5/17/2013 8:14:00 AM by Dr. Gary R. O’Brien
Teeth numbers 8 and 9 were extracted by one of our members 6 months prior to the date on the scan. The graft material was a combination of Puross and BioOss with a cytoplast membrane for GBR. He noticed from the scan that the graft material seems somewhat particulate. This is very characteristic of particulate banked bone at 6 months.
When this case is uncovered to place the implant, he...
5/17/2013 7:54:00 AM by Dr. Gary R. O’Brien
The first thing I would like you to do is checked with implant direct to see if they have a Legacy 3 7.0 mm in diameter. I know that the decision was made to add this to the options so that you could order a 7.0 implant with a stock abutment. If it is not available yet and you will have to order the Legacy 2 7.0 mm implant by 11.5 mm.
At first glance of the CBCT we noticed that there is a...
5/8/2013 1:13:00 PM by Dr. Gary R. O’Brien
This is one of those cases that everybody should have 2 or 3 of them every week. It is very rare to find post extraction and graft CBCT in the areas of 14 and 15 were there is enough bone without a subantral augmentation.
You can see from the plates below that even with the implants and ideal location leaving 3-4 mm of bone on the buccal there is still enough room for a 5.7 implant ideally...
5/7/2013 5:33:00 PM by Dr. Gary R. O’Brien
There are 2 issues that need to be discussed in this particular case that make the unique and somewhat challenging. First of all the quality of the bone in the body of the mandible is poor. The cortical bone is approximately 1.5-3 mm in thickness. For this reason the osteotomy will be prepared to conventional means the first 3 mm, and then undersize the remaining osteotomy by 1 drill.
5/2/2013 6:50:00 AM by Dr. Gary R. O’Brien
In this particular case there are only 1 or 2 details the need to be discussed. First, it is important to take care in mapping the mandibular nerve in this situation. Vertical bone height is limited so the position of the mandibular nerve in detail is critical. This can be done in the arc section mode making sure to only add 1-2 mm of the nerve at a time looking for obvious signs of landmarks.
5/1/2013 5:40:00 PM by Dr. Gary R. O’Brien
This case is very interesting. Tooth #28 is a complete bony horizontal impaction that is rotated 90° to the distal. Fortunately, the mapping of the nerve in this area needs room for extraction, grafting, and the placement of 4 Legacy 3 implants. The sizes of the implants starting from 28 and going to 30 are; 3.7 mm x 16 mm, 4.2 mm x 16 mm, 4.7 mm x 13 mm, and 5.7 mm x 8 mm respectively.
4/30/2013 1:01:00 PM by Dr. Gary R. O’Brien
There are 2 things that stand out as I review this CBCT. First I noticed the apical lesion associated with tooth #10. This is in its incipient form, but could have an effect on the success of our implant. Remember that the use chronic apical lesions act like a small Actinomycosis in the sense that the bacterial perfusion extends far beyond the radiographic evidence of infection. For this reason, I...