IMTEC – Implants By Paresh

miniMARK Dental Implant Seminar – Online Restorative Presentation

May 6, 2011/in Blog /by Paresh Patel

To view Part 1 The miniMARK Placement Protocol click the blue text.

So we left with the patient done with the miniMARK implants in his lower jaw.

A set of Locator impression caps were placed over the miniMARK mini dental implants. These look like champange glasses and will communicate to the lab the exact location of the one piece Locator miniMark implants.

A good impression is taken to ensure that all pertinent landmarks are captured in the impression. Land areas, retromolar pad, frenal attachments and of course the Locator impression caps.

Wax Rim

Master cast with the Locator retention caps placed on the lab analogs. These 'snaps' will be processed into the denture.

Final processed denture with the metal frame incorporated. If the denture is too retentive then different nylon rings can be placed to decrease the retention. Or if it is not tight enough stiffer rings can be placed to increase the retention on the miniMARK implants.

My patient has had the lower denture now for 4 weeks and loves how stable and retentive it is. This case utilized some of the best technologies avaliable today for implant overdentures. The Locator attachment, a metal frame incorporated into the denture, high quality composite denture teeth and lab processed attachments.

To use these kinds of materials and mini dental implants unfortunately has one setback: COST for the patient. This case is about 2 timesthe cost of a o-ball mini dental implant solution. Certainly something for the dentist and patient to discuss and come to the best solution that will fit every ones desires and needs. There are several good implant and mini implant systems out there….check them out and help your patients by getting the best system for you.

Paresh B Patel

Mini Dental Implants

Dental Implants Mooresville Lake Norman Charlotte NC

Dental Implants Lenoir Hickory Boone Asheville NC

Dental Implants to get rid of a Upper Partial Denture

February 1, 2011/in Blog, Uncategorized /by Paresh Patel

If you are missing a few teeth and wear a partial denture I can empathise with your situation.

Who wants to wear all that metal and plastic in their mouth if there was another option?

Typical design of a cast metal partial denture.

Metal hooks that are visible around the teeth that it holds onto.

If this describes your situation then you should consider dental implants – mini dental implants or traditional.

My patient without her upper partial denture in. She is missing her front three teeth and the tooth behind her canine tooth.

4 mini dental implants were placed with minimal surgery (no cutting of the gum, no stitches) The temporary crown is on the mini dental implant behind the canine tooth (right side of picture).

Temporary crowns in place over the mini dental implants. My patient gets to leave without her partial denture. I will let her 'test drive' the temporary crowns for a few weeks. Any changes we want to make to the look of the crowns can then be communicated to the dental lab that will make the final mini dental implant crowns. The 'test drive' period also allows me to assess the function and phonetics (how her speach is).

X ray of the OCO Biomedical mini dental implant used to replace the missing premolar tooth.

Paresh B Patel Dental Implants Charlotte NC

Mini Dental Implants

Dental Implants Hickory Boone Wilkesboro Asheville NC

Can Mini Dental Implant Crowns & Bridges Look Good and be kept clean?

November 23, 2010/in Blog /by Paresh Patel

I get asked this question a lot from both dentists and patients. I think the answer is most likely yes. Lots of variables contribute to the successful outcome of any implant and the crown or bridge that goes over the top of it. Tissue type, bone level and sometimes how much time and funds the patient has to invest.

But for the most part I think patients, if given all the information, can be happy with the aesthetic outcome with mini dental implants and the crown or bridge they support.

My next patient was in for her normal 6 month cleaning appointment. She stopped me to tell me how happy she was with her fixed crowns on her mini dental implants in her upper jaw.

These crowns and mini dental implants have been in for 1 year now. This case used Intra Lock mini implants. But as I state in most of my posts any well constructed mini dental implant such as the OCO Biomedical mini or micro, IMTEC MDI, or HiOssen mini are appropriate. Even as a dentist I think I would have a hard time figuring out which ones are regular crowns on teeth and the mini dental implant crowns.

This patient is able to keep her mini dental implant Crowns by First Impressions Dental Lab clean with a normal toothbrush, floss, and/or a water pick. The two crowns are connected together and are supported by 3 mini dental implants. The hygienist and patient both can floss between all the mini implants.

Paresh B Patel DDS Dentist Mooresville NC

Mini Dental Implants

OCO Biomedical Mini Dental Implant for a Molar Crown ~ 1/2 the Cost & 1/2 the pain

November 11, 2010/in Blog /by Paresh Patel

1/2 the time, 1/2 the cost, 1/2 to no surgery needed and less pain? This is what my patient asked me. She said, 'Are you sure about this?'

