implant – Page 2 – Implants By Paresh

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

Mini Dental Implants to solve problems

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

I got a phone call last night from a Dentist friend of mine in Buffalo NY (one of the worlds best respected Mini Dental Implant clinicians). He had a patient of his from years ago that had a Resin Bonded Bridge that had now failed.

She was an interesting young lady in grad school at UNC-Chapel Hill….of course she was in tears that she had lost her front tooth.

What to do? I got her numb and sounded the bone in the missing tooth area…very thin…hardly any bone left to work with in the Lip to roof of the mouth direction.

Knowing full well that this patient would end up back in the office of the guy who has restored the most mini implants in the US I felt a bit of pressure to get it as correct as possible.

The patient agreed to let me put a mini dental implant in to hold her resin bonded bridge in place until she could get back home and then have the permanent crown made over the mini implant.

So I put in a 2.0 x 15mm Intra Lock mini implant to hold the bridge. It was fairly easy to grind out a hole in the pontic and fit it over the mini…whew!
I filled in the one wing that was not broken and the hole I created in the pontic with resin cement. She left so happy and excited. She had a tooth until a new one could be made for her.

Now for me to see how I did….

The assistant put my mentors patient in the iCAT CT chair and a few nail biting moments later I could see if I had threaded the bone and kept the mini in between the bone and not in air or soft tissue.

The Pan x-ray looked good, plenty of bone between the implant and the adjacent roots.

Now for the CT slices…

We had kept the 2.0mm implant within the 2.5mm of available bone…man was I glad.

Mini Dental Implant Training ~Education ~Seminars~Lab Consulting

March 4, 2010/in Blog, Uncategorized /by Paresh Patel

Todd Shatkin DDS, the go to guy for mini dental implant education & the dentist who trained me, is having a 2 day advanced course in Las Vegas March 12 – 13.

Dr. Shatkin asked me to present some cases in Chicago last week. It was an honor for me. Clinical cases that I did over the past year were shown to highlight what can be done with mini dental implants. With the correct education and lab support from his father, Sam Shatkin DDS MD, I feel very confident that most conscientious restorative dentists can become good mini dental implant providers.

I have been given the opportunity to speak again in Vegas and look forward to meeting everyone excited about mini dental implants and their ability to change the lives of both dentists and patients.

Mini Dental Implants vs Traditional Implants

March 2, 2010/in Blog, Uncategorized /by Paresh Patel

The next story is about a patient of mine named Storie….how bizarre. Well actually the patient is the wife of a patient of mine who had placed mini dental implants on to replace his existing partial denture.

She had broken her tooth.

X ray of broken premolar #13

I gave her the option of a root canal, post and a crown. I thought it was a good option but she had it in her mind to take the tooth out and have implants. We talked about traditional implants but she wanted what her husband had been offered – mini dental implants and crowns.

I took the tooth out with some peritomes to preserve the facial bone as much as possible .

X ray of the tooth removed and the socket preservation with De-mineralized & Mineralized Freeze Dried Bone (6 months later)

The area had healed in quite well and I was pleased with the amount of bone that was preserved in both the Facial/Lingual dimension as well as height.

3 Intra Lock Mini Dental Implants were placed to act as the roots for the missing premolar and molar (#13 and #14)

As you can see the procedure was very atraumatic to the tissue as no flap was made. Notice hardly any blood in the sites where the mini implants were placed.

I standard impression was taken and the case was sent to Valdi and Shatkin FIRST Lab for 2 PFM Crowns. The thing I like about FIRST Labs is that you don't get charged for the lab analogs for the master model or the 2nd pour for contacts.

Not to mention that the crowns look good and more importantly fit well on the mini implants.

I dry fitted the mini dental implant crowns in the patients mouth…let her approve the color and aesthetics. She approved them and we cemented them. Overall it was a slam dunk case.

Mini Dental Implant Molar Crown ~One Mini Dental Implant per root Part II

February 3, 2010/in Blog, Uncategorized /by Paresh Patel

As promised here are the photos for the mini implant crown to replace a missing molar tooth. In this example of using mini implants for a crown 3 minis were used to replace the three roots on the missing upper molar.

3 Intra Lock Mini Dental Implants in tooth #3 position

We have been using the iTERO dental scanner for 20 months now and decided to see how it would scan muliple mini dental implants. I did take a traditional impression as a backup and also to verify the fit of the mini implant crown.

I discussed the case with Valdi at Shatkin FIRST Lab's and he felt like there should be no issue with the case using the iTERO scan. He built the case just like any other one he does on a daily basis.

iTero model of 3 mini dental implants

FIRST Lab Mini Dental Implant PFM Molar #3

Mini Implant Crown next to a standard crown

Mini Dental Implant Molar Crown Chewing Surface View

Mini Dental Implant Crown Side View

X-ray of Molar Crown on 3 Mini Dental Implants

Mini Dental Implant

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

What do you do when its Friday afternoon and this walks in with a crying patient attached to it?

Well I looked in the tool box and thankfully I had a stash. No not anything illegal but a stash of Intra Lock Mini Dental Implants from Shatkin FIRST Labs. Jay Moore (the well respected and highly knowledgeable sales manager) had just sent me 24 mini implants in the 'Cash for Clunkers' trade in program.

The patient stated that the bridge was 'slightly decayed' for a while and that she had noticed some movement over the past few months. Well from where I was sitting I don't know where the 'slightly decayed' came from…..it looked more like a stroll down the street in Anbar Province Iraq.

I was able to tack mush to mush and took a pre op pan xray

Of course I was drooling over the thoughts of Mini Implants everywhere for this patient! But I had to slow down and go over all the options from

1. Do nothing…not really an option….but I have heard that patients can get creative with Super Glue!

2. Extract and recommend a denture or partial.

3. Extract and implants for an over-denture or implants and a fixed bridge.

4. Extract and mini dental implants for a fixed bridge or mini implant retained full denture.

To my surprise the patient had done her homework and had come to see us specifically for mini dental implants and a mini implant bridge.

I told her lets's slow it down a bit. How about we make it the first goal to take out the broken root tips and preserve as much bone as possible with some peritomes(dental instruments to extract teeth with less trauma to the facial bone). Then see about placing some mini dental implants and for certain figure out how to make her a temporary bridge to wear while some healing occurred.

Minis all went in as planned. She will return in a few weeks for a tissue check and I will update the photos.

iCAT CT scan of mini dental implants in place for a fixed bridge

Post operative pan xray of mini dental implant in upper jaw for fixed bridge

Mini Dental Implant Crowns ~ Mini Dental Implant Bridge ~ Mini Impants Do they Hurt Part II

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

Ok…so more than 6 weeks have passed since the blog about the mini dental implants and do they hurt. But the patient has finally come back and we took the impression for her crowns. If you need to scroll down to the original post you can see the teeth that were extracted and the mini dental implants that were placed.

I really wanted to do some Porcelain crowns over the mini implants but $$$ were scarce in this case so a decision was made to use lab fabricated resin crowns. I took a standard Poly Vinyl impression and sent the case to Shatkin FIRST Lab.

Nothing new required for me as the dentist. From there FIRST Labs places the mini dental implant analog into the impression and makes a replica of what is in the mouth.

The following set of pictures are the resin crowns on the lab mini dental implant model. I will take clinical photos of the mini dental implant crowns cemented in place in 2 weeks.

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