Roundhouse Implant Supported Bridge Use Minis or Conventionals – OsseoNews Dental Implants

The patient has 4 remaining maxillary teeth which are flared buccally, indicating that there is some over closure of the bite. We should remember that no matter how good our dental implants seem to be, they are not teeth and are only poor imitations of the real teeth! As such, Dr WL is wise to insist on keeping the real teeth as far as possible.

Having all this in mind, I would like to offer a possible solution. The bite can be raised and corrected with some posterior implants, either conventional or minis. Once the posterior prostheses are in place, they can be used to orthodontically align the remaining right 3 and 5 and left 2 and 3 to its correct position and height. Alternatively, do a bridge on the right 3 and 5 and splint crowns on the left 2 and 3,if rapid results are required.

At the same time, the necessary implants can be placed between the canines and restored. Minis or conventionals can be used.

In most complex cases, I trinity treatment plan with both minis and conventionals in mind. In general, I find that I can complete a case faster this way, mainly because the healing and loading of minis can be done much faster, not because it is a better or cheaper implant but merely because it is smaller and therefore is minimally invasive and present a much lesser healing challenge to the body. And if placed judiciously with due attention to the biomechanics involved, should be quite durable.

At present, there are not enough studies and analyses of minis to provide anything definitive, just like the conventionals at one time. As such, we have to fall back on our knowledge of basic sciences of osseointegration and biomechanics and try our best to err on the conservative. At no time should we discount an alternative like minis unless proven otherwise. The history of dental implants have shown that we should not write off individuals like Linkow, Chercheve and Professor Branemark. These individuals have been severely ostracised and criticised in their time but have been proven substantially correct to all our current benefit!

Wow, all of the above comments are very interesting. I would have to first check my individual experience and figure out what I feel comfortable doing, anyone who has placed any implants knows that problems can come about at anytime during, and after the treatment is completed. We as dentists deal with this in every aspect of restorative dentistry from a broken filling to failed endo, yet when these issues are presented to us by our patients we do our best to correct them. My point is we really do not know what problems could arise in either scenario ,only what has happened to our patients in the past (traditional or mini’s), So my suggestion would be to present these options to the patient informing them of the possible future issues.

Last, I think it is important to point out also that the use of mini’s would be substantially less invasive, and less costly in both time and money. I am a dentist that places and restores both traditional and mini’s. I have had my share of issues with both, but my successes out-weigh those and I have dealt with every problem and been able to solve them. I would suggest not keeping the remaining teeth in this case as in my experience they are the weak link in the restoration. Regardless of whether they work with implants or not the potential for “tooth problems” to occur in the future is high and could sabatoge the entire treatment later on. Just my opinion, Good Luck