Uncategorized – Page 6 – Implants By Paresh

Secure Mini Dental Implants~A System to solve most dental problems

September 27, 2010/in Blog, Uncategorized /by Paresh Patel

Mini Dental Implants were originally used to Secure lower dentures….but they can be used for much more. From replacing a single missing tooth to replacing several missing teeth to a full arch of missing teeth with a fixed porcelain bridge.

Mini Implants ranging in size from 1.8mm~2.0~2.3mm~2.5mm~up to 2.9mm. Anything over 3.0mm gets in my mind into the traditional implant range. Some people will state that 3.25mm is the cutoff for a conventional implant to secure a 2 piece abutment system.

To Secure a lower set of crowns on our next patient we used traditional implants to do the All on 5 concept.

Pre Implant Pan x-ray

Post Implant Pan x-ray with 5 implants in place that will Secure the lower fixed porcelain crowns

Clinical photo day of surgery…full flap was made to find both mental nerve bundles. The lower ridge had to be surgically made wider to accomodate a larger traditional size implant. You can see from the photo the level of surgical skill needed to due such surgery. It is quite different than placing a mini dental implant. It takes a very talented dentist to do this kind of surgery on a daily basis. I commend and compliment any dentist that takes the time to offer this kind of implant dentistry. Although I did this case and several more; I question myself each time….could I have offered a different solution that would not have required so much from my patient?

The mini dental implant solution to Secure a lower set of crowns would be 8-12 of them. With that much surface area the minis have the ability to absorb the force of chewing and can equally distribue that force over the entire lower jaw.

This case illustrates how we can Secure with Mini Dental Implants a lower set of Porcelain crowns. As you can see from x-ray there would have not been room for a larger traditional implant without additional surgery. That surgery would have been to flatten the ridge of bone or to lay a full flap similar to the prior picture and expand the bone. Both would increase the cost to the patient….in terms of $$ and healing. I have done this same concept on the upper arch as well to replace a denture plate with fixed crowns.

To review, Mini Dental Implants do not replace the need for Conventional or Regular Implants….they just offer the patient another choice in their dental treatment. Technology has made it possible to make a smaller implant out of the same dental alloy with the same surface coating as a larger implant at a reduced cost. With this we now as Dentists should offer our patients ALL the choices from doing nothing and letting millions of patients suffer with missing teeth, to traditional implants that have the longest track history of success to mini dental implants that have over 15 years of success.

Paresh B Patel DDS Secure Mini Dental Implants

Dentist Mooresville NC

Mini Dental Implants to Replace an Upper Partial Denture Plate

September 23, 2010/in Blog, Uncategorized /by Paresh Patel

This is actually a case that was done last year. My patient came in for his 6 month cleaning about 6 months late…. Not what I like for patients to do. But he was certainly not the ideal patient and I explained that to him prior to committing my time, energy and mini implants to the case. He is a heavy smoker (around 2 packs a day). A big NO NO for traditional implants or any kind of implants in general. But I told him if I could get the mini's in without having to flap his gum away from the bone the implants would have a better chance of healing. He had seen another dentist about traditional or conventional implants but could not move forward with treatment due to the cost. A familiar story. I told him we could offer another choice…the mini implant choice. Not the same solution but a different solution that might work for him. He had a upper partial to replace his missing 6 front teeth. He had an accident over 10 years ago and had been wearing a cast metal partial that he did not like. His big complaint was the metal hooks and just the bulk of it. He did not really have a complaint on the way his front teeth looked on the partial plate.

View of upper partial denture in place. I cut the metal hooks off so he could see what things could look like once we had the final bridge over his mini dental implants.

6 Mini Dental Implants in place in the upper jaw…day of placement. Note the lack of bleeding. No flap had to be made to insert the mini implants into the gum and bone on the upper.

Upper Partial Denture modified to fit over the 6 mini dental implants that were placed in the upper jaw. This way he would be able to wear the upper partial while the dental lab made his crowns/bridge.

6 crowns with pink porcelain to simulate gum tissue on the stone model from First Impressions Dental Lab

Retracted cheek view of his 6 crowns on six mini dental implants…1 year post placement. Notice all the smoking stain on his lower natural teeth.

Close up view of Crowns

Bite view of the 6 crowns on mini dental implants.

