Dental Implants
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Description of the step by step surgery


This is the manual which describes the placement of mini implants. Mini implants cannot be placed along the back part of the ridge (the molars used to be because there is a large nerve trunk which could be injured while placing an implant). 


The day of the surgery comes closer and the dentist decides on the correct position for your  implants.  He marks their position on the ridge with an indelible marker.  Anesthesia will be injected into the gums right over the spots the surgeon mrked. Then the drilling takes place right through the gums into the bone. 

For that the surgeon uses a 1.1 mm pilot drill in a slow speed.  After the pilot hole is drilled, the dentist begins the procedure to insert the implant through the gums. 


Carefully the surgeon begins aligning the implant with the original pilot hole and slowly twists it with a finger wrench until the resistance stops him to continue.  Then the dentist will switch to a thumb wrench.  The thumb wrench will be slowly twisted until the implant is fully seated.

In the picture here, a special retraction device holds the tongue, lips and cheek away, so the field is kept clear and dry. 


In order to finish the procedure the dentist may switch to the usage of a special designed ratchet wrench, if too much resistance to twist the implant is met.


Finishing the case looks like the graphic .  It is the same as using a mirror, when one looks at it head on and again from above.  The pictures were also taken immediately after an operation.  There is no sign of any bleeding.


The x-ray taken after the operation.Remember that the implants also do not have to be perfectly parallel to one another.


The Retrofitting the lower denture and the snapping onto the new implant.


The old denture will be modified in order to retrofit the denture so that a snapping takes place onto the newly placed implant.  There will be a hollow in the underside corresponding to the general position of the implant.


Now two ways to engage the implants in the denture exist. 



The first option is to fill the hollow in the base of the denture with the soft reline material.  The material allows some movement but sits firmly.  It is transmitting less biting force  to the implant and certainly is the best solution for clenchers and smokers. The procedure is easy and very inexpensive, but the soft material needs to be replaced form time to time.  This procedure is used by dentists for many patients in the first three or six months, so that the healing process can be observed, before the long term option is being done by placing the o-rings in the denture for a better snap fit.


The billing for the implants and the retrofit are generally done separately, so the total charge for the patient of the soft reline option is considerably lower than the total price with permanent housings in the denture.  Many patients prefer the series of soft relines instead of placing housings, because the soft material is very comfortable for the gums and new relines.  The denture base is so well attached to the gums that food hardly ever gets under the denture. 


The second method to keep the denture over the implants is to put a specially designed housing with a rubber o-ring over the implant.  The dentist may decide to use this option on the day the surgery takes place, or when the soft reline material that was placed at the time of surgery is being replaced.  In the end the housings in the denture will be placed at a later date.  These housings will be transferred to the hollow which is located in the bottom of the denture.


Now your dentist will try the denture in your  mouth to see if it fits over the implants with their housings. It should not interfere with the original fit of the denture.  The dentist will keep grinding out the hollow in the denture until the lower denture sits perfectly over the implants without changing the bite habits.  If your dentist is satisfied that the upper and lower dentures meet in the mouth in the same relationship as they did before surgery without touching any of the implants, the dentist starts filling the hollow in the bottom of the denture with acrylic material that is self curing and fits the lower denture back over the implants with their housings.  The patient will then be instructed to bite down on the dentures while the plastic pick-up material sets.  Once the pickup plastic is on the right place and hardening is finished, the denture is snapping into the position over the implant.



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