2 visit implant dentistry
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Transcript of 2 visit implant dentistry
On-going Treatment
Pilot study
Literature Review
Investigation
Procedure Development
20132013Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2013
Project End11/30/13
Milestone 310/31/13
Milestone 28/15/13
Milestone 14/30/13
Project Start1/15/13
1/15/13 4/30/13
Legal Agreements Executed3/30/13 4/30/13
4/15/13 6/30/13
4/15/13 6/30/13
6/30/13 10/31/13
Publication10/15/13 12/1/13
Biotes/Nobel 2 piece ITI 1 pieceBuser
Investigation
1965
All of the implants systems have similar resultsNO STATISTICAL SIGNIFICANT DIFFERENCE in 10 years
Investigation
● Oraltronics
/3i
/SPI
Investigation
The world population will grow by 150,000 people daily
for the next 40 years.
Investigation
Based on the existing published statistics we can INFER: To provide world population optimal oral care the world
will need 70% more implant training programs
Investigation
Education Deficit
OIMC ID-SC ISC Overseas Jail
2002/OIMC 2000/ID-SC 2011/ISC 2002/Overseas 2010/Jail
0
200
400
600
800
1000
1200
OIMC ID-SC ISC Overseas Jail
FailureImplant No.Patient No.
36
875
346
28
974
329
0 2596
268
19 29
137
2
Pilot study
11 years of Data collection & Documenting all implant cases
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Ehsan Charity Hospital6/4/2012
Sharjah Jail9/7/2011
UOS26/4/2008
Study Circle26/4/2011
Int. University Adoption17/2/2008
Publication3/6/2006
OIMC20/10/2002
Investigation Pilot study
International PublicationsInvestigation Pilot study
ISC
• Education of One Piece Implant System(OPIS) is easier as it eliminates the teaching of the following concepts:
1. Different abutments (dimension, material)2. Abutment screw3. Impression4. Treatment Planning 5. No abutment/implant interface6. Cost effective(1/3 of the usual cost for the
patient)
Pilot study
ISC Time required and absorption of
information and practical training is minimized from 120 hours with 8 implant placement/Res in 1 year for 20 participants to 30hrs theory with 18 hours of practical training and 1 implant placement/Res for 9 participants in 1 year.
A small group of 9 dental students/dentist were selected from 4 different dental schools in UAE to participate in this study.
A 16 chapter hand book was read by the paragraph and all the participants comments recorded to update the book.
020406080
100120
ISC
ISC0
96
25
Pilot study
ISC
Pilot study
ISC (Implant Study Circle)• Conclusion:
1. 20 % (in addition) of the population who have ideal criteria could receive implants either in dental schools or by recent graduates.
2. The awareness of graduating students in dental colleges will improve by starting implantology treatment at early stage.
3. Lab/implant cost reduction by 33% can cater part of the 80% population that did not opt for it. (aaoms.org)
4. The existing implantology education is too costly and not sufficient to cope up with the number of graduating dentists per year.
Pilot study
We require 1/3 of time and cost to teach Implantology
Success Data Timeline Observations of pilot study
2011 August September October November December 2011
Milestone 5Milestone 4 Milestone 3
Milestone 2
Milestone 1Oct 5 - Nov 25
6 in 6 months / changed otho residency to surgery
Dentist 5
Sept 2 - Nov 246 implants and started teaching activityDentist 4
Aug 20 - Dec 24 13 patients 30 implants in 1 year/wide social circleDentist 3
Aug 20 - Nov 3Daughter/ Invited her motherDentist 2
Aug 1 - Oct 91st implant in 2 monthsDentist 1
Pilot study
The world population will grow by 150,000 people daily for the next 40 years.
Investigation
Education DeficitWe do offer a solution
Based on the existing published statistics we can INFER: 20 % of total world population belong to a subgroup
That needs to be categorized and identified separately
50 to 64 years 10.13% Edentulous
Treatment Deficit
Investigation
Older patients with minimum bone quantity having one or both arches edentulous seeking for fixed prostheses represent a great challenge for the dental clinician.
Generally this group of patients:
Not working and have financial limitation,Require a person to transport & accompany them,Under medication requires minimal invasive procedure,Less saliva and a removable prosthesis is uncomfortable,Frequent follow-up visits becomes tiring.
Investigation
How many options?
2 documented options!
