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When patients present with anatomic limitations for placement of conventional dental implants and bone grafting is not an option, we can use short and wide dental implants to replace their missing teeth. When properly planned and executed, short and wide dental implants can be very successful and provide patient with stable and strong teeth for years of service.
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Short & WideDental Implants
Dr. H. Ryan KazemiOral & Maxillofacial Surgery
Bethesda, MD
•This patient presents with missing teeth # 30 and 31•Minimal available height of bone due to nerve position and bone atrophy
•Site #31: CBCT shows 8 mm of bony height and 9 mm of width
•Site #30: CBCT shows 8.5 mm of bony height and 7-9 mm of width
•3-D model demonstrates a very wide ridge with minimal height of bone due to nerve position and atrophy at the crest.
•This is an ideal patient for short and wide dental implants. Through a 3-D planning two dental implants measuring 7mm width by 7 mm length were considered.
•Clinically, there is good tissue quality. While vertical onlay bone grafting is an option, it is very unpredictable and limited. Short and wide dental implants are ideal for this patient.
•The anatomy of available bone is shown on this photo. A surgical guide was prepared from the 3-D model to guide the surgeon during implant placement.
•Careful surgical preparation of the implant sites•The depth of preparation is very crucial as there is only 1 mm of safe zone between implant and the nerve.
•The implant is a wide body implant with machined smooth collar and blasted surface.
•These implants do come in various lengths: 5mm , 7mm, 9mm , or 11mm.
•Implants are placed. Due to tapered shape of the implants, great primary stability is achieved. While it is possible to provisionalize these implants immediately, they were allowed to integrate for 3 months in this patient.
•Post operative panorex
•Post op CBCT was done to assess placement. Normally, this is not indicated, but due to extreme close proximity, a verification was done. Note position of the canal with respect to the implants
•The final abutments and .....
•....the final implant-supported crowns. Crowns were fabricated as single units.
•3-D diagnostic imaging for precise measurement•Choose the right size implant to accommodate restorations while allowing safe placement with respect to adjacent teeth and the inferior alveolar nerve•Primary stability with proper torque test if considering immediate provisionalization•Use of surgical guide for precise positioning
The keys to Success...
Dr. H. Ryan KazemiOral & Maxillofacial Surgery
Bethesda, MD
www.facialart.com301.654.7070
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