Opinions on new and faster Dental Implant techniques
in [Dentistry]
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From: Chopper on 8 Aug 2008 13:33 I am a layman and was wondering what the opinions are on the new and faster Dental Implant techniques like the ones from Sargon� Dental Implants and Nobel Biocare and others. I saw a video by Sargon which explained how the implant "base" is similar to the type of screw you buy at the hardware store which expands when driven into the substrate. My understanding is that the post and the tooth can be mounted in one visit as the post binds very strongly to the bone (I assume the limiting factor might be that in a patient with profound bone loss this may not work) and the long wait time for osseointegration is not a factor. Anyway I think I get the general idea and it would seem to me that this is a preferable method of attachment for the patient. So my question is: What are some opinions on this process? Thanks, Copay
From: Steven Bornfeld on 8 Aug 2008 17:50 Chopper wrote: > > I am a layman and was wondering what the opinions are on the new and > faster Dental Implant techniques like the ones from Sargon� Dental > Implants and Nobel Biocare and others. > > I saw a video by Sargon which explained how the implant "base" is > similar to the type of screw you buy at the hardware store which > expands when driven into the substrate. > > My understanding is that the post and the tooth can be mounted in one > visit as the post binds very strongly to the bone (I assume the > limiting factor might be that in a patient with profound bone loss this > may not work) and the long wait time for osseointegration is not a > factor. > > Anyway I think I get the general idea and it would seem to me that this > is a preferable method of attachment for the patient. > > So my question is: What are some opinions on this process? > > Thanks, > > Copay I am not ready to do immediate loading implants in my practice. Yes, I know they work--sometimes. But "osseointegration is not a factor" had kind of a "famous last words" ring to it. Get back to me in 10-15 years. ;-) Steve
From: Chopper on 9 Aug 2008 06:38 [[ This message was both posted and mailed: see the "To," "Cc," and "Newsgroups" headers for details. ]] Hi, When I said "osseointegration is not a factor" that's what I've read from the mfrs. web sites. Remember, I'm a layman. What is it about the technology in it's current state that gives you pause? Thanks, Copay p.s.-Any relation to Jay Bornfeld formerly of Newark, N.J..? Would be about 60 years age by now. In article <T4KdnXAZVZgrIgHVnZ2dnUVZ_gudnZ2d(a)earthlink.com>, Steven Bornfeld <dentaltwinmung(a)earthlink.net> wrote: > Chopper wrote: > > > > I am a layman and was wondering what the opinions are on the new and > > faster Dental Implant techniques like the ones from Sargon� Dental > > Implants and Nobel Biocare and others. > > > > I saw a video by Sargon which explained how the implant "base" is > > similar to the type of screw you buy at the hardware store which > > expands when driven into the substrate. > > > > My understanding is that the post and the tooth can be mounted in one > > visit as the post binds very strongly to the bone (I assume the > > limiting factor might be that in a patient with profound bone loss this > > may not work) and the long wait time for osseointegration is not a > > factor. > > > > Anyway I think I get the general idea and it would seem to me that this > > is a preferable method of attachment for the patient. > > > > So my question is: What are some opinions on this process? > > > > Thanks, > > > > Copay > > > I am not ready to do immediate loading implants in my practice. Yes, I > know they work--sometimes. But "osseointegration is not a factor" had > kind of a "famous last words" ring to it. > Get back to me in 10-15 years. ;-) > > Steve
From: Mark & Steven Bornfeld on 9 Aug 2008 12:01 Chopper wrote: > [[ This message was both posted and mailed: see > the "To," "Cc," and "Newsgroups" headers for details. ]] > > > Hi, > > When I said "osseointegration is not a factor" that's what I've read > from the mfrs. web sites. Remember, I'm a layman. > > What is it about the technology in it's current state that gives you > pause? > > Thanks, > > Copay > > p.s.