She was reading from a poster in our office touting the benefits of mini dental implants. I told her in most cases YES. Well she told me….I don't really care about most cases I care about mine!

With that in mind we went to work. Yes I recognize the open margin on the molar behind the missing tooth. The patient is aware and will address that tooth as time and $$ allow.

X-ray of the missing lower tooth molar. I had extracted a failing root canal tooth about 4 months ago and packed the extraction socket with some Foundation bone preservation material. The area looked well healed and ready for some 'painless' mini dental implants.

I gave her 1/2 a carpule (shot) of dental anesthetic and placed 2 2.2 x 10mm OCO Biomedical Micro Implants. Less numbing than I give for a lower tooth filling.

OCO mini dental implant impression caps in place to take a traditional impression.

Final X-ray of OCO mini dental implants

Lab model from First Impressions Dental Lab showing the mini dental implants and the soft tissue silicone.

PFM Mini Dental Implant Crown to fit over the OCO mini implant

Although this case shows the use of a OCO Biomedical mini dental implant; it could have been done with any reputable mini (IMTEC MDI, Intra Lock MDL, HiOssen etc…)

OK…its been a few weeks and the patient is ready to get her crown. Here are the clinical photos of the mini dental implant crown over the OCO mini implants.

Paresh B Patel DDS General & Implant Dentist Mooresville NC

Mini Dental Implants

OCO Biomedical Mini Dental Implants ~ Improved Zest SaturnO-ring

November 11, 2010/in Blog, Uncategorized /by Paresh Patel

Is it difficult to get 6 mini dental implant o-ball attachments to line up for an upper full denture plate?

Several mini dental implants in the upper jaw with more than 5 degrees of divergence (off angles)

Is it sometimes hard for patients to line up that many snaps and figure out how to get the denture fully seated?

Well…..sometimes yes. As the dentist we have to put the mini dental implant where the bone is, or do another surgical procedure to make the bone ready to have all parallel mini dental implants. To make it clear, most of my patients decline to have this additional procedure done and we work with what bone is available.

As the patient the answer is sometimes yes as well.

Transistor sockets Transistor and the socket it fits in. You can imagine how difficult it becomes to line up the pins to fit into the socket if they are not all in line. Even with one off angle you have to figure out which one goes in first to make the pin and socket fit together. Very similar to the upper denture and 6 mini dental implants.

But hang on….now with the new Zest SaturnO-ring its a bit easier to handle off angle mini dental implants. These new o-rings allow for up to 30 degree of correction between mini implants. This is possible due to the housing having a Titanium Nitride race that allows the rubber o-ring to pivot inside.

OCO Biomedical should have the Zest SaturnO-rings available to ship. I have tried them and am sold on their ability to make snap in dentures easier for both the mini implant dentist and patient. These o-rings will fit on most mini dental implants, (IMTEC MDI, Intra Lock, Hiossen,OCO etc…)

Paresh B Patel DDS Dental Implants Charlotte NC

Mini Dental Implants

Zest SaturnO-rings for Mini Dental Implants ~ Upgrade your Snap in Dentures

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

After the hundreds of mini dental implants I have placed to secure upper and lower dentures I would have thought there could be a better snap for the O-ball attachment.

But thanks to Paul Zuest there is one now, the SaturnO-ring. Released in late October it offers up to 30' of angle correction. The standard o-rings that come with most mini dental implants(Intra Lock, IMTEC MDI, OCO Biomedical) offer around 5' .

It has a TiN coated race that allows the rubber

o-ring to rotate freely inside the metal housing.

Wow…great engineering and a great idea… I wish I had though of that.

Picture on right shows the race pivoted up inside the housing.

Zest offers a standard size Saturno for a 2.25mm Ball and a Micro size Saturno for a 1.8mm Ball attachment.

Standard on left and

Micro on right

There is also a neat little o-ring tool so when you need to replace those worn out black rings you don't damage them with a sharp dental instrument getting them in the metal housing.

I had just the case to try out these new Zest SaturnO-rings. My patient had 6 mini dental implants (Intra Lock) placed in the upper jaw to secure in his full upper denture plate. As much as we tired to make it easy for him to remove it was just too tight. He struggled to get it in or out. Some of the issue I am certain was the divergent angles of the mini dental implants. I fitted him with one of his bag full of old dentures with a lab processed Molloplast soft liner over the 6 mini dental implants.

