Blog – Page 6 – Implants By Paresh

Intra Lock Mini Dental Implant to Replace a Missing Tooth with a Crown

January 12, 2011/in Blog, Uncategorized /by Paresh Patel

With over 75 Million Americans missing at least one tooth I am amazed that there are not more mini dental implants being placed.

Typical of what most patients who are missing teeth have. A empty spot somewhere in the middle of their teeth….just past the smile line. If they smile big enough you see the empty space. This is easily and painlessly corrected with 2 short visits to the dentist and a mini dental implant and crown.

In this patient case a Intra Lock MILO 3.0mm mini dental implant was placed from Shatkin FIRST. No surgery, no flap of gum tissue was cut, no bone was added. Just a simple procedure to gently rotate the mini dental implant into the gum. A small dental bit was used to create a opening in the gum the size of a pencil lead. Notice the lack of bleeding or trauma to the surrounding gum tissue.

Internal view of the Porcelain to Metal crown that will be cemented over the mini dental implant. Sometimes I am asked is there a fit to the crown? In this case there is a true fit, the crown will not rotate as it intimately adapts to the square base on the mini dental implant.

Porcelain crown by First Impressions Dental Labcemented over the Intra Lock Mini Dental Implant.

Final x-ray of the crown over the mini dental implant. Easy to place, easy for the patient to keep clean and a cost effective way for patients to consider dental implants that otherwise would just walk around with a missing tooth.

Implant dentistry is not just for the wealthy. It is and should be for everyone. Technology and forward thinking dentists such as Todd Shatkin have created a solution that most patients need and most dentists can perform. Easy implant placement courses to consider:

Mini Dental Implant Seminars

OCO Dental Implant Hands On Seminars

Paresh B Patel Implant Dentistry Charlotte NC

Mini Dental Implants

Dental Implants Hickory Lenoir Wilkesboro Asheville NC

Mini Dental Implant Bridge ~ Full Arch Roundhouse Crowns for Fixed Teeth

January 11, 2011/in Blog, Uncategorized /by Paresh Patel

What do patients that have no teeth really want? Is it dental implants? Crowns? Implant supported dentures? NO…they want their teeth. For right now that is not something that dentistry can give back to them… However we can get pretty close with some mini dental implants and a well thought out and fabricated full arch roundhouse bridge of porcelain crowns.

When we decide make a full arch of teeth over mini dental implants I like to make a well fitting denture to begin with. It is our blueprint for what the final crowns should look like. The patient can approve in the denture the color, size, esthetics, function, speech, etc….all before we make the investment in the final porcelain bridge.

Once the provisional denture is approved by the patient all the diagnostic information is sent to the Dental Lab for the final planning. This case was done with Evolution Dental Lab. A guide stent is made for the placement of the mini dental implants. This is done off the Cone Beam 3D x-ray scan to ensure the dental implants are placed in sound bone and will allow for the crowns to be placed in the correct approved position.

A wax mock up of the final design is made on the stone cast over the mini dental implants. This mock up will be duplicated in putty so I can make the patient in their mouth a temporary set of teeth to confirm everything once more.

Surgical guide for the placement of the mini dental implants.

OCO Biomedical Mini Dental Implants in place ready to have the temporary bridge made.

The temporary is made…notice how similar it looks to the approved denture. Since we have worked out most of the details of esthetics and function in the denture all I need to do is place the dental implants the the predetermined positions and copy the denture into the temporary bridge. The patient leaves that day without the denture. He has a fixed set of teeth to chew and smile with. Any slight changes, if needed, are made and the dental lab can make the final bridge.

The final mini dental implant bridge was made in two pieces. There is an exact fit to this bridge. Notice the multicolor pink porcelain to frame the porcelain crowns.

Back teeth for the mini dental implant roundhouse bridge.

Final bridge over the OCO Biomedical dental implants.

Mini Dental Implant Bridge cemented in patients mouth…day of placement.

Lip retracted view of the mini dental implant bridge. Notice the intimate fit of the pink porcelain to the gum tissue. The patient can floss or waterpick between each mini dental implant.

Steve with his new teeth the day of placement. He has a full arch of mini dental implants and a fixed non removable set of Porcelain crowns. Solutions similar to this start at $12,999. This includes the implants and the crowns.

