Overdenture Delivery: Best Technique for Removing Redundant Tissue?

wait just a minute, let me get this strait. you have drilled for holes is someone's mandible, and you don't know how to take care of a little bit of hypertrophic gingiva- pardon the sarcasm, but this seems a bit strange. extraneous tissue can easily be contoured with en electro-surgery device. its no different than the one you probably use for crown and bridge. your patient is leaving in one month for three years... and you just found this out... when did you originally plan on delivering the over-denture? were you going to wait for osseo-integration, or choose a quicker protocol. what is the patient wearing now??? you have two choices. 1. deliver the denture now 2. let a dentist in the patient's new location do the work after osseo-integration. i think that the admirable thing to do hear is set the patient up with a DDS in new location, and transfer care. Otherwise you risk a problem in the early loading of these implants, and stranding a patient with a useless new denture and a situation that no DDS will want to deal with. Immediate loading of implants is a highly successful procedure. If you are comfortable, go ahead and deliver. The fact that your implants are firm after one week is a relatively useless finding. I am just amazed at the things I read here, I try not to be sarcastic, but I just can't help it. The patient management here is just horrible. You cannot control what your patients do. You can, however, control what you do.

Hi, one very good way of removing implants is to touch an electrosurgery tip against them; yeah you can have a go but is it worth it ? no just use a scalpel or wait longer? Always wait to load and ease denture off the area, as implants within one month actually loosen and then the bone remodels, so i would wait 12 weeks before making the overdenture active. Possibly at 1month GC soft reline to make more retentive. give the patient the female components to get a implant dentist to cold cure into the existing denture or to remake. Don't load ideally before 12 weeks so that really means no relien either!

The best and safest way to remove tissue around an implant is with a diode laser. Less bleeding then with a scapel and much safer then an electrosurg

I certainly agree that using an electrosurge near an implant is a no-no.Despite the vitriolic comments from our colleague about your implant skills, may i suggest you don't refer him any patients as you'll probably get nothing but criticism about your treatment to date. Despite the aforesaid critism, I think your question is legitimate-what is the easiest and simplest way to remove hypertrophic gingiva around an implant such as you described? I have found that in cases like these if you don't have a laser, then using a fine pointed multi fluted composite finishing carbide(finishing,not cutting) with a high speed handpiece (no water coolant) is an effective, simple,and relatively troublesome free means of performing a gingivoplasty around an implant such as you describe, with little danger of damaging the implant.

I agree with Dr. Berne......

KOS implants are descendants of the Bauer implant system(Bauer compressionschraubenimplantat). Excellent initial stability and compressiveness. However, the problem you described is commonly associated with them. I use the system among 4 other systems for more than 8 years now. Overdenture retention is not amongst it`s primary benefits. You can always use a scalpel and circumcise the soft tissues, or if you don`t like this approach use small diamond bur and remove the soft tissues around the implants with a turbine/highspeed handpiece. Hope this helps, Dr Dimitrov

Oh, and stay away of electrical coags. Use laser if needed, instead

tissue trimmer,diode laser or scalpel,whatever you like, i have encountered problem as well,KOS female rubber caps wear off pretty soon,see that you give one extra set as the patient is going away

Don't use an electrocautery device! You can accidentally touch the implant and cause a necrosis around it and its loss in a few weeks (some colleagues are actually using the electrosurgery device to remove failing implants in a very atraumatic way). You can remove the redundant tissue easily with the use of a simple #15 blade, and yes, it will bleed a little (many doctors are concerned about this, but I ask, is bleeding a little bit so tragic?). About the delivery of the overdenture: I would reline it in 2 or 3 weeks with soft relining acrylic and give the patient the retentive females, so he can give them to the next dentist. I don't think you should immediately load the implants though, because the patient will not be able to have follow up appointments with you, in case something needs adjustment.