-Any relation to Jay Bornfeld formerly of Newark, N.J..? Would be > about 60 years age by now. > > > > > > > > > > > > In article <T4KdnXAZVZgrIgHVnZ2dnUVZ_gudnZ2d(a)earthlink.com>, Steven > Bornfeld <dentaltwinmung(a)earthlink.net> wrote: > >> Chopper wrote: >>> I am a layman and was wondering what the opinions are on the new and >>> faster Dental Implant techniques like the ones from Sargon� Dental >>> Implants and Nobel Biocare and others. >>> >>> I saw a video by Sargon which explained how the implant "base" is >>> similar to the type of screw you buy at the hardware store which >>> expands when driven into the substrate. >>> >>> My understanding is that the post and the tooth can be mounted in one >>> visit as the post binds very strongly to the bone (I assume the >>> limiting factor might be that in a patient with profound bone loss this >>> may not work) and the long wait time for osseointegration is not a >>> factor. >>> >>> Anyway I think I get the general idea and it would seem to me that this >>> is a preferable method of attachment for the patient. >>> >>> So my question is: What are some opinions on this process? >>> >>> Thanks, >>> >>> Copay >> >> I am not ready to do immediate loading implants in my practice. Yes, I >> know they work--sometimes. But "osseointegration is not a factor" had >> kind of a "famous last words" ring to it. >> Get back to me in 10-15 years. ;-) >> >> Steve Implantology has a rather long and somewhat sordid history in dentistry. When I was in school in the '70s, there were some implantologists that used what were called endosseous blade implants. I think they were made of surgical steel, and were pounded into the body and/or ramus of the mandible. Often what were called "subperiosteal implants" were placed--with a mesh covering the bony ridge, but not placed into the bone. Most of the endosseous implants (and many of the subperiosteals) showed signs of infection sooner or later. In the case of the endosseous blades, this was accompanied by severe bone destruction that made restoration a real challenge for everyone. Often implants were retained in the obvious presence of infection because admitting the obvious (that the implant had failed) would deprive the patient of their appliance (usually a lower overdenture), and there were few satisfactory alternatives for these patients. The two parts of what Branemark introduced about 1980 were the use of pure titanium; and closing the tissue over the implant fixture, allowing the bone to heal around the fixture in a sterile environment. Of these two innovations, I strongly suspect the second was more important. I'm sure that titanium is very biocompatible, and probably contributes to the success of implants now when compared to the bad old days. But immediate exposure and loading, while many are trumpeting high success rates, is likely in some respects a big step backward (IMO). Mini implants were originally intended for temporary use; the fact that many seem to osseointegrate has led dentists to offer them as a cheap alternative to regular implants. There are some problems here. First of all, over years of experience, surgeons have modified their attitudes about the amount of contact fixtures must have in the bone, given the location and quality as well as quantity of the bone. Using mini implants automatically decreases the bony support when compared with traditional endosseous implants, even if we are to ignore the potential for bacterial invasion posed by immediate exposure and loading. Perhaps most troubling to me, the mini implants are being proposed at lectures (I had one at my study group) to be so easy that EVEN A GENERAL DENTIST CAN PLACE THEM!! In fact, there is no surgical incision--we were told to grasp the alveolar ridge between our thumb and forefinger and insert the bone drill between our thumb and forefinger through the gum and into the bone. To me, it's all a bit much. If these are as idiot-proof as they say, we'll know in maybe 10 years. But I'm not about to abandon years of experience of my surgeons because these immediate-load. implants are easy-peasy lemon squeezy! Steve -- Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
From: Frank on 11 Aug 2008 20:41 On Aug 9, 9:01 am, Mark & Steven Bornfeld <bornfeldm...(a)dentaltwins.com> wrote: > Chopper wrote: > > [[ This message was both posted and mailed: see > > the "To," "Cc," and "Newsgroups" headers for details. ]] > > > Hi, > > > When I said "osseointegration is not a factor" that's what I've read > > from the mfrs. web sites. Remember, I'm a layman. > > > What is it about the technology in it's current state that gives you > > pause? > > > Thanks, > > > Copay > > > p.s.-Any relation to Jay Bornfeld formerly of Newark, N.J..? Would be > > about 60 years age by now. > > > In article <T4KdnXAZVZgrIgHVnZ2dnUVZ_gudn...(a)earthlink.com>, Steven > > Bornfeld <dentaltwinm...