What a wonderful way to get rid of your dentures and get back to living you life enjoying the things you want to do.

Without the advent of mini dental implants solutions like this would require a commitment of around $20,000 with more time/discomfort.

Paresh B Patel Implant Dentist Charlotte NC

Mini Dental Implants

Dental Implants Hickory Wilkesboro Asheville NC

Dental Implant Education Seminars

OCO Mini Dental Implant to Replace a Missing Lateral Tooth with a Porcelain Crown

January 6, 2011/in Blog, Uncategorized /by Paresh Patel

About 2% of the population has a congenitally missing upper lateral tooth.

My patient after orthodontic treatment. He is missing one of his upper lateral teeth.

He is 17 and just wants to enjoy being a kid with teeth. The solution he has right now is a clear plastic retainer with a denture tooth in it to replace the missing tooth. His Mom was unable to consider a traditional two piece dental implant due to cost. In this case I think a one piece dental implant is a better service to the patient and at a much more affordable price point.

After measuring the space we determined that a OCO 3.0mm Mini Dental Implant could be placed. It is a one piece immediate load dental implant.

Partially seated OCO implant x-ray to confirm that it is at the correct angle.

OCO immediate load one piece implant being placed.

OCO Dental Implant fully in place. Notice the lack of gum being cut and or any bleeding.

The final porcelain crown will be placed next week from First Impressions Dental Lab

Paresh B Patel Dentist Mooresville

Dental Implants Lenoir Hickory Wilkesboro Asheville NC

Mini Dental Implants Charlotte NC

OCO Biomedical Mini Dental Implants for Single Tooth Porcelain Crowns

January 4, 2011/in Blog, Uncategorized /by Paresh Patel

Do you have a partial denture or are missing teeth? In some cases mini dental implants by OCO Biomedical can help you regain your teeth back in a very easy and cost effective way.

My patient had a lower partial that his wife called his 'church teeth'….as in he hated them and would only put the partial denture in when he went to Church.

Lower ridge without his lower partial denture in place.

I decided to use Mini Dental Implants due to the thin ridge of bone that was left. Once teeth are extracted the bone will melt away over time. Adding a partial denture will accelerate this process by the constant rubbing on the gum tissue.

This x ray shows the OCO Biomedical Implant in place. Notice how thin the bone is. If we did not have the option of using mini dental implants then either this case would not have been possible or the patient would have to have an additional surgical procedure to expand the bone or add a block of bone to the existing lower jaw. Both of which will increase expense, time, healing and discomfort.

OCO Biomedical Mini Dental Implants. These are 2.2mm Square Crown Versions. 2 are in place and the process will be continued for the additional two. These will support 4 individual lower front teeth crowns.

All 4 OCO one piece mini dental implants a few weeks later before the crown seat appointment. Notice how the gum tissue is climbing up the mini implants. I will re-contour the gum with a soft tissue laser.

The 4 individual mini dental implant porcelain crowns from First Impressions Dental Lab.

Mini Dental Implant Crowns. They are made to fit precisely over the OCO Biomedical one piece mini implants.

4 Crowns on the i-Tero scanned model. These crowns were designed and milled out of a solid piece of Zirconia Porcelain.

4 individual mini dental implant crowns in the mouth. They are cemented over the OCO Mini Dental Implants.

View with lower lip retracted. Photo is the day of the crowns being cemented in place, after the excess gum was shaped with the soft tissue laser.

Paresh B Patel Implant Dentist Charlotte NC

Dental Implants Hickory Lenoir Wilkesboro NC

Ace Surgical Mini Dental Implant Full Arch Roundhouse Bridge

December 22, 2010/in Blog, Uncategorized /by Paresh Patel

Can dental implants be affordable? My next patient wanted to get rid of his dentures and have a fixed set of crowns or a full arch roundhouse bridge on dental implants. He brought his treatment plan for 8 dental implants and a set of 12 porcelain crowns…..total cost a bit north of $28,000. With mini dental implants we could reduce that cost and still have a well engineered bridge.

