Ace Surgical Mini Dental Implant Full Arch Roundhouse Bridge

Can dental implants be affordable?  My next patient wanted to get rid of his dentures and have a fixed set of crowns or a full arch roundhouse bridge on dental implants.  He brought his treatment plan for 8 dental implants and a set of 12 porcelain crowns…..total cost a bit north of $28,000.  With mini dental implants we could reduce that cost and still have a well engineered bridge. 

IMG_1582

He had a nice ridge of bone to work with.  It would not need any pre surgery to accommodate dental implants.  With some planning with Jon Younce CDT at First Impressions Dental Lab a logical progression treatment plan was formulated that was restorative driven. 

 

 

 

 

 

 

Pre pan 1

His pan x-ray also showed good bone with the sinus cavity totally dropped down where the back teeth were in the upper jaw.  There was also a retained set of root tips that would need to be removed on the upper right.

 

 

IMG_1581

 

Using his upper denture as a guide I made holes in the center of each back tooth and the lingual of the front teeth to ensure the mini dental implants would line up correctly for the final roundhouse full arch bridge.

 

 

 

 

IMG_1587

 

10 ACE Surgical Mini Prep 2.3mm implants were placed in the upper arch.  They were placed as parallel as possible to allow for proper draw of the final roundhouse full arch bridge.

His denture was soft lined to fit over the ACE Surgical Mini Dental Implants. 

 

 

 

IMG_1590

 

 

A regular crown and bridge impression was taken of the 10 ACE Surgical Mini Dental Implants.  No additional impression copings or lab analogs were used.  With mini dental implants we can create a more efficient and cost effective solution for patients by reducing parts and pieces that are normally required with traditional dental implants.

 

 

 

 

IMG_1620

A standard crown and bridge model was poured in Pol-u-rock by the lab and a set of trial resin crowns were made to let the patient 'test drive' the crowns.

 

 

 

 

 

 

IMG_1619

 

Lab fabricated resin temporary crowns ready to try in and have the patient give us his feedback on esthetics, function, comfort and color.

 

 

 

 

 

 

 

IMG_1664

 

It was decided after a few days that the temporary crowns were too long. The patient also had Bell's Palsy and we decided to try and correct the slant.  This photograph shows one side of the temporary crowns shortened to the new lenght for the lab to see our corrections.  I shapedthe other side and let the patient go home to 'test drive' them again for final approval.

 

 

Reshaped temps and final photos for the lab to duplicate the arcylic temps in porcelain for the full arch bridge

IMG_1659  IMG_1692  IMG_1693

IMG_1733

 

Final porcelain bridge back from the lab.  It is in three sections.

 

 

 

 

 

IMG_1820 

IMG_1823 

IMG_1826 
IMG_1839

Final porcelain bridge cemented over 10 ACE Surgical Mini Prep Mini Dental Implants.

 

 

 

 

 

IMG_1844

 

Full smile with the bridge in place.

 

 

 

 

 

 

James post zirc roundhouse

 

Final pan x-ray with the 10 Ace Surgical Mini Dental Implants with the 12 units of bridge work cemented over them.  Our plan is to do a lower mini dental implant overdenture that will be converted to a bridge over time as $$ can be invested.

 

Paresh B Patel Mini Dental Implants Charlotte Hickory Lenoir NC

Mini Dental Implant & General Dentistry Mooresville NC

Implant Dentistry a Great Way to Replace Missing Teeth with OCO Mini One Piece Dental Implants

If you are missing one or more teeth, dental implants are a cost effective way to replace them with fixed crowns or bridges.  With the advent of the mini dental implant and the one piece traditional size dental implants you now can have teeth back once again. 

Slide1

 

Missing Premolar and Canine teeth shown on the patients pan x-ray.  She has had a few mini dental implants and crowns already.

 

 

 

 

Slide2

 

It looks like a wide ridge with plenty of bone.  But with a 3D i-CAT scan we see something different.

 

 

 

 

Slide3

 

The ridge of bone is only 3.0mm wide at the top.  Choices are to widen the bone, flatten it a bit (both of these would require a bit more surgery and healing time).  Or to consider using a one piece mini dental implant by OCO Biomedical.

