Uncategorized – Page 7 – Implants By Paresh

Mini Dental Implants to solve problems

March 16, 2010/in Blog, Uncategorized /by Paresh Patel

I got a phone call last night from a Dentist friend of mine in Buffalo NY (one of the worlds best respected Mini Dental Implant clinicians). He had a patient of his from years ago that had a Resin Bonded Bridge that had now failed.

She was an interesting young lady in grad school at UNC-Chapel Hill….of course she was in tears that she had lost her front tooth.

What to do? I got her numb and sounded the bone in the missing tooth area…very thin…hardly any bone left to work with in the Lip to roof of the mouth direction.

Knowing full well that this patient would end up back in the office of the guy who has restored the most mini implants in the US I felt a bit of pressure to get it as correct as possible.

The patient agreed to let me put a mini dental implant in to hold her resin bonded bridge in place until she could get back home and then have the permanent crown made over the mini implant.

So I put in a 2.0 x 15mm Intra Lock mini implant to hold the bridge. It was fairly easy to grind out a hole in the pontic and fit it over the mini…whew!
I filled in the one wing that was not broken and the hole I created in the pontic with resin cement. She left so happy and excited. She had a tooth until a new one could be made for her.

Now for me to see how I did….

The assistant put my mentors patient in the iCAT CT chair and a few nail biting moments later I could see if I had threaded the bone and kept the mini in between the bone and not in air or soft tissue.

The Pan x-ray looked good, plenty of bone between the implant and the adjacent roots.

Now for the CT slices…

We had kept the 2.0mm implant within the 2.5mm of available bone…man was I glad.

Mini Dental Implant Training ~Education ~Seminars~Lab Consulting

March 4, 2010/in Blog, Uncategorized /by Paresh Patel

Todd Shatkin DDS, the go to guy for mini dental implant education & the dentist who trained me, is having a 2 day advanced course in Las Vegas March 12 – 13.

Dr. Shatkin asked me to present some cases in Chicago last week. It was an honor for me. Clinical cases that I did over the past year were shown to highlight what can be done with mini dental implants. With the correct education and lab support from his father, Sam Shatkin DDS MD, I feel very confident that most conscientious restorative dentists can become good mini dental implant providers.

I have been given the opportunity to speak again in Vegas and look forward to meeting everyone excited about mini dental implants and their ability to change the lives of both dentists and patients.

Mini Dental Implants vs Traditional Implants

March 2, 2010/in Blog, Uncategorized /by Paresh Patel

The next story is about a patient of mine named Storie….how bizarre. Well actually the patient is the wife of a patient of mine who had placed mini dental implants on to replace his existing partial denture.

She had broken her tooth.

X ray of broken premolar #13

I gave her the option of a root canal, post and a crown. I thought it was a good option but she had it in her mind to take the tooth out and have implants. We talked about traditional implants but she wanted what her husband had been offered – mini dental implants and crowns.

I took the tooth out with some peritomes to preserve the facial bone as much as possible .

X ray of the tooth removed and the socket preservation with De-mineralized & Mineralized Freeze Dried Bone (6 months later)

The area had healed in quite well and I was pleased with the amount of bone that was preserved in both the Facial/Lingual dimension as well as height.

3 Intra Lock Mini Dental Implants were placed to act as the roots for the missing premolar and molar (#13 and #14)

As you can see the procedure was very atraumatic to the tissue as no flap was made. Notice hardly any blood in the sites where the mini implants were placed.

I standard impression was taken and the case was sent to Valdi and Shatkin FIRST Lab for 2 PFM Crowns. The thing I like about FIRST Labs is that you don't get charged for the lab analogs for the master model or the 2nd pour for contacts.

Not to mention that the crowns look good and more importantly fit well on the mini implants.

I dry fitted the mini dental implant crowns in the patients mouth…let her approve the color and aesthetics. She approved them and we cemented them. Overall it was a slam dunk case.

Mini Dental Implant Molar Crown ~One Mini Dental Implant per root Part II

February 3, 2010/in Blog, Uncategorized /by Paresh Patel

As promised here are the photos for the mini implant crown to replace a missing molar tooth. In this example of using mini implants for a crown 3 minis were used to replace the three roots on the missing upper molar.

