Dentist Q&A

Questions and Answers about Dental Implants and Advanced Clinical Dentistry

Steve Wilson

I am a GP practicing in Florida, I did a bone graft and the area has now become infected I need some advice how to handle it. The area is #8 and 9, it was a buccal ridge defect. I flapped the area place the graft and the membrane and closed leaving the membrane exposed. The areas is now infected. What do I do? Antibiotics?

(9)
Sam2493

I graduated from dental school 10 years ago and have taken Arun Gargs implant seminars maxi course to learn implants and his weekend seminar on grafting.
I have a piezo in my office but no matter what I do I tear the membrane over and over. I repair with a membrane but my patients usually have alot of pain and swelling. The overall graft results are usually poor with often having trouble placing the implants.
What can I DO TO IMPROVE????

(14)
pranav

I have two questions:
1) I started dabling with infuse and ti-mesh. I am having a problems with the mesh getting exposed. How should I handle this? What can I do to avoid the mesh being exposed? What type os mesh is best for this procedure?
2) My second question is what affect smoking will have on an osseointegrated implant of a chain smoker who resumed smoking 6 months after implant placement.
Regards, Pranav

(9)
almezan dent

How can I control the bleeding from superior posterior alviolar artery during sinus window opening ?? Is there a way to avoid this issue? Will the balloon help avoid this?

(16)
Sam2493

I did a sinus lift 4 weeks ago. There was a tear of the sinus membrane in the distal part of the sinus measuring 5 mm. I proceeded with the lift and placed a collagen membrane covering the defect and fill the sinus with Biooss. The repair was done using a loma linda pouch technique The patient had antibiotics prior and then 10 days after surgery.
4 weeks later the patient presents with swelling, puss and granules coming out her nose.
How would you approach this? Can I recover? Do I get an ENT involved?
Sam

(17)
drymnenveds

A patient recently came to my office wanting to get rid of her dentures. 
Which is a better solution for the upper arch: A sinus lift with 8 implants or bilateral zygoma implant with 4 implants?
What are the risks of zygoma implants?
Is there long term studies showing success?
How is the sinus adversly affected by putting the implant through the sinus?

(6)
keyslelomomma

What is the best approach to extraction site and site preservation?
Is it better to extract the tooth, place an implant and bone graft at that visit or is it better to extract the tooth, place a bone graft and membrane and wait for the graft to osseointegrate and then go back in and place the implant?
In cases where I need to extract and place a graft and wait, which graft material is best to use in a situation like that?
Which membrane should I use in a situation where I will be grafting a socket and will not be able to get a tension free primary closure?

(5)
drbrmac

I recently placed 2 immediate implants in the position of the lower right bicuspids. I had placed a small concurrent graft and covered with a resorbable membrane and a cytoplast non resorbable membrane on top. I removed the sutures which were mostly gone 2 weeks later and the incision line was open by 4 mm or so. I think the cytoplast sprung the wound open. It is healing by secondary intention and at this stage looks like a wide ridge in that area. Should I expect any long term problems from this and will the ridge likely narrow as it heals ?

Thanks

Brent

(1)
rmbenian

Dose anyone have any experience placing implants in a patient with dentogenesis imperfecta? Do you know of any contraindication for such a patient. In my opinion it should be fine, but I am not able to find any articles about the subject in specific to support my opinion.

(3)
DR FARHAN DURRANI

hello
i placed four implants in edentulous mandible anterior region, 4.3 with 15 mm ,but one just failed without any obvious reason ,i removed it and placed pt on some
antibiotics,as there was a periapical infection below the implant in panorex
i want to replace that implant ,please advise how to proceed,
i can post panorex on your website for you guidance ,pt is 65 year old without any systemic cause bone density is D3 i want to give him an i
implant retained overdenture

(2)
dr.yashpal_84

First off what is working time for platlet rich plasma, prgf and prf? Can we store or freeze these for later use?
Is there a place for any or all these? I see orthopedics still using prp on atheletes like tiger woods and others to heal injuries.
Is there one that is a benefit to all patients? Or are they all just smoke and mirrors?
Opinions needed and wanted?

(10)
aya ali

i wanna ask some questions about plastic surgery around dental implants :
1) Are there rules or protocols of optimizing the soft tissues buccal to the dental implant is it important whether there is soft tissue defect buccally or not ?
2) How can I estimate that this area need soft tissue augmentation in cases of mild defects ?
3)What is the acceptable width of keratinized tissue around dental implant beyond which the gingiva must be harvested ?
4) Does this width differs in anterior implants from posterior implants ?

(4)
sydney2008

It seems that there is a very mixed bag of opinions of the subject of immediate placement and immediate provisionalisation;some will do and some will not.
Does anyone with alot of experience have a "golden rule" with respect to ideal criteria when they can guarantee success with immediate implant placement and immediate provisionalisation?
Examples: Like thick biotype; class 1 implant site only;complete absence of occlusal contact (although there will always be contact on the provisional from a food bolus and the lips and the tongue);non-buxer.

(13)
HerndonDDS

Since experimental fracture tests on endodontically treated teeth with porcelain restorations show that even in fracture, the dentin bond survives and the tooth breaks instead, in what way do you think this may alter the dynamics of biologic width invasion or crown lengthening procedures?

And if a bonded margin is subgingival (and therefore no marginal gap, assuming isolation during the bonding), and there is no microenvironment for bacterial colonization, does that alter our perception of biologic width compromise as it does with a cemented crown with it's inherent marginal gap?

(6)
coxsakie

A patient presented in my office with an implant replacing a lower second molar.on the lingual sides there were 3 threads visible. I want to polish it and give it a smooth surface for perio-health issues.Any idead on what polishing kit should i use for optimum results on the titanium surface? thx

(4)
Dr. Barbie

I typically what 4-6 months before letting my restorative dentist restore the implants. What is the besr way to determine if the Implants are Osseointegrated and ready to be restored?

(6)
Dr. Barbie

What is the course of treatment these days for ailing/failing implants. If surgery and regrafting the way to go what is the best way to detox the implant to increase success.

(8)
RJKellyDMD

I have a patient with missing molars on the right side of the maxilla. I did a Cone Beam CT I discovered a lesion that looks mucous retention cyst.
The lesion occupies over 40% of the right maxillary sinus. I referred the patient for surgical removal of the lesion with ENT specialist. The ENT refused to do the surgery. He stated that according to ENT guidelines this kind of lesion does not require any treatment if asymptomatic, and that success of sinus graft will be decreased due to this lesion. He reommended not doing the implant.
What should I do?

(7)
sohail

I had this patient come in with a fractured implant #30.
I have not had much experience removing broken implant fixtures. I will eventually replace this with a new implant fixture. How do I get the implant out without destroying the buccal cortical plate?
Do I trephine it out? Should I replace it immediately with another implant and bone graft or should I bone graft and allow the site to heal first? What kind of bone graft would you recommend

(8)
Ptery

I want to offer laser periodontal treatment in my office. I saw some info on LANAP. This looks like it is pretty easy to do.

What do periodontists think of this treatment? Which laser are you using?

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