From: gary l. henkel d.d.s.
To: implants@rximplants.com
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
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 the threads.
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