Overall I am happy. I know he is happy. I think his comment was, 'Doc now that I got my show teeth do I really need to get the rest of them fixed?' How do you answer that question as a Dentist?

Now if I could just get him to quit smoking, come in when he is required to for his cleanings and move forward with fixing the rest of his teeth….. But as they say, Rome was not built in a day so we move forward one MINI step at a time.

Paresh Patel DDS mini dental implants

General Dentist Mooresville NC

Mini Dental Implants ~What I use them for ~Just about anywhere in the mouth

September 18, 2010/in Blog, Uncategorized /by Paresh Patel

Mini Dental Implants have a wide variety of uses. I find more and more uses for this as a General Dentist. I think in a matter of time mini implant dentistry will become everyday dentistry. As routine as getting a filling.

Mini Dental Implants in the lower jaw. With 4 mini implants in place you can secure a lower denture. Even with a thin ridge most of the time these can be placed without cutting the gum. If the gum is not cut then no blood supply to the bone is disrupted. The bone heals faster around the mini implants allowing the patient to function with a implant retained denture immediately.

Mini Dental implants in the upper jaw. The upper jaw bone is softer and not as dense as the lower jaw. With 6 mini implants in place you can secure an upper denture. With a good well made denture that covers the hard bone at the very end of the upper arch (maxillary tuberosity) you can remove the middle of the denture. Most patients appreciate the palate of the denture being removed. With this horseshoe shape design patients can taste food better, have better speech, decrease in gagging and less bulk of plastic. With more implants sometimes it is hard for patients to 'line up' all the o-balls and housings in the denture. What I would like as a dentist is if someone would make a Zest Locator mini dental implant. The Zest Locator is the 'gold standard' in attachments for the traditional or conventional implants. It is much smaller in height and guides the patients denture into the retentive rings. The retention rings are also made of nylon so the rings last much longer than the rubber ring used in the o-ball attachment. Right now OCO Biomedical i- mini and i-micro implants, IMTEC MDI, and Intra Lock mini implants all use the o-ball with no locator attachment available.

Zest Locator attachments with metal housings shown in picture. You can see how close to the gum they are. Increase in patient comfort, less vertical and horizontal stress to the implants due to less of a lever arm.

Image of the Zest Locator implant attachment. You can see the 'flat' top surface. The male snap that fits on the outside and inside of the Zest Locator acts as a guide for ease of inserting the denture. When you have multiple mini implants this would be a welcome advantage.

Mini Dental Implant to retain lower partials.

With just a few mini implants you can take a lower partial denture and remove the metal clasp, fit the retention housing in the partial denture and now the patient does not have any visible metal on their teeth. If the partial is well made and has proper stops in the back of the lower jaw (retromolar pad) the partial will not settle and the implants will not get overstressed.

Mini Dental Implants to retain an Upper Partial Denture

Once again even with a few of these minis you can make a case that works. Over time if the patient's desires change and they want to add more its always possible.

Mini Dental Implants to secure a fixed bridge (Multiple teeth connected together)

In this case multiple teeth were failing and mini dental implants were placed the day of extraction to support a acrylic temporary bridge made in our dental lab. I used some pink acrylic around the front teeth to help hide the extraction sites while they were healing. A final porcelain bridge was made to fit over the mini dental implants once all the gums heal. This case is now been in function for over two years.

Mini Dental Implants to replace a few missing teeth with a crown

Here mini dental implants were placed to support 2 premolar crowns. They are the two teeth in the middle of the picture behind the large canine tooth. The last tooth in the picture is a crown on a natural molar.

mini dental implants

Paresh B Patel dentists Mooresville NC

Academy of Mini Dental Implants First Journal

September 10, 2010/in Blog, Uncategorized /by Paresh Patel

Many thanks to Dr. Bob Caseldine for getting the first edition of the Journal of the Academy of Mini Dental Implants published. For him it has been a labor of love and it shows. Great Job! With this new addition to the Academy I hope it encourages more Dentists to see the value that the mini dental implant has to offer for our patients who all too often suffer from ill fitting dentures and missing teeth. Without these mini implants I just do not see how we can help so many patients who think there is no other option except to stay at home and suffer.