Option 1
An ideal treatment for a patient can be a compromised option for another
Option 2
A compromised treatment for a patient can be the ideal treatment for another
First Miss India ( held in the year 1949) Pramila (Esther Abraham) is now 90 Years old
Vimto 1908 U.KJohn Noel Nichols (1883 - 1966)
kellogs 1906 U.S.AW. K. Kellogg (1860 – 1951)
Coca Cola 1888 U.S.AJohn Pemberton (1831 -- 1888)
PEPSI 1890s U.S.ACaleb Davis Bradham (1867 — 1934)
Tang 1957 U.S.AWilliam A. Mitchell (1911 - 2004)
Twinkies 1930 U.S.AJames A. Dewar (1897-1985)
Patchi 1974 LebanonNizar Choucair
Ferrero Rocher 1946 ItalyPietro Ferrero
Nestle 1866 GermanyHenri Nestlé (1814 - 1890)
Lipton 1890 U.KSir Thomas Johnstone Lipton (1848 – 1931)
Karl Benz and Gottlieb Daimler
Per Ingvar Branemark
1952
Sweden
1879 Germany
John Montagu, 4th Earl of Sandwich
1718 –1792
Garrett Morgan1923USA
Copyright © 2012, Office Timeline, LLC. All rights reserved.
Patient Satisfaction Learn Morewww.ID-SC.com
Treatment Code: 2DVILFAFOPFR
GET
66% chair time OFF!“Receive a 66% more profit on your
full mouth implant case”.
2 day visit immediate loading full arch flapless one piece fixed restoration.
On-going Treatment
Photos are all Copyright © 2013, OIRI, FZLC. All rights reserved.
2 day visit immediate loading full arch flapless one piece fixed restoration.
Simple, easy surgery.
Professional, quick results.
Restoration the next day.
““I love this! I’ve been rejected all these years by other dentists because I have no bone left and if they add bone the procedure takes 9 months before I get teeth.”
“I can’t believe I’ve been using dentures all these years! I've been missing out.”
“I like it because it's simple, intuitive and looks great! I used it to eat hard food and I like the result and has changed my life.”
What are patients saying about 2DVILFAFOPFR?
Abstract: Dental clinicians are confronted with an increasing number of elderly patients who present with insufficient bone and require implant surgery for their oral rehabilitation. However, there are few guidelines on dental implant therapy in this patient category, so that numerous issues regarding pre- and post-operative management remain unclear to the dental clinician. Therefore, the aim of the present review is to offer a critical evaluation of the literature and to provide the clinician with scientifically based data for implant therapy in that category of patient with borderline diabetic receiving medication with partial negligence or who normally are not good candidates to undergo surgical procedures or whom are under certain medications regime (eg: anti-coagulant therapy) and cannot stop it during surgical dental procedures.
What are dentists saying about 2DVILFAFOPFR?
On-going Treatment
6 patients with 8 edentulous jaws (3 maxillary and 5 mandibular) have been treated with the following protocol.
On-going Treatment
-CBCT, Panoramic radiograph and articulated study casts were made.-Patient received oral amoxicillin 1 g and mefenamic acid tablet 500 mg one hour before surgery. Diclofinac sodium 75mg/3ml (Voltarine) IM-injection after surgery.-Surgery was performed under aseptic protocol, patient rinsed with 0.2% chlorhexidene mouth wash.-2% lidocaine infiltration was given from molar to molar area -motor driven 3 mm diameter soft tissue punch locates and removes the crestal part- #4 round slow speed round bur with 400 speed with both thumb and index finger holding the ridge to feel the bur while its insertion 5mm deep in the 8 planned implant locations-2mm diameter pilot drill was used in full required length of final implant with keeping an emphasis on the parallelism of all the osteotomies -followed by placing the one piece implants in each osteotomy to a range of 60-70 NCm torque-the smallest implant used was 3.3x9.5 and the biggest one was 3.8x13. (sizes were: 3.3or 3.8x9.5/11/13.-The impression was made with placing the plastic impression caps with polyether material with making an inter occlusal record-The implants were covered with plastic comfort caps-The patient was provided with an ice pack for one hour post surgery and instructed to continue the Amoxicillin 500 mg tds for 7 days and mefenamic acid 500 mg tds for 3 days and to apply clorhexidene gel 0.5% (Elugel) and hyaluronic acid 0.2% (Gingigel) 3 times daily for 2 weeks .-The next day a composite 14 unit bridge was cemented using glass ionomer cement-The same procedure was performed for both arches.
6 patients with 8 edentulous jaws (3 maxillary and 5 mandibular) have been treated with the following protocol.
