Implant case - Courtesy ROOTS
From: gary l. henkel d.d.s.
Sent: Tuesday, March 20, 2007 1:36 AM
Subject: [implants] case from this afternoon
This was a straight forward case we just placed this afternoon
using the deplaque nested guide components. Since this
was a second molar, the greatest challenge was vertical dimension.
Patient was a trooper and did an excellent job. Although this was
not a cone beam scan, note how close the final placement comes to
the original planned position. Implant is a 5.0x11.5 prima connex
Gary, Why use a tapered implant? or is it irrelevant? - KendelG
Good question. the answer in this location is i could have easily
gone with either, but i've recently gone more to tapers as i find
them a little more universally applicable. specifically:
1.Where space is tight between adjacent roots, i may be able to get
a taper in where a parallel wall wouldn't fit
2.in situations where there might be a significant lingual undercut,
as in my current case, or a buccal undercut, say in a congenitally
missing lateral, you can avoid fenestration (windowing) the bone.
3.in immediate load situations, they can provide more initial
stabilization as they "wedge" themselves as you tighten them
4.in sinus lifts, the same wedging can provide better stabilization in
the limited bone height that is available
5.one can undersize an osteotomy to provide greater stabilization from
the lateral wedging affect.
what is the bad news.
1. all else being equal, a 5x10 taper provides 20-30 percent less
surface area to bone than a 5x10 parallel wall
2. you need to make the osteotomy a little deeper than the planned
placement. if you bottom out the tip of the implant, you can strip
both work, but these are the general guidelines.
in this case i primarily chose the fixture as it was the correct
length and width for my application. i have so damn many fixtures
in inventory, some of which i use once in a blue moon, i've been
trying to consolidate my supply and go a little leaner and meaner.
not scientific, but reality - Gary
Cool info--thank you Gary! - KendelG
Perfect placement Gary. if I may add another reason to consider a
taper fixture in a lower 2nd molar site.... lingual concavity and
more risk of perforation with a parallel walled implant.
- Gregory Kurtzman
See #2 - Gary