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Missing Teeth Replaced with Mini Dental Implants & Porcelain Crowns ~ A technique from the Advanced CE Seminar

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This is part II of the post Mini Dental Implants to replace a missing front upper tooth.  See recent posts for the history of the case.

Missing teeth    Minis in

Its been 4 weeks or so and the all Porcelain crowns are back from First Impressions Dental Lab to fit over the ACE Secure Mini Dental Implants. 

Front crown Zirc  Front crown ridge lap desing   Lateral crown 

                               Lateral ridge lap Mini Dental Implant Crowns

 

A scan was taken of the mini dental implants with a iTERO digital optical scanner and Jon Younce at the lab was able to plan the case in a all digital format to make Zirconium all porcelain crowns.

Itero model ACE mini dental implant Crowns on modelAll Porcelain Ridge Lap Mini Dental Implant Crowns. 

 

These crowns could be made over any mini dental implant (Intra Lock, IMTEC, OCO Biomedical mini, Hiossen etc…) 

I have often been told that it is not possible to make good looking anterior(front) tooth crowns on top of mini dental implants because of the ridge lap design.  Or without creating a emergence profile below the gum its not possible. 

Crowns over mini dental implants

 

I think the real issue is the patients gum thickness.  If the gum is too thin you see the gray halo of the implant as it comes out of the gum.  Even if you have a traditional implant with a two piece design and a custom fabricated ceramic abutment if the gum is too thin its hard to have room for the crown. 

So I like to have patients know before we place the mini dental implants if they have thin tissue type and what can be done to make the gum thicker if aesthetics is a primary concern. 

As with anything in dentistry….almost everything is possible…..its just how much time, money and effort the patient and doctor are willing to invest. 

Paresh B Patel DDS  Dentist Mooresville NC   Before after mini dental implants porcelain crowns

OCO Mini Dental Implants

 

 

 

ACE Surgical Mini Dental Implant with a Zest Locator for the Upper Denture Plate

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Does your upper denture gag you?  Does it feel like a big bulky piece of plastic?  Do you not taste your food anymore?  Do you talk funny or don't sound like yourself anymore? 

These are all the things my patient told me yes to.  That is a lot of yes answers to have on one patient.  Usually I don't get that many issues with the upper denture.  But when we do have someone that just simply can not wear the upper full denture plate its a huge problem; both for function and esthetics. 

Relined upper denture

 

Upper denture prior to placing 4 Mini Dental Implants with a Zest Locator attachment (different than a o-ball and ring snap typically used on mini dental implants).

 

 

Locator

 

 

 

 

Zest Locator attachment.  It has a flat surface to make inserting the snap easier on the patient than the o-ball and ring.  It also has different nylon rings that can be swapped out by the dentist to offer the patient levels of retention…..so if the denture is not tight enough a more retentive ring can be placed.  This feature is not available on the o-ball mini dental implant.

 

4 minis in place upper

 

4 ACE Surgical Secure Mini Dental Implants with Locator attachments.

 

 

Marked inside upper denture

 

Upper denture marked for location of the ACE Secure Mini Dental Implant.

 

 

 

 

 

 

Space for locator mini implant  Space created for the Zest Locator 'snaps' that will be fitted inside the existing upper denture.  In a few weeks I will make the upper denture into a horseshoe shape so he can: 'Talk better, taste his food better and gag much less'

Black housing in denture

 

Snaps picked up in the upper denture.  These rings will be replaced with more retentive rings after the implants heal into the bone.  But even today the denture is tight and my patient is impressed with how much hold he has now.

 

 

 

 

Robert ratner post

 

Final Pan X-ray of the ACE Surgical Mini Dental Implants with a Zest Locator Attachment. 

 

 

In the end I am impressed with the Locator attachment.  A bit more skill required to place these mini dental implants than a o-ball type.  This is mostly due to the protocol of using a 2.3mm in the front and having to place a 3.25mm in the back.  My preference would have been to just use 6 2.3mm minis and give the patient a few extra implants.  But as with any product it is up to the dentist to determine what he/she feels is best for the patient.  This case could have been done and been successful with any mini dental implant, IMTEC MDI, Intra-Lock, OCO Biomedical mini or micro. 

Paresh B Patel DDS  Dentist Mooresville NC

ACE Surgical Mini Dental Implant