On-going Treatment
DiagnosisPART I
Maintenance
PART VPART II
Surgery
PART III
Uncovery & Impression
PART IV
Restoration
Sequence
Parts are Inter related
Tx Sequence5 Steps
On-going Treatment
Diagnosis
On-going Treatment
On-going Treatment
On-going Treatment
On-going Treatment
On-going Treatment
Commonly prescribed post operatively
On-going Treatment
Restoration & Maintanance
Uncovery & Impression
On-going Treatment
13 May 2014/ Loading
13 December 2014/maintenance
Maintenance visit after 6 months
http://www.tekscan.com/occlusal-analysis-system
60 seconds 5 seconds
Esthetics Phonetics Function
Do you like it’s looks?Yes, I like every thing about it.
Does it look nice?It is very nice, yes.
Did anyone comment on your teeth?No, Nobody said anything.
Previously I could not eat dates, sticky sweets, it would lift off.
Bread and food would make my lower teeth move upward.
Now I eat everything it is firm.
Surgical phase – 8 implants in 1 hour
On-going Treatment case 2
On-going Treatment case 2
Surgical phase – 8 implant placement with surgical template in 3.5 hours
On-going Treatment case 3
On-going Treatment case 3
On-going Treatment case 3
On-going Treatment case 3
Sever class III
On-going Treatment case 4
On-going Treatment case 5On-going Treatment case 4
On-going Treatment case 5
On-going Treatment case 5
An ideal treatment for a patient can be a compromised option for the same patient
A compromised treatment for a patient can be the ideal treatment for the same patient
On-going Treatment case 6
On-going Treatment case 6
On-going Treatment case 6
On-going Treatment case 6
Presentation TitleYour company information
Results
Publication
Tx SequenceTimeline
Day
1 2 2 10 10 11 21 90 365
maintenance 30
Final Restoration 15
Removal and fitting framework 30
Follow-up By phone
Occlusal adjustment 15
installation 15
Impression 15
Implant placement 120
Extraction 30
Impression/inter-occlusal registration 15
Tx planning 45
Chair time In minutes: 315/5.25Hours
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Patients on oral anticoagulants, chemotherapy, & borderline diabetic do not stop medication.
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minimally invasive flapless approachAvoids bone augmentation procedure
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to place multiple implants supported fixed prostheses the next day visit
maximizes patient satisfaction Esthetically, Phonetically & Functionally
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Primary stability is the key principle in successful treatment, immediate extraction.
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No visibility so CT scan or bone sounding is the key principle in
successful treatment
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Parallelism is the key principle in successful treatment
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Millions of doctors with billions of patients vs. One doctor with 6 patients
Classic vs. Modified
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Lack of Data
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Comparison
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Discussion
The present study was designed to treat elderly patients with minimum bone quantity by using narrow diameter one piece implants with immediate loading procedure. Implant supported fixed restoration was reported to have more advantages when compared with over denture treatment. In this respect, the placement of cross-arch multiple narrow diameter implants shows potential for immediate loading fixed prostheses and hence improvement in patient’s comfort, retention, chewing and speaking ability.The main advantage of narrow diameter implant is to avoid bone augmentation procedure for medically compromised patients.A flapless approach has proven to be less traumatic, less time consuming, fewer complications, faster soft tissue healing, with higher esthetic and functional acceptance. In this study, the health benefits that patients could gain from 2 day visit implant-supported fixed prosthesis compelled this technique against the risks of surgical treatment on medically compromised patients. 2 day visit surgery could minimize cardiovascular stress. The entire procedure took two hours which was convenient to provide the patients with a stable fixed restoration in 24 hours after surgery.The advantages of the one-piece implant include; saving chair time during placement and restoration, the elimination of microbial influx at the abutment-fixture junction, avoiding screw loosening and cost are preferable over two-piece implants.
Publication
Publication
“…the purpose of this review is to provide rational, summarize current available literature, and analyze factors that influences this newly introduced treatment method.”
