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Endo tips    Better Endo    Endo abstracts    Endo discussions

Mandibular fracture:SynCone - Courtesy ROOTS

The opinions and photographs within this web page are not ours. Authors have been
credited for the individual posts where they are -
From: Henry
Sent: Sunday, May 02, 2010 7:21 PM
Subject: Syn cone

A 71 years old can not handle her dentures any more asking for help.
Would Syn Cone be an option? what to watch out for and warn Pt about before even a CBCT is available?
- Henry Mulla, Australia

Henry,in this case i would suggest that a CBCT is imperative.  you should warn the patient about
parasthesia and potential of mandibular fracture during the procedure.
you absolutely need to plot the course of the nerve and locate the mental foramen.
SynCone need four implants to be positioned in the mandbile (Interforamenal placement is OK)...

if you cannot get four fixtures place, then look at options of two or three.
Locator abutments on them will have to do - Dwayne

Unless great finger strength or should I say dexterity go with ball attachments
Photos to follow
Remember they rotate and distalge will move and needs or should have retromolar support - jchdmd

With Syn Cone being a rigid attachment you need a minimum of 4..I don't know if you have that much bone.
Ball attachments, Locators, ERA's or anything that is resilient only requires two implants.
That may be your best option -  Barry

Hi Henry, I had a similar case last week. She was a 60 y.o. female with not much bone in the
maxilla and large sinuses. She had just basal bone in the mandible but a very thin band of attached
gingivae situated to the lingual of the bone. Not easy!

I have no experience with Syncone ( but it looks good) but I have done a couple of overdentures.
Subject to CT views, it looks to me that you have enough bone in the upper for fixtures in the
incisor and cuspid positions but not at the 5 or 6. I suspect that you will need to graft the sinuses
to get the required 6 implants in the upper jaw. In the lower jaw you should be able to fit the
required 4 implants in the distance between the mental foramina.

The simple alternative to Syncone is to bolt a flat U shaped bar to the fixtures and use a recess
inside the dentures filled with Molloplast soft lining material. I got this idea from Robert Aitken
yesterday. Cheap and Iffictive! Those Kiwis really know how to fux things, eh? Or you could do a
single lower midline implant with a zest locator like Scott showed on Ozdent. Zest locators need
frequent insert replacement in some cases. - Kym Stock

Thanks guys!! I will update you when CBCT is available - Henry

The bony resorption is probably greater that appears on the panoroamc and my guess is that there is
more bone on the pan than you expected from your clinical exam.  This patient is at risk for pathologic
fracture.  I prefer to place 4-5 anterior implants for a fixed-removable hybrid denture that stays in
unless you unscrew it.  These prostheses provide bending movements and can cause increased mandibular
height in the anterior body region (i.e. posterior to the most posterior implants).  You need to leave
enough space between the ridge and the denture/framework to allow for the increase in bone height
that will occur -  Jeffrey A. Halpern, DDS

Sent: Friday, May 14, 2010 3:56 AM
Subject: syncone humor

May be some people that lecture can use this in their presentations.- Jose

Thanks Jose, but I think the midline is slanting slightly to the left. - Barry Love it...i will use it with your permission... - dwayne

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