerm into a canine, molar, premolar or incisor. Also, it has to be specific in left or right and in terms of size. Next, dentists have to be trained to place them and special surgical protocols have to be developed.
Not easy, but nevertheless we must be reachfortheskyers and not playitsafers. Imitating the original is one hack of a job!
Meanwhile, dental implants are already a vast leap forward to the moon. Motgis will be a quantum leap to Mars.
Cheers."
Meanwhile, lets be thankful for dental implants. Yes, the current holy grail in dental implantology is the tooth germ implant or MOTGI: Made to Order Tooth Germ Implant. However, Motgis will probably take at least another 10 years, maybe more. The hurdles involved are growing the toothgerm in the lab, twitching the genetic switches to develop the toothgerm into a canine, molar, premolar or incisor. Also, it has to be specific in left or right and in terms of size. Next, dentists have to be trained to place them and special surgical protocols have to be developed.
Not easy, but nevertheless we must be reachfortheskyers and not playitsafers. Imitating the original is one hack of a job!
Meanwhile, dental implants are already a vast leap forward to the moon. Motgis will be a quantum leap to Mars.
Cheers."
Sunday, September 28, 2008
Dental Implantology: The next Challenge
Dental Implants are recognised widely both professionally and by people at large as the best replacement for lost teeth. Though it cannot be as good as the original, it is close to it in terms of function, appearance and durability. Previously the challenge was to replace lost teeth that bite well, look good and last long. These challenges have largely been overcome in the last ten years or so. The new challenge is to make dental implants universally available at an easily affordable price. To achieve these, the training of dentists have to be made simple and speedy and adequate. This is important because currently worldwide, hardly 5 to 10% of dentists routinely practise dental implantology. A universally simple and affordable dental implant system needs to be invented.
Subscribe to:
Posts (Atom)