He had a nice ridge of bone to work with. It would not need any pre surgery to accommodate dental implants. With some planning with Jon Younce CDT at First Impressions Dental Lab a logical progression treatment plan was formulated that was restorative driven.

His pan x-ray also showed good bone with the sinus cavity totally dropped down where the back teeth were in the upper jaw. There was also a retained set of root tips that would need to be removed on the upper right.

Using his upper denture as a guide I made holes in the center of each back tooth and the lingual of the front teeth to ensure the mini dental implants would line up correctly for the final roundhouse full arch bridge.

10 ACE Surgical Mini Prep 2.3mm implants were placed in the upper arch. They were placed as parallel as possible to allow for proper draw of the final roundhouse full arch bridge.

His denture was soft lined to fit over the ACE Surgical Mini Dental Implants.

A regular crown and bridge impression was taken of the 10 ACE Surgical Mini Dental Implants. No additional impression copings or lab analogs were used. With mini dental implants we can create a more efficient and cost effective solution for patients by reducing parts and pieces that are normally required with traditional dental implants.

A standard crown and bridge model was poured in Pol-u-rock by the lab and a set of trial resin crowns were made to let the patient 'test drive' the crowns.

Lab fabricated resin temporary crowns ready to try in and have the patient give us his feedback on esthetics, function, comfort and color.

It was decided after a few days that the temporary crowns were too long. The patient also had Bell's Palsy and we decided to try and correct the slant. This photograph shows one side of the temporary crowns shortened to the new lenght for the lab to see our corrections. I shapedthe other side and let the patient go home to 'test drive' them again for final approval.

Reshaped temps and final photos for the lab to duplicate the arcylic temps in porcelain for the full arch bridge

Final porcelain bridge back from the lab. It is in three sections.

Final porcelain bridge cemented over 10 ACE Surgical Mini Prep Mini Dental Implants.

Full smile with the bridge in place.

Final pan x-ray with the 10 Ace Surgical Mini Dental Implants with the 12 units of bridge work cemented over them. Our plan is to do a lower mini dental implant overdenture that will be converted to a bridge over time as $$ can be invested.

Paresh B Patel Mini Dental Implants Charlotte Hickory Lenoir NC

Mini Dental Implant & General Dentistry Mooresville NC

Implant Dentistry a Great Way to Replace Missing Teeth with OCO Mini One Piece Dental Implants

December 22, 2010/in Blog, Uncategorized /by Paresh Patel

If you are missing one or more teeth, dental implants are a cost effective way to replace them with fixed crowns or bridges. With the advent of the mini dental implant and the one piece traditional size dental implants you now can have teeth back once again.

Missing Premolar and Canine teeth shown on the patients pan x-ray. She has had a few mini dental implants and crowns already.

It looks like a wide ridge with plenty of bone. But with a 3D i-CAT scan we see something different.

The ridge of bone is only 3.0mm wide at the top. Choices are to widen the bone, flatten it a bit (both of these would require a bit more surgery and healing time). Or to consider using a one piece mini dental implant by OCO Biomedical.

A OCO 3.0mm one piece mini dental implant was selected and placed with no surgical flap of gum tissue and minimal trauma to the area.

The OCO one piece mini dental implants were prepped in the mouth with light pressure (water and air spray).

An optical scan was taken of the prepped one piece mini dental implant for First Impressions Dental Lab to make the porcelain crowns.

All porcelain crowns prior to cementation.

Crowns in place over the OCO Biomedical one piece dental implants.

Paresh B Patel Implant Dentist Charlotte Hickory Lenoir NC

Mini Dental Implants Dentist NC

One Piece Dental Implant ~ OCO Biomedical ISI Extraction & Immediate Placement

December 22, 2010/in Blog /by Paresh Patel

In keeping with our mission at my dental office we try to make implant dentistry affordable to those patients that have not been able to move forward with their treatment.

I have been thrilled to find a one piece dental implant in a regular or traditional implant size. The OCO Biomedical ISI dental implant offers me the option of using a larger implant that does not require additional parts. The abutment(the part of the implant that comes up out of the gum) is made right along with the body of the dental implant(the part that is inserted into the bone).

This offers me the things I like about mini dental implants:

One piece design
No additional parts to buy
No microgap
Prepping of the abutment in the mouth is part of the insertion protocol
No surgical flap is recommended
Less trauma
Less healing for the patient
Increase in affordability for patients
Ease of placement….

