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Coagulum forming over the implant
From: Terry Pannkuk
Sent: Thursday, May 06, 2010 2:21 AM
Subject: Immediate Placement
>Terry: No disrespect, but I was one of the first users of Nobel Biocare
SR in St. Louis MO, and I would never ever use this implant in the
esthetic zone. I probably placed 900 SR nobels
>and I could not stand sometimes getting crestal bone loss. I feel I placed
them as well as most and I could never achieve ideal cosmetics with this system.
Massive Micro-Gap and Micro-movement. Educate your referring GPs and I bet they
then change their mines. My referring base knows I am doing what is best for the
patient always. Technology changes and we have to learn and keep up - Bill, Perio
I agree with you. I donít place these in the esthetic zone either. I don'ít find the
micromovement/microgap problem to be as severe a clinical problem as you claim
with NBC. Hereís this guyís smile when we asked him to smile. If this had been an
esthetic case and the referring dentist had insisted on NBC Replace Select,
I wouldn'ít have performed the case. I prefer the Astra implants for the esthetic zone.
I checked the site a few moments ago (two days later), a nice coagulum is forming
over the implant. Iíll leave it for 4 months no rush, then uncover and send to
the restorative dentist for restoration. Not pushing the envelope when you doní't
have to seems like a good credo to me. The NBC Replace Selects have been very
trouble free, extremely rare complications, and a favorite of the majority of
dentists in Santa Barbara. When in Rome I do what Romans do, otherwise I'íd be exiled
and have to go to another province. J Quite frankly, I donít get a chance
to place many max anterior implants because its problematic reconciling the fact
that so many dentists want me to place NBCís in these areas. I wonít do it.
I pick and choose my cases that I think are appropriate and refer out the ones
I find would be a conflict with the restoring dentistís desires. Basically,
if the dentist wonít accept an Astra in the esthetic zone, I refer out to someone
who will do what they want. Iím not worried about an NBC in this second
bi spot for this particular patient. - Terry