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Endo tips    Better Endo    Endo abstracts    Endo discussions

  Implant # 30

The opinions within this web page are not ours. Authors have been credited
for the individual posts where they are. Photos courtesy Jared T Buck - ROOTS

From: Fred Barnett
To: ROOTS
Sent: Saturday, February 28, 2009 6:23 AM
Subject: [roots] final photos for implant #30

from a 2nd year resident....Fred

Attached are the finals of a case I have posted before.   It is nice to 
be able to see it to completion.  I had my patient come in after the 
restorative was placed by her GP to take photos and of course check the 
occulsion.  I am a true believer that occulsion is king, and it can very, 
very easily destroy a beautiful case. In the photos you can see the 
lateral interferences picked up at today's appointment.   After I removed 
them, I removed the sweeping protrusive interference.

- Jared T. Buck, D.D.S.

implant tooth #30

implant tooth #30

implant tooth #30

implant tooth #30 Great follow up. The occlusion is the key, always, but especially with implant prosthetics. It is awesome to have endudes looking at it too. If I had restored this case I would have taken a clue form the large cervical abfraction of #3 and looked at it as #3 being 50% responsible for #30 failing. It takes tremendous excess, pathologic force to help those things to happen- a max molar w a large cervical abfraction and a failed mand molar. Its hard to tell from the buccal view only but #3 looks slightly out of postion (still) and could have very sharp, malpostioned cusps. If that were the case and I had restored this case I would have coronoplastied #3 to create a better occlusal shape and postion. Then I would restore #30 to that. It never ceases to amaze me how dentists can expect even a perfectly placed and restored implant to survive any better long term when it is put into the exact same hostile occlusal force environment that helped cause the previous tooth to fail. And teeth are far better at handling force than implants. So endudes ecnourage your restoring dentist to handle this or even better, to avoid having to handle that blank look on their face when you try to explain it to them and since they probably wont even notice it, just do it yourself and polish it up nicely so those diamond tracks dont show :-). It's all about creating value for your referral base's patients ;-)! Arturo Thanks for your comments Arturo. Endudes need to be much more than 'white line' mavens ;-)) - Fred Am I missing something here? Is that radiograph showing the crown on the molar endo for real? Just looks different than what I was taught was clinically acceptable, but then there are lots of new philosophies out there that werenít around 40 years ago, when I was in dental school- Terry The crown is less than ideal ;-) - Fred I would love to see the restorative dentist try and floss that burger. Best have the patient using an irrigation device of some sort. Ah, just makes me feel better when I see that other dentists are as bad as I am - Terry Iím not sure what Iím missing here, but given the position of that tooth in the arch, the mesial inclination, the position of the opposing 2nd molar in the arch, the excellent marginal fit, Iím not sharing the position that this is a poorly done crown or that it is not cleanable by usual means - gary I'm with you Gary---perhaps the premolar seems a bit suspect, but tough to say, i wasn't there - Kendel

Horizontal percussion

Calcified central incisor

23 year recall

Irreversible pulpitis

Ortho and retrograde

coronal restoration

Isthmus anatomy

14 year recall

Caries exposure

Cracked tooth syndrome

Perio inflammation

Severe percussion

2 D healing

Crown access

Endo implant

To CT or not

Huge lesion

Polished collar

Molar restoration

Immediate implant

Whiteline puzzle

Orthoband cases

Symmetric resorption

Removing Niti instruments

Calcified incisor

Ca(OH)2 extrusion

Resorption defect

Apico on MTA