Posts

Mini Dental Implant Upper Denture Tooth Bridge

Part II of the fixed hybrid bridge post.  You can scroll down 1/2 into the web page to see the complete case…

This is the finished product for our patient that came in just gagging on her upper denture.  She wanted to have a solution that would allow her to have the roof of mouth not covered with plastic. Cost was certainly a factor.  We offered the solution of 4 to 6 locator's implants and a removable over-denture without a palate.  I like to place 6 on the upper arch to withstand the lateral stress if we plan to remove the palate in the denture.  This certainly would have been the most elegant solution (easy to keep clean and offers a tremendous amount of retention)but was declined. 

I put in 8 mini dental implants to support a metal frame (not a tissue supported upper denture).  This metal frame would hold and support her new set of teeth made out of acrylic and denture teeth (a fixed hybrid solution).  Since there are no two piece mini dental implants (a diameter of less than 3.0mm) we can either cement the teeth over the mini dental implants or we can incorporate a teflon keeper that is processed into the metal acrylic base.  Shatkin First has this option if you need further information. 

Mini Dental Implant Fixed Hybrid

 Mini Dental Implants in place

Cast metal frame with Preat E-Fiber underMetal Frame acrylic

 connecting both sides together.  I would have preferred to continue that cast framework from one side to the other…but to accommodate the patients bite and other request it did not work out.  So the solution to use the e-fiber was decided upon with patient approval.  For technical data on the e-fiber you can go to their website.  It is 10x more fatigue resistant than fibrekore and 2x as strong in flexural strength.  Occlusion is only on the posterior teeth with only light occlusal stops on the lingual of the anterior teeth.  This is done to provide the artificial dentition patientt anterior incisal clearance during all posterior masticatory function.  All four anterior teeth do touch the lower teeth during incising and protrusive function. 

No Palate

View of Fixed hybrid denture in place with no palate

Smile

Smile view of fixed hybrid denture in place

Flange

There is about a 1/2mm to 1mm of space to allow for floss and water pick to keep the fixed hybrid denture clean.  Lingual side has a tight fit against tissue. 

Paresh B Patel Dentist Mooresville NC

mini dental implants

Mini Dental Implant Bridge ~ Similar Results as a traditional implant ~ Tremendous saving in cost

As promised here are the pictures of the fixed cement hybrid bridge (denture teeth with a metal frame that fits over the mini dental implants). 

Mini Implant Hybrid Bridge

Denture tooth bridge with a cast metal frame that will be cemented over the 9 mini dental implants 

Mini Implant Bridge Palate 

View of upper fixed hybrid cemented in place to show horseshoe shape and no coverage in the roof of the mouth.

Mini Implant Bridge Facial Space to clean

There is a 1mm space around the pink acrylic to clean under the teeth with a waterpick and sonicare toothbrush. 

  You can scroll down to the OCO Biomedical i-mini i-micro post to review the original case before the mini dental implants were placed. 

Nine mini dental implants were used in the upper jaw to hold in 12 teeth. 

Paresh B Patel  Dentist Mooresville NC

mini dental implants 

Mini Dental Implants – Small Diameter Implants Training Seminar & Education Lecture

Todd E. Shatkin DDS & Paresh B Patel DDS will teach in Dr. Shatkin's 1 and 2 day seminars on Nov 5th 2010 in Baltimore, MD and Dec 3rd in Pittsburg, PA: Mdbaltharbor

mini-implant placement and case selection

treatment planning and case selection

one stage denture stabilization; immediate implants and crowns

full arch reconstruction with mini implants

handling bruxism; handling thin and atrophic ridges.

Mini dental implants, with their minimally invasive nature, provide less risk to patients. The lower cost of mini dental implants are readily accepted by patients. Mini dental implants are easily placed by general dentists and are a true service to your patients.

Register today at 1-888-4-SHATKIN, ext 121 (1-888-474-2854).  7 hours of AGD approved Dental CE (Continuing Education) Credits will be given. 

Todd E Shatkin DDS – President International Academy of Mini Dental Implants

Paresh B Patel DDS – Mastership in Academy of Mini Dental Implants Dentist Mooresville NC

Paresh B Patel is a General Dentist who places mini dental implants to replace dentures and missing teeth.