Mini Dental Implants

Dentist Mooresville NC

Mini Dental Implant Upper Denture Tooth Bridge

September 9, 2010/in Blog, Uncategorized /by Paresh Patel

Part II of the fixed hybrid bridge post. You can scroll down 1/2 into the web page to see the complete case…

This is the finished product for our patient that came in just gagging on her upper denture. She wanted to have a solution that would allow her to have the roof of mouth not covered with plastic. Cost was certainly a factor. We offered the solution of 4 to 6 locator's implants and a removable over-denture without a palate. I like to place 6 on the upper arch to withstand the lateral stress if we plan to remove the palate in the denture. This certainly would have been the most elegant solution (easy to keep clean and offers a tremendous amount of retention)but was declined.

I put in 8 mini dental implants to support a metal frame (not a tissue supported upper denture). This metal frame would hold and support her new set of teeth made out of acrylic and denture teeth (a fixed hybrid solution). Since there are no two piece mini dental implants (a diameter of less than 3.0mm) we can either cement the teeth over the mini dental implants or we can incorporate a teflon keeper that is processed into the metal acrylic base. Shatkin First has this option if you need further information.

Mini Dental Implants in place

Cast metal frame with Preat E-Fiber under acrylic

connecting both sides together. I would have preferred to continue that cast framework from one side to the other…but to accommodate the patients bite and other request it did not work out. So the solution to use the e-fiber was decided upon with patient approval. For technical data on the e-fiber you can go to their website. It is 10x more fatigue resistant than fibrekore and 2x as strong in flexural strength. Occlusion is only on the posterior teeth with only light occlusal stops on the lingual of the anterior teeth. This is done to provide the artificial dentition patientt anterior incisal clearance during all posterior masticatory function. All four anterior teeth do touch the lower teeth during incising and protrusive function.

View of Fixed hybrid denture in place with no palate

Smile view of fixed hybrid denture in place

There is about a 1/2mm to 1mm of space to allow for floss and water pick to keep the fixed hybrid denture clean. Lingual side has a tight fit against tissue.

Paresh B Patel Dentist Mooresville NC

mini dental implants

Mini Dental Implant Bridge ~ Similar Results as a traditional implant ~ Tremendous saving in cost

September 1, 2010/in Blog, Uncategorized /by Paresh Patel

As promised here are the pictures of the fixed cement hybrid bridge (denture teeth with a metal frame that fits over the mini dental implants).

Denture tooth bridge with a cast metal frame that will be cemented over the 9 mini dental implants

View of upper fixed hybrid cemented in place to show horseshoe shape and no coverage in the roof of the mouth.

There is a 1mm space around the pink acrylic to clean under the teeth with a waterpick and sonicare toothbrush.

You can scroll down to the OCO Biomedical i-mini i-micro post to review the original case before the mini dental implants were placed.

Nine mini dental implants were used in the upper jaw to hold in 12 teeth.

Paresh B Patel Dentist Mooresville NC

mini dental implants

Mini Dental Implant Training ~Education ~Seminars~Lecture~CE Continuing Education

July 16, 2010/in Blog, Uncategorized /by Paresh Patel

Its that time of year again….the Annual Academy Meeting on Mini Dental Implants at the Walt Disney World Beach & Yacht Club Resort. August 21-22, 2010.

It is going to be a great time with new and old members showing off some of the cases they have done over the past year with mini dental implants. From bread and butter denture stabilization to more complex crown and bridge cases that simply could not have been possible without mini implants. (Well without additional bone grafting, bone splitting and expansion).

Dr. Todd Shatkin has been gracious enough to let me lecture with him again. Many of the Las Vegas course attendees have contacted me to let me know how mini dental implants have changed their practice and their patients lives for the better. It has been a wonderful experience to see so many Doctors want to get training on mini implants. With many Academy members offering over the shoulder help I think mini implant will be in most dental offices soon.

Paresh B Patel DDS

Dentist Mooresville NC

Mini Dental Implants for Back Jaw Teeth Crowns

July 8, 2010/in Blog, Uncategorized /by Paresh Patel

Our next patient came to us seeking an alternative to the treatment options that were given to him:

1. A set of removable partials

2. Bone expansion or bone grafts a then traditional or conventional size dental implants.

I told him that those were both great options and at our office I would include a option #3 of some mini dental implants and fixed crowns.