He was comfortable with that molloplast liner and it did provide some grab on the mini dental implants but of course I wanted to give the SaturnO-rings a try.

I reamed out his horseshoe upper denture, taking away the old standard housings.

In the mouth were fitted 6 micro housings, they were picked up inside the upper denture with some self cure pink acrylic. They worked great! I thought I was done. But darn it, he still could not get that thing in and out like he wanted to a few days into it. Poor guy was just getting older and I wanted to make him happy. I think most of it was he just wanted to feel like he could accomplish this task for himself.

So I reamed them out again and decided to try the idea of using the larger SaturnO-ring on the mini implants to give him some retention but not quite as much.

The SaturnO rings snapped over the 1.8mm ball like I expected and had less retention. There were 3 mini implants that touched each other with the housings so I placed 3 standard housings for those areas.

We picked them up just like normal. Less retention…yes. Enough retention? Charlie said two thumbs up. He was able for the first time now to put them in and out….without a Mirror! Even I was impressed. He was smiling ear to ear.

Thanks to some clever engineering at Zest Anchors we as have another choice to make patients lives better with mini dental implants.

Paresh B Patel Dentist Mooresville NC

Mini Dental Implants SaturnO rings for Intra Lock IMTEC OCO Biomedical

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

November 8, 2010/in Blog /by Paresh Patel

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.

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.

Lateral crown

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.

All 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.

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

OCO Mini Dental Implants

Mini Dental Implants are not FDA approved to use for crowns…or are they?

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

Where is this coming from? Why would we as dentists want to misinform the very patients that seek our help? If we don't know the answer its best to tell the patient I don't know. We should say, if you are considering getting this procedure with mini dental implants you ought to seek out a dentist that does a lot of them. I think it would be better to let our patients know the truth and let them make decisions for themselves on how they want their mouth taken care of. In the end its their health, time and money….not ours.

To answer the question do Mini Dental Implants have FDA approval to use long term for crowns or dentures… YES they are.

Image of the 510(k) approval from the FDA, straight from their website stating in plain English that mini dental implants (IMTEC MDI) are approved to use for however the dentist sees fit; long term or short term. IMTEC MDI is the substantial equivalent that most other, if not all other manufacturers have applied to get their FDA approvals.

Does being FDA approved mean anything? Well it means something, but as with any medical device you have certain risks and benefits. If we as dentists are going to try and take the position that traditional implants are FDA approved and minis are being used outside of their prescribed approval then that is just wrong and means nothing. They are both approved to use in the mouth. Do they both work…yes. Do they both have the potential to fail…yes.

They both have about the same success rate (anywhere from 96-97% success). You can make any study look good for the parameters you want it to….but in everyday wet fingered dental offices you will find this number to be correct. A skilled traditional implant dentist and a skilled mini implant dentist will have around the same success ratios. If anyone tells you they have a huge failure rate with minis then they just have not got the proper training….just like if someone tells you that traditional have a huge failure rate in their hands….you may wish to see the help of someone else.

FDA 510(k) approval for a Intra Lock Mini Dental Implant Prosthetic Abutments in plain English showing approval for use in either upper or lower jaws for a removable (denture) or fixed (crowns and/or bridge) prosthesis. You can see all the other major brands, OCO Biomedical mini and micro, ACE Surgical Secure Mini, etc… have FDA approval on the FDA website.

Paresh B Patel DDS Dentist Mooresville NC

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 Implants for Missing Laterals

January 12, 2010/in Blog, Uncategorized /by Paresh Patel

One of the most prevalent dental conditions is missing upper laterals (about 10% of the population is missing these teeth from birth).

Some of the time, even with orthodontics, there is not enough space to restore the missing teeth with traditional implants (implants with a diameter greater than 3.0 mm).

Most of the patients I have seen either have some sort of removable appliance or a orthodontic retainer with the two missing teeth on it. The issue is that these teens don't really care to wear their retainer.

Another solution, the bonded bridge, seems to fail. While the bonded bridge works well on missing lowers, the clinical data shows that bonded bridges to replace missing upper laterals fail quite often because the central and canine tooth both move to different degrees under chewing function.

One solution that works well in my hands is a technique that Dr. Todd Shatkin taught me….use mini dental implants. The Intra Lock or IMTEC Mini Dental Implant can be threaded in between the canine and central. This mini implant can then hold a crown in place that the patient does not remove.

This photograph shows a Intra Lock 2.5 x 18mm mini dental implant to replace missing laterals.

www.dentalminiimplant.com

Posts