3 Intra Lock Mini Dental Implants in tooth #3 position

We have been using the iTERO dental scanner for 20 months now and decided to see how it would scan muliple mini dental implants. I did take a traditional impression as a backup and also to verify the fit of the mini implant crown.

I discussed the case with Valdi at Shatkin FIRST Lab's and he felt like there should be no issue with the case using the iTERO scan. He built the case just like any other one he does on a daily basis.

iTero model of 3 mini dental implants

FIRST Lab Mini Dental Implant PFM Molar #3

Mini Implant Crown next to a standard crown

Mini Dental Implant Molar Crown Chewing Surface View

Mini Dental Implant Crown Side View

X-ray of Molar Crown on 3 Mini Dental Implants

Mini Dental Implant

January 29, 2010/in Blog, Uncategorized /by Paresh Patel

What do you do when its Friday afternoon and this walks in with a crying patient attached to it?

Well I looked in the tool box and thankfully I had a stash. No not anything illegal but a stash of Intra Lock Mini Dental Implants from Shatkin FIRST Labs. Jay Moore (the well respected and highly knowledgeable sales manager) had just sent me 24 mini implants in the 'Cash for Clunkers' trade in program.

The patient stated that the bridge was 'slightly decayed' for a while and that she had noticed some movement over the past few months. Well from where I was sitting I don't know where the 'slightly decayed' came from…..it looked more like a stroll down the street in Anbar Province Iraq.

I was able to tack mush to mush and took a pre op pan xray

Of course I was drooling over the thoughts of Mini Implants everywhere for this patient! But I had to slow down and go over all the options from

1. Do nothing…not really an option….but I have heard that patients can get creative with Super Glue!

2. Extract and recommend a denture or partial.

3. Extract and implants for an over-denture or implants and a fixed bridge.

4. Extract and mini dental implants for a fixed bridge or mini implant retained full denture.

To my surprise the patient had done her homework and had come to see us specifically for mini dental implants and a mini implant bridge.

I told her lets's slow it down a bit. How about we make it the first goal to take out the broken root tips and preserve as much bone as possible with some peritomes(dental instruments to extract teeth with less trauma to the facial bone). Then see about placing some mini dental implants and for certain figure out how to make her a temporary bridge to wear while some healing occurred.

Minis all went in as planned. She will return in a few weeks for a tissue check and I will update the photos.

iCAT CT scan of mini dental implants in place for a fixed bridge

Post operative pan xray of mini dental implant in upper jaw for fixed bridge

Mini Dental Implant Crowns ~ Mini Dental Implant Bridge ~ Mini Impants Do they Hurt Part II

January 27, 2010/in Blog, Uncategorized /by Paresh Patel

Ok…so more than 6 weeks have passed since the blog about the mini dental implants and do they hurt. But the patient has finally come back and we took the impression for her crowns. If you need to scroll down to the original post you can see the teeth that were extracted and the mini dental implants that were placed.

I really wanted to do some Porcelain crowns over the mini implants but $$$ were scarce in this case so a decision was made to use lab fabricated resin crowns. I took a standard Poly Vinyl impression and sent the case to Shatkin FIRST Lab.

Nothing new required for me as the dentist. From there FIRST Labs places the mini dental implant analog into the impression and makes a replica of what is in the mouth.

The following set of pictures are the resin crowns on the lab mini dental implant model. I will take clinical photos of the mini dental implant crowns cemented in place in 2 weeks.

Mini Dental Implants for Missing Laterals

January 12, 2010/in Blog, Uncategorized /by Paresh Patel

One of the most prevalent dental conditions is missing upper laterals (about 10% of the population is missing these teeth from birth).

Some of the time, even with orthodontics, there is not enough space to restore the missing teeth with traditional implants (implants with a diameter greater than 3.0 mm).

Most of the patients I have seen either have some sort of removable appliance or a orthodontic retainer with the two missing teeth on it. The issue is that these teens don't really care to wear their retainer.

Another solution, the bonded bridge, seems to fail. While the bonded bridge works well on missing lowers, the clinical data shows that bonded bridges to replace missing upper laterals fail quite often because the central and canine tooth both move to different degrees under chewing function.