 

 

 

Slide6

 

A OCO 3.0mm one piece mini dental implant was selected and placed with no surgical flap of gum tissue and minimal trauma to the area.

I-mini_imgbig[1]

 

 

 

Slide10

 

The OCO one piece mini dental implants were prepped in the mouth with light pressure (water and air spray).

 

 

 

 

Slide11

 

An optical scan was taken of the prepped one piece mini dental implant for First Impressions Dental Lab to make the porcelain crowns.

 

 

 

 

Slide13

 

All porcelain crowns prior to cementation.

 

 

 

 

 

Slide14

 

Crowns in place over the OCO Biomedical one piece dental implants.

 

 

 

 

 

Paresh B Patel Implant Dentist Charlotte Hickory Lenoir NC

Mini Dental Implants Dentist NC

One Piece Dental Implant ~ OCO Biomedical ISI Extraction & Immediate Placement

In keeping with our mission at my dental office we try to make implant dentistry affordable to those patients that have not been able to move forward with their treatment. 

I have been thrilled to find a one piece dental implant in a regular or traditional implant size.  The OCO Biomedical ISI dental implant offers me the option of using a larger implant that does not require additional parts.  The abutment(the part of the implant that comes up out of the gum) is made right along with the body of the dental implant(the part that is inserted into the bone). OCO ISI implant

This offers me the things I like about mini dental implants:

  • One piece design
  • No additional parts to buy
  • No microgap
  • Prepping of the abutment in the mouth is part of the insertion protocol
  • No surgical flap is recommended
  • Less trauma
  • Less healing for the patient
  • Increase in affordability for patients
  • Ease of placement….

My next patient was missing his upper eye tooth and the little tooth next to it was fractured and need to be extracted.Pre op buccal view

Of course there was a lot else going on but this is where we decided to start after getting his periodontal condition as stable as possible. 

 

 

 

Using some PDL-vators from Salvin Dental Supply I removed the tooth with minimal trauma.

Pdl to remove #7

 

Peritome to seperate the PDL fibers from the tooth that needed to be extracted. 

 

 

 

 

7 extracted socket

 

Extraction socket with the tooth removed.  Notice very little trauma to the soft gum tissue.

 

 

 

#8 marking bur  Tissue punch 4.0mm  Pilot bit 1.8mm w drill stop  R11

The same insertion protocol was used for the OCO One Piece Dental Implant as I would do for a mini dental implant.  Its called logical progression.  If you can place a mini dental implant; add one more bone former and you can put in a one piece regular implant.  I try to follow the philosophy of selecting a implant that will fit the bone NOT make the bone fit the implant with additional surgical procedures. 

Parallel pin in  Oco isi 4.0 yellow cap in Thumb driver clinical  Socket wrench

The same concept is applied to the Mini Dental Implant that will be placed into the extraction site.  It is is one piece dental implant like the OCO ISI 4.0 x 14mm that was placed to act the the root for the missing eye tooth. 

We are going to place a OCO i-mini 3.0 x 16mm to get at a minimum 3mm past the end of the root of the tooth that was extracted.  This is to ensure stability of our mini dental implant for the temporary crown.

3.0 yellow cap  3.0 thumb driver  R12

With both the traditional one piece dental implant and the mini dental implant in place we can make the temporary crowns to fit over them while they heal.  You can see on the xray that the mini dental implant has gone past the tip of the extraction socket.  The regular size OCO ISI one piece dental implant is firm with over 50ncm of torque. 

Temps 6 7 close up

Two temporary acrylic crowns are made and cemented over the OCO one piece dental implants.  Once the tissue heals in around the extraction site and fills in with bone the final impression will be made for First Impressions Dental Lab to make the Porcelain Crowns over the mini dental implant as well as the regular one piece implant. 

 

 

Paresh B Patel Dental Implants Hickory Lenoir Wilkesboro NC

Dental Implants Charlotte Mooresville NC

Mini Dental Implants Long Term Use for Crown and Bridge in the Upper Jaw

Picture-is-worth-a-thousand-words

"A picture is worth a thousand words"  Very true that it is easier to convey the meaning of a complex idea with just a single picture.

I believe the proverb is contributed to the ancient philosopher Confucius. 

Well I am just not that smart to have come up with such an elegant way to describe that visualization is a great way to absorb lots of data quickly and efficiently.

