Maxillary Rehab with Small Diameter Implants Case

This case truely shows the benefits of splinting. It is also important to have a low lip line as small dia. implants have less than ideal emergence profiles. Nice case. Great case selection.

I assume that the small diameter implants were chosen because the ridge width was very narrow. They are an excellent way round to avoid augmentation, and extremely useful win immediate denture replacement cases. Well done excellent job

The case looks nice, just a few questions... What diameter are the narrow implants you used? At least in the front area you had enough bone (there are some teeth remaining) why did  you choose narrow implants, anyway? The occlusal  plane can be improved if you cut away a few mm From the upper posteriors adding them  to the lower bridge. Congratulations.

I'm waiting for the anti-mini crowd to check in. I love the case, I've done dozens like it, with great results IF the case is splinted from the beginning. Do you have the same anti-mini implant bias in Israel as we have in the United States?

Wow. thanks for the positive comments. I have to check my chart notes to see what size i used. The pt came in for an all on 4/6 but the ridge was thin. I love the alpha bio arrow press implants they are great even as stand alones in narrow spaces.they have one piece ,2 piece with 15 deg and of course ball heads.As you see on bottom right i used the Malo concept of tilting to avoid the foramen and limited size of the posterior ridge.

Dear Yossi, I am glad you are using both regular sizes as well as narrow diameters. This should be the trend because a lot of surgery and bone grafts can be avoided with narrow diameters and there are occasions when regulars would be ideal. However the severely tilted implant on the lower right may give problems in the long term. I would prefer to have vertical implants as far as possible as they are easier to restore and also result in less lateral forces on the adjacent bone and therefore less possibility of bone resorption. My last concern is the problem of long term maintenance. Are there food traps between the implants and under the bridge? How do your patient maintain good oral hygiene to reduce the chances of peri-implantitis ? Overall a commendable effort. Cheers.

Dear Dr Chow, thanks for your comments . The pt uses a proxabrush on the maxillae and a superfloss on the lower. About tilted implants - As you can see i was able to place longer implant in d2 bone instead of a shorter in d3 .Also, and this is critical by tilting i avoid the highly detrimental distal cantilever . Thanks

dear dr, its truly a good n new approach to splint n have the rehab, the occlusal settlement n esthetic damn improved by this phenomenon, thanks dr of the caes photograph u'd rendered of the aforesaid case.narrowdiameter 'l really serve a lot of surgical remedies.