So we get asked a lot about the importance of surgical guides in implant dentistry. One of the more common things I hear is they work with a surgeon or a periodontist, and they have never really liked surgical guides, and so they just work without them.
When you're looking at designing centric stops for implants, whether it's a single implant crown or a full-arch fixed prostheses, it's very important first to understand the difference between implants and teeth.
Let's talk about how to cement a bridge every single time in 30 minutes or less. Now, cementing a bridge is a little bit different than a single-unit crown because you have three teeth involved in the occlusion, you have interproximal contacts. You have a lot of issues.
I think if you look initially, the key is to have a good plan. So if you have not planned exactly where the teeth go, in the neutral zone and in the mouth, then they are doomed to fail in some way, some shape, some form.
When patients come to us with existing maxillary dentures and want to transition to afixed implant supported prosthesis, sometimes the treatment planning process can be a little confusing and a little challenging.
And we tend to maybe let the patient drive that decision and we end up doing a fixed prosthesis. But really the question is, is that the best prosthesis for them?
When looking at implants versus teeth, it is very important to consider the differences between them. There are many differences.
One difference that's very important for us as Dawson Dentists to consider is that a tooth has a periodontal ligament, the PDL. An implant does not.
An implant is essentially an ankylosed unit.
So recently, there's been a lot of debate as to whether we should be using screw-retained restorations on our implants or cement-retained restorations. I think the trend lately toward screw-retained restorations has been driven by research that shows retained cement in that delicate sulcus around the implant is the leading cause of peri-implantitis.
We have been driven by a number of market factors in dental implant treatment: those of the implant companies, those of our surgeons and so on. Yet, all of us know that this should be a prosthetically driven process, but who is making the decisions?
Placing and designing implants in a restorative case can be a valuable asset to keep inside a Complete Dentist's toolbox. With the technological advancements in the last few years, it can make a once complex procedure, predictable.
So my quick tip is about immediate non-occlusal load temporaries for implant restorations.
I love doing INOL temporaries.
I just think it's a great value for patients, but what I found was that there's a lot of chair time involved in doing these. I've done many of them in my office and the patient would come over from the surgeon's office, implant was placed that morning. They come to me. I have my stent ready. I fabricate the INOL temporary and it looked great, but it took me an hour or an hour and a half to do it. And there's a lot of bleeding involved, and tissue involvement that just becomes very frustrating to work with when you are trying to deal with a temporary material.