Minimally invasive Biomimetic immediate replacement of lower molars with wide dental implants. Part 2. CAD design.

49 Rating(s).


Posted on By Anton Andrews In Digital Scanning & CAD/CAM

45y.o healthy, non-smoker female presented with #30-32 failed bridge due to the first molar mesial root fracture.
3 months after the extractions and immediate implants placement + GBR , the case was scanned with TRIOS intraorally.
Ideal emergence profile without "black triangles" to ensure self-cleansabilty of restorations was designed using Andrews RRR (Reversed Restorative Rehabilitation) method.
Besides that occlusal part of restorations designed in HYPEROCCLUSION (1.5-2 mm ) with upper molars to achieve non-invasive intrusion.
The STL file was sent to a milling center for Full Contour Zirconia CAM and sintering.
Comments, suggestions?

current occlusal contacts
"Andrews Intrusion Phenomenon"

Intrusion via hyperocclusion
"Andrews Intrusion Phenomenon"


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10 Comments

Very nice. How does Hyperocclusion with implants intrude opposing dentition? thanks Dr. Salama


Reply

Thank you Maurice.
You will be surprised but Its actually very effective and non-invasive compared to TADs, lets say.
BTW what is the "current" theory explaining why do teeth over-erupt?


Reply

Hello Anton,

I must say, this is impressive use of technology and a very interesting approach with the molar intrusion technique.

But,

What about occlusal trauma?
Patient discomfort?
Implant occlusal overload?

Are you aware of any literature describing this approach?

Thanks for sharing,

Ehab


Reply

Ehab,
I tried to look into literature, but found only intrusion "teeth against teeth" which was not successful and the idea was abandoned.
I've discovered the working protocol and called it "Andrews Intrusion Phenomenon" .
Someone has to be the first, anyway.
Besides, I think I also can explain it too.
I've done few cases and one was quite extreme. I intruded an entire upper quadrant against a single lower implant!
Pt didn't report any discomfort and amazingly there were no loss of bone neither around implant, nor teeth!


Reply

Can't wait to see the final result.

So you mill the crowns in your clinic? Or send them to a lab?

Thanks


Reply

Anton; When are you publishing your findings and technique? Would love to see it in print....thanks for sharing. Dr. Salama


Reply

Maurice,
I need help with that. I haven't published anything yet.


Reply

Hi Anton!
I´m asking a few questions because I wouldn´t tell that this is possible.
1.- Does not generate periodontitis to the upper molar?
2.- TMJ disorders?
3.- How long does take to intrude 1mm?
4.- Can you show XRays of intruding process?
This is very interesting!! Please share with us.
Thanks, Jorge.


Reply

Jorge,
you can refer to my other case I posted
http://forum.dentalxp.com/case/details/wide-diameter-immediate-molar-implants-/3481

I used the posterior implant ((#18) to intrude the second upper molar in order to improve curve of Spee and so forth...
It was done making contours of#18 FCZ crown 0.5-0.8 mm higher occlusaly.
The entire occlusal force ended up pounding this poor implant for about three months. And then...
Nothing has happened to my implant.
You can appreciate the fact of intrusion making reference points on 2-year follow up comparison X-ray . EX : apex of #15 in reference to sinus floor and mesial restoration of #15 to distal restoration of #14.
There is neither bone loss,nor soft tissue damage nor recession had occurred passed two years since.
The Upper molar is fine as well.


Reply

Regarding TMJ..
that patient was a clencher-grinder, you can tell by abfraction lesions on premolars....
She reported no discomfort around TMJs or any other TMD symptoms.


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