 

 

As a dentist I am bothered that many try to misinform the very patients we try and help daily with web postings such as this:

"Mini implants, often offered by less experienced dentists as a quick and less costly solution to replacing missing teeth, have a high degree of complications and failure and therefore are not recommended for long-term tooth replacement. Only standard size implants should be used for teeth replacement to achieve long-term success and longevity."  These comments were made in December 2009.

Where are these complications?  Where are these failures?  I would think that a practice like mine where we focus on mini dental implants I would have hundreds of documented cases of failed mini dental implants.  All the colleagues I meet from around the country would certainly share with me their failures if there was a high degree of them.  To date I have not seen this.  If anyone wants to see long term data you can look at them in Todd Shatkin's Compendium Article as well as several articles by Gordon Christensen. 

Do mini dental implants fail?  Sure they do….but not at any rate different than standard size implants.  The basic premise applies.  Place the implant under the correct protocol it will integrate.  If the occlusal (biting) loads are managed correctly then the implant will work long term under function.

I think the higher road to take is to explain both options to patients.  Mini Dental Implants do work and have been show to work well for a multitude of fixed (Crowns and Bridges) and removable (Partial and Complete Dentures) solutions for 12 years.  Can I provide 35+ years of success.  No….but if 12 years is an indicator then I suspect that they will.  No gain is provided to dentistry and the patients we serve with misinformation.

In conclusion lets use Confucius's proverb show what I hope to communicate. 

Day of

 

3 Mini Dental Implant to support 2 premolar crowns in the upper jaw.  Placed and restored with PFM crowns 12-21-2009.

 

 

 

 

 

One year post op

 

One year post op x-ray 12-21-2010.  Same three mini dental implants with 2 PFM premolar crowns in the upper jaw. 

 

 

 

 

Mini one year  

 

 

 

 

 

 

 

Confucius emphasized personal morality, correctness of social relationships, justice and sincerity.  I hope to see more of this in organized dentistry. 

Paresh B Patel Dentist Mooresville NC

Mini Dental Implants Charlotte NC

Easy Dental Implant Placement to Replace a Missing Tooth with a Fixed Crown

Lets face it….we are getting older and our teeth age along with us.  Some of us will have missing teeth due to decay or injury or just daily use.  With tooth loss comes other potential problems.  Such as aesthetic concerns and not being able to eat the things you like.  Bone loss

With the advent of a dental implant (a small titanium screw that is gently rotated into the gum and bone) we can now use that as a new root to anchor a replacement porcelain crown or bridge. 

 

 

 

 

Missing molar

Here is a good example of how the bone starts to melt away after a tooth is lost.  This also shows show the sinus cavity starts to drop down giving us even less volume of bone to place the dental implant.  This is a great spot to use two mini dental implants or if there is enough width one larger regular size dental implant.  I like using a one piece dental implant.  It has the advantages of being cost effective, no microgap, and immediate use just like a mini dental implant. 

 

Occlusal

 

Here we can see the missing molar tooth.  Plenty of width of bone.  Options given to the patient were 2 mini dental implants or one regular size one.  In this case we decided to use a OCO Biomedical ISI one piece dental implant 4.0mm in diameter.  Lots of times I have been asked, is it not harder to place the larger size implant.  I don't think so.  With the logical progression design of the OCO dental implants it is very similar in placement protocol to what I am use to doing with mini dental implants.  One pilot bit and one final bit to form the bone.  No flap of gum tissue is made.  Patients go home with no blood or stitches.

 

Parallel pin

 

Parallel pin in place to check for proper angle and depth.  I will use some SalvinOsteotomes to push up the sinus and some DynaBlast bone putty to fill in around the end of the implant.  Chris Totty at Salvin can provide additional information on these products. 

 

 

 

OCO ISI 4.0mm

 

Final photo of the OCO Biomedical ISI 4.0mm dental implant to replace the missing upper molar.  As you can see, no blood and no stitches.  It will have the same surface area as two mini dental implants. Either solution would provide this patient the opportunity to have her missing molar tooth once again.

 

 

Sinus bump

 

Final x-ray with the sinus membrane bumped up to allow for the end of the OCO dental implant to be covered with added bone.  This will fill in and turn into live bone in a few months.  A i-TERO impression was taken and First Impressions Dental Lab will make a porcelain crown to fit over the OCO ISI one piece dental implant. 

