Splinting different connection implants?

72 Rating(s).


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?


Add to Favorites
Add a comment to the discussion on Splinting different connection implants?


Upload photos
1.  Photo Title:

2.  Photo Title:

Would you like to follow this post?
Case has been added to your favorites.
Case has been removed from your favorites.
Thank you for your input. Your comment has been posted.
You are now following this member. You will get notified on any new topics posted by this member.
You are no longer following this member. You will not get notified on any new topics posted by this member.
Edit Comment
1.  Photo Title:
Current Image:   Delete Image
2.  Photo Title:
Current Image:   Delete Image
Comment has been updated.

4 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.


Reply

1. It is generally not recommended to connect an implant with a Morse connection to an implant with an internal hex connection, as the stress distribution may not be optimal and may put excessive force on one of the implants. This could lead to implant failure or other complications. Additionally, because of the different connections, it may be difficult to achieve proper alignment of the implant abutments and may affect the fit of the final restoration.

2. The position of the microthreads of the implant being just covered by the keratinized gingiva is not ideal. It may be safe to restore the implant, but there is a risk of implant failure or other complications. It's better to have a detailed discussion with the patient about the potential risks and benefits, and also recommend a follow-up radiograph to monitor the implant position. Additionally, there's a possibility that the implant may need a bone grafting procedure prior to restoring.

3. Placing an implant between sites #30 and #31 and splinting it to the implant on #29 could be an option, but again, it may be challenging to achieve proper alignment of the implant abutments which may affect the fit of the final restoration. Additionally, it is important to consider the amount of available bone at the proposed implant site and if there's enough space to place the implant, and also the quality of the bone and the potential need for bone grafting.

In general, the age of the patient should be considered when planning implant treatment. The implant success rate tends to be lower in older patients, and they may also have a higher risk of medical complications. Therefore, it is important to carefully evaluate the patient's overall health, as well as the quality and quantity of the remaining bone, before proceeding with implant placement.


Reply


Dentalxp
Henry Schein