Implant positioning: create less trauma for patients without complications?
I have been placing implants for 13 years and when appropriate I place full arch implants with immediate loading. The company I use for my surgical guides accidentally sent me a virtual plan that an oral surgeon had prepared. The plan was to place and load immediately. I noticed in his planning he was careful to always leave good buccal bone, but toward the palate the implants were often not in bone for 2-3 mm. I have a colleague who does alot of All-On-Four, and he had recently been to a lecture given by a prominent surgeon. He showed many cases, and there were several implants placed as I described above, sometimes the cases were done flapless. Now when I do these cases I open a flap and adjust the alveolar bone so I have bone 360. I do often leave thin palatal bone adjacent the restorative platform, but it gets pretty thick within a couple of millimeters. I would like to create less trauma for my patients, but I don’t want to introduce potential complications. Does the thick gingiva and great blood supply negate possible complications? I included a slice of a ct scan showing the positioning I am describing.
Slice with implant positioning I described.