 

 

Paresh B Patel Dentist Mooresville NC

Mini Dental Implants

 

 

 

 

 

Missing Front Teeth Replaced with OCO Mini Dental Implants & Porcelain Crowns

Ext bridge 9 -11

Who would be happy if they lost 1/2 of their front teeth? 

My next patient unfortunately broke her bridge and just could not stand the partial she had to replace them. 

Of course everyone wants to have fixed teeth; but cost is certainly a factor that must be addressed as an individual issue.  I tell everyone, anything can be accomplished…its just how much time, effort and other dentist more skilled than me do you want to see.  She had been given an treatment plan that was just too far out of her budget.  So we considered the option of using mini dental implants to create her a fixed bridge.

OCO 3.0 x 16 mini

For this case I selected some OCO Biomedical 3.0 x 16mm mini dental implants.  Cost effective and strong enough to make for a successful mini dental implant bridge case.

 

 

 

 

 

The simple placement protocol for mini dental implants allows for a no gum cutting procedure.  One small pilot bit is used to make a pencil lead size hole in the gum.  From that hole in the gum and bone a mini dental implant is gently rotated into position.

Second mini insertion

 

Here we see one OCO Biomedical mini dental implant fully inserted and the second 1/2 in.  Very minimal trauma to the gum and bone creates little discomfort for the patient.  The thread geometry allows for immediate stabilization of the implant.  Cases that would have taken 4 to 6 months now can be completed in 4 to 6 weeks. 

 

 

OCO 3.0 x 16

 

OCO mini dental implant x-ray fully inserted in the bone 3.0 x16mm long.

 

 

 

 

 

 

 

 

 

 

OCO mini 3.0 x 14

 

OCO Biomedical 3.0 x 14mm long mini dental implant fully inserted.

 

 

 

 

 

 

 

 

 

 

An i-Tero digital scan was taken on this case for First Impressions Dental Lab to make a 3 tooth bridge that will fit over the OCO mini dental implants. 

If you are a dentist considering adding implant placement to your practice a good place to start is the  Simple Implant Placement Education Course Seminar It is in Orlando Fl Jan 8th and is given by OCO Biomedical and Dr. Ara Nazarian.  I am very honored that I have been invited to present at this dental implant seminar as well. 

Paresh B Patel General & Implant Dentist Mooresville NC

Mini Dental Implants

OCO TSI Dental Implant & ISI One Piece Dental Implant

If you have a missing tooth or several teeth, dental implants are an option you should consider.  A dental implant (mini or traditional) acts as the root of a tooth and allows the attachment of a fixed crown to chew and smile with.

Jerry B pre pan

 

Pan x-ray with missing premolar teeth in the upper and lower jaws

 

 

Missing 12 13 Clinical

 

The missing premolar teeth upper jaw

 

 

 

 

 

 

Missing 29

Missing premolar tooth lower jaw

 

 

 

 

 

 

 

 

The placement of the OCO Biomedical one piece ISI implants is very straight forward.  No flap and minimal steps to insert; very similar to placing a mini dental implant.  With little surgery very little healing time is required.  Less discomfort is experienced by the patient with this kind of protocol.

Pilot bit with 10mm drill stiop

A small pilot bit is used to make a small hole in the gum and bone.  I do like in the OCO placement kit the various drill stops.  These are slipped over the pilot bit and will not allow the dentist to drill any further down that the stop. The 10mm drill stop is show here on the x-ray.

 

 

 

 

 

 

10mm drill stip

10mm drill stop on the OCO Biomedical pilot bit.  A great idea that I am glad to see made it into the placement kit.

 

 

 

 

 

Tissue punch

One more item I like in the OCO Biomedical ISI placement kit is the tissue punch.  The rounded end fits precisely into the pilot hole and a perfect plug of tissue is removed the exact size of the dental implant. 

 

 

 

 

 

Tissue out

Tissue removed for the placement of an OCO ISI 4.0mm dental implant.

Look at how nice of a tissue punch is created. 

