The Denisa To Bulk Out Ridges

down angle photography of red clouds and blue sky

the densa to bulk out ridges or

deficient so I’m a big fan of rotary

expanders for sure I’m an actual

clinical case where the abutment and

crown are loosened I did not place the


neither the crowned if I was placed over

15 years ago as well as the crown I know

the abutment and crown loosened what

would be the best way to help this

patient giving the fact that we don’t

know what the implant brand in size is

well it should keep giving out those


email but Jarvan Badgley is awesome and

he can probably tell you which implant

you’re dealing with so you know you can

send Darwin I know you can contact

implant direct and they’ll get you to

hold of Darwin you can give them the

radiograph and hotel you can send it to

me and I can tell you what it is

sometimes you just get what you get so

some of you just have to get in there

and get it out and see what you have in

your armamentarium I mean I’ve dealt

with all sorts of different weird

implants and surprisingly the 11 screws

were all the same so I was able to use

another abutment screw and turn it into

a screw mental restoration like the one

I showed what tie base to use for the

3.0 and 3.4 interactive and Emax locks

but is a question that’s geared towards

direct users for that purple implant to

the 3 millimeter platform you’re going

to use the 4.5 noble active um tie base

and for the gold you’re going to use the

the 5.0 what do you torque your screws

bid wait 10 minutes and torque one last

time system I do

I don’t wait 10 minutes because I think

maybe my adult-onset a DD won’t allow it

but I do wait two minutes so I’ll start

at about 20 and then I’ll torque it down

to 20 and I’ll wait two minutes and then

I go to 25 and I wait two minutes and

then do the last 30 Newton centimeters

all right thanks guys have a good night

if any questions just go ahead and send

me an email to August DDS at

really choose what implant I use do is

whatever this specialist sent me and I’m

sure there’s a lot of them GPS out there

that are either placing their own

implants or wanting to listening to this

webinar and so it’s a nice way to kind

of talk about all the different

connections the pros and the cons of

mainly two of them the internal hex

implant and the conical connection and

kind of help you out and figure out

which one of you want to start out with

so go ahead and get started I’m going to

talk for a while I’m going to save all

the questions for the end I have a it’s

kind of funny if you’ve never seen any

of my live surgeries that I’ve done for

implant direct something always goes

wrong so earlier today my computer

crashed and it totally killed my you

know presentation that I had for this

luckily I had made a PDF of it and so

I’m lecturing off of the PDF and it’s

hard for you to see the little screen

and the question bar of the GoToMeeting

that we’re using so I’m the wait till

the end to answer all the questions but

save them up type them and we’ll get

through as many as we can so

a little bit about about my background

as I said before I’m a general dentist I

learned how to place implants during my

GP our residency ages ago

so about 20 years ago I did at CPR and

as many of us who have gone dental

school a while back

implants are really not part of our

general education going to dental school

there was an elective on restorative at

the University of Washington where I

went but there is definitely nothing

surgical so it’s really excited that my

GP are offered surgical training in

implants however her you know as most

new grads getting out of residency were

getting a school you know I just wanted

to get out and start you know working

and paying off my student loans and

starting a practice and so I did

introduce implants really until about

ten years ago in my practice you know I

relied on different specialists who did

excellent excellent work and I ended up

restoring them and even in restoring

them I went through an evolution of you

know just using stock abutments that

this the specialist torqued down for me

with a little snappy cap and eventually

getting into doing abutment level and

fixture level impression as we said

before I wrote a couple of books so my

first book implants made easy was just

sort of a cookbook approach for GPS to

snow top mountain under clear sky

learn how to start placing implants my

checking book which is a lot more

popular is on guided implantology and as

the moderator said before I do a lecture

for implant direct as a matter of fact

this week I’m flying to Vegas to teach

our restorative course so I teach the

restorative course at our facility in

Las Vegas as well as our 3d implantology

course there as well if you ever have a

chance and check out dental town comm on

one of the forum moderators for dental


downtown is great it’s a consumer

reports of Dentistry you get all sorts

of people on there talking about

implants so if you are a newbie either

to restoring or surgically placing

implants I highly recommend you check it


I moderate the implant form and

admitting a platform there let’s talk a

little bit about what this evening is

going to be about we’re going to talk

about mainly three implant connections

so the trial of implant connection the

internal hex implant connection and the

Cockell connection as well we’ll talk a

little bit about how these connections

affect the surgical placement of the

implant as well as most importantly the

restorative aspect and I think that’s

where you’re going to see most of the

differences in internal connections

we’ll talk a little bit about cost

difference between different implants

and conclude with our Q&A first things

first let’s sort of get the terminology

down and I know we’ve got different

people in our audience some people that

placing implants and brand mark others

are completely new and curious so I just

want to go over some of the terms going

to be using today to make sure we’re all

on the same page so the implant platform

is the top of the implant or the part

that you know you put in abutment into

in different implant systems they

certainly have all sorts of different

colors one thing that does confuse

newbies is that the implant platform the

diameter of the implant platform may or

may not be the same diameter of the

implant so we’ll talk later on about

something called a platform switch in a

platform switch is very important and

very integral to the different types of

internal connections that we have with a

platform switch we’ve got a Adder

implant with a smaller implant platform

and that’s done on purpose we’ll talk

about why that’s important implant

bodies really kind of vary out there

there is a very parallel wold implants

or some people call them straight

implants we also have very tapered

implants as well and different

manufacturers certainly have varying

degrees of paper implant threads are

certainly something that’s a big area of

discussion not an area of discussion

tonight but if you ask my preference on

a thread design I like big aggressive

threats and the implant that you see

here is a legacy 3 implant from implant

direct that has a very nice red pattern

implant collars we will be talking about

implant callers today and how they

relate to the implant connection most of

us are using bone level implants I

prefer a bone level implant that has

some sort of implant surface or coating

all the way to the top of the platform

some people like tissue level implants

I’m certainly not one of them but there

are indications for tissue level

implants that we will be talking about

them implants or services certainly

differ between different manufacturers

not really an area of discussion today

but I either use one of two types spm

stand for soluble blast media it’s a

process in which an implant is bombarded

with hydroxyapatite particles and

soluble and then rinsed off the other

type that I personally use as HJ and it

would sink as for hydroxyapatite which I

tend to use a d3 and d4 bone finally the

apex of the implant there’s two styles

out there sharp or blunt sharp base

apices are most common in minis where we

under prepare are osteotomy and rely on

the implant travel the rest of the

distance I personally like a blunt apex

and I like a blood apex because I do a

lot of guided implant surgery and I take

a lot of time to plan my implants in my

little video games and create surgical

eyes and darn it I want my implant to go

where I told it to not to travel we have

a sharp apex there is a chance than

implant travel all right so most

importantly we’re going to talk about

the different types of implants out

there and let’s get a little bit of

close up photo of water drops

history here the external hex implant

was really the one that started it all

so back in the day with Branagh Mark and

early fledgling companies we had

external hex implants and I think that

everyone agrees that that external hex

that little portion that’s sticking out

of the top of the implant just wasn’t

long enough to resist lateral forces

there are some people that still place

external hex implants and different

companies such as Verizon or Nobel still

make external hex implants if that’s how

you learned and that’s what you want but

in general they’ve certainly lacked in

popularity tissue level implants or

something that I started restoring a lot

of periodontics really jumped on the

Stremme and tissue level implants when

it came out because the tissue looks so

good around it

we’ll talk later on about why tissue and

bone look great around tissue level

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