My next patient was going to be a traditional implant case. The treatment plan he wanted was to replace all his upper missing teeth with regular implants. This would require a sinus lift on both sides where the lost teeth had allowed the sinus to drop down with no bone left under the gum tissue.
I did the sinus lift on the patients right side first. When I went over to the left side there was a thin section of tooth root left. Upon removal of that root there was enough damage to the sinus membrane that I elected to let the sinus heal and would come back at a later date to finish.
Flap for Sinus Lift and
Pizzotome to cut lateral window
Bone packed into Sinus Cavity
Sutures being placed
Although he healed just fine....the patient elected not to do the sinus lift on the other side and asked if I could change his treatment plan to accommodate a full fixed roundhouse bridge on mini dental implants. Of course I could...there was good bone where we did the sinus lift and I would not have to expand the bone in the anterior maxilla(front upper jaw). This is what I believe in...minimal surgery, minimal augmentation of the bone, place what will fit and enough of them to equal the surface area of a regular size implant.
I had the dental lab produce a wax up model of what I wanted the patient to 'test drive' in his mouth. A 12 tooth bridge. I would make this out of chairside arcylic much like a temporary crown that you wear while the dental lab is making the final porcelain crown.
Based off the 3D Cone BeamiCAT scan I decided to place some OCO Biomedical 3.0mm mini dental implants to support the back teeth and OCO Biomedical 2.5mm mini dental implants to support the front teeth.
OCO Biomedical mini dental implants in place to support a full fixed roundhouse porcelain fused to metal bridge. This will be like any other bridge that the patient does not remove and will brush and floss like his own teeth.
3D CT slice showing how thin the bone is in the front upper jaw. As thin as the bone is we were able to place the OCO 2.5mm mini dental implant fully supported in the bone.
3D CT slice in the area where I did the sinus lift. You can see the new bone that has filled in from the middle of the implant to the tip. The OCO 3.0mm mini dental implant is centered in the ridge for proper crown placement.
A standard full arch impression was taken. The lab will insert the OCO mini dental implant analogs and will make the full roundhouse bridge supported by our mini dental implants.
My patient immediately after the placement of the OCO Biomedical 2.5mm and 3.0 mini dental implants. He left the office with a totally mini implant supported temporary bridge that was made off the diagnostic wax up. It was made chairside with Luxatemp temporary material.
Final pan x-ray of the 11 OCO mini dental implants in place with the resin temporary bridge over the top. When I get the final bridge new clinical photographs will continue the post.
Paresh B Patel DDS Dentist Mooresville NC
Comments