 

 

 

 

 

 

The only other step is to use the final sizing bit and the OCO ISI dental implant is inserted into the gum and bone.  Since the dental implant is a one piece design there is no abutment to screw into place.  A impression cap is placed over the OCO ISI implant and off to First Impressions Dental Lab it goes for a porcelain crown.  OCO 4.0 x 10mm

The upper jaw was a bit more challenging in this case.  The bone that had filled in was not very dense and was soft in density.

Missing 12 13

X-ray of the missing upper premolar teeth. 

 

 

 

 

 

 

I decided to place a two piece OCO Biomedical TSI implant.  With this I could place the dental implants and let them heal in the bone without my patient putting undue stress and strain on them.  The thing I like about the OCO TSI is that it has the same thread geometry and immediate stabilization design as the one piece OCI ISI dental implants.  I believe that most cases can be solved with the OCO ISI dental implant….however in those cases where primary stability can not be achieved then the two piece OCO TSI is a great tool to have in the office.

OCO TSI and driver

OCO TSI dental implant.  Same design….just in two pieces.

 

 

 

 

 

Placement is the exact same protocol. All the step are followed and a cover screw that is included is placed over the OCO TSI dental implant.

TSI cover and no cover

Clincial photo showing the OCO Biomedical TSI Two-Piece Implants.  One has the cover screw.  The other shows the gold Ti-Ni coating.  This gives the gum tissue a warm glow instead of a grey halo by masking the Ti surface of the dental implant.

 

 

 

 

OCO TSI pack

The collar is machine finished and is 2mm tall.  If a smaller collar is needed the OCO ERI (Esthetic Region Implant) offers a 1mm collar that is also Ti-Ni coated gold in color.

 

 

 

 

 

 

 

 

 

 

For Dental Implant Educationthe next OCO Biomedical course seminar will be in Orlando on Jan 8, 2011.  7 hours of Dental CE in implant dentistry is given. 

I  continue the post with the final crowns.

Paresh B Patel General & Implant Dentist Mooresville NC

Mini Dental Implants Charlotte Hickory Lenoir NC

OCO Mini Dental Implants An Easy Procedure to Replace Missing Teeth

Mini Dental Implants have become a popular choice for patients who are missing teeth to replace them with fixed crowns.  This cost effective procedure allows many patients to move forward with dental implant therapy that otherwise would not.  These crowns are just like a crown that would fit over a natural tooth.  The mini dental implant acts as a new root for the crown to attach to.

Pre op thin ridge

 

Thin ridge of bone on the lower jaw where the canine and premolar teeth have been missing for several years.  Without teeth, the ridge of bone will resorb away in height and width.  A mini dental implant will keep that bone from deteriorating and will serve as an anchor for a crown or bridge. 

 

 

Kathy Gordon Pan Pre

 

Pan x-ray showing the missing teeth on the upper and lower jaws.  My patient was very nervous about the procedure and wanted to start with two dental implants on her lower jaw.

 

OCO 3.0 in

 

In 30 minutes we had two OCO 3.0mm mini dental implants in place ready to take a impression for First Impressions Dental Labto make two PFM crowns. 

The placement procedure is very simple.  No flap of gum tissue is made.  No real surgery to do.  No fracturing and expanding the bone.  The design and engineering of the OCO Biomedical implants is consistent from the small size of 3.0mm all the way up to 6.0mm in diameter. 

Dstab_graphic_sm[1]

 

 

They are dual stabilized and in good bone can be used immediately.  The tip of the OCO Biomedical Dental Implants have a bull nose design.  This pulls the bone up and places in under tension not compression.  This important fact promotes bone growth and healing.  Compression (small hole and forcing a larger dental implant into it) creates an environment of bone resorption before healing and stabilization.

 

Patel 1st imicro

 

X-ray with the two OCO Biomedical Mini Dental Implants in the lower jaw to act as 'roots' for two PFM crowns.  They will replace the missing premolar and canine teeth.

 

 

 

 

PFM 22 21 OCO 3.0mm

 

PFM crowns in place over the mini dental implants. The adjustments on porcelain will be polished out and re-glazed in the porcelain oven.  I will post a final picture at that time.

 

 

 

 

 

Kathy Final 20 21 OCO 3.0

 

X-ray of the crowns on the OCO Biomedical mini dental implants. 