Before Mini Dental Implants

Before Mini Implants Right

Before Mini Implant Left

X-rays and study impressions were taken to see if I could place some mini implants to hold in a few crowns. All looked possible and a phased treatment plan was made. The patient wanted to start with a single molar on his right side, and a premolar to fill in the missing teeth on both left and right sides.

As he could afford it additional mini dental implants would be placed to replace the missing molars and other teeth on the top and bottom.

As usual for me two mini implants were placed to support a molar sized crown and a single mini was placed to support a premolar sized crown. If I could have placed additional minis in the premolar area I would have – I make it a standard at my office to price the case and not by number of implants placed.

Mini Dental Implants Right side lower jaw

Mini Dental Implants left side lower jaw

A standard PVS impression was taken and sent to First Impressions Dental Lab in Lenoir NC. 3 PFM crowns were made and cemented with self cure resin cement.

Molar Mini Dental Implant Crown far left ~ crown on a natural tooth in the middle ~ Premolar Mini Dental Implant Crown on right ~ natural canine tooth far right

Premolar crown on a mini dental implant lower left jaw

Paresh B Patel DDS

Mini Dental Implants

Dentist Mooresville NC

Mini Dental Implants Upper Fixed Denture~Bridge

June 17, 2010/in Blog, Uncategorized /by Paresh Patel

Our next patient came to see us because she had some lower minis placed. She could not stop talking about how she was now able to actually wear her lower denture and chew. Wonderful….so what could I do to help her?

I did notice that the entire time she was in the dental chair talking she kept gagging and several times her eyes watered up like she was getting ready to vomit. Hopefully I was not that hard on her eyes that the thought of looking at me would make someone want to hurl…..

But after some questioning it was discovered that her upper denture just made her want to gag….no matter how many she had made, how much of the denture was cut back she just could not tolerate the buildup of saliva.

She had seen a patient of mine that had mini dental implants and a fixed hybrid bridge (a set of teeth over a cast metal bar that is not removable by the patient. It is cemented over the mini dental implants).

Her words to me were "I'm confused; I want that fixed set of upper teeth not that fixed hybrid car thing you were talking about." So I guess I did a poor job taking mumbo jumbo dental talk into usable ideas for my patient. From now on I am going to start calling the fixed hybrid bridge what it really is: fixed teeth for people who have no existing teeth.

The total cost for the mini dental implants and fixed tooth bridge allowed her to move forward with dental treatment. The other options she had been give prior would just not fit into her budget.

Intra Lock 2.5 x 13mm mini dental implants were used in this case. 4 were placed on each side for a total of 8 minis to support a fixed set of teeth.

Photo day of mini dental implant placement….notice lack of bleeding and no gum had to be cut.

I will update the post with the metal frame, and try in photos in a few week.

Paresh

http://www.dentalminiimplant.com

Mini Dental Implants for Upper Crowns

March 29, 2010/in Blog, Uncategorized /by Paresh Patel

This is part II of the post… The mini dental implants have been placed and allowed to heal. Impressions were taken and sent to the crown and bridge lab for resin crowns to be fabricated. Resin crowns were selected instead of traditional PFM upper crowns due to patient $$. I kept the model work so that over time when the patient is better able to afford the Porcelain Upper Crowns we can just send the models back to the lab and skip one step in the fabrication process.

The upper crowns were tried in over the mini implants. Our patient approved the look and color. They are now cemented in place.
Close up of premolar crowns
Single Premolar mini implant upper crowns (2 minis were placed to hold the crown in place)
Chewing view of premolar upper crowns over a total of 5 mini dental implants.

I have had lots of dentists ask me and even tell me that mini implants do not work in the upper arch or that they can't work in soft bone. My personal experience has been if mini implants are placed in the upper arch they just need time to heal like any other size implant. Don't be in a hurry to get the final product…you can only go as fast as the mini will integrate into the bone.

Over the past 2 years and close to a 1000 mini implants being placed I have had one case fail in the upper arch. It was two minis used to support a upper molar crown. They went in solid but over 6 weeks they did not stay that way. I believe it was either smoking or the patient functioning on them that was the cause of the failure.

Paresh B Patel DDS Mooresville NC

http://www.dentalminiimplant.com or http://www.lkndds.com