Full mandible implant placement: 3 SS op. flap and the use of Densah Bur

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Posted on By Jorge Campos In Implants

A very narrow mandible was treated. We did 3 SS op flap and we used the Densah Bur kit to expand crest on anterior region. All implant were placed with more thant 40 Nw torque.
Distal implants were inclined.
I´m showing details of the preparation.
In cases with so narrow crest ridge , this kind of approach helps to manage implant placement.
Jorge




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21 Comments

Jorge. Well done. I like this approach very much. The combination of PET and ridge expansion (with Densah burs) is a minimally invasive way to preserve tissues. Thank you for sharing. Best regards. Chuck


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Incredible management....why no immediate load here? Also, did you consider saving teeth and telescopic denture prosthesis? regards Mo


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Mo I would love to do Immediate Load...but patient budget doesn´t allow ...the treatment option.
Teeth were firm, but not as to resist that option, and she insisted on implants.
Extracted lateral was not elegible for SS due to mobility and poor lingual bone level.
Thanks for commenting!
Jorge


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Chuck I do agree with you. PET therapy and expansion makes us save bone and have good perspective for the future response of the implants sorrounding tissues.
Thanks for commenting.
Jorge.


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Jorge:

Just perfect. Thank you for sharing.


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My pleasure Salah!
Jorge


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Bravo! Gregory


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Thanks Gregory!


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Jorge,

I am curious to know with the Densah burs even though the bone is compacted, still, it remains thin. How does this thin bone hold up over the implant in the next 2-3 years ?


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Anoosh, time will tell! I don´t know...
But the clinical sensation is good! Do others in this forum has the same perception?
Thanks for asking.
Jorge


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Anoosh:

Osseodensification preserves the existing bone by compaction autografting but does not increase its thickness. It maintains the existing bone bulk and plastically expands the osteotomy, without creating a dehiscence or fenestration as can occur with standard extraction drilling, so the whole implant body is still surrounded with autogenous bone. Histologically, the surrounding bone becomes denser even if not measurably thicker. I tend to add an allograft when buccal bone thickness becomes less than 1 mm as well as I utilize the roll technique to enhance soft tissue thickness. I always recommend following the established surgical principles.

I hope I was able to answer your question.

Salah

Osseodensification expansion
Osseodensification with grafting


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do you need to split the ridge if you are using the densah burrs?


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10 weeks healing
1 year post restoration


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2 years post restoration


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Excelente Jorge. Lo comparti con nuestro cirujano. Saludos. Miguel


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Impressive....


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Gracias Miguel!
Abrazo.
Jorge


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Jorge,

I like the way you manage thish case.
Perfect minimal invasive way.

Best Regards, Vincent


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Vincent, this was the purpose: more success warranties and long term biology respect.
Thanks for noticyng.
Jorge


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Final pics. As Chuck observed there is an exposed SS that is being slowly covered by epithelium. We will continue watching carefully the evolution.


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