Dental Implantology: Mini Implant Abutments

Dental Implantology: Mini Implant Abutments

One of the ongoing problems in Mini Implant Dentistry is the need for an elegant prosthodontic solution. The BUDs are my contribution to this need. Here the 3 unit bridge is being cemented over the BUDs as seen in the previous picture. The BUDs are cemented or bonded over the mini implant heads, and the excess cement cleared off immediately. The advantage here is that we can actually eyeball it to make sure that no excess cement is left and this will prevent any inflammation or beachhead for pathogens to gain a foothold on and eventually cause peri-implantitis.

A rubber dam is used during cementation so as to prevent cement from seeping into the transmucosal passage of the dental implants.Hope my readers found them interesting.

Mini Implant Abutments

Three implant abutments. These are called BUDs which stand for Bridge Underpinning Device. Two of them are stainless steel buds and one is a composite bud.

Dr Chow on connection problems between the implant and the crown

April 15th, 2009

All things being equal, i.e. no major systemic problem and local conditions are healthy…a morse taper connection ensures that there is no microgap between the fixture and the abutment and therefore no toxic pump as a result of colonisation of the gap together with function. Fact is the 2 pieces behave like one piece….basic engineering principle. Thus in makes like Astra, Bicon, Ankylos and others like some Korean Implants, the Morse taper connections cum platform shifting(if its Morse taper, it automatically translates into a platform shift), there is little or no bone resorption in the majority of cases. In fact often it can be seen that the bone grows right onto the “gap”!

There are 2 critical margins:- one is the abutment-fixture margin and the other is the abutment-crown margin which is also a major problem in that excess cement from this margin often remains in the gum-implant interface and can cause resorption of the bone as well as inflammation of the gums.

The abutment-fixture connection problem,I feel has been largely addressed successfully by the Morse taper solution. The crown-abutment margin with its excess cement or microgap if screw-retained is still quite an enigmatic problem that is yet to be addressed as successfully. I call it the “critical margin” in oral implantology.

Cheers!

Dr Chow on Allergy to grafts in oral implantology

Dr K. F. Chow May 14th, 2009

Theoretically, an individual can be allergic to anything because anything can be an allergen i.e. a substance that is considered by the immune system as a foreign body. Once the immune system identifies a foreign body, it responds basically 4 different possible ways…..4 types of hypersensitivity mediated either by B cells of T cells.

Your patient’s sounds like the 4th type….T cell mediated delayed hypersensitivity……allergic contact dermatitis likely due to your gloves..powder….ointment or something that touched your patient’s face.

Treatment is usually steroids systemic or topical or both. If things are getting better, that means things are getting better and no drastic treatment like removing the grafts etc. is necessary. Just make a note on your patient’s record and avoid the possible causes in the future.

Cheers!

Flapless Implant Surgery | OsseoNews Discussions on Dental Implants

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."

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"