My next patient was missing his upper eye tooth and the little tooth next to it was fractured and need to be extracted.

Of course there was a lot else going on but this is where we decided to start after getting his periodontal condition as stable as possible.

Using some PDL-vators from Salvin Dental Supply I removed the tooth with minimal trauma.

Peritome to seperate the PDL fibers from the tooth that needed to be extracted.

Extraction socket with the tooth removed. Notice very little trauma to the soft gum tissue.

The same insertion protocol was used for the OCO One Piece Dental Implant as I would do for a mini dental implant. Its called logical progression. If you can place a mini dental implant; add one more bone former and you can put in a one piece regular implant. I try to follow the philosophy of selecting a implant that will fit the bone NOT make the bone fit the implant with additional surgical procedures.

The same concept is applied to the Mini Dental Implant that will be placed into the extraction site. It is is one piece dental implant like the OCO ISI 4.0 x 14mm that was placed to act the the root for the missing eye tooth.

We are going to place a OCO i-mini 3.0 x 16mm to get at a minimum 3mm past the end of the root of the tooth that was extracted. This is to ensure stability of our mini dental implant for the temporary crown.

With both the traditional one piece dental implant and the mini dental implant in place we can make the temporary crowns to fit over them while they heal. You can see on the xray that the mini dental implant has gone past the tip of the extraction socket. The regular size OCO ISI one piece dental implant is firm with over 50ncm of torque.

Two temporary acrylic crowns are made and cemented over the OCO one piece dental implants. Once the tissue heals in around the extraction site and fills in with bone the final impression will be made for First Impressions Dental Lab to make the Porcelain Crowns over the mini dental implant as well as the regular one piece implant.

Paresh B Patel Dental Implants Hickory Lenoir Wilkesboro NC

Dental Implants Charlotte Mooresville NC

Mini Dental Implants Long Term Use for Crown and Bridge in the Upper Jaw

December 21, 2010/in Blog, Uncategorized /by Paresh Patel

"A picture is worth a thousand words" Very true that it is easier to convey the meaning of a complex idea with just a single picture.

I believe the proverb is contributed to the ancient philosopher Confucius.

Well I am just not that smart to have come up with such an elegant way to describe that visualization is a great way to absorb lots of data quickly and efficiently.

As a dentist I am bothered that many try to misinform the very patients we try and help daily with web postings such as this:

"Mini implants, often offered by less experienced dentists as a quick and less costly solution to replacing missing teeth, have a high degree of complications and failure and therefore are not recommended for long-term tooth replacement. Only standard size implants should be used for teeth replacement to achieve long-term success and longevity." These comments were made in December 2009.

Where are these complications? Where are these failures? I would think that a practice like mine where we focus on mini dental implants I would have hundreds of documented cases of failed mini dental implants. All the colleagues I meet from around the country would certainly share with me their failures if there was a high degree of them. To date I have not seen this. If anyone wants to see long term data you can look at them in Todd Shatkin's Compendium Article as well as several articles by Gordon Christensen.

Do mini dental implants fail? Sure they do….but not at any rate different than standard size implants. The basic premise applies. Place the implant under the correct protocol it will integrate. If the occlusal (biting) loads are managed correctly then the implant will work long term under function.

I think the higher road to take is to explain both options to patients. Mini Dental Implants do work and have been show to work well for a multitude of fixed (Crowns and Bridges) and removable (Partial and Complete Dentures) solutions for 12 years. Can I provide 35+ years of success. No….but if 12 years is an indicator then I suspect that they will. No gain is provided to dentistry and the patients we serve with misinformation.

In conclusion lets use Confucius's proverb show what I hope to communicate.

3 Mini Dental Implant to support 2 premolar crowns in the upper jaw. Placed and restored with PFM crowns 12-21-2009.

One year post op x-ray 12-21-2010. Same three mini dental implants with 2 PFM premolar crowns in the upper jaw.

Confucius emphasized personal morality, correctness of social relationships, justice and sincerity. I hope to see more of this in organized dentistry.