 

 

 

 

 

Paresh B Patel Dentist Mooresville NC

Mini Dental Implants

Dental Implants Charlotte Hickory Asheville Lenoir Wilkesboro Boone NC

OCO ISI Dental Implant to Replace a Missing Upper Molar Tooth

My patient came to see me because she was tired of her gum hurting when she would eat where she was missing her upper molar.Occlusal Pre OCO 5.0

Food would poke her in the gum and she was just unhappy.

 

 

 

 

 

Buccal Pre OCO 5.0

She also did not like when she smiled everyone seeing the empty space.

 

 

 

 

Pre PA

 

I had extracted the molar tooth about 5 months ago due to a failed Root Canal.  We packed the extraction socket with a bone grafting material so her own bone would fill in where the tooth roots used to be. As you can see on the x-ray it filled in very nicely.

 

 

 

OCO ISI 5.0 x 12mm

 

I explained to my patient her choices in implants…either two mini implants to support the molar size crown or one regular size implant.  It would cost a bit more to do the traditional implant but that is what she decided on after our treatment planning and consultation.  I measured the space and a OCO ISI One Piece Regular size implant would work just fine here.

 

 

With the OCO ISI dental implant system only 2 burs are necessary to place the implant.  Here we see the pilot bit with a drill stop to keep it from going any farther in the bone than we want.  Its right in line and we proceed to the next step.Slide9

 

 

 

OCO 5.0 parallel pin

 

The next size bit is used and a implant replica is placed to verify fit and angle.  All looks good so we gently rotate the OCO ISI one piece dental implant into the gum and bone.

 

 

 

 

Final OCO ISI 5.0

 

Clinical view of the OCO ISI 5.0mm implant in place ready for a traditional impression like you would have for a crown on a tooth.  Notice the lack of blood, stitches or any real trauma to the area.  With the OCO implant protocol it is very similar to the placement of a mini dental implant.  No flap of gum tissue is made.  It is one piece in design, so no extra parts and pieces for the dentist to buy. 

Final PA

 

Final x-ray of the OCO ISI 5.0 x 12mm dental implant in place. 

In the end a missing upper molar tooth can be replaced quite easily for both the dentist and patient with either:

A regular implant that is one piece in design or

A 2 mini dental implants to support the larger size crown.

Slide10

 

The impression is off to First Impressions Dental Lab for them to make a Upper Molar Crown.

 

Paresh B Patel Dentist Mooresville NC

Mini Dental Implants

Dental Implants Charlotte NC

Mini Dental Implants ~ The Permanent Solution for replacing a Missing Tooth with a Crown

A mini dental implant is titanium root that One_body_index_img is placed into your jaw to secure a porcelain crown or bridge. Mini Dental implants are the perfect option for anyone who has lost their tooth or teeth due to periodontal disease, a traumatic iinjury, or a failed root canal.  Mini dental implants do less trauma than traditional bridgework, since implants do not require Dentists of grind down the adjacent teeth.  Mini Dental Implants can create a natural looking result.  If you are teeth and would like to smile, speak and eat again with comfort and confidence, then consider Mini Dental Implants.  Long-term studies show great success rates for mini dental implants.

 

My next patient was missing one of her upper teeth.  Made her feel very self conscious when she smiled or was out in public.IMG_1753

 

Missing Premolar tooth and decayed premolar tooth behind it.

 

 

 

Before OCO

X-ray of the area of the missing premolar tooth.  A great spot for a OCO mini dental implant to replace the missing tooth with a fixed porcelain crown.

 

 

 

 

 

Pilot Bit

Pilot bit in place to check to see if the mini dental implant would line up in between the adjacent teeth. 

 

 

 

 

 

Space check

 

The one piece OCO Biomedical Mini Dental Implant in place ready for a regular impression for First Impressions Dental Lab to make the Porcelain Crown. 

 

Lyndis ing oco #12

 

Final pan x-ray of the OCO Mini Dental Implant that will be used as the root to anchor a crown.

 

 

Temp

 

Temporary Crown made chairside to fit over the OCO Mini Dental Implant.

 

 

 

 

 

 

Final

 

Final PA x-ray showing the OCO immediately stabilized implant. 

 

 

 

 

 

Paresh B Patel DDS  Dentist Mooresville NC

Dental Implants Charlotte NC