Publication
M Chiapasco, C Gatti, E Rossi… - Clinical Oral Implants …, 1997 - Wiley Online Library... Edentulous jaw; mandible; osseointegrated implants; mandibular prosthesis; long-term effects; immediate loading. ... Waldenburg, Switzerland); Ha-Ti screw implants (Mathys Dental Implants, Bettlach, Switzerland ... bar was fabricated and implants were immediately loaded with an ...DP Tarnow, S Emtiaz, A Classi - … of Oral and Maxillofacial Implants, 1997 - oralartslab.com... The purpose of the present study was to evaluate immediate loading of threaded cylinder implants at stage ... Germany).12 The im- plants with the lower values (better resistance to load) and the ... A minimum of five implants were submerged and allowed to heal without any loading. ...C JOLIVET, K NGUYEN, C TESTON - WO Patent …, 2005 - patentscope.wipo.intAbstract: The invention relates to an immediate-loading dental implant. The inventive implant is characterised in that it consists of a single long piece comprising: a bone screw anchoring part (10); an inlay-core (30) comprising elements (32) for the rotation of the ...K Randow, L Ericsson, K Nilner… - … Oral Implants …, 1999 - Wiley Online Library2. Abstract A clinical and radiographical study was performed to compare the out-come of oral rehabilitation in the edentulous mandible by fixed supra-constructions connected to implants installed according to either i) a l-stage surgical procedure and immediate ...RA Jaffin, A Kumar, CL Berman - … of oral & maxillofacial implants, 2003 - europepmc.orgPURPOSE: The purpose of this article was to determine whether clinical success can be achieved with immediate loading in the completely edentulous maxilla with endosseous screw-type implants. MATERIALS AND METHODS: The study sample consisted of 34 ...M Degidi, A Piattelli - Journal of periodontology, 2003 - Am Acad PeriodontologyBackground: The aim of this study was the evaluation, from a clinical point of view, of implants subjected to immediate functional loading (IFL) and to immediate non-functional loading (INFL) in various anatomical configurations. Methods: The study included 152 ...D Steenberghe, R Glauser, U Blombäck… - … implant dentistry …, 2005 - Wiley Online LibraryBackground: Based on three-dimensional implant planning software for computed tomographic (CT) scan data, customized surgical templates and final dental prostheses could be designed to ensure high precision transfer of the implant treatment planning to …rly loading of dental implants: a eeting in Barcelona, Spain, 2002C Aparicio, B Rangert… - Clinical implant dentistry …, 2003 - Wiley Online LibraryBackground: Immediate/early loading protocols are becoming frequently used in implant dentistry, but the prerequisites for achieving good results and the limitations of such protocols are not fully known. Moreover, the terminology used in immediate/early loading ...A Piattelli, M Corigliano, A Scarano… - Journal of …, 1998 - Am Acad Periodontology... (2006) Peri-Implant Bone Organization Under Immediate Loading State. ... (2006) Immediate LoadProtocol for Anterior Maxilla With Cortical Bone From ... (2005) Histologic and HistomorphometricFindings From Retrieved, Immediately Occlusally Loaded Implants in Humans. ...K Horiuchi, H Uchida, K Yamamoto… - … & maxillofacial implants, 2000 - ncbi.nlm.nih.gov... Of the 140 immediately loaded implants, 136 osseointegrated during an 8- to 24-monthfollow-up ... The results suggest that immediate loading of Brånemark System implants at the timeof placement ... be a valuable adjunct to therapy and as predictable as delayed loading, in both ...
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LD Campelo, JR Camara - … journal of oral & maxillofacial implants, 2001 - europepmc.org... CONCLUSION: Flapless implant surgery is a predictable procedure if patient selection andsurgical ... and serve either as abutments or as cosmetic replacements for missing teeth. ... your current search. Dental Implantation, Endosseous. Holding a DENTAL PROSTHESIS in ...D Steenberghe, R Glauser, U Blombäck… - … implant dentistry …, 2005 - Wiley Online LibraryBackground: Based on three-dimensional implant planning software for computed tomographic (CT) scan data, customized surgical templates and final dental prostheses could be designed to ensure high precision transfer of the implant treatment planning to ...A Rocci, M Martignoni, J Gottlow - Clinical implant dentistry and …, 2003 - Wiley Online LibraryBackground: Immediate loading of dental implants shortens the treatment time and makes it possible to give the patient an esthetic appearance during the whole treatment period. Purpose: The aim of the present study was to evaluate an immediate-loading treatment ...M Degidi, A Piattelli - Journal of periodontology, 2003 - Am Acad Periodontology... Fifty-eight implants were used to replace single missing teeth. ... AD Dominici. (2011)Solidarizzazione elettronica su impianti a carico immediato: un caso clinico in chirurgiaflapless. ... (2009) Clinical Viability of Immediate Loading of Dental Implants. ...W Becker, M Goldstein, BE Becker… - … implant dentistry