Paresh B Patel Dentist Mooresville NC

Mini Dental Implants Charlotte NC

Easy Dental Implant Placement to Replace a Missing Tooth with a Fixed Crown

December 20, 2010/in Blog, Uncategorized /by Paresh Patel

Lets face it….we are getting older and our teeth age along with us. Some of us will have missing teeth due to decay or injury or just daily use. With tooth loss comes other potential problems. Such as aesthetic concerns and not being able to eat the things you like.

With the advent of a dental implant (a small titanium screw that is gently rotated into the gum and bone) we can now use that as a new root to anchor a replacement porcelain crown or bridge.

Here is a good example of how the bone starts to melt away after a tooth is lost. This also shows show the sinus cavity starts to drop down giving us even less volume of bone to place the dental implant. This is a great spot to use two mini dental implants or if there is enough width one larger regular size dental implant. I like using a one piece dental implant. It has the advantages of being cost effective, no microgap, and immediate use just like a mini dental implant.

Here we can see the missing molar tooth. Plenty of width of bone. Options given to the patient were 2 mini dental implants or one regular size one. In this case we decided to use a OCO Biomedical ISI one piece dental implant 4.0mm in diameter. Lots of times I have been asked, is it not harder to place the larger size implant. I don't think so. With the logical progression design of the OCO dental implants it is very similar in placement protocol to what I am use to doing with mini dental implants. One pilot bit and one final bit to form the bone. No flap of gum tissue is made. Patients go home with no blood or stitches.

Parallel pin in place to check for proper angle and depth. I will use some SalvinOsteotomes to push up the sinus and some DynaBlast bone putty to fill in around the end of the implant. Chris Totty at Salvin can provide additional information on these products.

Final photo of the OCO Biomedical ISI 4.0mm dental implant to replace the missing upper molar. As you can see, no blood and no stitches. It will have the same surface area as two mini dental implants. Either solution would provide this patient the opportunity to have her missing molar tooth once again.

Final x-ray with the sinus membrane bumped up to allow for the end of the OCO dental implant to be covered with added bone. This will fill in and turn into live bone in a few months. A i-TERO impression was taken and First Impressions Dental Lab will make a porcelain crown to fit over the OCO ISI one piece dental implant.

Paresh B Patel Dentist Mooresville NC

Mini Dental Implants

Missing Front Teeth Replaced with OCO Mini Dental Implants & Porcelain Crowns

December 17, 2010/in Blog /by Paresh Patel

Who would be happy if they lost 1/2 of their front teeth?

My next patient unfortunately broke her bridge and just could not stand the partial she had to replace them.

Of course everyone wants to have fixed teeth; but cost is certainly a factor that must be addressed as an individual issue. I tell everyone, anything can be accomplished…its just how much time, effort and other dentist more skilled than me do you want to see. She had been given an treatment plan that was just too far out of her budget. So we considered the option of using mini dental implants to create her a fixed bridge.

For this case I selected some OCO Biomedical 3.0 x 16mm mini dental implants. Cost effective and strong enough to make for a successful mini dental implant bridge case.

The simple placement protocol for mini dental implants allows for a no gum cutting procedure. One small pilot bit is used to make a pencil lead size hole in the gum. From that hole in the gum and bone a mini dental implant is gently rotated into position.

Here we see one OCO Biomedical mini dental implant fully inserted and the second 1/2 in. Very minimal trauma to the gum and bone creates little discomfort for the patient. The thread geometry allows for immediate stabilization of the implant. Cases that would have taken 4 to 6 months now can be completed in 4 to 6 weeks.

OCO mini dental implant x-ray fully inserted in the bone 3.0 x16mm long.

OCO Biomedical 3.0 x 14mm long mini dental implant fully inserted.

An i-Tero digital scan was taken on this case for First Impressions Dental Lab to make a 3 tooth bridge that will fit over the OCO mini dental implants.

If you are a dentist considering adding implant placement to your practice a good place to start is the Simple Implant Placement Education Course Seminar It is in Orlando Fl Jan 8th and is given by OCO Biomedical and Dr. Ara Nazarian. I am very honored that I have been invited to present at this dental implant seminar as well.

Paresh B Patel General & Implant Dentist Mooresville NC

Mini Dental Implants