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Endo tips    Better Endo    Endo abstracts    Endo discussions

The opinions within this web page are not ours. Authors have been credited
for the individual posts where they are. Photos courtesy Terry Pannkuk - ROOTS
  6mm x 4.0 Astra implant

From: Terry Pannkuk
Sent: Thursday, June 18, 2009 5:19 AM
Subject: [roots] A Shorty Implant

Here's the second implant I placed today.

Very interesting resorption case and good endo-implant algorithm issue. 
I saw the patient on consultation October 2007 she was having pain with 
the labial resorption of #20.  We had originally hoped to monitor it
as long as possilbe knowing the mental nerve proximity would be a 
significant risk consideratio for an implant treatment plan.  
I didn't really want to do the implant and thought it was too high risk.  
I extracted the tooth let it heal completely then tentatively placed 
a 3.5 x 8mm Astra but with mediocre primary stability last Fall.
She was having some pain, I was concerned about nerve proximity and 
took it out promptly and grafted the buccal wall defect with BioOss.  
I wasn't sure I was going to attempt to place another implant later 
but the site healed nicely with better ridge width and I replaced 
it today.

This time I used a 6mm. x 4.0 Astra for added safety. I was able 
to get it down with excellent torque and depth. The drilling 
sequence was a bit scarry, but I was very careful.  I buried it 
with a cover screw and will uncover in 4 months.

She has a similar resorbed bicuspid on the opposite side but needs 
three teeth replaced. It will be an implant supported bridge.  
It's not an extension of my endo services so I'll refer that side 
to my buddy the oral surgeon. - Terry

Terry, thanks for sharing such a thought provoking case! :-) Do you think she was having pain (after the first implant placement) because of nerve impingement? Last cases you have posted on ROOTS you used Nobel... now Astra... have you switched (and why?) or do you have multiple systems in your office (and why?)? Do you have experience with 6mm implants? (i used to do 8mm-s a while ago and got big critique from collegues... now i wouldn't give a crap about that, but anyway...) - Dmitri
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