One solution that works well in my hands is a technique that Dr. Todd Shatkin taught me….use mini dental implants. The Intra Lock or IMTEC Mini Dental Implant can be threaded in between the canine and central. This mini implant can then hold a crown in place that the patient does not remove.

This photograph shows a Intra Lock 2.5 x 18mm mini dental implant to replace missing laterals.

www.dentalminiimplant.com

One Mini Implant for Each Root?

January 11, 2010/in Blog, Uncategorized /by Paresh Patel

At the last Annual meeting for Mini Implant Dentists a friend of mine, Dr. Steve Brown, showed several of his cases where he used one mini dental implant for each root on a missing tooth. Of course I thought, huh? Not a bad idea, but is there really space?

To confirm I spoke with Valdi at Sam Shatkin's FIRST Labs. Valdi is the master lab tech at the Lab and he said, 'No problem, Dr. Brown has been doing that for years.' So with that information in hand I had to give it a try.

So, having the sink or swim kind of attitude, I enlisted the help of a friend and long time patient of mine. He had a missing upper molar that he desperately wanted back, not to mention he had been bugging me to death about it.

So with the big day here and multiple sizes of Intra Lock mini dental implants in stock, we got John numb with 1/2 a carpule of Lidocaine…not a lot really. Just enough to get the gum tissue numb.

We made one pilot hole and placed a 2.0 x 11mm mini….and then another pilot hole was made carefully. One more mini was tightened into place…..was there space for one more? I looked over at the assistant, she nodded her head in approval. The patient was just sitting there just like the guy in the cartoon….'A bit wider Mr. Sprinkle, I need to see if this tennis ball, I mean this last mini implant can be fit in' I said.

So there it was, 3 mini dental implants all snug in place ready to support a molar crown!

An Itero impression was taken and its off to Shatkin FIRST Lab for a PFM Mini Implant Crown.

Mini Dental Implant Bridge – Part II

November 17, 2009/in Blog, Uncategorized /by Paresh Patel

Ok..after a few weeks of procrastination I have finally got the pictures off the digital camera and am ready to share the initial results of the Ken Clifford Fixed Mini Implant Bridge.

To read Part I scroll down in the main blog to the Ken Clifford Bridge Post.

To clarify, the acrylic bridge is totally mini implant supported; it is not tissue supported. Every effort has been made to keep the bridge at least 1mm off the tissue to allow my patient to use a water pick to flush out any food that gets under the pink acrylic.

Mini Implant Bridge Lingual view Mini Implant Bridge Space under Acrylic Ken Clifford Bridge
Underside of Acrylic Fixed Hybrid Clifford Bridge

The acrylic bridge cemented in place. 2 week post op picture. The patient has been keeping the acrylic mini implant bridge clean with a water pick and a electric toothbrush. I will continue to take clinical photos at the 6 month recare appointments and will share how the bridge functions, looks, gum health, and implant stability.

2 weeks post insertion

Mini Dental Implant Upper and Lower Dentures made by First Impressions Dental Lab. Mini Dental Implant Lab

Expand the Bone or not to Expand the bone? That is the question

October 29, 2009/in Blog, Uncategorized /by Paresh Patel

Mini Dental Implants for Single Crown

Our patient today, as it seems like most these days…seem to know WAY more about implant placement than I would have ever thought.

Charlotte had braces years ago and was going to get an implant to replace her missing lower premolar tooth. As we all know, life has a way of throwing the unexpected at you and she never got the implant and crown. Over that period of time the molar tipped forward a bit into the space.

More importantly the width of the missing tooth area collapsed (cheek to tongue distance). Charlotte had already did her research on bone splitting and bone block grafting as an option to place a traditional implant. She decided to consider getting a mini implant as an alternative to those procedures and have a PFM crown placed as the final restoration.

We talked about her options and she elected to have the mini implant placed. Mini Dental Implant placed in thin ridge

With Charlotte's permission guiding planes were made on the two adjacent teeth. This also helped to upright the tipped molar for a better contact area for the PFM mini implant crown.

Intra Lock MDI 2.0 x 10mm in place and above the Inferior Alveolar Nerve Canal

I will continue the post with pictures of the Mini Implant Crown in place.

The impression of the mini dental implant was sent to First Impressions Dental Lab for the fixed crown. Mini Dental Implant Lab