From: "Jeffrey C. Hoos DMD"
To: "ROOTS"
Sent: Wednesday, December 31, 2008 6:58 AM
Subject: [roots] Fractured implant
So glad not my case........but should the piece stay in there
You have been sent 2 pictures.
Should is perhaps not the term. COULD it stay in there.
Absolutely. Depends on what is to be done prosthetically.
If you need a fixture at that site, two objects cannot
occupy the same space at the same time according to
the law of physics. Then it has to come out to make way
for a new one. It could stay put, and fixtures placed
mesial and distal to it, and bridge over it for instance.
But leaving it there is not a problem - gary
Jeffrey, just for the record, do you know what brand that
fractured implant is? (i a more strict sense the question
is what particular material the fractured implant is made
of - commercially pure titanium or TiAl alloy?, brand
doesn't really matter).- Dmitri
I do not......done in Mexico......5 years ago.
The location of the implant placement does not matter.
Titanium alloy is certainly stronger.
What is interesting is the location of the fracture.
The distribution of stress..........Jeffrey
What type of implant is it? If you are going to replace
the implant you will have to trephanate it, if not I
suppose that you could put it to sleep. Jhoyo
Intresting case, Jeffrey,
I wonder how problems with material fatigue will develop
in the years to come, with more and more youg patients
receiving implants, patients who may have a life expectency
of more than 60 years after implantation. A Swiss lectuerer,
I think it was Konrad Meyenburg, said last year he would
not place any implants longer than 11 mm any more, because,
as he put it, if the patient develops a periimplantitis,
you can only get a long implant out with a grenade!With a
shorter implant, you can take it out, wait and reimplant.
Same thing with fractures due to material fatigue - Winfried
I trained with a guy who said....the best implant patient is
someone about 100 years old. We are making some interesting
assumptions with our dentistry..... Porcelain veneers on
20 years old..... I wrote an article on a word that is not
discussed in dentistry....ENTROPY. The best day, is the day
it is put in.
http://www.dentalexplorations.com/articles/38.html
This is the article.....not a peer reviewed journal.....
but it is out there.- Jeffrey
I found that interesting myself. Generally they fracture at
the crest, not half way down. wish we knew the story behind it.
- gary
Hi Jeffrey,
I couldn't agree more! I've been a dentist for 28 years and
in my own practice for 25 years.
My goal has always been
* to do the best job I can
* to be the least invasive I can
* to do the job in such a way that I or another colleague has a
second chance because nothing will last forever (unless the
patient dies before)
I 'd like to pick up your statement on on veneers:
I try to talk young patients out of getting veneers for esthetic
reasons. On my website, there are examples of veneers I did
(sorry, just noticed the website broke down), but there is also a
very clear statement on this point:
"In the US, veneers on immaculate teeth for esthetic reasons are
quite common to improve the shape and looks of teeth. Even though
the loss of natural tooth stucture may be small, I'm very reserved
concerning these treatments. Especially in young patients you should
always keep in mind what effect a dental treatment will have within
the next 40, 50 or 60 years including all treatments that will have
to follow. Unnecessary loss of sound tooth structure should always
be avoided." I hope i translated this correctly - original German
text below:
"In den USA ist die Versorgung makelloser Frontzähne mit Veneers aus
ästhetischen Gründen weit verbreitet, um Zahnform und Zahnstellung zu
verbessern. Auch wenn der Verlust an gesunder Zahnsubstanz sehr gering
ist, stehe ich solchen Behandlungen sehr kritisch gegenüber.
Insbesondere bei jungen Patienten sollte man immer überlegen, wie sich
eine zahnmedizinische Versorgung mit allen eventuellen Folgebehandlungen
in den nächsten 40, 50 oder 60 Jahren auswirken wird. Unnötiger Verlust
an gesunder Substanz sollte möglichst vermieden werden."
- Winfried
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