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Einstein implant case to completion
From: Fred Barnett
To: ROOTS
Sent: Sunday, January 18, 2009 9:44 AM
Subject: [roots] Fwd: Einstein implant case to completion
First start to finish implant case using Ankylos......
done by one of my 2nd yr residents, started when he was a
first year resident.- Fred
Thanks Dr Fred for sharing this case......
Nicely done but there are some things that will allow for improvement.
So easy to poop on others work.....please do not look at mine..
The implant should be deeper, below bone crest
The uncovering.....the punch is a great idea but not for this system
....all other systems.
Using the instruments in the uncovering kit....a mini flap and then a
healing screw to form the gingiva......the ideal is having bone over
the implant.
Make sure there is floss on the depth gauge......they can be swallowed
and that goes for the tissue punch as well.
The contour of the crown as related to the buccal lingual dimension
has to be wrong at the cervical because of the shape of the abutment.
You have ridge lap on both sides. So later that could be a problem.
The buccal lingual width may be to great and I am willing to bet that
there is a balancing side contact.....noting the position of the
lingual cusps.
So many things to consider with Ankylos......which is an amazing
implant system but has to be thought about a little differently
in terms of planning.
In all teaching situations......we have to focus on the positive.
So the student will keep moving forward.
Preop planing.....wax up
Placement.........where does the top of the implant really go.
So we are so interested in mesial distal buccal lingual angulation
......do not forget vertical
Healing........what should be done to the gingiva at placement
time and what should happen at uncovering
Placement of abutment......how to get the gingiva to do what we want
Crown......It is all about the occlusion because that is about the
only thing that will kill the implant. The load must be checked.
But all being said what a wonderful job and just think of the great
thing to get to do in the program.............keep on trucking.
All the best and sent with respect for the great program you have
- Jeffrey C Hoos DMD
Dear Fred, Referring to picture no. 8
Why take such a big punch for tissue removal,
I like the small diameter of the gingival abutment, no way for me
to take such a bite!
I’m using the posterior abutment also but I missed the transfer
for placing the abutment.
What do you think about the A and B abutment, to be placed
immediately after surgery of even delayed ? - Drs. J.W.J. Spaargaren
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