and …, 2005 - Wiley Online LibraryBackground: Placement of implants with a minimally invasive flapless approach has the potential to minimize crestal bone loss, soft tissue inflammation, and probing depth adjacent to implants and to minimize surgical time. Purpose: The aim of this multicenter study was ...G Cannizzaro, M Leone, M Esposito - … oral & maxillofacial implants, 2007 - ncbi.nlm.nih.gov... Implants placed in the edentulous maxilla with a flapless procedure can be ... Endosseous/methods*; Dental Implants*; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; ... Prospective Studies; Tooth Socket/surgery; Treatment Outcome; Wound Healing/physiology. ...V Choquet, M Hermans… - Journal of …, 2001 - Am Acad Periodontology... (2010) Immediate Placement of Dental Implants Into Fresh Extraction ... (2009) Comparison of interproximal soft tissue height for single implants and contra-lateral natural teeth. ... (2009) Esthetic Rehabilitation of Maxillary Incisors in Conjunction with Flapless Surgical Techniques ...M Esposito, MG Grusovin, H Achille… - … Database Syst Rev, 2013 - Wiley Online Library... either immediately, after 6 weeks (early) or after at least 3 months (conventional) led to anyimportant differences in the failure of the implant or the artifical tooth, or to ... 6 Interventions for replacing missing teeth: different times for loading dental implants (Review) Copyright ...SS Wallace, SJ Froum - Annals of Periodontology, 2003 - Am Acad Periodontology... A. Serafini. (2012) Rialzo di seno transcrestale e chirurgia guidata: proposta di nuova tecnica.Dental Cadmos 80:5, 228-244 Online publication date: 1-May-2012. ... 2012. ReconstructivePeriodontal Surgery. ... Implant Dentistry 20:6, 418-424 Online publication date: 1-Dec-2011. ...GAPD Giacomo, PR Cury, NS Araujo… - Journal of …, 2005 - Am Acad Periodontology... During the implant operation, the surgical guide was placed on the jawbone and/or the teeth. …(2010) Transference of virtual planning and planning over biomedical prototypes for dental implant placement using guided surgery. ... (2010) Flapless implant surgery in the edentulous ..
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KB Tan, JE Rubenstein, JI Nicholls… - … International journal of …, 1992 - europepmc.org... A conventional commercial laboratory one-piece casting method, using a silver-palladium alloy, was used. ... small rotational displacements may manifest large gap appearances with the one-screw test ... Or filter your current search. Dental Stress Analysis. Alloys that contain a high ...JS Hermann, DL Cochran, D Buser… - … Oral Implants …, 2001 - Wiley Online Library... Joachim S. Hermann, FICOI, Department of Preventive Dentistry, Periodontics, and CariologyUniversity of Zürich Dental School Plattenstrasse ... periimplant soft tissue dimensions dependent on varying locations of a rough/smooth implant border in one-piece implants or a ...J Oliva, X Oliva, JD Oliva - … journal of oral & maxillofacial implants, 2007 - ncbi.nlm.nih.gov... MATERIALS AND METHODS: One-piece zirconia dental implants (CeraRoot, Barcelona,Spain) with 1 of 2 different roughened surfaces were designed and manufactured forthis study. Five different implant designs were manufactured. …I Ericsson, K Randow, K Nilner… - Clinical implant dentistry …, 2000 - Wiley Online Library... ver the years, the successful use of jawbone-anchored 0 (osseointegrated) titanium dentalimplants for the ... Department of Prosthetic Dentistry and +Department ... been published by Astrand et al,l4 and Buser et aI,l5 who reported on a number of one-piece implants (ITI) installed …SS Porter - Dent, 2006 - biomet3i.ch ... 1.5 mm apical to the IAJ or at the first thread) has been used as one of the ... explain in part the biologic and radiographic observation of crestal bone loss around exposed and restored two-piece dental implants. ... 12 The International Journal of Periodontics & Restorative Dentistry ...P Lonca - US Patent 4,722,688, 1988 - Google Patents... SUMMARY OF THE INVENTION A main object of the present invention is to provide a 20 complete dental procedure for installing implants of carbon carbon composite materials. According to the invention there is provided a dental implant comprising a one-piece structure of …R Glauser, P Schüpbach, J Gottlow… - … implant dentistry and …, 2005 - Wiley Online LibraryBackground: Following connection to the oral cavity, osseointegrated dental implants and surrounding tissues are exposed to microbiologic and biomechanical challenges. The establishment of a firm functional periimplant soft tissue barrier (PSTB) is considered to be ...NBroggini, LM McManus, JS Hermann… - Journal of Dental …, 2003 - jdr.sagepub.com... corresponding author, perio{at}dental.uthscsa.edu. Next Section. Abstract. ... Two-piece implants were placed at the alveolar crest and abutments connected either at initial surgery (non-submerged) or three months later (submerged). The third implant was one-piece. ..
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Education Deficit
Treatment Deficit
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