Mini Dental Implant Training ~Education ~Seminars~Lecture~CE Continuing Education

Its that time of year again….the Annual Academy Meeting on Mini Dental Implants at the Walt Disney World Beach & Yacht Club Resort.  August 21-22, 2010. 

It is going to be a great time with new and old members showing off some of the cases they have done over the past year with mini dental implants.  From bread and butter denture stabilization to more complex crown and bridge cases that simply could not have been possible without mini implants.  (Well without additional bone grafting, bone splitting and expansion). 

Dr. Todd Shatkin has been gracious enough to let me lecture with him again.  Many of the Las Vegas course attendees have contacted me to let me know how mini dental implants have changed their practice and their patients lives for the better.  It has been a wonderful experience to see so many Doctors want to get training on mini implants.  With many Academy members offering over the shoulder help I think mini implant will be in most dental offices soon. 

Disney meeting_Page_1 
Disney meeting_Page_2

Paresh B Patel DDS

Dentist Mooresville NC
  
 

Mini Dental Implants for Back Jaw Teeth Crowns

Our next patient came to us seeking an alternative to the treatment options that were given to him:

1.  A set of removable partials

2.  Bone expansion or bone grafts a then traditional or conventional size dental implants.

I told him that those were both great options and at our office I would include a option #3 of some mini dental implants and fixed crowns. 

Before Mini Implants 

Before Mini Dental Implants

Before minis right

Before Mini Implants Right

Before minis left

Before Mini Implant Left

  

X-rays and study impressions were taken to see if I could place some mini implants to hold in a few crowns.  All looked possible and a phased treatment plan was made.  The patient wanted to start with a single molar on his right side, and a premolar to fill in the missing teeth on both left and right sides. 

As he could afford it additional mini dental implants would be placed to replace the missing molars and other teeth on the top and bottom. 

As usual for me two mini implants were placed to support a molar sized crown and a single mini was placed to support a premolar sized crown.  If I could have placed additional minis in the premolar area I would have – I make it a standard at my office to price the case and not by number of implants placed. 

Minis Rt side
 Mini Dental Implants Right side lower jaw

 

 

 

 

 

Mini left side

 

Mini Dental Implants left side lower jaw

 

 

 

Pan minis
 

A standard PVS impression was taken and sent to First Impressions Dental Lab in Lenoir NC.  3 PFM crowns were made and cemented with self cure resin cement.

Mini implant molar crown  
Molar Mini Dental Implant Crown far left ~ crown on a natural tooth in the middle ~ Premolar Mini Dental Implant Crown on right ~ natural canine tooth far right

 

 

 

 

 

Mini implant premolar crown

 

Premolar crown on a mini dental implant lower left jaw

 

 

 

 

 

Paresh B Patel DDS

Mini Dental Implants

Dentist Mooresville NC

The Mini Implant has Arrived ~ Dentures, Crowns, Bridges & More…

I think someone told me that Dr. Christensen said that in an article in 2006….well its been 4 years since that statement and the mini dental implant is good for lots more than holding down a lower denture.

Mini Dental Implants can stabilize lower dentures of course.  But they can also do the same for upper dentures.  However I think most Dr.s and patients are missing the boat if they don't think that mini implants can be of service in other areas.

Mini Implants I think have their best uses to replace missing teeth.  That can be in the form of a mini implant crown or a mini implant bridge. 

Broken Tooth & Missing Tooth

Our patient who has come in with a broken tooth that has had a root canal and a missing tooth behind it.  Great spot in my mind for a mini dental implant instead of removing the gold crown on the molar to place a bridge.  In addition the mini dental implant will…hold bone and gum tissue in place and remove lots of stress on a root canal tooth by not having to place a bridge.

Mini Dental Implant placed

I like to place two mini dental implants to hold a molar sized crown.   You can see how little tooth we have left on the broken down premolar. 

2 Intra Lock Mini Implants in this case.

But all mini dental implants work…IMTEC, OCO Biomedical, etc…

Mini Dental Implant Crown Picture

Porcelain to Metal Crowns in place.  The molar crown is on 2 Mini Dental Implants.  The premolar crown is on the root canal tooth.   

