Splinting different connection implants?

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Posted on By sid Chand In Implants

I have a 78 year old patient. He had some zimmer/MIS internal hex connection implants placed 6 years ago. As show on x-rays, He wants to get an implants on the site of #30 and #14. As #13 is missing my idea is to place a wide implant on #14 and then splint it to the implant on #12. We currently place hiossen implants at my practice.

my questions are-
1) Can I place hiossen (Morse connection) on #14 site and then connect it with the internal hex implant on #12. Will there be any issues on stress distribution with the two different types of connections?

2) on implant #29, we can see the micro threads are not in the bone but are just covered by the keratinized gingiva. There is no pain or any symptoms. Is it safe to restore it?

3) can I place an implant between sites of 30 and 31 , and then splint it to the implant on #29 will there be any problems?

Please give your answers based on the case of 79 year old patient, and will you do it any differently if the patient was younger?


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3 Comments

These are very good questions. Here are my answers below.

1) Can I place hiossen (Morse connection) on #14 site and then connect it with the internal hex implant on #12. Will there be any issues on stress distribution with the two different types of connections? YES, you should be able to BUT we do NOT know for sure about stress distributions being different with the sharing of different connection types. I would suggest perhaps short multiunits MUAs and work with them for better stress distribution.

2) on implant #29, we can see the micro threads are not in the bone but are just covered by the keratinized gingiva. There is no pain or any symptoms. Is it safe to restore it? It should be safe as microthreads are soft tissue friendly to CT.

3) can I place an implant between sites of 30 and 31 , and then splint it to the implant on #29 will there be any problems? Yes, you can but I would prefer to splint #30 and 31 and leave #29 as a single unit.


Reply

Can I put hiossen (Morse connection) on site 14 and connect it to the internal hex implant on site 12? Will the two distinct types of connections cause any stress distribution issues? YES, you should be able to, but we don't know for sure if stress distributions alter when different connection types are shared. I would propose working with short multiunit MUAs for improved stress dispersion.


Reply

I agree with the above comments. Using the MUA is imperative because different implants have different prosthetic connections and also micro movements. By having the prosthetic connection at the abutment level and with a passive fit, the bridge should be stable.
I would restore #29 individually and connect #30,31.


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Salvin
Ritter