(a)earthlink.net> wrote: > > >> Chopper wrote: > >>> I am a layman and was wondering what the opinions are on the new and > >>> faster Dental Implant techniques like the ones from Sargon® Dental > >>> Implants and Nobel Biocare and others. > > >>> I saw a video by Sargon which explained how the implant "base" is > >>> similar to the type of screw you buy at the hardware store which > >>> expands when driven into the substrate. > > >>> My understanding is that the post and the tooth can be mounted in one > >>> visit as the post binds very strongly to the bone (I assume the > >>> limiting factor might be that in a patient with profound bone loss this > >>> may not work) and the long wait time for osseointegration is not a > >>> factor. > > >>> Anyway I think I get the general idea and it would seem to me that this > >>> is a preferable method of attachment for the patient. > > >>> So my question is: What are some opinions on this process? > > >>> Thanks, > > >>> Copay > > >> I am not ready to do immediate loading implants in my practice. Yes, I > >> know they work--sometimes. But "osseointegration is not a factor" had > >> kind of a "famous last words" ring to it. > >> Get back to me in 10-15 years. ;-) > > >> Steve > > Implantology has a rather long and somewhat sordid history in > dentistry. When I was in school in the '70s, there were some > implantologists that used what were called endosseous blade implants. I > think they were made of surgical steel, and were pounded into the body > and/or ramus of the mandible. Often what were called "subperiosteal > implants" were placed--with a mesh covering the bony ridge, but not > placed into the bone. > Most of the endosseous implants (and many of the subperiosteals) showed > signs of infection sooner or later. In the case of the endosseous > blades, this was accompanied by severe bone destruction that made > restoration a real challenge for everyone. Often implants were retained > in the obvious presence of infection because admitting the obvious (that > the implant had failed) would deprive the patient of their appliance > (usually a lower overdenture), and there were few satisfactory > alternatives for these patients. > The two parts of what Branemark introduced about 1980 were the use of > pure titanium; and closing the tissue over the implant fixture, allowing > the bone to heal around the fixture in a sterile environment. Of these > two innovations, I strongly suspect the second was more important. > I'm sure that titanium is very biocompatible, and probably contributes > to the success of implants now when compared to the bad old days. But > immediate exposure and loading, while many are trumpeting high success > rates, is likely in some respects a big step backward (IMO). Mini > implants were originally intended for temporary use; the fact that many > seem to osseointegrate has led dentists to offer them as a cheap > alternative to regular implants. There are some problems here. First > of all, over years of experience, surgeons have modified their attitudes > about the amount of contact fixtures must have in the bone, given the > location and quality as well as quantity of the bone. Using mini > implants automatically decreases the bony support when compared with > traditional endosseous implants, even if we are to ignore the potential > for bacterial invasion posed by immediate exposure and loading. > Perhaps most troubling to me, the mini implants are being proposed at > lectures (I had one at my study group) to be so easy that EVEN A GENERAL > DENTIST CAN PLACE THEM!! In fact, there is no surgical incision--we > were told to grasp the alveolar ridge between our thumb and forefinger > and insert the bone drill between our thumb and forefinger through the > gum and into the bone. > To me, it's all a bit much. If these are as idiot-proof as they say, > we'll know in maybe 10 years. But I'm not about to abandon years of > experience of my surgeons because these immediate-load. implants are > easy-peasy lemon squeezy! > > Steve > > -- > Mark & Steven Bornfeld DDShttp://www.dentaltwins.com > Brooklyn, NY > 718-258-5001- Hide quoted text - > > - Show quoted text - Hey, Stevo, long time, no see! I just happened by SMD and ran across this question. I have done quite a few immediate load implant cases with great success. The key to this, I believe, is simply how stable is the initial stability and what type of bone the patient has (really how healthy the patient is) I was reading an article the other day that pointed out the little known fact the the bone that is holding at the initial placement of the implant for stability resorbs eventually and is replaced with new bone in that the net result is ALL new bone attached to the implant eventually. In other words, the bone that holds it at first is very important to keep it still for other bone to attach. If there is some form of splinting with another implant, it is pretty well proven you will have predictable results (and that has been my experience) If very good primary stability cannot be obtained, you cannot immediately load. The beauty of all of this is that it actually is making physiologic sense as we learn more. knowledge and reason is replacing try this and see, and the accompanying fear of the unknown. fwiw fmn
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