Replacing over retained baby teeth with mini dental implants
- 1. Replacing Over-retained Deciduous Maxillary Canines with Small Diameter Implants Dr. A. F. Paghdiwala Pearl Dental Arts, Newtown, PA www.pearldentalarts.com 1-888-PEARL81 or 215-504-4070
- 2. A 57 years old school teacher, had congenitally missing maxillary permanent canines bilaterally
- 3. Due to resorption, both canines had almost no roots
- 4. The presence of roots gives bulk and volume to the alveolar bone Since the roots of the deciduous canines had resorbed and there were no permanent teeth underlying them, the alveolar ridge was extremely thin bucco- lingually apical to the deciduous canines
- 5. Options available to replace the over-retained canines Flipper Cast Partial Denture Fixed Bridge Maryland Bridge Implant Supported Crown After discussing the pros and cons of the various options, the patient preferred to get an Implant supported crown
- 6. Why the patient had reservations about getting implants Fear and Anxiety Cost Time Need for Bone Grafting- another invasive procedure, increasing her fear and anxiety
- 7. Advantages of small diameter implants for this patient Less invasive Only one drill needed - osteotomy completed faster No need for bone grafting, no need to reflect flap - less anxiety for patient Less expensive - implant less expensive, separate abutment not needed, less chairside time Treatment completed faster Small diameter implant, easier to fit when available room and width of bone compromised
- 8. The deciduous canine was extracted
- 9. Steps in Placing Small Diameter Dental Implants Each Implant takes less than 10 minutes and usually, no incision or suturing is needed • Local Anesthetic • Osteotomy with 1.1 mm surgical drill, x-ray • Insert the Implant with a finger wrench • Place it in some more with a Wing Nut • Secure it in completely with a mini wrench
- 10. Steps in placing the implant- Implant is threaded in with a finger wrench
- 11. Steps in placing the implant- Implant inserted some more with wing nut
- 12. Steps in placing the implant- Implant seated to position with mini wrench
- 13. The dental implant was placed 3M (Imtec) MDI Max Standard O-Ball 13mm.
- 14. A Composite Resin Build-up was made directly onto the implant
- 15. Radiographs Two Weeks Post-op
- 16. The resin build-ups were prepped, impressions made, Porcelain Crowns cemented
- 17. Radiographs Two Years Post-Op
- 18. Photographs four years post-op
- 19. Radiographs four years post-op
- 20. Another case, showing a missing tooth to be replaced by a small diameter implant
- 21. Implant inserted
- 22. Missing tooth built up directly on top of Implant with resin This small diameter implant with resin buildup has been in function for 8 years
- 23. Another case, showing two missing teeth restored mini implants and PMCs These two mini implants and crowns have been in function for four years
- 24. Conclusion • small diameter implants are usually placed to support removable dentures •For replacing individual teeth, standard diameter Implants are usually the method of choice
- 25. •However, some patients may not be prepared to accept implants for various reasons: - fear and anxiety - cost of treatment - length of time involved • In addition, oral conditions may not allow standard diameter implants, such as reduced mesio-distal space or inadequate width of bone bucco- lingually
- 26. In these cases, small diameter dental implants may be presented to the patient as a less invasive, less expensive, faster treatment option for replacing the missing teeth. In this presenter’s experience, a direct resin build-up right onto the small diameter implants can be an extremely inexpensive and quick temporary cosmetic solution for a patient short on time and finances