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Endo tips    Better Endo    Endo abstracts    Endo discussions

Extraction and immediate implant placement - Courtesy ROOTS

The opinions and photographs within this web page are not ours. Authors have been
credited for the individual posts where they are - www.rxroots.com
From: Liviu Steier
To: ROOTS
Sent: Tuesday, April 13, 2010 12:17 AM
Subject: [roots] Case of the day

Patient flew in and out today accompanied by his own dentist 
for extraction and immediate implant placement.
- Dr.med.dent. Liviu Steier

immediate implant placement

immediate implant placement

immediate implant placement

immediate implant placement

immediate implant placement

immediate implant placement

immediate implant placement

immediate implant placement

immediate implant placement

immediate implant placement

immediate implant placement

immediate implant placement

immediate implant placement

immediate implant placement

immediate implant placement

immediate implant placement

immediate implant placement And what Implant could that be? An Alpha Bio or a Noble activ? - Dr Sanjay Jamdade who cares the brand? it looks like perfect treatment to me. - Sergiu Dr Sergiu obviously it is perfect there is no argument about it. But the macrogeometry and microgeometry of the implant obviously play an important role. That is an established fact of implant dentistry. Hence you SHOULD care what the brand is. I ask you Dr Sergiu would bone healing around an implant with sharp threads. with blunt threads, deep threads and shallow threads, Implant with machined surface, rough surface all be identical? - Dr Sanjay Jamdade Dr Sanjay, your point is highly appreciated. Having placed couple of thousands of implants since 1989 and having had the chance to review quite a high number of them over the decades beside reviewing the literature evidence different questions had to be answered before deciding what system to choose and how to be best treatment plan. I shared my case with you and shared multiple other cases with this forum and proved my point. I wonder if you could do the very same to prove the evidence of your point, but ...I can understand if you do not have any and just prefer to play "devils advocate" for the sake of the theory... I had a great teacher in Germany I would love to quote: "Don t tell me - show me!" Respectfully, L. Steier Sanjay, All differences you mentioned have anything to do about final outcome in first 6 to 9 motnhs. After implant is successfully osseointegrated there is no any study, as far as I am informed, which can show us a statistically significant differeneces in results. The "hollow cylinder with vents" implant of Straumann sold in the past may be is the only exclusion with its high percentage of late failures due to its design. See some pictures attached of over 30 years loaded Tramonte implant and also of 8 and 13 years loaded SDV 1 implant (which I developed back in 1990). A 30 years result of blade implant is also attached with endo failing next to it :-). It's ALL about correct implant treatment planning and NOT because of particular implant design after first year of successful loading. - Valeri Stefanov immediate implant placement

immediate implant placement

immediate implant placement

immediate implant placement

immediate implant placement Sanjay, I can not speak on behalf of Liviu, but with my post I just wanted to teach you something I've come to through many years of personal experience and accumulated knowledge by placing implants, designing implants and at certain point by manufacturing the system I developed myself. The discussion you are now trying to start on ROOTS is imho not appropriate for this endo forum, although some of endodontists have already started placing implants, too. We have had these discussions on another on-line list for many years - IMPLANTLOGY list founded by Dr.John Cliff back in 1996. What is good within first 6 months post implant insertion imho - thin body and large sdv threads in case you want to do delayed immedaite loading ( I do not like real immediate loading myself and I do not practice it ). If you will do it in a classic way Bicon implant system approach is fine and same is valid for all other classic implant systems with thick body and low height threads. There is an implant which allows you to practice both approaches depending on the circumstances in each clinical case using ONE design implant only ( see attached photo of ARDS implant - made in Israel ). Another important thing - rough is better than smooth. At least at this stage how exactly the roughness will be created does not matter too much. TPS and HA coatings are worse than SLA, SXLA, RBM and etc similar surfaces which are not coatings. I am attaching the PPT of my lecture I had on Experts Podium during a DGZI / ICOI Congress held in Budapest in 2002 (8 years ago). If you have questions about some of the electron microscopies I'll be glad to explain in details, since Power Point presentation is not a lecture itself. In advance I can tell you that resorbtion of HA coating - both low crystalinity and high crystalinity can be seen even only 3 months after insertion without any loading of implants ! Hope you will enjoy the presentation. - Valeri immediate implant placement Power point presentation

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