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Endo tips    Better Endo    Endo abstracts    Endo discussions

The opinions within this web page are not ours. Authors have been credited
for the individual posts and photographs where they are. -

Today's Buried polished collar

From: Terry Pannkuk
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 donít 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

K 3 lightspeed

Crown replacement

Root reinforcement

Vertical root fracture

Periodontal pocket

Cox crapification

Cold sensitivity

Buccal sinus

Nikon 995

Distal canals

Second mesial canal

Narrow escape


Severe curvatures

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Molar access

Perforation repair

Maxillary molars

Protaper shaping

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Apical periodontitis

Mesial middle

Isthmus protocol

Fragment beyond apex

Apical trifurcation

Jammed K file

Mesial canals

Irreversible pulpitis

Bicuspid abscess

Sideways molar

Red Dye allergy

Small mirrors

Calcified molar

Extraction and implants

Calcificated central

Internal resorption

Bone lucency

Porcelain inlay

Bone allograft