All in all I must say that I have been impressed with the ability of mini dental implants to solve so many issues for such a large set of dental patients. 

Paresh B Patel DDS – Dentist Mooresville NC

http://www.dentalminiimplant.com 

http://www.lkndds.com

Mini Dental Implants Upper Fixed Denture~Bridge

Our next patient came to see us because she had some lower minis placed.   She could not stop talking about how she was now able to actually wear her lower denture and chew.  Wonderful….so what could I do to help her? 

I did notice that the entire time she was in the dental chair talking she kept gagging and several times her eyes watered up like she was getting ready to vomit.  Hopefully I was not that hard on her eyes that the thought of looking at me would make someone want to hurl…..

But after some questioning it was discovered that her upper denture just made her want to gag….no matter how many she had made, how much of the denture was cut back she just could not tolerate the buildup of saliva. 

She had seen a patient of mine that had mini dental implants and a fixed hybrid bridge (a set of teeth over a cast metal bar that is not removable by the patient.  It is cemented over the mini dental implants). 

Her words to me were "I'm confused; I want that fixed set of upper teeth not that fixed hybrid car thing you were talking about."  So I guess I did a poor job taking mumbo jumbo dental talk into usable ideas for my patient.  From now on I am going to start calling the fixed hybrid bridge what it really is:  fixed teeth for people who have no existing teeth. 

Fixed Hybrid Mini Prius

The total cost for the mini dental implants and fixed tooth bridge allowed her to move forward with dental treatment.  The other options she had been give prior would just not fit into her budget.

Intra Lock 2.5 x 13mm mini dental implants were used in this case.  4 were placed on each side for a total of 8 minis to support a fixed set of teeth.

Mini Dental Implant Fixed Hybrid

Photo day of mini dental implant placement….notice lack of bleeding and no gum had to be cut.

I will update the post with the metal frame, and try in photos in a few week.

Paresh

http://www.dentalminiimplant.com

 

 
 

Mini Dental Implants for Upper Crowns

This is part II of the post… The mini dental implants have been placed and allowed to heal.  Impressions were taken and sent to the crown and bridge lab for resin crowns to be fabricated.  Resin crowns were selected instead of traditional PFM upper crowns due to patient $$.  I kept the model work so that over time when the patient is better able to afford the Porcelain Upper Crowns we can just send the models back to the lab and skip one step in the fabrication process. IMG_7727 IMG_7728

The upper crowns were tried in over the mini implants.  Our patient approved the look and color.  They are now cemented in place.  IMG_7729
IMG_7731 Close up of premolar crowns
IMG_7732 Single Premolar mini implant upper crowns (2 minis were placed to hold the crown in place)
IMG_7733 Chewing view of premolar upper crowns over a total of 5 mini dental implants. 

 I have had lots of dentists ask me and even tell me that mini implants do not work in the upper arch or that they can't work in soft bone.  My personal experience has been if mini implants are placed in the upper arch they just need time to heal like any other size implant.  Don't be in a hurry to get the final product…you can only go as fast as the mini will integrate into the bone. 

Over the past 2 years and close to a 1000 mini implants being placed I have had one case fail in the upper arch.  It was two minis used to support a upper molar crown.  They went in solid but over 6 weeks they did not stay that way.  I believe it was either smoking or the patient functioning on them that was the cause of the failure. 

Paresh B Patel DDS Mooresville NC

http://www.dentalminiimplant.com or http://www.lkndds.com

 

Mini Dental Implants to solve problems

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.  IMG_7697

 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.  IMG_7698

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!IMG_7701
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.

IMG_7704
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.

IMP^PAN^R^Lisa_Raymond^20100316^000 The Pan x-ray looked good, plenty of bone between the implant and the adjacent roots.

Now for the CT slices…

MPR^EXP^R^Lisa_Raymond^20100316^000 MPR^EXP^R^Lisa_Raymond^20100316^001
MPR^RL^R^Lisa_Raymond^20100316^000 
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

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.

Wonder_ad332012