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Today's Buried polished collar
From: Terry Pannkuk To: ankylos@rxdentistry.com Sent: Thursday, May 13, 2010 9:15 AM Subject: RE: Today's buried polished collar. Arturo, You mean like this one I torque tested and sent back to the referring dentist today? Seriously, what do you think is going to be the problem 10 years from now with this implant? Is this stable? If it's stable and the adjacent teeth hold the interproximal bone up, it will be a success, not just a survivor, right? There was no graft in this case. The buccal plate is fine and esthetically contoured. The implant is deep enough to get a nice emergence profile. The tissue is tight to the platform. What will doom this case? Is there a history of these types of cases developing peri-implantitis? According to Tord Berglund, "no", unless it functioned as a splint for a bigger prosthesis under an unfavorable biomechanical load. I will continue to do these until I see a scientific /empirical reason to stop. I like the concept of Ankylos, but I don't see a huge clinical advantage to change unless restorative dentists want it. Having bone up to the platform on the radiograph looks nice for us but for some reason doesn't seem to matter much to the patient. If I had my way entirely I would prefer bone up to the platform, but it's not always my call and unless someone can show me this is an evidence-based problem, there really is no compelling reason to change. Why do you disagree with Lindhe, Becker, Nowarzi, Chee, and others? - Terry P.S. How about this cantilever with an old-school implant that's been in my mouth for 10 years? :):):) I don’t see any bone migration down past the first thread? Maybe I have bad breath though!
Terry this is exactly my experience with extractions: why we need to place something inside the socket if we have
bone there? - Carlos Murgel
I am enclosing two long term CT scans of Ankylos restorations. As you can see, one is an implant fixed partial
denture and the other is two single crowns. You can see the post op times from cementation. I am only showing
this as someone asked me last week if I had any to show.
I'm not asking you to change. The point is to share experiences. My experience has told me that there is a
clinical advantage to saving bone. Soft tissue follows hard tissue so if you lose bone you will ultimately get
soft tissue recession. To place an implant "deep enough" to get a nice emergence profile does not hold merit.
An implant with a connection exhibiting a microgap and micromovement placed subcrestally will soon be supracrestal.
You are correct when you say that for some reason bone up to the platform doesn't seem to matter to the patient...
why should it matter to a patient...it should matter to us - Barry
Nice case Barry, we are lucky to have people like you, Bill, and Dwayne that can show the benefits and back up the
claims of this system. Take care my friend. - Jose
Thank you for sharing. Do you have preop scans by any chance? Looking at the current condition of the bone I would
be surprised if there is much change. What is your impression? - Benedict
I know I have one with the implant bridge. I'll send it out as soon as I can. Good idea to compare the two. - Barry